Scottish Health Survey: health board analysis 2008-11
The data for Health Board comparisons is from the combined 2008-2011 Scottish Health Surveys.
Introduction
The data for Health Board comparisons is from the combined 2008-2011 Scottish Health Surveys. In 2008, the survey was designed to allow analysis at Health Board level based on four years of combined data.
This document quotes Scotland level figures to provide context for the Health Board figures but readers should note that as these are based on the combined 2008-2011 datasets, the Scotland figures may not match those in volume 1 of the report which are based on 2011.
The data tables and interactive maps which accompany this commentary show 95% confidence intervals for all estimates. Care should be taken when interpreting the results and the confidence intervals should be considered before drawing conclusions. For example, if the confidence intervals for the two figures being compared overlap, the difference is not statistically significant1 and may be due to sampling variation.
The commentary below takes the confidence intervals into account and therefore in some cases a Health Board’s figure may not be mentioned, even if it is the lowest (or highest), if it is not a statistically significant difference from the national average.
General Health and Mental Wellbeing
Self Assessed Health
Around three quarters of adults (76%) in Scotland described their health as being ‘good’ or ‘very good’. The proportion was slightly higher among men (77%) than women (75%).
The proportion was significantly higher than the national average in Orkney (83%), Shetland (81%), Grampian (80%), Tayside, Lothian and Borders (79%). The proportion was significantly lower than the national average in Greater Glasgow & Clyde (72%).
Long-term Conditions
42% of adults in Scotland had a limiting or non-limiting long-term condition. The proportion was higher among women (44%) than men (40%). There was a significantly higher proportion than the national average in Orkney (50%), and a significantly lower proportion in Grampian and Lothian (39%).
27% of adults had a limiting long-term condition (29% of women, 24% of men). Greater Glasgow & Clyde had a significantly higher proportion of adults with a limiting long-term condition (29%) than the national average. Grampian (23%) and Lothian (24%) had significantly lower than average prevalence.
Mental Wellbeing
Mental wellbeing is measured using WEMWBS, where a higher score indicates more positive wellbeing. The mean score for all adults was 49.9, and was slightly higher for men than women (50.1 and 49.7). The average score was significantly higher than the national average in Borders (50.8), Highland, and Orkney (50.7). Additionally, Ayrshire & Arran (49.2), Lanarkshire (49.3) and Greater Glasgow & Clyde (49.5) all had mean scores significantly below the national average.
GHQ-12
15% of adults in Scotland scored 4 or more on the General Health Questionnaire (GHQ12), indicative of a potential psychiatric disorder. There were significantly more women (17%) than men (12%) with high GHQ scores.
Those in Orkney (9%), Shetland (10%), Dumfries & Galloway, and Western Isles (11%) were significantly less likely to have a high GHQ score, whereas those in Greater Glasgow & Clyde were significantly more likely to have a high GHQ score (18%) than the national average.
Life Satisfaction
Life satisfaction was measured on a scale of 0 - 10 where higher scores signified greater life satisfaction. The average score among all adults in Scotland was 7.6 with no difference between men and women. The highest life satisfaction score was recorded in Shetland (8.0), with Borders, Grampian, Highland, and Western Isles also having a significantly higher score than the national average (7.8). The lowest life satisfaction score was recorded in Greater Glasgow & Clyde (7.4).
Provision of informal care
12% of adults in Scotland provided regular informal care, with significantly more women than men providing care (14% and 10%). The highest proportions of carers were seen in Western Isles and Highland (15%) though these were not significantly different from the national average.
Dental Health
Percentage with natural teeth
11% of adults in Scotland had no natural teeth. This proportion was higher among women (13%) than men (9%). Orkney (17%) had the highest prevalence of no natural teeth followed by Ayrshire & Arran (15%). There was a significantly lower proportion of adults with no natural teeth in Lothian (8%) and Highland (9%).
Alcohol
Hazardous and harmful drinking
23% of adults in Scotland consumed a hazardous or harmful amount of alcohol (>21 units for men and >14 units for women) in an average week with men being significantly more likely to do so than women (27% compared to 19%). Lothian was the only health board with a prevalence significantly higher than the national average (25%) whilst Western Isles had a prevalence significantly lower than the national average (15%).
