Scottish Health Survey: content review outcomes report
This report summarises changes that have and will be made to the content of the Scottish Health Survey (SHeS) from 2024 onwards. Some of these changes do not apply to the 2024 survey and will be made to future years.
Summary of questionnaire changes
Summaries for individual topic areas are included in the following chapters, with Table 1-4 summarising all changes.
The following topics have been removed from the survey due to little evidence of support or use received through the review process, or due to the availability of data elsewhere:
- Discrimination and harassment
- Gambling
- Social capital
- Child eating habits
Additionally, some sets of questions have been made less frequent:
- Chronic pain
- Child fruit and vegetable consumption
New topics included in the survey include:
- Menopause/perimenopause
- Eating disorders
Additional questions have also been added to existing modules including:
- Two questions about the modes of transport involved in road traffic collisions added to the unintentional injuries module (previously called the accidents module).
- Two questions about neglect and resilience added to the Adverse Childhood Experiences (ACE) module.
- Two questions about diagnosis of Transient Ischaemic Attack (TIA) and experience in the past 12 months added to the cardiovascular disease and use of services module.
- A question about the use of an insulin pump for diabetes added to the cardiovascular disease and use of services module.
- A question about the impact of long COVID added to the COVID-19 module.
- A question about training in AED (automated external defibrillator) added to the CPR training module.
- A question about areas long-term conditions/illnesses affect added to the general health and long-term conditions module.
- Two questions about diagnosis of Obstructive Sleep Apnoea (OSA) and experience of OSA in the last 12 months added to the respiratory module.
- A question about use of nicotine pouches and a question about exposure to second-hand vapour added to the smoking module.
- A question about the likelihood of losing job added to the stress at work module.
- Two questions about quantity/dosage and frequency of consumption of vitamin D and a question about quantity/dosage of folic acid added to the vitamins module.
A number of alterations have been made to existing survey questions. These are fairly minor for the most part. Examples include adding additional responses to the location of alcohol consumption question, expanding the folic acid consumption question to be asked of all respondents and updating the terminology used in the suicide and self-harm module and unintentional injuries module (previously known as the accidents module).
The biggest changes are to the adult physical activity module and child diet module.
The adult (aged 16+) physical activity questions have historically taken up a disproportionate amount of space in the survey and, due to the estimated adult survey length in 2025 overrunning, it was a priority to reduce this module length. Following discussions with SG policy and research colleagues, Public Health Scotland (PHS) and academics specialising in the field, we have agreed to replace the physical activity question set with the Global Physical Activity Questionnaire (GPAQ) and a single-item question asking about muscle strengthening activities from 2025 onwards. We will retain the existing motivation and barriers to physical activity questions and the location of physical activity questions with minor changes, details are outlined in the physical activity section below.
Intake24 - an online food diary – has replaced the previous diet questions asked of adults in SHeS. During the review process we asked respondents to consider whether we should expand the use of Intake24 to include children. This proposal received support and Food Standards Scotland (FSS) noted that they were going to be using Intake24 for a child survey that they were running in 2023/2024. Due to this, it was agreed that to include children in Intake24 in 2024 would be unnecessary duplication of data and costs and we will therefore be asking children to complete the online food diary from 2027 (the next time Intake24 is due to be included for adults). In the meantime, we will be asking children to complete the fruit and vegetable module in 2025 to provide some child diet data in the intervening Intake24 years.
The review process identified a number of topics with potential for inclusion in the future, should space become available in the survey.
Table 1: Summary of questions being removed from SHeS
|
Removals Question(s) |
Module |
Frequency |
|
Discrimination and harassment (all questions) |
Discrimination and harassment |
Asked of two thirds of adults (aged 16+) in Version A every second year (odd years). |
|
Gambling (all questions) |
Gambling |
Asked of all adults (Aged 16+) every 4 years. Last included in 2021. |
|
Social capital (all questions) |
Social capital and loneliness |
Asked of adults (aged 16+) every second year (odd years). |
|
Questions about individual health conditions that are duplicated in doctor-diagnosed questions.
