Scotland's Health:
Scottish Health Survey 1995

A Survey carried out on behalf of The Scottish Office Department of Health
Edited by Wei Dong and Bob Erins

VOLUME 1

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CONTENTS

Editors’ Acknowledgements
Foreword

1 INTRODUCTION
1.1 The 1995 Scottish Health Survey
1.2 Overview of survey design
1.2.1 Sample design
1.2.2 Fieldwork design
1.2.3 Survey response
1.2.4 Data analysis
1.2.5 Ethical approval
1.3 This report
1.3.1 Volume I: Findings
1.3.2 Volume II: Technical report and documentation
1.4 Comparison with the Health Survey for England
1.5 Comparison with the Scottish Heart Foundation
1.6 Notes to tables

2 PHYSICAL ACTIVITY
Andrea Nove
2.1 Introduction
2.1.1 Background
2.1.2 Method
2.1.3 Classification
2.2 Overall levels of physical activity
2.2.1 Frequency-intensity activity level
2.2.2 Maximum intensity level
2.2.3 Frequency
2.2.4 Comparisons with the Health Survey for England
2.3 Individual components of activity
2.3.1 Home activity
2.3.2 Sports and exercise
2.3.3 Work activity
2.4 Attitudes towards taking more exercise
2.4.1 Perceptions of current physical activity level
2.4.2 Desire to take more exercise
2.4.3 Reasons for considering taking more exercise
2.5 Regional variations
2.5.1 Frequency-intensity level
2.5.2 Maximum intensity level
2.5.3 Frequency
2.5.4 Individual components of activity
2.6 Social class variations
2.6.1 Frequency-intensity activity level
2.6.2 Maximum intensity level
2.6.3 Individual components of activity
2.6.4 Attitudes towards taking more exercise
Tables

3 EATING HABITS
Kavita Deepchand
3.1 Introduction
3.2 Consumption of foods containing sugar
3.2.1 Sugar in tea and coffee
3.2.2 Biscuits, cakes and confectionery
3.3 Consumption of foods containing fat
3.3.1 Fat spreads
3.3.2 Milk
3.3.3 Cheese
3.4 Consumption of meat
3.4.1 Meat and meat products
3.4.2 Poultry
3.5 Fish consumption
3.5.1 White fish
3.5.2 Oil-rich fish
3.6 Consumption of foods containing fibre and starches
3.6.1 Bread and rolls
3.6.2 Breakfast cereals
3.6.3 Potatoes, pasta, rice and chips
3.6.4 Pulses
3.7 Consumption of fresh fruit and vegetables
3.7.1 Fresh fruit
3.7.2 Cooked green vegetables
3.7.3 Cooked root vegetables
3.7.4 Raw vegetables or salad
3.8 Salt consumption
3.9 Dietary supplements
3.10 Social class differences
3.11 Regional comparisons
3.12 Comparisons with England
3.13 Comparisons with the Scottish Heart Health Study
Tables

4 SMOKING
Rachel Turner
4.1 Introduction
4.2 Self-reported smoking prevalence by sex and age
4.2.1 Smoking status by sex
4.2.2 Smoking status by age
4.3 Number of cigarettes smoked by age and sex
4.3.1 Estimating consumption
4.3.2 Number of cigarettes smoked
4.4 Past cigarette smoking
4.4.1 Whether ever smoked cigarettes
4.4.2 How long ago stopped smoking
4.4.3 Medical advice to stop smoking
4.4.4 Whether tried to give up smoking due to a health condition
4.4.5 Smoking and pregnancy
4.4.6 Age at which started regular cigarette smoking
4.5 Serum cotinine
4.5.1 Introduction
4.5.2 Serum cotinine levels
4.5.3 Serum cotinine levels by self-reported smoking status
4.5.4 Serum cotinine levels by age and sex
4.5.5 Serum cotinine levels and current smoking behaviour
4.6 Passive smoking
4.6.1 Passive smoking by sex
4.6.2 Passive smoking by age
4.6.3 Passive smoking by social class
4.6.4 Passive smoking by level of serum cotinine
4.7 Smoking and social class
4.8 Smoking and region
4.9 Comparison of Scotland and England
4.9.1 Self-reported smoking prevalence in Scotland and England
4.9.2 Number of cigarettes smoked: comparison of Scotland and England
4.9.3 Comparison of Scotland and Northern England
4.10 Comparison of the Health Survey with the Scottish Heart Health Study
Tables

