Scottish Health Survey 2015: summary report

The Scottish Health Survey: 2015 edition: Summary

INTRODUCTION

The Scottish Health Survey (SHeS) is commissioned by the Scottish Government Health Directorates to provide reliable information on the health, and factors related to health, of people living in Scotland that cannot be obtained from other sources. The series aims to:

• estimate the occurrence of particular health conditions
• estimate the prevalence of certain risk factors associated with health
• look at differences between regions and between subgroups of the population
• monitor trends in the population's health over time
• make a major contribution to monitoring progress towards health targets

Key findings from the 2015 survey are presented here alongside trends, some of which extend back two decades. Further discussion of the findings and full documentation of the survey's methods and questionnaire can be found in the 2015 annual report available from the Scottish Health Survey website: www.gov.scot/scottishhealthsurvey. The report is accompanied by an extensive set of web tables for 2015 and updated trends for key measures.

ABOUT THE SURVEY

The sample

SHeS has been designed to provide data on the health of adults (aged 16 and over) and children (aged 0-15) living in private households in Scotland annually. In 2015, 5,000 adults and 1,421 children took part in the survey. Representative data for adults in all NHS Health Board for the 2012-2015 period are also available.

The interview

The principal focus of the survey is cardiovascular disease (CVD) and related risk factors. Some questions and topics are asked annually while others vary from year to year. In addition to the questionnaire, height and weight measurements are collected from everyone aged 2 and over. Each year a sub-sample of adults also complete a biological module which includes blood pressure and waist circumference measurements along with urine and saliva sample collection. Participants are also asked for permission to link survey responses to their administrative NHS health records. Key topics included in the 2015 survey were:

MENTAL HEALTH AND WELLBEING

Overall, average levels of wellbeing for adults have changed little since 2008, with WEMWBS scores ranging between 49.7 and 50.0 over this period (49.9 in 2015).

Wellbeing among 13 to 15 year olds decreased with age for all children (52.3 for those aged 13 compared with 50.0 for those aged 15).

The average score for 13 to 15 year old boys (52.0) was significantly higher than for girls of the same age (49.9).

Levels of wellbeing were significantly lower for women aged 16-24 than for other age groups of men and women

The proportion of women with two or more symptoms of anxiety (15%) was higher than for men (9%).

The prevalence of those with two or more symptoms of depression in 2014/2015 was 10%, with this being a similar level to that seen in recent survey periods.

Those in the most deprived quintile were more likely than those in the least deprived quintile in 2012-2015 to have two or more symptoms of anxiety (15% compared with 7%) and two or more symptoms of depression (16% compared to 4%).

Prevalence of two or more symptoms of anxiety increased between 2012/2013 and 2014/2015

Levels of self-reported self-harm were highest among those aged 16-24 in 2012-2015 (18%) and, particularly, women in that age group (23%).

The proportion of adults who have ever attempted suicide was 6% in 2014/2015.

Prevalence of having ever attempted suicide was much higher in the most deprived areas (10%) than in the three least deprived areas (3-4%) in 2012-2015.

Levels of self-reported self-harm increased between 2008/2009 and 2014/2015

The proportion of children aged 4-12 who had a borderline or abnormal total difficulties score decreased from 2003 (17%) to 2014/2015 (14%).

Children in the most deprived areas were more likely to have a borderline or abnormal total difficulties score (22%) than those in the least (6%).

Prevalence of borderline or abnormal total difficulties scores higher for boys than girls in 2014/2015

GENERAL HEALTH AND MULTIPLE CONDITIONS

The proportion of adults reporting to be in 'very good' or 'good' health declined with age from 88% of those aged 16-24 to 55% of those aged 75 and over.

Levels of 'very good' health for children ranged between 65% and 73% for those aged 0-11 but declined from 63% for those aged 12-13 to 52% for those aged 14-15.

Prevalence of long-term health conditions among adults, 2012-2015

Prevalence of multiple long-term conditions much higher among older adults, 2012-2015

Half (50%) of adults had at least one long-term condition in 2012-2015. These were split equally between 25% with only one condition and 25% with more than one condition.

Just under a fifth (18%) of those in the least deprived areas had multiple conditions compared with around a third (34%) of those living in the most deprived areas.

In 2012-2015, 9% of adults had both a physical health condition and symptoms of mental disorder.

Adults with one or more physical condition were twice as likely to exhibit symptoms of a mental disorder compared with those with no physical conditions (22% and 11% respectively).

In the most deprived areas, 29% of those with a physical condition also had a possible mental disorder, compared with 14% in the least deprived areas.

