Introduction
Alcohol consumption has health and social impacts borne by the individual, their families and the community. The number of patients admitted with health conditions linked with alcohol used in Cambridgeshire is rising. For example, in 2018, about 3,452 hospital admissions were caused by excessive alcohol use (Cliss, 2019). This data represents patients suffering from health conditions attributed to alcohol abuse, such as liver cirrhosis and depression. Based on this, reducing harmful drinking is among the seven priority areas in which public health in Cambridgeshire is focusing on approaches aimed at eradicating social determinant of health. Nurses play an integral role in promoting health in the area because they identify high-risk individuals and educate and advise them on safe drinking limits. Therefore, there is a need to address the alcohol consumption rate in Cambridgeshire.
The Local Health, Social Services, And Health Services
Locality
Cambridgeshire is among the counties in the UK and is situated in the East of England. It borders Lincolnshire, Norfolk, Suffolk, Essex, Hertfordshire, Bedfordshire, and Northamptonshire (Mostert, 2018). The county consists of the City of Cambridge, Peterborough Unitary Authority and four district councils. In 2016, the population of Cambridgeshire was found to be about 851,430 people, and it is projected to reach one million by 2030 (Mostert, 2018). However, in the area of health, alcohol use is now the leading factor for ill-health in the county. In addition, it contributes to health conditions resulting in hospital admissions. This is considered a threat to the healthcare system in the county. Thus, the prevalence of alcohol use in Cambridgeshire calls for the assessment and proposal of mitigation strategies.
Health and Social Care Data
Despite being home to one of the most prestigious universities, Cambridgeshire has shocking statistics regarding alcohol abuse and treatment outcome. As shown in figure 1, between 2018 to 2019, the number of alcohol-dependent adults with children was 1,265 in the county (Public Health England, 2022). This number is high, considering the county’s population is less than one million. The use of alcohol is associated with the risk of developing health problems such as cancers, cardiovascular conditions, depression and liver disease. With these conditions, more people are likely to be hospitalized, increasing the healthcare system’s burden. Therefore, the high number of adults who are dependent on alcohol is a health problem because it increases the county’s hospitalization rate.
Adult alcohol dependency is a problem experienced in the UK and across the globe. Alcoholism has been a significant problem in the UK for decades, and the numbers of people with alcohol addiction continue to rise yearly. More than 7 million people in the UK show signs of alcohol dependence (Public Health England, 2022). Other than in the UK, alcoholism is a health issue affecting people and countries across the globe. For example, about 300 million individuals across the globe have alcohol use disorder. This is a threat to global healthcare due to the likelihood of alcohol-related conditions. As a result, alcohol uses a problem that should be given proper attention.
In Cambridgeshire, there is a high number of people who abuse alcohol and do not complete their treatment. As shown in figure 2, about 20% of adults living with children in treatment complete their treatment compared to 30% in the entire UK (Public Health England, 2022). This shows that approximately 80% of adults in Cambridgeshire, against 70% in the entire country who enroll for treatment, fail to finish the program (Public Health England, 2022). This is a major health problem because these people are more likely to continue to abuse alcohol and eventually develop alcohol-induced ill-health. Therefore, when alcoholic individuals fail to complete their treatment, they are likely to increase the burden on the healthcare system in the county.
Children are among the people who suffer when parents abuse alcohol. In Cambridgeshire alone, about 20.8% representing 933 of children in needs assessments, claim that alcohol abuse is a major health and social issue for a parent or other adults between 2019 to 2020 (Public Health England, 2022). Children are concerned because they experience the effect of living with an alcohol-dependent parent. As a result, alcohol abuse is a significant health and social issue for people living in Cambridgeshire.
Determinants, Inequalities, And Barriers to Health
Determinants of health are social, environmental and economic factors that have an impact on alcohol use in Cambridgeshire. Social factors are things that affect an individual’s lifestyle (Mercer, 2018). Culture is one of the social aspects that contribute to alcohol use in this county. There is an existence of a culture that normalizes and romanticizes self-destructive drinking. In addition, in Cambridgeshire, alcohol use is viewed as a means of dealing with a situation especially stressful (Mercer, 2018). This shows that people may use alcohol to overcome an adverse situation. For example, when the pressure is high and the work too challenging, individual’s living in Cambridgeshire may find comfort in alcohol use. Based on this, adults with children are more likely to abuse alcohol to evade some of the problems that come with having a family.
