ABSTRACT
This chapter argues that to achieve health gain effectiveness is not the only criterion for commissioners. Appropriateness or relevance to social need cannot be ignored. While there are always a number of possible aims, the most health gain will be achieved if the aim is appropriate to population need; that is, relevant to social need. The epidemiological perspective provides information on the effect that alcohol has on the population of Salford as a whole. It is now indisputable that alcohol use has a cardio-protective effect and commissioners need to balance the positive effects of alcohol with the harmful effects and try to optimize that balance at a population level. The key point from the needs assessment work is that most of the harm caused by alcohol in the community is caused by the occasional binge drinkers, rather than regular dependent drinkers. Health needs assessment and agreement on appropriate aims are important prerequisites.
