Dr John Boffa, Chief Medical Officer Public Health, Central Australian Aboriginal Congress, Adjunct Professor of Primary Health Care, Charles Darwin University; and Edward Tilton, Senior Health Policy Adviser, Central Australian Aboriginal Congress
The highly charged topic of alcohol-related violence in Mparntwe (Alice Springs) made headlines late last year, after the expiry of the ‘Stronger Futures’ dry areas provisions led to a wave of alcohol-related violence and property damage.
In response, on 24 January 2023, during a visit to Alice Springs by Prime Minister Albanese, the Northern Territory Chief Minister, Natasha Fyles, announced a number of alcohol restrictions for the town. These included no takeaway alcohol sales on Mondays and Tuesdays, restrictions on the numbers of purchases a person may make in a day, and further limitations on take-away trading hours from Wednesday to Sunday. These are the most significant alcohol supply reduction measures ever introduced in an Australian town.
On 6 February, following the release of an interim report into the crisis, further actions were taken, including reintroducing legislation so that Aboriginal living areas (town camps) and remote communities would revert to being ‘dry’ areas. Many remote areas had remained dry areas under NT legislation, so this new legislation mainly affected the Aboriginal living areas in and around Alice Springs.
The need for special measures on alcohol had been evident for a long time.
As yet unpublished analysis carried out by the Menzies School of Health Research for Central Australian Aboriginal Congress (Congress) indicates that in 2020, alcohol-attributable hospitalisations for Aboriginal people in Alice Springs were approximately 110 per 1,000 population. This equates to around 11,000 alcohol-attributable hospitalisations per 100,000 population, around twenty times the national average of 510 alcohol-attributable hospitalisations per 100,000.
In the months since, the new restrictions have been extensively debated, with various opinions highlighted across media outlets locally and nationally.
Some have described the restrictions as ineffective.
Others have criticised the alcohol bans on Aboriginal communities as being a return to the deeply unpopular ‘Intervention’ policies of the past.
However, leading Aboriginal organisations such as Congress have argued for a more nuanced approach, calling for a twofold strategy to address the excessive harm that alcohol causes Aboriginal people in Central Australia.
First, the alcohol restrictions are needed to break the cycle of violence and keep Aboriginal women and families safe, at least until communities can be consulted and can put their own plans to manage alcohol in place.
Second, sustained action is required on the drivers of unregulated, harmful drinking such as intergenerational trauma, poverty, poor education, overcrowding and discrimination.
Congress has been tracking the effect of alcohol policy and other changes on key indicators of alcohol-related harm for many years. The latest Northern Territory Police crime statistics available online show a significant drop in violence associated with the 2023 restrictions. In particular, the number of domestic violence assaults fell 37% since the introduction of the restrictions, translating to around 70 fewer domestic violence assaults in Alice Springs per month.
It’s also clear that this drop isn’t due to any so-called ‘seasonal effect’ (i.e., a rise in violence around the festive season, and then a resultant drop in the following months).
Historically there have been small peaks in alcohol related assaults around the festive period. But after the legislated dry area restrictions expired in July 2022, the rates of domestic and family violence rose to unprecedented levels, as Figure 1 shows.
Looking historically at the data, the introduction of a package of alcohol reforms under the NT Labor Government, including a minimum unit price, from October 2018 led to a reduction in domestic violence in the town of around nine per cent. Unfortunately, COVID led to increasing levels of alcohol-related harm, as has been documented across the world during the pandemic. But it was the removal of the dry areas protections in the Aboriginal living areas around Alice Springs that led to an explosion in domestic violence, which increased by 77% to around 180 domestic violence assaults per month (see Figure 2). The 2023 restrictions have seen the numbers fall to 114 domestic violence assaults per month.
Police statistics on the number of general assaults show a similar pattern.
Even property offences, which have been rising year on year, fell 22% during the period February to April 2023 compared to the same months in 2022. Anecdotally, police have largely attributed the improvement in property offences to their increased capacity due to the reduced interpersonal violence.
When considering this context, the correlation between the reintroduction of alcohol restrictions and the overall drop in alcohol-related assaults cannot be ignored.
What about the non-violent effects of alcohol?
The longer term, non-violent effects of alcohol use on individuals’ bodies must also be considered with regards to alcohol restrictions.
As described in the World Health Organization’s 2021 report on non-communicable diseases, one of the so-called ‘best buy’ interventions they recommend is to:
“Enact and enforce restrictions on the physical availability of alcohol in sales outlets (via reduced hours of sale)”
These ‘best buy’ interventions are chosen based on their cost-effectiveness and evidence base for addressing non-communicable diseases. Aside from reducing crime levels, the restrictions on when takeaway alcohol could be purchased also have the potential to address disease and illness in the long term.
Where to from here?
The data from Alice Springs stimulates optimism that interpersonal violence can continue to be lowered. However, as Congress has been arguing, alcohol restrictions by themselves aren’t enough to address the complex intergenerational issues at play.
These restrictions have given Alice Springs a reprieve, but they also highlight the need to address other social determinants of health, including poverty, racism, housing, employment, and education. This would ensure that the positive social and health improvements already evident in Alice Springs are enhanced in the long term and that Central Australia can move beyond the need for special measures on alcohol.