5 ALCOHOL CONSUMPTION
Bob Erens
5.1 Introduction
5.2 Estimating weekly alcohol consumption
5.3 Alcohol consumption levels
5.3.1 Current drinkers, ex-drinkers, and never-drinkers
5.3.2 Alcohol consumption by sex and age
5.3.3 Drinker ‘profiles’
5.3.4 Drinking frequency
5.3.5 Comparison with the Health Survey for England
5.3.6 Average daily drinking
5.4 Types of drink
5.5 Changes in drinking behaviour
5.5.1 Cutting down drinking over the past five years
5.5.2 Reasons for stopping drinking
5.6 Social class differences
5.7 Regional differences
5.8 Problem drinking among 16-17 year olds
5.8.1 Drinking among 16-17 year olds
5.8.2 Problem drinking
5.8.3 Drunkenness
5.9 Gamma gt
5.9.1 Analytical considerations
5.9.2 Gamma gt results
Tables

6 BLOOD PRESSURE
Wei Dong, Paula Primatesta and Lualhati Bost
6.1 Introduction
6.2 Methods
6.3 Classification of blood pressure levels
6.4 Blood pressure by age and sex
6.4.1 Systolic blood pressure (SBP)
6.4.2 Diastolic blood pressure (DBP)
6.4.3 Pulse pressure
6.4.4 Mean arterial pressure (MAP)
6.4.5 High blood pressure
6.4.6 Detection, treatment and control of high blood pressure
6.5 Blood pressure and region
6.5.1 Region and mean systolic and diastolic blood pressure
6.5.2 Region and high blood pressure
6.6 Blood pressure and social class
6.6.1 Systolic and diastolic blood pressure and social class
6.6.2 High blood pressure and social class
6.7 Blood pressure and behavioural characteristics
6.8 Comparison with the Scottish Heart Health Study
6.8.1 Comparison of systolic and diastolic blood pressure
6.8.2 Comparison of the prevalence of raised blood pressure
6.8.3 Discussion
6.9 Blood pressure in Scotland and England
6.9.1 Comparison of systolic and diastolic blood pressure
6.9.2 Comparison of high blood pressure
6.9.3 Discussion
Tables

7 OBSESITY
Wei Dong, Lualhati Bost, Wei Dong and Paula Primatesta
7.1 Introduction
7.2 Methods and definitions
7.2.1 Characteristics measured
7.2.2 Response to anthropometric measures
7.3 Anthropometric measures by age and sex
7.3.1 Height by age and sex
7.3.2 Weight by age and sex
7.3.3 Body mass index by age and sex
7.3.4 Waist-hip ratio by age and sex
7.3.5 Waist-hip ratio and body mass index
7.4 Comparison of Scotland and England
7.5 Comparison with the Scottish Heart Health Study
7.6 Regional variations
7.6.1 Region and mean body mass index
7.6.2 Region and raised body mass index
7.6.3 Region and waist-hip ratio
7.7 Social class variations
7.7.1 Social class and body mass index
7.7.2 Social class and obesity
7.7.3 Social class and waist-hip ratio
7.8 Obesity and behavioural factors
7.8.1 Body mass index and behavioural factors
7.8.2 Waist-hip ratio and behavioural factors
Tables

8 RESPIRATORY SYMPTOMS AND LUNG FUNCTIONS TESTS
Wei Dong Paola Primatesta and Sarah Walsh
8.1 Introduction
8.2 Respiratory symptoms
8.2.1 Methods and definitions
8.2.2 Respiratory symptoms by age and sex
8.2.3 Comparison with England
8.2.4 Respiratory symptoms and region
8.2.5 Respiratory symptoms and social class
8.2.6 Respiratory symptoms by smoking status
8.3. Lung function tests
8.3.1 Methods and definitions
8.3.2 Predicted values and relative lung function levels
8.3.3 Response rate to the lung function test
8.4 Lung function results
8.4.1 Mean FEV1, FVC and PEF by age and sex
8.4.2 Relative lung function levels by age and sex
8.4.3. Relative lung function levels by region
8.4.4 Relative lung function by social class
8.4.5 Relative lung function levels by cigarette smoking status
8.4.6 Relative lung function levels by respiratory symptoms
Tables