Adults with physical conditions were twice as likely to exhibit symptoms of a mental disorder than those without, 2012-2015

DENTAL HEALTH

Proportion of adults with at least some natural teeth increased

Older women less likely to have natural teeth than men of the same age

The proportion of men and women with some natural teeth increased between 2008 and 2015 (from 91% to 94% for men and from 86% to 91% for women).

Around six in ten (61%) adults aged 75 and over had some natural teeth compared with almost all (97-100%) of those aged 16 to 54.

Almost all (97%) adults with some natural teeth say they brush them daily with fluoride toothpaste, while 40% reported using a mouth rinse.

Women more likely then men to use dental floss or restrict sugar to help improve their dental health, 2013/2015

ALCOHOL

The proportion of adults drinking above three units (women) and four units (men) on their heaviest drinking day fell from 41% in 2003 to 36% in 2015.

Drinking above the recommended maximum of 14 units a week down since 2003

A similar pattern was seen for binge drinking (drinking above eight units (men) or six units (women) on their heaviest drinking day) which decreased from 24% in 2003 to 20% in 2015.

Non-drinking among adults increased significantly from 11% in 2003 to 16% in 2013 and has remained at that level since.

The mean number of units per week among drinkers declined from 16.1 units in 2003 to 12.2 units in 2013 and remained at a similar level in 2015 (12.9 units).

Male drinkers consume around twice as much a week on average as female drinkers

Drinking more than 14 units a week was reported by 36% of men and 17% of women.

Drinking above the recommended maximum amount declined with age-standardised income for both men (46% in the highest income group to 25-26% in the bottom two groups) and women (equivalent figures 24% and 11%).

Drinking more than 14 units a week was more common in the higher income groups

Using AUDIT scores, in 2014/2015, 82% of adults drank at low risk levels or were abstinent, 15% drank at hazardous levels, 2% at harmful levels and 1% had possible alcohol dependency.

Prevalence of drinking at hazardous or harmful levels, or having a possible alcohol dependency, decreased with age from 35% of those aged 16-24 to 2% of those aged 75 and over.

SMOKING

Self-reported smoking levels for adults have decreased significantly from 28% in 2003 to 21% in 2015.

When adjusted for cotinine levels, prevalence among all adults for 2014/2015 was 25%.

A significantly higher mean number of cigarettes were smoked by male smokers (13.9 per day) than female smokers (11.3).

In 2015, current e-cigarette usage was at comparable levels for men (6%) and women (7%), but higher for those aged 25-64 (7-9%) than other age groups.

Younger adults were much more likely to have ever tried e-cigarettes than older ones (22-26% of those aged 16-34, compared with 4-10% of those aged 65 and over).

Levels of e-cigarette usage increased between 2014 and 2015

There was a significant decrease from 2014 to 2015 in the proportion of children who were exposed to second-hand smoke in the home (11% to 6%).

There was also a significant decrease from 2014 to 2015 in the proportion of children who lived in accommodation where someone smoked inside (16% to 12%).

The proportion of non-smokers aged 16 and over who said they'd been exposed to second-hand smoke in their own or other people's homes declined from 25% in 2003 to 12% in 2015 and was significantly higher in 2015 for women (14%) than men (11%).

Exposure of children to second-hand smoke in the home fell between 2014 and 2015

DIET

Adults consumed a mean of 3.1 portions of fruit and vegetables a day in 2015 (3.3 for women compared with 3.0 for men), the same amount as in 2003.

Mean consumption of fruit and vegetables was lowest for those aged 16-24 (2.6 portions) and highest for those aged 55-74 (3.4 portions).

The proportion of children aged 2-15 consuming no fruit and vegetables on the previous day in 2015 (7%) was significantly lower than that in 2012 and 2013 (10-11%).

In total, 43% of children whose parents ate no fruit and vegetables on the previous day also ate none themselves, compared with just 2% of children whose parents met the 5-a-day recommendations.

Mean levels of sodium (Na), potassium (K) and creatinine (Cre) found in spot urine samples were all higher for men than women in 2014/2015, although mean Na/Cre and K/Cre ratios were higher for women.

Mean levels of urinary sodium and creatinine both decreased with age, while mean K/Cre ratios increased with age.

In 2015, 27% of adults and 19% of children consumed vitamin or mineral supplements, including 14% of adults and 16% of children who took supplements containing vitamin D.

More women than men took supplements; 30% of women and 24% of men took any supplement, and 16% of women and 12% of men took vitamin D.

Supplement use was highest among older adults (33-34% of those aged 65 or over), while consumption of vitamin D was highest among those aged 4-5 (25%).

PHYSICAL ACTIVITY

Just under two-thirds (63%) of adults in 2015 met the guideline for Moderate or Vigorous Physical Activity (MVPA), a similar level to those seen since 2012 (62-64%).