Mean units per week
Average weekly consumption was 12.0 units (16.6 for men, 7.8 for women). Western Isles was the only health board with mean consumption significantly lower than the national average (8.5 units). Lothian had the highest mean consumption of all boards (12.7) but this wasn’t significantly higher than the national average.
Units consumed on the heaviest drinking day in the previous week
38% of adults (43% of men and 34% of women) drank more than the recommended regular daily limit (more than 4 units for men, 3 units for women) on their heaviest drinking day in the previous week. Lanarkshire had the highest prevalence of exceeding daily limits (43%) and Western Isles (26%) and Highland (34%) had significantly lower prevalence than the national average.
Across Scotland 21% of adults consumed more than twice the recommended daily limit on their heaviest drinking day in the previous week (more than 8 units for men, 6 units for women). Western Isles (13%), Dumfries & Galloway (15%) and Highland (17%) were the least likely to have consumed this level of alcohol whereas Lanarkshire had a significantly higher prevalence of drinking at twice the daily limits than the national average (25%).
Adherence to weekly and daily drinking advice
Across Scotland 43% of adults drank outwith the government guidelines. Men were more likely than women to do so (49% compared to 39%). Western Isles (29%) and Orkney (39%) had a significantly lower proportion of people drinking outwith the guidelines than the national average. Lanarkshire had the highest proportion, (46%) and this was significantly higher than the national average.
Frequency of Drinking
On average, adults in Scotland consumed alcohol on 2.7 days each week, and 12% drank on more than 5 days a week. Government advice is to have at least 2 alcohol free days per week. These figures were higher among men (2.9 days; 15%) than women (2.5 days; 10%). A significantly higher proportion of adults drank on more than 5 days in Borders (17%), Highland and Forth Valley (both 16%). Adults in Lanarkshire (9%) and Greater Glasgow & Clyde (10%) were the least likely to drink on more than 5 days a week.
Potential Problem Drinking Indicators (CAGE)
Across Scotland as a whole 12% of adults who drink scored on 2 or more indicators of the CAGE questionnaire, indicating potential problem drinking. Men (14%) were significantly more likely to do so than women (9%). Drinkers in Greater Glasgow & Clyde were significantly more likely to be problem drinkers (14%) than the national average whereas drinkers in Orkney (7%), Highland (8%) and Borders (9%) were significantly less likely to be problem drinkers.
Smoking
Prevalence of Smoking
25% of adults in Scotland were current smokers. The proportion was slightly higher among men than women (26% compared to 24%). A significantly lower proportion of adults than the national average smoked in Orkney (18%), Shetland (19%), and Grampian (21%). A significantly higher proportion were current smokers in Greater Glasgow & Clyde (27%).
Average cigarette consumption
The mean cigarette consumption per day among current smokers in Scotland was 14.2. Average consumption was higher among men than women (15.0 compared to 13.4). Average daily consumption was highest in Fife (15.2) and was significantly higher than the national average. Although Shetland, Borders, and Highland (all 13.1) and Orkney (13.2), had the lowest mean consumption figures, Lothian (13.3) was the only board which was significantly lower than the national average.
Exposure to second-hand smoke
17% of non-smoking adults in Scotland had been exposed to second-hand smoke in their own or somebody else’s home. Those in Lanarkshire (23%) were most likely to be exposed to second-hand smoke – a significantly higher proportion than the national average. Shetland, Borders, Dumfries & Galloway, (all 10%), Highland, Orkney (both 12%), and Grampian (14%) all had a significantly lower proportion than the national average.
7% of non-smokers had been exposed to second-hand smoke in public places. Non-smokers in Shetland (3%), Orkney, Highland, Western Isles, Dumfries & Galloway and Borders (all 4%) were all significantly less likely to be exposed to second-hand smoke in public places than the national average.
Diet
Fruit and Vegetable Consumption
22% of adults in Scotland consumed the recommended 5 portions or more of fruit and vegetables per day. A higher proportion of women than men meet the recommendations (24% compared to 21%). Adults in Orkney (28%), Lothian and Highland (both 26%) were significantly more likely to meet the recommendations than the national average. A significantly lower proportion of adults consumed 5 portions or more per day in Lanarkshire (17%), Ayrshire & Arran (19%) and Greater Glasgow & Clyde (20%).