Gender is among the social factors that contribute to the use of alcohol. According to Bhattacharya et al. (2018), men drink more alcohol than women in the UK and worldwide. People have said that the main reason why men and women drink differently is because of their different roles in society. That indicates that the distinction between the rates of drinking by men and women is lower when women have more power in society. Even though health promotion should not get in the way of working towards gender equality, various prevention approaches aimed at women, particularly those in male-matched roles, are in line with a focus on equity.
Economic factors are things that have an impact on an individual’s income. According to Matthews et al. (2019) alcohol dependent individuals are more likely to be unemployed and marginalized in society. For example, in Cambridgeshire, the unemployment rate ranges from 3.1% to 5.2% (Houston, 2020). This shows that there are people who are not employed in this county. For instance, people with low social and economic status tend to have worse health and are more likely to drink alcohol and use illegal drugs. These factors can make an individual’s problems worse and prevent them from receiving treatment or reaping the benefits of treatment. As a result, this explains why the number of alcohol-dependent people seeking treatment is low and those who fail to complete treatment high.
Environmental factors have an impact on the consumption of alcohol in Cambridgeshire. One of the aspects that contribute to the increase in the use of alcohol is its availability in the market. Over the past few years, the county has seen an unpreceded increase in the accessibility of alcohol (Bhattacharya et al., 2018). This is evidenced by an increase in the number of licensed shops and hours of availability. In addition, technological advancement has led to the introduction of online sales. This shows that people can order alcohol in the comfort of their homes or workplaces. For example, the distance to a liquor shop is no longer a deterrent to alcohol use due to online services. Therefore, with these factors, the number of individual using alcohol continue to rise in the county.
A Review of the Services and Health Care
Review of Current Service Provision
Inclusion Cambridgeshire is one of the drug and alcohol treatment and recovery services. It has a remit consisting of prevention activities, brief interventions, and hospital liaison (Werner-Seidler et al., 2018). Although Inclusion states that they conduct a significant number of assessments for community detoxes, it is important to note that due to clinical and safety considerations, not all patients can be treated in the community setting. As a result of funding from Cambridge City Council, Inclusion provides outreach services in Cambridgeshire to those with alcoholism and homelessness (Werner-Seidler et al., 2018). In addition to helping the homeless find housing, it offers expert advice on alcohol harm reduction and referrals to community detoxification programs. Therefore, Inclusion plays a crucial role in reducing the number of adults abusing alcohol.
Additionally, Inclusion has been given the responsibility of supervising a supervised consumption program that community pharmacists run. Observing patients and the associated communication with the Inclusion service results in monetary compensation for pharmacies (Werner-Seidler et al., 2018). The medications are used as part of maintenance treatment for alcohol dependence, and research suggests that their introduction was associated with a decrease in the number of deaths caused by drug use. To enhance effectiveness, national guidance recommends that Inclusion offer a wide range of relapse prevention groups to ensure that clients complete the treatment program (Werner-Seidler et al., 2018). As a result, Inclusion services are aimed at helping people avoid abuse of alcohol.
Apart from Inclusion, Cambridgeshire has Gainsborough Foundation, which helps prevent and manage alcohol abuse in the county. Just like Inclusion, it assesses and provides information and advice to individuals. The Gainsborough ANSWERS programme is for use with dependent alcohol users and post detoxification (Werner-Seidler et al., 2018). In addition, its treatment model includes the most important psychosocial parts of the NICE treatment pathway used by Inclusion services. On the other hand, patients in Gainsborough seem to get a more intensive service without a clear end date for treatment (Werner-Seidler et al., 2018). National guidance recommends providing essential services like and not limited to community-based support for education, training, and family support.