Just over a quarter (26%) of adults met both the MVPA and muscle strengthening guidelines, with men being significantly more likely to do so than women (29% compared with 24%).

The proportion of adults meeting both guidelines decreased with age, from 42% of those aged 16-24 to 7% of those aged 75 and over.

Men were more likely than women to meet the Moderate or Vigorous Physical Activity guidelines

Average time spent sedentary (adults) excluding time at work

In 2015, just under three-quarters (73%) of children met the guideline on physical activity (including school-based activity), a similar proportion to that seen in 2008 (71%).

The proportion of children meeting the guideline in 2012-2015 was significantly higher if their mother was active at the recommended level than if their mother was not. There was no significant difference according to whether their father met the recommendations or not.

Around two-thirds (68%) of children had participated in sport in the prior week, a similar level to that seen in 2014 (67%) but lower than in 2008 (71%).

Sports participation levels were comparable for boys (69%) and girls (66%)

More boys than girls met the physical activity guidelines

Average time spend sedentary (children) excluding time at nursery/school

OBESITY

In 2015, two-thirds of adults (65%) were overweight, including 29% who were obese, figures which have changed little since 2008.

Levels of overweight tend to increase with age

Waist circumferences were higher on average in 2014/2015 than in 2003 for both men (98.2 cm in 2014/2015 and 95.3cm in 2003) and women (89.5 cm in 2014/2015, 86.3 cm in 2003).

The proportion of men with a raised waist circumference (greater than 102cm) increased from 28% in 2003 to 37% in 2014/2015. The proportion of women with a raised waist circumference (greater than 88cm) increased from 39% to 52% over the same period.

Around two-thirds of all women (66%) and three in five men (59%) had an increased risk of disease based on their BMI and waist circumference.

The proportion of boys of healthy weight (73% in 2015) has increased year on year since 2011 (63%) and is comparable to the level seen in 1998 (70%).

The proportion of girls who were a healthy weight in 2015 was 70%, a level which has remained relatively steady since 1998.

In 2015, 15% of boys and 14% of girls were at risk of obesity, figures which were identical to those in 1998.

Compared with children with parents who are not overweight, children with an obese parent were significantly more likely to be at risk of overweight, including obesity (40% compared with 22%), or at risk of obesity (23% compared with 11%).

The proportion of boys of healthy weight has increased every year since 2011

The proportion of boys of healthy weight has increased every year since 2011

CARDIOVASCULAR CONDITIONS AND DIABETES

Fifteen percent of adults aged 16 and over reported ever having been diagnosed with any CVD condition by a doctor in 2015 (similar to the levels of 14-16% from 2003 onwards).

Among adults aged 16 and over, 19% had any CVD condition or diabetes, 6% had doctor-diagnosed diabetes and 8% had ischaemic heart disease (IHD) or stroke.

Doctor-diagnosed diabetes had increased significantly from 2003 to 2011 (4% to 6%) and has remained at this level since.

From 2003 to 2015, figures for any CVD condition (14-16%) and IHD (6-7%) were relatively static.

Prevalence levels of IHD or stroke were significantly higher for men (9%) than women (6%).

In 2014/2015, 29% of adults had survey-defined hypertension, significantly higher than doctor-diagnosed levels (25%).

The level of survey-defined hypertension has not changed from 2012/2013 (also 29%).

Prevalence of survey-defined hypertension was higher for men (31%) than women (27%) and rose from 3% of those aged 16-24 to 71% of those aged 75 and over.

Diagnosis of hypertension, 2014/2015

INJURIES/ACCIDENTS

Just over a tenth (11%) of adults aged 16 and over in 2013/2015 had an accident in the previous twelve months, a comparable prevalence to that in 2009/2011 (11%) and 2003 (12%).

Prevalence of adults reporting an accident was similar for men (12%) and women (11%), with higher prevalence for those aged 16-24 (16%) than those aged 25 and over (9-12%).

The proportion of children aged 0-15 having had an accident in the previous twelve months was similar in 2003 (16%), 2009/2011 (14%) and 2013/2015 (15%).

The proportion of boys (17%) having had an accident in the last twelve months in 2013/2015 was significantly higher than the proportion of girls (12%).

Prevalence of accidents tended to increase with age, from 9% among those aged 0-1 to 20-22% among those aged 12-15.

Main causes of accidents, 2013/2015

The main cause of accidents for all respondents (aged 0 and above) was a fall, slip or trip (57% of adults and 53% of children who had had an accident in the last 12 months), followed by sports or recreational accidents (12% of adults and 21% of children).

Falls, slips or trips were more frequently cited by women than men (68% compared with 46%), while sports or recreational activities (6% compared with 18%) and accidents using a tool, implement or equipment (2% compared with 12%) were less frequently mentioned by women than men.