|
Cardiovascular disease and use of services |
Asked annually of all adults (aged 16+). |
|
Refresher CPR training (CPRRef_19) |
CPR training |
Asked of all adults (aged 16+) every second year (odd years). |
|
Child eating habits (all questions). These questions are being replaced, see table 2 for details. |
Diet |
Asked annually of children (aged 2-15). |
|
Adult physical activity section (all questions). These questions are being replaced, see table 2 for details. |
Physical activity |
Asked annually of all adults (aged 16+). |
|
Location of physical activity – frequency |
Physical activity |
Asked of two thirds of adults (aged 16+) and two thirds of children (aged 2-15) in version A annually. |
|
Questions about chronic obstructive pulmonary disease (COPD) that are duplicated in doctor-diagnosed questions. |
Respiratory |
Asked annually of all adults (aged 16+). |
|
Question about whether exposure to other people’s tobacco smoke bothers respondent. (Bother) |
Smoking |
Asked annually of all respondents aged 13 and over. |
Table 2: Summary of new questions being added to SHeS
|
Additions |
Module |
Frequency |
|
Eating disorders module |
Mental wellbeing |
Asked of all adults (aged 16+) in 2024. Currently included on a one-off basis but will be considered for inclusion again every 2 or 4 years. |
|
Menopause and perimenopause module |
Menopause and perimenopause |
Asked of women (aged 16+) in 2024. Currently included on a one-off basis but will be considered for inclusion again every 2 or 4 years. |
|
Two additional questions about the modes of transports involved in road traffic collision |
Unintentional injuries (previously called accidents) |
Asked of all respondents (aged 0+) every second year (in odd years). |
|
Neglect Resilience |
Adverse Childhood Experiences (ACEs) |
Asked of adults (aged 16+). To be included in 2025. An ACE module was previously included in SHeS in 2019. |
|
New questions about diagnoses of TIA and experience in past 12 months (TIA1, RecTIA) |
Cardiovascular disease and use of services |
Asked annually of all adults (aged 16+). |
|
Use of insulin pump for diabetes |
Cardiovascular disease and use of services |
Asked annually of all adults (aged 16+). |
|
Impact of long covid (LCSymIm) |
COVID-19 |
Asked annually of all respondents (aged 0+). |
|
Training in AED (defibrillator) use |
CPR training |
Asked of all adults (aged 16+) every second year (odd years). |
|
Children Intake24 (food diary) |
Diet |
Asked of all children (aged 2+). Going to be included in 2027. |
|
Areas long-term conditions/illness affect (LTImp24_) |
General health and long-term conditions |
Asked annually of all respondents (aged 0+). |
|
Modified GPAQ and |
Physical activity |
Asked annually of all adults (aged 16+). |
|
Obstructive Sleep Apnoea (OSA) diagnosis and experience in last 12 months |
Respiratory |
Asked annually of all adults (aged 16+). |
|
Exposure to second-hand vapour (PassVap ) |
Smoking |
Asked annually of all respondents (aged 0+) . |
|
Stop smoking apps used to aid smoking cessation (SuppApp) |
Smoking |
Asked annually of all adults (aged 16+). |
|
Use of nicotine pouches |
Smoking |
Asked annually of all adults (aged 16+). |
|
Likelihood of losing job |
Stress at work |
Asked of two thirds of adults (aged 16+) in version A every second year (odd years). |
|
Dosage of folic acid |
Vitamins |
Asked of all respondents (aged 0+) every second year (odd years). |
|
Quantity/dosage of vitamin D and frequency of consumption (VitaminD1, VitaminD2) |
Vitamins |
Asked of all respondents (aged 0+) every second year (odd years). |
Table 3: Summary of questions that are changing frequency in SHeS
|
Changing frequency Question(s) |
Module |
Frequency |
|
Chronic pain (all questions) |
Chronic pain |
From every second year to every 4 years (next included in 2026). Asked of all respondents (aged 0+). |
|
Child fruit and vegetable (all questions) |
Diet |
From every year to a one-off basis in 2025. Asked of children (aged 2-15). Child diet questions are being replaced by Intake24, an online food diary, see table 2. The fruit and vegetable questions being included on a one-off basis to provide data in years without Intake24. |
|
Food insecurity (all questions) |
Food insecurity |
Were previously due to be removed from SHeS and were not included in 2022, but will now be included annually from 2024. Asked of all adults (aged 16+). |
Table 4: Summary of questions that are being altered in SHeS
|
Alterations |
Module |
Frequency |
Alteration |
|
Accidents (all questions) |
Unintentional injuries (previously called accidents) |