9 BLOOD ANALYTES
Part I: Lualhati Bost, Wei Dong and Paola Primatesta
Part II: Wei Dong, Lualhati Bost, Patrica E. Fitzsimmons and David I Thurnham
PART I: CHOLESTEROL, FIBRINOGEN, FERRITIN and HAEMAGLOBIN
9.1 Introduction

9.1.1 Response to measurements
9.1.2 Comparisons with the 1994 Health Survey for England and the 1984- 86Scottish Heart Health Study
9.2 Total and HDL-cholesterol
9.2.1 Introduction
9.2.2 Total cholesterol by age and sex
9.2.3 Region and total cholesterol
9.2.4 Social class and total cholesterol
9.2.5 Cholesterol monitoring
9.2.6 HDL and LDL-cholesterol by age and sex
9.2.7 Region and HDL-cholesterol
9.2.8 Social class and HDL-cholesterol
9.2.9 Total and HDL-cholesterol and lifestyle factors
9.2.10 Total and HDL-cholesterol and cardiovascular morbidity
9.3 Fibrinogen
9.3.1 Fibrinogen by age and sex
9.3.2 Region and fibrinogen
9.3.3 Social class and fibrinogen
9.3.4 Cigarette smoking and fibrinogen
9.4 Haemoglobin
9.4.1 Haemoglobin by age and sex
9.4.2 Region and haemoglobin
9.4.3 Social class and haemoglobin
9.5 Ferritin
9.5.1 Ferritin by age and sex
9.5.2 Region and ferritin
9.5.3 Social class and ferritin
9.5.4 Low haemoglobin and ferritin
PART II:VITAMINS AND CAROTENOIDS
9.6 Vitamins C, A, and E and cartenoids

9.6.1 Introduction
9.6.2 Data interpretation
9.6.3 Results by age and sex
9.6.4 Results by social class
9.6.5 Results by season
9.6.6 Results by other population chararistics
Tables

10 CARDIVASCULAR DISEASE AND ITS RISK FACTORS
Wei Dong Paola Primatesta and Sarah Walsh
10.1 Introduction
10.2 Methods and definition
10.2.1 Methods
10.2.2 Cardiovascular conditions
10.2.3 Summary measures of cardiovascular disease
10.2.4 Rose angina and possible myocardial infarction
10.2.5 Intermittent claudication
10.2.6 Interpretation
10.3 Prevalence by age and sex
10.3.1 Cardiovascular conditions
10.3.2 Summary measures of self-reported conditions
10.3.3 Rose angina and possible myocardial infarction
10.3.4 Intermittent claudication
10.3.5 Comparison with the 1984-86 Scottish Heart Health Study
10.3.6 Comparison with the Health Survey for England
10.4 Region and prevalence of cardiovascular disease
10.5 Social class and prevalence of cardiovascular disease
10.6 Risk factors in the total and sub-group population
10.6.1 Introduction
10.6.2 Definition of risk factors
10.6.3 Risk factors in the total population
10.6.4 Risk factors by cardiovascular conditions
Tables

11 GENERAL HEALTH, USE OF HEALTH SERVICES, PRESCRIBED MEDICINES AND DENTAL HEALTH
Andrew Shaw
11.1 Introduction
11.2 General health
11.2.1 Introduction
11.2.2 Perception of general health
11.2.3 Longstanding illness and disability
11.2.4 Acute sickness
11.3 Prevalence of gastroenteritis
11.4 Use of health services
11.4.1 Introduction
11.4.2 GP consultations
11.4.3 Inpatient stays in hospital
11.4.4 Outpatient visits to hospital
11.4.5 Blood pressure monitoring
11.4.6 Cholesterol monitoring
11.5 Prescribed medicines
11.5.1 Introduction
11.5.2 Medicines taken: number and category
11.5.3 Medicines and cardiovascular disease
11.5.4 Use of contraceptive pills and injections
11.5.5 Hormone replacement therapy
11.6 Dental health
11.6.1 Introduction
11.6.2 Prevalence of false teeth
11.6.3 Type of toothpaste
11.6.4 Frequency of brushing teeth
11.6.5 Frequency of visiting a dentist
Tables

