Local government responses to preventing alcohol-related harm

Local governments are at the forefront of responding to alcohol and other drug issues and have a range of mechanisms that they can use including local regulation and enforcement, social marketing, service provision, advocacy and planning.

Speakers

Welcome and introduction
Mr Todd Harper, CEO, VicHealth

Local government reducing harm from alcohol consumption
Mr Ged Dibley, Director, PDF Management Services

Health credits: identifying the economic benefits of licensed premises for local government
Associate Professor John Fitzgerald, The University of Melbourne, Centre for Health and Society
Ms Penny Francis, Health and Well-being Office, Community Health Unit, Stonnington Council

Getting policy over the line: encouraging whole of local government action on reducing alcohol harms
Mr Mark Boyd, Senior Project Officer—Health Inequalities, VicHealth

Two short films about alcohol, young people and friendship on the Mornington Peninsula
Ms Jenny Macaffer, Coordinator Social Planning and Community Development, Mornington Peninsula Shire

Welcome and introduction

Mr Todd Harper

• Local governments play a key role in the prevention of alcohol harms. They are well placed to bring about change through working with communities.
• Planning is one mechanism through which local governments can achieve such prevention.
• It is important for local governments to strive to reduce alcohol harms as alcohol is entrenched in society. The case for intervention in alcohol is as strong as it was for tobacco in the past.

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Local government reducing harm from alcohol consumption

Mr Ged Dibley

Local governments are key players and those in the alcohol and other drug (AOD) sector need to ensure that alcohol is on the agenda for councils. The things to consider in influencing the alcohol agenda include an understanding of the planning process and the fact that alcohol has positives for local governments, such as revenue.

In order to understand where councils' role fits, it is important to identify and understand the things that contribute to harmful alcohol consumption, such as social and individual harms, and supply and demand factors.

• Supply factors that affect harm include how late alcohol-serving venues are open, how they serve alcohol, alcohol promotions and price of alcohol. Councils can engage in and influence these supply factors.
• In terms of demand factors, there is a huge acceptance of alcohol, hence demand is high. Alcohol used for all occasions—when people are down, when they're up and when they're in the middle. There is a lot of pressure to join in. Alcohol can be seen as a badge of honour. We need to look at the types of things that council can influence on the demand side. For example, there are a lot of positive things happening in sporting clubs.

Local governments have a:

• Corporate Plan-long term vision
• Municipal Public Health Plan—focus on strategies to improve the health and wellbeing of their community
• Alcohol and Drug Strategy—focus on activities to reduce harm from the use of drugs, including alcohol.

The Municipal Public Health Plan and the Alcohol and Drug Strategy tend to have strong linkages with other council strategies or plans.

It's important for those in the AOD sector to understand the cycle of planning within councils and where alcohol is likely to sit within the councils' plans.

Principles that underpin good planning include:

• understanding the community
• deciding what to do
• making a commitment to that decision.

It can be useful to plan within four environments to identify issues and to plan actions; the four environments being:

• built
• social
• economic
• natural.

The four environments may be used to identify issues in the following way:

• built—the number and location of liquor outlets
• social—social alternatives to alcohol consumption
• economic—the economic impacts on local businesses
• natural—damage to natural settings caused by intoxicated persons.

The four environments may be used to plan actions in the following way:

• built—restricted number and location of liquor outlets
• social—alcohol-free events for young people
• economic—business incentives, for example, RSA training
• natural—protection of natural settings

In choosing strategies to reduce harm from alcohol consumption it's important to remember that some are more effective than others. Strategies may include:

• pricing and taxation strategies
• regulating the physical availability of alcohol
• modifying the drinking context
• drink driving countermeasures
• regulating alcohol promotion
• interventions in communities, homes, schools and workplaces
• treatment and early intervention.

It is important to be wary of popular strategies, for example, the approach of instilling fear in young people to deter them from drugs. It has been shown that this type of approach can in fact encourage young people to use drugs.

Current council projects:

• Frankston Drink Safe Project—taking education to venues. Successful in engaging young people.
• Ballarat Safe City Taxi Rank—helping people get home safely. Ensuring there is some order around people getting into cabs. A bus service has been introduced as a more affordable option than a taxi for traveling out to the suburbs.
• Port Phillip Safer City Licensees Accord—developing standards in partnership.
• Councils help to make partying safer—Party Safe, Schoolies Week. A Surf Coast website encourages young people to do ‘homework' before turning up for their breaks. The website is sympathetic to young people and acknowledges that they will drink, but asks that they look after their friends.
• ‘Vomit tax'—an innovative idea being pursued in Geelong and Greater Shepparton. Ensuring alcohol-related mess in the immediate surroundings of late-night venues is cleaned up.

