Scottish Health Survey: content review outcomes report

New topics

The next section provides details about requests for new topics, including those that will be included in SHeS

Eating disorders

During the review the charity BEAT and PHS suggested adding questions on eating disorders to the survey. BEAT proposed including the five-item Sick, Control, One stone, Fat, Food (SCOFF) questionnaire and a supplementary question regarding impacts on quality of life (‘Did your feelings about food interfere with your ability to work, meet personal responsibilities and/or enjoy a social life?’). The SCOFF is a brief screening tool, which has been validated for use in general adult population samples in the UK, that can identify individuals who may be experiencing a pattern of disordered eating and require a clinical assessment.

After researching the SCOFF we found that the Adult Psychiatric Morbidity Survey 2007 and Health Survey England 2019 used an amended version of the questionnaire, adding a time frame of the last 12 months, and changing the order of the questions. We, therefore, agreed with policy colleagues that we would follow this approach to allow the Scottish figures to be compared to the Health Survey for England. The questions have been included in the self-completion booklet in the 2024 survey (currently in field) for all adults (aged 16+) on a one-off basis with the possibility of including them in even years (every 2 or 4 years) in the future.

The eating disorder module is included in annex 14.

Women's health

PHS requested we ask questions that cover women’s health in SHeS. This is an important emerging policy area and the SHeS team were already aware of the lack of available data and the demand for this before the review began.

After discussions with policy and stakeholders we have included 6 questions on menopause and peri-menopause in SHeS 2024 in the self-complete booklet. These questions were developed in-house, due to the lack of existing questions, and cognitively tested by the survey contractor to ensure that they would be understood by respondents and measured what we intended them to.

We are currently including these on a one-off basis with the possibility of including them in even years (every 2 or 4 years) in the future if the data is useful and space allows.

See annex 15 for the full module.

Headache disorders and musculoskeletal conditions 

PHS identified headache disorders and musculoskeletal conditions as two new topics for consideration in SHeS. They suggested a number of questionnaires, details of which were included in the review analysis report published last year.

They noted that ‘the chronic pain section will have overlap with both questions for headache disorders and musculoskeletal conditions. Therefore, it would seem opportune to review the chronic pain questions and assess whether these could be updated or augmented ‘a once for all’ list of questions which could be used going forwards instead of questions in disparate sections.’

We met with SG policy and PHS to discuss the possibility of merging these topics into the chronic pain module which will next be included in SHeS in 2026. It will not be possible to include a full questionnaire, such as those suggested by PHS, due to the number of questions and lack of space in the survey, but we will work with stakeholders to see if there is a shorter set of questions or single question we can include to capture this information.

GP and A&E contact

The Scottish Government Mental Health Directorate would be interested ‘to know the number of contacts people have had with their GP and A&E department in the past 3 months.’

Data from the 1998, 2003 and 2008-2020 Scottish Health Survey has been linked to health record data (with 1995, 2021 and 2022 being added soon, and records being updated annually going forward). This includes some data on hospital admissions. Additional variables can potentially be included in this linked dataset, such as GP and A&E contact, following permissions from the relevant Public Benefit and Privacy Panel.  As such, we will therefore not be including  questions on this in SHeS.

Heating 

The Scottish Government Mental Health Directorate mentioned that ‘it would be worth asking people how they heat their home’, as ‘this might help with climate change policy as well as the response to the cost of living crisis.’

This is not directly related to health and we will therefore not be including any questions about heating homes in SHeS.

Experience of care 

ASH Scotland requested we include questions in SHeS to identify adults and children who had ever been in care (foster care, residential care etc.).The latest Children’s Social Work Statistics 2022-23 survey found that on 31st July 2023 the rate of looked after children was 12.1 per 1,000 children (aged 0-17 years) – it is therefore unlikely that the SHeS sample would gather a large enough sample of looked-after children to provide robust health data for this group.

Violence against women and girls

The Scottish Government violence against women and girls policy team suggested adding questions on violence against women and girls to the health survey. Questions on violence against women and girls are included in the Scottish Crime and Justice Survey (SCJS) and, due to limitations in space, it is not possible to also include them in the health survey.

Homelessness 

Crisis, the homelessness charity, suggested adding two questions on homelessness to SHeS. They stated that ‘including questions on experiences of homelessness will add valuable data on a group at particular risk of poor health outcomes which will be valuable in ensuring parity of care and informing service planning.’

‘Do you consider yourself to have ever been homeless?’

‘Do you consider yourself to have been homeless in the past two years? (two years is in line with other UK surveys on this topic)’

Data on homelessness is managed by the Communities Analysis Division and, due to the sampling frame used for SHeS, it is unlikely we would recruit a large enough sample of respondents who have experienced homelessness to provide useful data.

Non-medical management techniques (such as social prescribing) 

An organisation suggested adding ‘a question which picks up on the positive wellbeing benefits from a variety of non-medical management techniques (such as social prescribing) for managing each of the listed physical and mental health conditions,’ and finding out if this was the main management route or used alongside other techniques. The interest from this organisation being specifically related to looking at the outcomes from engagement with the historic environment.

Due to the lack of policy need for this information this request will not be taken forward.

Other topics 

PHS stated that ‘the following topics/issues have been identified through PHS’ Mental Health Indicators work as “data gaps”.’ At present they are not requesting specific questions to address these gaps, as further work is planned to identify exactly what is needed. In the meantime, PHS ‘would support proposals from others that would enhance the available data on these topics:

• Sleep
• Social media
• Racism
• Stigma around mental health

Survey coverage 

As noted in the initial review paper, the purpose of the review was to assess the content of the survey, and requests relating to the survey process were out with the scope of this review. However, the SG Mental Health Directorate asked if ‘the survey could go beyond private households to include people who live in care homes or other residential settings.’ The SHeS sampling frame is drawn from the postcode address file (PAF). The PAF includes all private households in Scotland but does not include accommodation in hospital, prisons, military bases or larger student halls, it is therefore not currently possible to include ‘people who live in care homes or other residential settings’ in the SHeS sample.