Physical Activity
Percentage meeting physical activity recommendations
38% of adults in Scotland met the recommendation to do at least 30 minutes of moderate intensity physical activity on most days of the week. The proportion was higher among men than women (45% compared to 33%). Adults in Lothian (41%) were significantly more likely to meet the recommendations than the national average while those in Lanarkshire (35%) were the least likely to meet the recommendations.
Percentage taking part in sport or exercise
44% of adults in Scotland participated in some form of sport or exercise within the four weeks prior to being surveyed. The proportion was higher among men than women (47% compared with 42%). There was a significantly higher participation rate than the national average in Lothian (51%), and a significantly lower rate in Western Isles (33%), Orkney (37%), Shetland (38%) and Ayrshire & Arran (39%).
Obesity
Prevalence of overweight including obesity
The proportion of adults in Scotland classed as overweight or obese (BMI of 25 or over) was 64.6%. Significantly more men than women were overweight or obese (68.2% compared to 61.1%). There was a significantly higher prevalence than the national average in Orkney (72.6%), Western Isles (72.0%), Shetland (71.1%), Highland (70.2%), and Dumfries & Galloway (69.5%). The proportion of adults who were overweight or obese was significantly lower than the national average in Lothian (61.1%) and Greater Glasgow & Clyde (61.6%).
Prevalence of obesity
27.4% of adults in Scotland had a Body Mass Index (BMI) of 30 or over, and were therefore classed as obese. There was little difference between the percentage of men and women who were obese (27.0% and 27.8% respectively). The prevalence of obesity was significantly higher than the national average in Western Isles (35.3%), Shetland (33.2%), Orkney (32.9%) and Fife (30.5%). The prevalence of obesity was lowest in Forth Valley (24.8%) but this was not significantly different from the national average.
Health Conditions
Cardiovascular Disease
14.9% of adults in Scotland had been diagnosed with a cardiovascular disease (CVD). The prevalence was higher among men than women (15.6% compared to 14.2%). Prevalence was highest in Dumfries & Galloway, Western Isles, and Borders (all around 17%) although none of these was significantly higher than the national average. The lowest rates of CVD were seen in Shetland (12.4%) and Grampian (13.4%) although only the Grampian figure was significantly lower than the national average.
Chronic Obstructive Pulmonary Disease
3.8% of adults in Scotland had been diagnosed with chronic obstructive pulmonary disease (COPD). There was a significantly higher prevalence among women than men (4.2% compared to 3.3%). The proportion of adults diagnosed with COPD was significantly lower than the national average in Western Isles (2.2%), Shetland (2.3%), Borders, and Grampian (both 2.6%). Greater Glasgow & Clyde had the highest prevalence of COPD (4.4%) but this was not significantly different from the national average.
Diabetes
5.2% of adults in Scotland had been diagnosed with diabetes. There was a significantly higher prevalence among men than women (6.0% compared to 4.5%). The proportion of adults with diabetes in each health board varied between 4%-6% with none significantly different to the national average.
Healthcare Use
GP Consultations
The average number of GP consultations per year among adults in Scotland was 5.9. Women made significantly more visits to their GP than men (7.0 compared to 4.6). The average number of consultations was significantly lower than across Scotland as a whole in Ayrshire & Arran (5.1), and significantly higher in Tayside (7.0).
Hospital Use
37% of adults in Scotland had attended hospital as an outpatient during the 12 months prior to being surveyed. The figures were significantly higher for women than men (40% compared to 34%). A significantly lower proportion attended as outpatients in Orkney (30%) and Highland (34%) than the national average. The highest proportion was found in Dumfries & Galloway (41%) although this wasn’t significantly different from the national average.
11% of adults had attended hospital as an inpatient during the 12 months prior to being surveyed. Women were significantly more likely than men to be inpatients (13% compared to 9%). A significantly lower proportion of adults attended as inpatients in Lothian (9%). Several health boards had a higher than average rate of attendance for all adults, but the only one which was significantly greater than the national average was Greater Glasgow & Clyde (12%).
1 In some cases, if the extent of the overlap is very small, the difference between the two figures may be significant As a general rule, however, overlapping confidence intervals suggest that there is no real difference between the two estimates.
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