Conclusion
Alcohol consumption is likely to remain a feature of life in Victoria, including both its welcome and unwelcome consequences. Smoking is close to disappearing—people have accepted a huge number of interventions, but it seems that alcohol will be with us for a long time.

The options for local governments are vast. In considering the supply and demand side features, there are many chances for local governments to modify some of the positive and negative impacts of alcohol.

Through understanding linkages and building alliances with those who have similar goals, positive impacts on harms associated with alcohol consumption are possible.

Planning in an integrated way and choosing strategies based on evidence means that resources are used to greatest effect to achieve improved health outcomes.

There is no one solution for all communities—each council needs to work with their community partners to find what is needed and what will work locally. It's not one size fits all but rather, ‘what can my community do to reduce harm from alcohol consumption'.

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Health credits: identifying the economic benefits of licensed premises for local government

Associate Professor John Fitzgerald and Ms Penny Francis

Drug and alcohol issues are significant for the City of Stonnington and the council has been working in collaboration with The University of Melbourne to explore options to combat these.

The City of Stonnington is situated 4km from the central business district (CBD) of Melbourne, has a high density of liquor licenses and a high level of alcohol related harm. A high density of liquor outlets typically leads to a high density of alcohol-related harm. Licensed premises are, however, major economic drivers and are thus advantageous to local governments.

It seems there is a willingness at a local level to do something about alcohol harms but councils need ideas on how to begin. This project was an attempt to reconcile economic evidence of alcohol consumption with evidence of health harms.

The aim of the research was to estimate the costs and benefits of alcohol consumption. Volumetric data—that is, data on the volume of alcohol sold from a particular venue over a particular time—has not been collected since 1996. Without volumetric data it is difficult to conduct economic modeling. Economic modeling in this context involves trying to generate a unit cost, for example, what is the cost of a standard drink, what is the benefit of a standard drink, or, from the volume of alcohol sold at one place, what is the volume of harm.

Through the project, we are trying to create a system for collecting volumetric data. In the past, premises were required to provide volumetric data. That is no longer the case and furthermore, the industry may be reluctant to provide such data since it may not be in their interest. Licensees do not want to provide data that may lead to tighter regulation. Therefore, we needed to create incentives for licensees to provide their sales data and a tangible benefit for the licensee.

The idea behind the research was to create an accreditation process for licensees. The licensee would voluntarily provide the team with sales data and in exchange would receive a ‘healthy drinking space' bonus. That is, they would be able to promote themselves as a ‘healthy drinking space'. This may be offensive to some (who don't believe drinking can ever be described as ‘healthy'), however we were responding to the political environment in which we had to work. We are still working on other benefits that could be built in as an incentive.

Requirement of a ‘healthy drinking space':

• comply with the accreditation process
• attend licensees forums
• rotate staff to attend industry-related forums
• promote harm minimisation
• provide accurate data in a timely manner
• display ‘healthy drinking space' branding
• participate in annual monitoring
• attend annual meetings.

The ‘healthy drinking space' title would require annual renewal and would ideally have a number of benefits for venues, including:

• assisting them to manage alcohol responsibly, with the potential to lead to a reduction in violence at the venue, which would be a positive result for venues.
• promoting positive messages to the community and thus improving perceptions of the venue.

Moreover the ‘healthy drinking space' title would ideally have a number of benefits for local governments:

• provide an additional municipal public health planning tool. Local governments are light on economic regulatory tools.
• provide an alternative perspective
• may improve planning of the built environment
• may influence upstream (state government) areas.

There may be a number of stakeholders with interest in the project, for example, the police. Once economic costs and benefits can be measured, economic modeling can be done. Economic modelling is around three areas:

1. local licensing accords
2. health credits scheme
3. stratified health credits system.

It hasn't been an easy ride so far. Challenges have included:

• collecting current data on alcohol sales
• achieving a whole of government approach—state and local
• needing to look at the benefits as well as the harms
• ensuring the research is valued by decision makers—important for implementation.

This project is a small piece of the large picture. It's the beginning not the end. This is the first public discussion of the idea of ‘healthy drinking spaces'

The researchers have spoken to many stakeholders about where to proceed from here and have developed an advisory group. A report of the findings will be compiled. The project will run from July 2007 to 2008.