12 PSYCHOSOCIAL WELL-BEING
Susan Purdon and Bob Erens
12.1 Introduction
12.2 Age and sex variations
12.3 Comparing Scotland with England
12.4 Regional and area type variations
12.5 Variations by social class, activity status and marital status
12.5.1 Social class
12.5.2 Economic activity status
12.5.3 Marital status
12.6 Relationship with drinking, smoking and physical activity
12.6.1 Drinking
12.6.2 Smoking
12.6.3 Physical activity
12.7 Relationship with self-reported health measures
12.8 Multivariate analysis of the GHQ12 scores
Tables

13 ACCIDENTS
Susan Purdon
13.1 Introduction and background
13.1.1 Accident classification and recall period
13.1.2 Coverage of accidents
13.1.3 Derivation of accident rates and weighting to compensate for selection bias
13.2 The incidence of accidents and their characteristics
13.2.1 The incidence of accidents by age and sex
13.2.2 Estimated annual rates by age and sex
13.2.3 Comparisons with England
13.2.4 Cause of accident
13.2.5 Location of accidents
13.2.6 Type of injury
13.2.7 Source of help or advice about accidents
13.2.8 Prevention of Accidents
13.3 Prevention of accidents
13.3.1 Accidents at work by age and sex
13.3.2 Causes of accidents at work
13.3.3 Accidents at work by SIC group
13.3.4 Location of work-based accidents
13.3.5 Time off work
13.4 Accidents outside of work
13.4.1 Accident rates for non-work accidents by age and sex
13.4.2 Accidents outside of work and sports participation
13.5 Accidents and social class
13.6 Regional variations in accident rates
Tables

Scotland's Health:
Scottish Health Survey 1995

A Survey carried out on behalf of The Scottish Office Department of Health
Edited by Wei Dong and Bob Erins

VOLUME 2

This document is also available in pdf format: download Volume 2 (1.97mb)

CONTENTS

1 SURVEY METHODOLOGY AND RESPONSE
Bob Erens and Wei Dong
1.1 Survey design and procedures
1.2 Survey coverage
1.3 Ethical clearance
1.4 Sample selection
1.4.1 Sample coverage
1.4.2 Sample design and selection
1.4.3 Deadwood
1.4.4 Selecting households
1.4.5 Selection within the household
1.5 Survey Response
1.5.1 Response to the interview
1.5.2. Response to nurse visit
1.5.3 Response to the blood sample
1.5.4 Response by sex
1.5.5 Response by age
1.5.6 Net response rates
1.5.7 Response by Carstairs index
1.6 Weighting
1.6.1 Weight 1
1.6.2 Weight 2
1.6.3 Weight 3
1.6.4 Weight 4
1.7 Comparison of the responding sample with the general population
1.8 The accuracy of the survey results
1.8.1 Sampling error
1.8.2 Bias
1.8.3 Simple random sampling formulae
1.8.4 Estimating errors in complex sample designs: design factors Allowing for sampling error when using the data
1.9 Social class variables
Tables

2 BLOOD ANALYTES, QUALITY CONTROL AND QUALITY ASSESSMENT
Wei Dong, etc
2.1 Introduction
2.1.1 Samples collected in the 9 ml plain tube for serum
2.1.2 Samples collected in the 2 ml EDTA tube
2.1.3 Samples collected in the 4 ml citrate tube
2.2 Biochemistry
2.2.1 Total cholesterol
2.2.2 HDL-cholesterol
2.2.3 Gamma gt
2.2.4 Ferritin
2.3 Cotinine
2.4 Haematology
2.4.1 Haemoglobin
2.4.2 Fibrinogen
2.5 Quality control
2.5.1 Internal quality control
2.5.2 External quality assessment2.6 Quality assessment results
2.6.1 Total cholesterol, HDL-cholesterol, gamma gt and ferritin
2.6.2 Cotinine
2.6.3 Haemoglobin and fibrinogen
2.6.4 Conclusions
2.7 Reference intervals
2.8 Maintenance
2.9 Vitamins C, A and E, and carotenoids
2.9.1 Sampling, storage and transportation
2.9.2 Assay methods
2.9.3 Quality control and assessment for vitamin C
2.9.4 Quality control and assessment for vitamins A and E and carotenoids
Tables

APPENDICES
A Fieldwork documents
B Measurement protocols
C Health boards
D Measurement error experiments
E Glossary