Alcohol-Attributable harm to health in urban Europe: Disability-Adjusted Life Years in a policy context

Abstract

IntroductionThe majority of the European population live in urban areas (UAs). Policy making in urban areas is complex and the use of summary and aggregate measures for public health are important tools. Disability-Adjusted Life Years (DALYs) are important for national and international comparison. However, DALYs have not been calculated at urban level. Alcohol is an important European urban public health problem. Therefore the aim of this study was to calculate urban level DALYs attributable to alcohol consumption in Europe(AA-DALYs) and years of life lost (AA-YLL). This work was one of the deliverables of the European Urban Health Indicator System Part II (EURO-URHIS 2), a European Commission funded project. MethodologyDesign: This is a cross sectional study with four components to be able to calculate comparable DALYs. The boundary study determined the denominator to ensure comparability and facilitate identification of the UAs to be included in the study. The systematic review and national level DALY calculations were used to develop the methodology for calculating AA-DALYs, including AA-YLL. The main methodology was to calculate AA-DALYs and AA-YLL were calculated for comparison between UAs, but also to measure the relationship between alcohol policy strength (measured using the Alcohol Policy Index) and harms to health.ResultsIt was possible to calculate urban level AA-DALY and AA-YLL for males and females and for different age groups in 20 different UAs. There was no association at either national (p=0.15) or urban level with AA-DALYs and AA-YLL and API score. Clustering of the countries by European region may have influenced the lack of association as well as the need for further refinements of the API to include enforcement. Mean male (female) AA-YLL was 12.75 (3.23) per 1000 population (p

Date of Award	31 Dec 2013
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Arpana Verma (Supervisor), Frank De Vocht (Supervisor) & Erik Van Ameijden (Supervisor)