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Getting policy over the line: Encouraging whole of local government action on reducing alcohol harms

Mr Mark Boyd

Darebin Council's strategy is a case study for influencing alcohol policy. Current alcohol issues in Darebin include:

• high-level harms
• public drinking
• greater choice and availability.

When working on alcohol strategies, it is important to align them with the local government plans, for example, the Municipal Health Plan, since this makes it easier when talking to departments.

Alcohol is an area where the evidence isn't enough to change policy. Influencing policy is a collaborative process.

Successful policy is often that which:

• has consensus with the community
• builds confidence with senior decision-makers (Parliamentary members, local government councillors)
• improves on current actions
• creates and drives a learning culture
• is pragmatic—looks at strategies as building blocks that will make a difference in five years
• has a balance between government action, personal responsibility and market mechanisms.

(Ben Rimmer, Victorian Health Inequalities Network, 2007)

Those working in the area should not only focus on young people in their drug strategy but should also consider what local governments can do from a planning perspective.

The lack of data on community attitudes is an obstacle. There is some relevant Australian Institute of Health and Welfare data (e.g. data showing that 60% of people do not think that alcohol should be available at local sporting events), however it would be useful if local government surveys included questions on alcohol. Useful data, including the top 10 places where people drink-drive, can be found from sources such as the Herald Sun. Turning Point's alcohol statistics are also useful.

Strong media liaison, for example, constant articles in the local papers, can be useful. The involvement of police and those in similar roles who have the capacity to enforce is crucial. It is also useful to have an active police member on side. It is important to persevere and be optimistic in taking a strategy through to different areas.

In getting alcohol strategies through, the team talked regularly to different departments within the Council about their plan. To be able to talk to governments, it is important to have things documented, as can make a huge difference in convincing important people that something is more than "talking in the corridors".

In regard to outlet density, the team wanted to find out whether the Council could use harm minimisation grounds to object to new licenses. There is a need for evidence on outlet density and associated harms but councils should not wait for such evidence before acting. There is also a need to talk about the cost of not acting when making outlet density decisions. The harms are too high to do nothing; we can't wait for watertight research before action.

It is important to act now, since alcohol has a huge impact on workplace absenteeism and productivity. An imbalance between workplace effort and reward can lead to alcohol dependence.

More information about the City of Darebin's work on alcohol issues can be found on their website.

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Two short films about alcohol, young people and friendship on the Mornington Peninsula Shire

Ms Jenny Macaffer

The Mornington Peninsula Shire:

• includes the lowest taxable income households and highest taxable income households in Victoria
• has a mix of rural and coastal areas
• has areas of high domestic violence and high child protection
• has a trend of 18 year olds moving to the city
• has a low school retention rate for those 15 years and older.

The Peninsula has a beach culture which brings in new populations with different expectations of the area. People come to the area for a good time; therefore it's different to normal residential areas.

The Mornington Penninsula Shire Council's Health and Well-Being Plan is based on the Ottawa Charter, identifying five key values:

• Healthy places and spaces
• Healthy lifestyle choices
• Active local communities
• Quality of life for all
• Sense of hope and belonging.

It was in the spirit of these values that the 2pic project was developed. The two films are each three minutes in length and were made by young people, for young people, aged between 16 and 21 years. The films are titled ‘Adrift' and ‘Everywhere You Go' and focus on the importance of friendship and looking out for one another. The films were made for community awareness, to create positive images of young people, to challenge the cultural acceptability of alcohol and to involve young people in harm minimisation.

Why focus on alcohol?

• Australia has a strong binge drinking culture
• alcohol was identified in the Peninsula's Drug and Alcohol Issues paper as a key risk factor for young people
• alcohol has been identified as a key social health issue.

Approximately 25 young people were involved in organising, writing and producing the films. The films have had a big effect in the community and involvement in the films has developed skills and connection among young people. Two of the young people involved in the production have gone on to media-related jobs. The experience was a great confidence booster for them. It is estimated that the films have been seen by 30 000 people.

What next? The council is developing a school set so young people can talk about the films at schools.

So what difference did the films make? The films created:

• a life changing impact for some young people
• an interest in a long term review of the impact
• a tool developed for schools
• an opportunity for the young people involved to have a few seconds of fame, which they enjoyed and was beneficial for their confidence
• opportunities for the young people involved to make friends across geographical boundaries
• parents and friends proud of the changes they have seen in their young people
• lots of tears, frustration, fun and friendship.

The success of the films gives confidence that emerging generations can make our world a much better place for all.

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