The National Institute for Health and Care Excellence (NICE) is among the agencies that provide essential services to people in Cambridgeshire and across the UK. It is an executive non-departmental public body sponsored by the department of health and social care (Werner-Seidler et al., 2018). NICE offers national guidance and advice to improve health and social care. For example, to reduce excessive consumption of alcohol, NICE provides advice in the form of quality standards. This quality standard talks about how to keep alcohol problems from happening and find them when they do. It includes policy and practice ways to stop adults, teens, and kids from drinking too much and doing harm (Werner-Seidler et al., 2018). Therefore, NICE recommends that it is very important for local governments, the police, schools, and colleges to collaborate in preventing and managing alcohol use.
The Role of the Nurse in Health Promotion and Screening
Table 1: The Role of a Nurse
Summary of Findings
There are various findings obtained from the analysis of alcohol consumption in Cambridgeshire. Firstly, alcohol use is a major health and social issue in the county. According to statistics, about 1,265 adults with children still depend on alcohol. This is a problem because alcohol abuse can lead to health conditions such as cancer. Secondly, there is a significant number of people who are alcoholic and fails to complete their treatment program. This is a setback because the main purpose of rehabilitation in this area is to make sure that clients get the solution. Thirdly, culture is among the primary factors contributing to alcoholism in the county. Alcohol consumption is perceived to be a solution to individual problems in life. Fourthly, the availability of alcohol through many liquor stores in the county and the existence of online services. Therefore, alcohol use in Cambridgeshire is caused by social, economic, and environmental factors.
Conclusion
Cambridgeshire is among the counties in the UK with the highest rates of alcohol consumption for adults. This prevalence is caused by its culture, availability of alcohol, and lack of effective social support. Most people believe that alcohol can help someone overcome challenges they experience in life, such as stressful situations. However, the increase in alcohol consumption in the county is due to people who fail to complete their treatment program. There are agencies such as Inclusion, Cambridgeshire has Gainsborough Foundation, and NICE to solve this problem. These service providers help inform, educate and management of alcoholism. In addition, nurses in different healthcare facilities are helping reduce alcohol consumption in Cambridgeshire. Therefore, despite interventions established to control alcoholism, alcohol use, especially among adults, is still a major health and social issue in the county.
Recommendations
Different strategies can be adopted to manage alcohol consumption in Cambridgeshire effectively. Firstly, the government and health services should consider countering the social factors listed, such as culture, and improve people’s lives and health. This can be done by investing in infrastructure to make it easier for people to get to the community and hospitals and by running national campaigns to raise awareness and point people to places where they can get help. Legislation from the government can improve things like unemployment and education. Based on this, there is a need for robust education to deconstruct a perception that alcohol is a solution to life situations. Finally, local leaders should engage opinion shapers to effectively engage the public on the impact of negative cultural beliefs.
Secondly, the government and health services should continue with social approaches offered through Inclusion and the Cambridgeshire Foundation. With a social approach, the work should be focused on the social environment, the family, or a larger social network. For example, social behavior and network therapy use various cognitive and behavioral techniques to help clients build social networks that support change. These techniques involve the patient and members of the patient’s networks, like friends and family, to help the patient build positive social support for a change in alcohol consumption. With a continuation of this approach, the clients will be able to develop positive relationships with people, which is integral for their healing.
Secondly, nurses should be inspired and trained regularly on how to use existing resources to solve the issue of alcohol consumption in the county. For example, they should act on the recommendations outlined by NICE to provide quality care and achieve the anticipated health outcome. In addition, they should be equipped with appropriate skills to provide brief advice on alcohol beyond health checks and use of health promotional tools in new patient registration and opportunistically at appointments provided by various clinicians.
Recommendations for Future Practices
Nurses are becoming more important in addressing population health due to frequent contact with people. Firstly, to effectively perform this role, the nurses should be allowed to work with social workers to promote community health and address health-based issues. They are supposed to be informed that they play an integral role in preventing illness and solving healthcare issues at a personal and community level. Secondly, nurse leaders should ensure that nurses are constantly updated with interventions established by the government in addressing issues such as alcohol consumption. With this information, the nurses can use the intervention to achieve the intended health goal.
References
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