The Scottish Health Survey 2022 – volume 2: technical report
This publication presents information on the methodology and fieldwork from the Scottish Health Survey 2022.
Footnotes
1. The 1995 and 1998 surveys were carried out by the Joint Health Surveys Unit of the National Centre for Social Research (NatCen Social Research) and the Department of Epidemiology and Public Health University College London Medical School (UCL). The MRC Social and Public Health Sciences Unit at the University of Glasgow (MRC SPHSU) joined the consortium in 2003. ScotCen Social Research (a branch of NatCen Social Research), UCL and MRC SPHSU conducted the 2008-2011 surveys after a decision was made to carry out the survey annually.
2. Further information on the sample designs and the methodology used is available here: https://webarchive.nrscotland.gov.uk/3000/https://www.gov.scot/Topics/Statistics/About/SurveyDesigns201215 .
3. Further information on the 2011 Scottish Health Survey questionnaire review for the 2012-2015 surveys can be found on the Scottish Government SHeS website: https://webarchive.nrscotland.gov.uk/3000/https://www.gov.scot/Topics/Statistics/Browse/Health/scottish-health-survey/questionnairereviewreport
4. Scottish Health Survey: content review (2022). Available at: Scottish Health Survey: content review - gov.scot (www.gov.scot)
5. Questionnaire Content of the Scottish Health Survey (2017): Consultation Analysis Report. Available from https://consult.gov.scot/population-health/scottish-health-survey/
6. Further information on the 2017 Scottish Health Survey questionnaire review for the 2018-2021 survey can be found on the Scottish Government website: http://www.gov.scot/Resource/0053/00537370.pdf
7. Defined for the purposes of SHeS analysis as pain or discomfort experienced for a period of 3 months or more
8. The household reference person (HRP) is defined as the householder (a person in whose name the property is owned or rented) with the highest income. If there is more than one householder and they have equal income, then the household reference person is the eldest.
9. Lynn, Peter, Beerten, Roeland, Laiho, Johanna and Martin, Jean 'Recommended Standard Final Outcome Categories and Standard Definitions of Response Rate for Social Surveys', Working Papers of the Institute for Social and Economic Research, paper 2001-23. Colchester: University of Essex. 2001.
10. A report on the development of the weighting procedures is available here: https://webarchive.nrscotland.gov.uk/3000/https://www.gov.scot/Topics/Statistics/About/Surveys/WeightingProjectReport
11. Scottish Health Survey – telephone survey – August/September 2020: main report. Edinburgh, the Scottish Government. Available from: https://www.gov.scot/publications/scottish-health-survey-telephone-survey-august-september-2020-main-report/
12. Where time series SIMD data are presented, the appropriate version of the SIMD is used for each year. More details are provided within the main report and at SIMD&cat=filter&publicationTypes=statistics&page=1">https://www.gov.scot/publications/?term=SIMD&cat=filter&publicationTypes=statistics&page=1
13. Kammann, R. and Flett, R. (1983). Sourcebook for measuring well-being with Affectometer 2. Dunedin, New Zealand: Why Not? Foundation. Information on measuring mental wellbeing using WEMWBS is available online from: https://warwick.ac.uk/fac/sci/med/research/platform/wemwbs Further information about WEMWBS is available at: www.healthscotland.com/scotlands-health/population/Measuring-positive-mental-health.aspx
14. Stewart-Brown, S and Janmohamed, K (2008). Warwick-Edinburgh Mental Well-being Scale (WEMWBS). User Guide Version 1. Warwick and Edinburgh: University of Warwick and NHS Health Scotland. Available at: http://www.healthscotland.com/documents/2702.aspx
15. See: http://nationalperformance.gov.scot/
16. Goldberg, D and Williams, PA (1988). A User's Guide to the General Health Questionnaire. a. Windsor: NFER-Nelson.
17. Lewis, G. & Pelosi, A. J. (1990). Manual of the Revised Clinical Interview Schedule CIS–R. London: Institute of Psychiatry; Lewis G, Pelosi AJ, Araya R, Dunn G. (1992) Measuring psychiatric disorder in the community; a standardised assessment for use by lay interviewers. Psychological Medicine; 22, 465-486.
18. The nurse interview is conducted with one adult at a time, whereas the main interview can be conducted concurrently with up to four household members present. It was therefore easier to ensure that these questions could be answered in confidence. Nurses were also thought to be better placed to handle very sensitive topics such as these than interviewers conducting a general health survey who would have required additional specialist briefing. A leaflet with various help lines was handed to all participants in the nurse visit. From 2012, these questions have been included in the biological module of the survey, conducted by specially trained interviewers, and will be completed by participants using a self-completion computer aided questionnaire.
19. See: www.healthscotland.com/scotlands-health/population/mental-health-indicators.aspx
20. Diabetes and high blood pressure are not included in the definition of 'any CVD condition' as they are risk factors for CVD.
21. Prior to 2012 a fuller version of the MRC Respiratory Symptoms Questionnaire was included in the 1995-2003 and 2008 and 2010 surveys, alongside questions about wheezing and whistling in the chest that were added to the survey in 1998 as part of the asthma module. To reduce duplication and participant burden, from 2012 onwards the MRC Questionnaire items on wheezing were cut (the questions on phlegm and breathlessness were retained).