Asked of all respondents (aged 0+) every second year (in odd years). |
Terminology used in module changed from ‘accidents’ to ‘unintentional injuries’. |
|
Accidents |
Unintentional injuries (previously called accidents) |
Asked of all respondents (aged 0+) who reported an unintentional injury every second year (in odd years). |
Term ‘road traffic accident’ changed to ‘road traffic collision’. |
|
Accidents |
Unintentional injuries (previously called accidents) |
Asked of all respondents (aged 0+) who reported an unintentional injury every second year (in odd years). |
Additional causes added. |
|
Accidents |
Unintentional injuries (previously called accidents) |
Asked of all respondents (aged 0+) who reported an unintentional injury every second year (in odd years). |
Additional sources of help or advice added. |
|
Verbal abuse Household domestic abuse Physical abuse |
Adverse Childhood Experiences (ACEs) |
Asked of adults (aged 16+). To be included in 2025 – an ACE module was previously included in SHeS in 2019. |
Response options changed from ‘Never, once or twice, sometimes, often, very often’ to ‘never, once, more than once.’ |
|
Sexual abuse |
Adverse Childhood Experiences (ACEs) |
Asked of adults (aged 16+). To be included in 2025 – an ACE module was previously included in SHeS in 2019. |
The sexual abuse question has been collapsed from two separate questions that were combined to one ‘yes/no’ response question. |
|
Location of alcohol consumption |
Alcohol and drinking experiences |
Asked annually of adults (aged 16+). |
Additional locations added. |
|
Questions about doctor-diagnosed individual health conditions (BP1, Angina1, Heartattack1, Heartmurmur1, Heartrhythm1, Hearttrouble1, Stroke1, Diabetes1) |
Cardiovascular disease and use of services |
Asked annually of all adults (aged 16+). |
Terminology changed in questions asking about doctor-diagnosed conditions to ask about ‘doctor or other healthcare professional’. |
|
Management of diabetes |
Cardiovascular disease and use of services |
Asked annually of all adults (aged 16+). |
Changed terminology to ask about management of diabetes with insulin. |
|
Long COVID symptoms |
COVID-19 |
Asked annually of all respondents (aged 0+). |
List of long covid symptoms updated. |
|
When had CPR training |
CPR training |
Asked of all adults (aged 16+) every second year (in odd years). |
Wording of question changed from asking about the first time respondents received CPR training to asking about the last time. |
|
Taken following substances in last 12 months |
Drugs |
Asked of all adults (aged 16+) every second year (in odd years). |
List of substances updated before the module is included in SHeS every second year (odd years). |
|
Types of long-term illnesses/conditions |
Long-term conditions |
Asked annually of all respondents (aged 0+) . |
Categories of long-term conditions updated. |
|
Self-harm |
Mental wellbeing |
Asked of a third of adults (aged 16+) in version B of the survey. |
Terminology changed to replace the term ‘killing yourself’ with ‘taking your own life.’ |
|
Suicide |
Mental wellbeing |
Asked of a third of adults (aged 16+) in version B of the survey. |
Wording of the question changed to be more explicit. |
|
Self-harm and suicide most recent time questions |
Mental wellbeing |
Asked of adults (aged 16+) who reported attempting suicide or harming themselves in version B of the survey. |
Added ‘in the last month’ to the response options. |
|
Question about doctor-diagnosed COPD (COPDDoct)
|
Respiratory |
Asked annually of all adults (aged 16+). |
Terminology changed in COPD question asking about doctor-diagnosed conditions to ask about ‘doctor or other healthcare professional’.’ |
|
Smoking cessation support (NRTSupp24) |
Smoking |
Asked annually of all adults (aged 16+). |
Asked of all adults from 2024, not just those who have used any Nicotine Replacement Therapy (NRT) products. |
|
Exposure to second-hand smoke (Passive24) |
Smoking |
Asked annually of all respondents (aged 0+). |
Added new response option. |
|
Ever smoked tobacco (SmokEv) |
Smoking |
Asked annually of all adults (aged 16+). |
Changed question to ‘Ever somoked or used a heated tobacco product and added a new response option for heated tobacco product. |
|
Taking folic acid |
Vitamins |
Asked annually of all respondents (aged 0+) every second year (in odd years). |
Expanded question to ask of all respondents (aged 0+), not just pregnant women and women of child-bearing age. |
Contact
ScottishHealthSurvey@gov.scot
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