The complexities behind alcohol harm in Canada

Hospitalization rates and alcohol policies vary considerably across Canada

July/August 2017

The warm weather is here, and for many Canadians, it’s difficult to imagine a summer long weekend without alcohol. CIHI’s report Alcohol Harm in Canada: Examining Hospitalizations Entirely Caused by Alcohol and Strategies to Reduce Alcohol Harm explores hospitalizations that are entirely caused by alcohol. It found that last year there were more than 77,000 hospitalizations for harms entirely caused by alcohol, such as alcohol poisoning, alcohol withdrawal or liver disease caused by alcohol.

Hospitalization rates varied across Canada

Hospitalization rates varied considerably across Canada in 2015–2016. The eastern provinces generally had lower rates of hospitalization than those in the west, while the territories had higher hospitalization rates than the provinces, on average. There were substantial regional (within-province) variations, with higher rates in several northern and remote regions. You can find out more about hospitalizations entirely caused by alcohol in your region by using our Your Health System web tool.

Hospitalizations entirely caused by alcohol

There were also significant differences in alcohol sales and heavy drinking rates across the country. Heavy drinking means 5 or more drinks for men and 4 or more drinks for women at 1 time, at least once a month over a 1-year period.

Overall, males had higher heavy drinking and hospitalization rates than females. However, among children and youth age 10 to 19, girls had higher rates of hospitalization than boys. Those living in the lowest-income neighbourhoods were hospitalized more than twice as often for conditions entirely caused by alcohol than those living in the highest-income neighbourhoods.

Nearly 3 out of 4 hospitalizations entirely caused by alcohol are due to mental and behavioural disorders, such as alcohol dependence and intoxication. Almost 3 out of 4 alcohol-related hospitalizations were linked to conditions related to mental health and addictions. Examples include chronic alcohol use disorder, alcohol withdrawal and alcohol intoxication.

Evidence shows that greater government control of the sale and distribution of alcohol is typically associated with lower consumption and harm. The report found significant regional variations in alcohol harm within the provinces, regardless of the provincial policies that applied to each region.

A complicated issue

“The sheer complexity of the issue of alcohol harm, along with the magnitude of harm, is surprising,” said Dana Riley, program lead for the Canadian Population Health Initiative at CIHI. “For example, there are more hospitalizations for harms entirely caused by alcohol than for heart attacks in Canada, and this is really only the tip of the iceberg.”

The new indicator is focused on hospitalizations entirely caused by alcohol and does not include people who visit the emergency department who are not admitted to the hospital. The whole picture of alcohol harm is likely much larger than the numbers found in the report.

A recent World Health Organization report estimated that Canadians drink 3.6 times more alcohol per capita than the global average. According to this report, Canada is the largest consumer of alcohol in the Americas at 10 litres per capita, compared with 9.3 litres in the United States and 7.1 litres in Mexico.

CIHI’s new indicator will be a useful tool to inform service needs, drive action to reduce alcohol harm and monitor the effectiveness of local policies.