22. NHS inform (2023) Chronic pain [Online]. Available at: https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/chronic-pain
23. See: https://www.drinkaware.co.uk/alcohol-facts/alcoholic-drinks-units/latest-uk-alcohol-unit-guidance/
24. Reid S (2009). Chapter 3: Alcohol consumption. In: Bromley C, Bradshaw P and Given L. (eds.) The 2008 Scottish Health Survey – Volume 1: Main Report. Edinburgh: Scottish Government. 2009. Available at: www.gov.scot/Publications/2009/09/28102003/31
25. For participants aged 16 and 17, details on alcohol consumption were collected as part of a special smoking and drinking self-completion questionnaire. Some aged 18 and 19 also completed the self-completion if the interviewer felt it was appropriate. For all other adult participants, the information was collected as part of the face-to-face interview. The method of estimating consumption follows that originally developed for use in the General Household Survey and is also used in the Health Survey for England. For six types of alcoholic drink (normal strength beer/lager/cider/shandy, strong beer/lager/cider, spirits/liqueurs, fortified wines, wine, and alcoholic soft drinks), participants were asked about how often they had drunk each one in the past twelve months, and how much they had usually drunk on any one day. The amount given to the latter question was converted into units of alcohol, with a unit equal to half a pint of normal strength beer/lager/cider/alcoholic soft drink, a single measure of spirits, one glass of wine, or one small glass of fortified wine. A half pint of strong beer/lager/cider was equal to 1.5 units. The number of units was then multiplied by the frequency to give an estimate of weekly consumption of each type of drink. The frequency multipliers were:
| Drinking frequency | Multiplying factor |
|---|---|
| Almost every day | 7.0 |
| 5 or 6 times a week | 5.5 |
| 3 or 4 times a week | 3.5 |
| Once or twice a week | 1.5 |
| Once or twice a month | 0.375 |
| One every couple months | 0.115 |
| Once or twice a year | 0.029 |
The separate consumption figures for each type of drink were rounded to two decimal places and then added together to give an overall weekly consumption figure.
26. See: https://www.gov.scot/publications/scottish-health-survey-2008/pages/29/
27. Gray L & Leyland AH (2009). Chapter 4: Smoking. In: Bromley, C., Bradshaw, P. and Given, L. (eds.) The 2008 Scottish Health Survey – Volume 1: Main Report. Edinburgh: Scottish Government. 2009. www.gov.scot/Publications/2009/09/28102003/0
28. Gray L & Leyland AH (2013). Chapter 4: Smoking. In: Rutherford, L., Hinchliffe, S. and Sharp, C. (eds.) The Scottish Health Survey 2012 – Volume 1: Main Report. Edinburgh: Scottish Government. Available at: www.gov.scot/Publications/2013/09/3684
30. Romero-Corral, A. et al (2008). Accuracy of body mass index in diagnosing obesity in the adult general population. International Journal of Obesity, 32: 959–966.
32. These cut-offs differ to those used in the previous surveys. In 1995 and 1998 the normal weight range was defined as 20-25 kg/m2, in 2003 it was changed to 18.5-25 kg/m2. From 2008 onwards the ranges are defined as set out below. This brings the definition in line with WHO recommendations. The impact of the change of definition is very marginal as very few people have a BMI measurement that is exactly 18.5, 25, 30 or 40 kg/m2.
| 2003 | 2008 onwards | |
|---|---|---|
| Underweight | 18.5 or under | Less than 18.5 |
| Normal weight | Over 18.5 – 25 | 18.5 to less than 25 |
| Overweight | Over 25 – 30 | 25 to less than 30 |
| Obese | Over 30 – 40 | 30 to less than 40 |
| Morbidly obese | Over 40 | 40+ |
33. These cut-offs differ to those used in the previous surveys. In 1995 and 1998 the normal weight range was defined as 20-25 kg/m2, in 2003 it was changed to 18.5-25 kg/m2. From 2008 onwards the ranges are defined as set out below. This brings the definition in line with WHO recommendations. The impact of the change of definition is very marginal as very few people have a BMI measurement that is exactly 18.5, 25, 30 or 40 kg/m2.
| 2003 | 2008 onwards | |
|---|---|---|
| Underweight | 18.5 or under | Less than 18.5 |
| Normal weight | Over 18.5 – 25 | 18.5 to less than 25 |
| Overweight | Over 25 – 30 | 25 to less than 30 |
| Obese | Over 30 – 40 | 30 to less than 40 |
| Morbidly obese | Over 40 | 40+ |
34. The questions used in the survey since 1998 are based on the Allied Dunbar National Fitness Survey, a major study of physical activity among the adult population in England carried out in 1990. For further details see: Health Education Authority. Allied Dunbar National Fitness Survey. Health Education Authority and Sports Council, London. 1992
35. Bromley C. (2013) Chapter 6: Physical Activity. In Rutherford L, Hinchliffe S and Sharp C (eds.) Scottish Health Survey 2012 – Volume 1: Main Report. Edinburgh: Scottish Government. Available at: https://www.gov.scot/publications/scottish-health-survey-2012-volume-1-main-report/pages/10/
36. The questions on child physical activity included in SHeS since 1998 are based on the 1997 Health Survey for England (HSE) children's physical activity module.
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