Inequalities in the distribution of the costs of alcohol misuse in Scotland: a cost of illness study

Aims: To examine the distribution of the costs of alcohol misuse across Scotland in 2009/10, in relation to deprivation.
Methods: A cost of illness approach was used. Alcohol-related harms were assessed for inclusion using a literature review. The harms were based upon the following categories: direct healthcare costs, intangible health costs, social care costs, crime costs, and labour and productivity costs. An analysis of secondary data supplemented by a literature review was carried out to quantify each harm, determine its value and provide an estimate of the distribution by deprivation. The deprivation distributions used were area measures (primarily the Scottish Index of Multiple Deprivation).
Results: The overall cost was £7,456.94 million. Two alcohol harms were not included in the overall cost by deprivation due to a lack of data. The included alcohol harms demonstrated that 40.41% of the total cost arose from the 20% most deprived areas. The intangible cost category was the largest category (78.65%).
Conclusion: The study found that the burden of alcohol harms is greater in deprived groups and these burdens do not simply arise from deprived groups but are also experienced more by these groups. The study was limited by a lack of data availability in certain areas, leading to less precise cost estimates.