Table Of Content

NDA Health Related Behaviour An Epidemiological Overview HEwHAE LTH orm NATION CENTRAL HEALTH MONITORING UNIT EPIDEMIOLOGICAL OVERVIEW SERIES London: HMSO Commissioned by Central Health Monitoring Unit through the Office of Population Censuses and Surveys © Crown copyright 1996 Applications for reproduction should be made to HMSO Copyright Unit, Norwich NR3 1PD ISBN 0 11 321976 8 FOREWORD The Health of the Nation White Paper published in 1992 emphasised the fact that an individual’s health is dependent, at least in part, on their own chosen lifestyle. This underlines the key role of behaviour and I believe that an understanding of health related behaviours and the factors which influence them (ie “behavioural epidemiology”) is one of the most important public health issues for the future. It is for this reason that the Department of Health (DH) has itself embarked on an initiative in this area which will be taken forward in collaboration between its Health Promotion and Research and Development Divisions. An essential preliminary to this process is reviewing existing knowledge. For this reason the Department of Health’s Central Health Monitoring Unit (CHMU) has commissioned the present overview through the Office of Population Censuses and Surveys. It is the latest in a series produced by CHMU and it describes how behaviours related to the 5 Health of the Nation key areas are distributed across time, place and person. This, and other such reviews which have also been commissioned, will pinpoint specific sub-groups who need to be targeted for health promotion interventions (eg the young), identify gaps in information, and generate hypotheses which can then be tested through further work. The overview is complementary to a number of other projects including the Health Education Authority’s Health Education Monitoring Surveyl, and DH’s Health Survey for England2. I believe that this overview, and the others mentioned above, represent a major contribution to public health policy and will, therefore, be of interest to all those centrally and at a local level who are concerned with health promotion and the prevention of disease. Sir Kenneth Calman Chief Medical Officer 'Bridgwood A, Malbon G, Lader D, Matheson J. Health in England 1995: What people know, what people think, what people do. London: HMSO, 1996. 2Colhoun H, Prescott Clarke P (eds.) Wei Dong, Hedges B, Lampe F, Taylor A (principal contributors). Health Survey for England 1994. London: HMSO, 1996. . ‘i 7 1 3 r \ pan 5 a o Lite s om e= ecatrer wie [a Se fous Ge Ta aus am mR IC kein wife mle yd a _-_ : : ’ 2 aie.i on Re: ‘i. aa oe Wael Se ae ACKNOWLEDGEMENTS This overview was commissioned by the Department of Health (DH) through Jil Matheson and Karen Dunnell of the Office of Population Censuses and Surveys (OPCS). The overview was produced by external consultants, Alison Walker and Elizabeth Hoinville under the supervision of Sunjai Gupta of DH’s Central Health Monitoring Unit (CHMU). It was carried out in consultation with other parts of DH (including other members of CHMU, Androulla Michael of Health Promotion Division, Liza Catan of Research and Development Division, and members of Statistics Division and the relevant Policy Divisions). The work has been carried out with the assistance of organisations outside DH including OPCS, the Health Education Authority (HEA), the Ministry of Agriculture, Fisheries and Food (MAFF), the Department of Trade and Industry (DTI), and also selected individual experts including Michael Farrell at the Maudsley Hospital. » 7 CONTENTS Page STUTACVERFENR” Corcnonpcsinceone quae ase Bench Ringe SCE SSC SE RONG TeP ERE aS EEE LAME Ent | ae 2 (LORS COLD TINVBAERG SO ela ta eRe oe aaree 28 Ai ems Red ere ad Se er ee 5 HEISE (OL TPG Boonton ent aeds ek atari hie ott mie me Rene Re SOOO ee a a 8 |T CO Ting nts oe okWe he oh con RU RIS sce CoRR CGN Cr eere erie RE eR PETES oe2p Renee hE te 9 ieatnenclaved behaviours mmcluded: in this OVELVIEW ..4...0.8.s.scssescnsoescewdsccetenessSsoeee 10 An overview of behaviour within socio-demographic Sroups .........ccc:::cccccccceeeeeeees Ils “SUEDTIEEA TRENa es vg hat Oc oar apm Ue areU n Oh Ca. Arn ete A 18 INIG IUG So siresn com pa cetionle eame eahn7 ee oe e 21 THE VARIATION IN HEALTH RELATED BEHAVIOUR 0) en ee en ed bene ie ie ee an conha ics Sau abteve red baslaadekeud 22 Alcohol consumption ................ na Mos a nthe tle a 35 EyeG a MRC EEUU Vietet ere cea eet ra snr ac eae ea Bn eae ee Neontaet faa eeateouawacwaesenet 47 GAL ELLO aS 111O KI Oe ree ener ee arnt et tae RN rien eae es oe I can Sarenmeneh Reteanosaoeeemanaebies DS Pyeh e CINLIOEOeCo INCC l pn a arama Manatee ese ese 6 fate secieaaatsn ss Unepehsnasseeescacseoucoseaepcnsemice 70 ERoCs V C BOUIIEGRIOLSC M Meer meena Meri rgatcedat sos tsob candtereurtnnd nance seer ceesaanemeatusustecwanss 76 STINTS GTSS ieg assed arini h ecah ly ctdaet Sopa ae nets lee ee oheas SERA re os eee Re ee 82 Ne) ERS ACU Ger Re ree eee Menem an Seccend ce. uert oc veonaraneisnamesceesse 88 MEU Sea iSUSee een eee ee ee tes has atte ect es useisatek er tiene os. sree eaatnemaeehesteee aetaatomts 102 PSCCICOMUS sores ears corecetsrcacwrscsearacasaz¥asaeesretssde¥duistesc2-psiostsrsaeeocoweueventoeancarratncacanenrare 105 Data sources and further research including matrix Of SOUFLCES ............:ccceeseeees 119 LCCC S ee ee ee ote eee te et Neo eo ace nes teat deb thats ssungnwalehaenasuleaeacuacadany 121 PAP PeNCix sR CQIONA leta Diese. eereesstae. eneesasers avadess dectnetentan tusee- nw accrenessenieeccr once sate 1) CST Aggy sc an ee Ran ch Perr ree core p27 SUMMARY This overview brings together in one publication up-to-date information on health related behaviour. It concentrates on behaviours relevant to the five Health of the Nation key areas, presenting data for England as a whole. An appendix gives some summary figures for regions. Diet * The percentage of food energy obtained from total fat and saturated fatty acids showed almost no variation with any of the socio-demographic factors presented Dietary behaviour varied with most socio-demographic factors. For example 34% of people aged 75 or more reported using butter or hard margarine, compared with 18% of 16-24 year olds 44°% of women in social classes IV & V reported using whole milk, compared with 27% in social classes I & II Alcohol Consumption * 26% of men and 12% of women in England drank more than the recommended sensible level of alcohol 39% of divorced and separated men drank over the sensible level compared with 24% of married men 1 in 7 road accident fatalities occurred in accidents where the driver had illegal blood alcohol levels Physical activity ** More men than women were regularly physically active * 1 in 4 young women and | in 6 young men took no regular physical activity * Among unemployed men, 34% took no regular physical activity compared with 22% of men in work Similar proportions of men and women were sedentary Smoking * 29% of men and 27% of women were smokers * From the age of 14, girls were more likely to smoke than boys and there was no evidence of a decline in girls smoking Prevalence of smoking was higher among people in the manual social classes, the unemployed, people who were widowed, separated or divorced, and Bangladeshi men