Scottish Surveys Core Questions 2013

1 Core Health Questions

This chapter presents breakdowns of SSCQ data on:

• self-assessed general health (section 1.1)
• long-term limiting mental and physical health conditions (section 0)
• smoking (section 0)

All reported differences are statistically significant unless otherwise stated.

Self-assessed general health

Self-assessed general health is a critical measure of the population's overall health status and a key marker of health inequalities. One of the Scottish Government's National Outcomes is the overall strategic objective for health: We live longer, healthier lives^[3]. This is supported by a number of National Indicators including 'improve self-assessed general health'^[4]. The preferred source of statistics for time series at Scotland level is the Scottish Health Survey. The SSCQ is the preferred source for comparison across demographic or area results.

A comparison of SSCQ and census findings is provided in Annex A, Table A.6.

Disability and limiting long-term

One of the Scottish Government's National Performance Framework National Outcomes is for people in Scotland to 'live longer, healthier lives'.^[5] There is also a National Performance indicator to 'reduce premature mortality' (deaths from all causes in those aged under 75)^[6].

In the Scottish Government's National Action Plan on long-term conditions, long-term conditions are defined as 'health conditions that last a year or longer, impact on a person's life, and may require on-going care and support'. Conditions include a wide range of mental and physical health conditions.

Long-term conditions account for 80% of all GP consultations and for 60% of all deaths in Scotland^[7]. The link with deprivation, lifestyle factors and wider health determinants is also of importance in Scotland, given its persistent health inequalities. Long-term conditions therefore represent personal, social and economic costs both to individuals and their families and to Scottish society more widely. Details of long-term conditions are discussed in full in Chapter 8 of the Scottish Health Survey^[8].

The preferred source of statistics for time series at Scotland level is the Scottish Health Survey^[9]. The SSCQ is the preferred source for comparison across demographic or area results.

Smoking

Reducing smoking is a major priority for improving health. In Scotland, tobacco use is associated with over 13,000 deaths (around a quarter of all deaths) and around 56,000 hospital admissions every year.^[10]

The Scottish Government's Tobacco Control Strategy sets a target to reduce smoking prevalence to 5% or lower by 2034.

Two of the Scottish Government's National Performance Framework (NPF) National Indicators are relevant to smoking.^[11] There is a specific indicator on reducing the proportion of adults who are current smokers, as well as a more general indicator on reducing premature mortality (deaths from all causes in those aged under 75), for which smoking is a significant contributory factor. Details of smoking behaviour are discussed in full in Chapter 4 of the Scottish Health Survey^[12]. The preferred source of statistics on smoking for time series at Scotland level is the Scottish Household Survey. The SSCQ is the preferred source for comparison across demographic or area results.

1.1 Self-assessed general health

In 2013, three quarters (75%) of adults in Scotland assessed their health in general as either 'good' or 'very good,' while 7.6% assessed their heath as being 'bad' or 'very bad'.

General health was strongly correlated with age, as shown in Figure 2. The proportion of men and women who reported being in 'good' or 'very good' health declined with age from 86% of women and 89% of men aged 16-24 to 51% of women and 54% of men aged 75+^[13].

Self-assessed health also reduced with increasing area deprivation. In the 20% most deprived areas in Scotland, 64% of adults reported being in good health, compared to 84% of adults in the least deprived areas.

There were strong associations with other demographic characteristics, e.g. worse self-assessed health among people with lower educational qualifications and among people in social rented housing, which correlate with deprivation. The strong association between age and general health is also likely to have influenced some of these patterns. For example, older people were more likely to own their home outright, and the age distribution by ethnic group varied. A full set of statistics on the age distribution of subgroups is provided in supplementary tables^[14].

Despite being a group made up of younger people, unemployed people were significantly more likely to report 'bad' or 'very bad' health (6.2%) compared to employed people (1.3%), and lower levels of 'good' or 'very good' health (73% instead of 87%).

Smokers were twice as likely to report 'bad' or 'very bad' health (12%) than non-smokers (6.2%).

Figure 2: Percentage of people reporting self-assessed "Good" or "Very good" general health by sex and age group, Scottish Index of Multiple Deprivation (SIMD) quintiles, and tenure

Table 1.1: Self-assessed general health

	Good/Very good	Fair	Bad/Very bad	Adults	Sample
All	74.6	17.8	7.6	4,398,900	21,038
Scottish Index of Multiple Deprivation
1: most deprived fifth of households	63.7	22.3	13.9	859,800	3,942
2	68.7	21.5	9.7	871,600	4,305
3	75.4	17.8	6.8	902,300	4,615
4	80.3	15.0	4.6	891,700	4,454
5: least deprived fifth of households	84.3	12.4	3.2	873,500	3,722
Detailed Tenure
Owned outright	72.2	20.6	7.1	1,265,100	6,894
Mortgaged	85.1	12.3	2.6	1,543,600	6,445
Social rented	57.0	25.2	17.8	950,900	4,889
Private rented	81.2	14.2	4.5	583,300	2,558
Unknown rented	66.7	16.2	17.2	46,800	222
Car Access
No car	59.9	24.9	15.1	1,090,800	5,780
1 car	74.9	18.1	7.0	1,834,300	9,200
2 cars	85.3	11.9	2.6	1,152,900	4,918
3 or more cars	83.8	12.9	3.3	320,600	1,139
Ethnic Group
White: Scottish	72.9	18.8	8.2	3,501,200	16,949
White: Other British	77.2	16.0	6.7	531,400	2,631
White: Polish	92.1	5.6	2.3	55,800	211
White: Other*	88.0	9.1	2.9	155,300	661
Asian**	81.7	15.6	2.7	99,800	359
All other ethnic groups***	86.7	9.3	4.0	51,300	209
Respondent Economic Activity
In employment	86.8	11.9	1.3	2,427,100	10,762
Unemployed	73.1	20.7	6.2	190,200	804
Inactive	58.1	25.5	16.3	1,778,200	9,457
Highest Qualification Held
No qualifications	53.4	27.9	18.6	833,600	4,453
Level 1	75.9	18.1	6.0	859,400	3,928
Level 2	81.9	13.7	4.4	745,000	3,234
Level 3	80.1	15.7	4.1	477,200	2,198
Level 4	85.3	11.6	3.1	1,219,400	5,768
Other qualification	55.9	30.6	13.5	228,500	1,293
Limiting Long-term Health Condition
Limiting condition	26.4	42.7	30.9	992,300	5,644
No limiting condition	88.8	10.4	0.8	3,391,000	15,318
Currently Smokes Cigarettes
Yes	64.6	23.1	12.3	999,400	4,879
No	77.5	16.2	6.2	3,391,200	16,131
Respondent Age and Sex
Female 16-24	85.7	12.3	2.0	312,600	981
Female 25-34	85.9	11.0	3.1	346,000	1,730
Female 35-44	81.8	13.4	4.7	363,100	1,800
Female 45-54	74.7	17.6	7.7	407,200	2,077
Female 55-64	68.6	20.4	11.0	337,900	1,920
Female 65-74	60.8	26.5	12.7	268,300	1,691
Female 75+	50.7	31.6	17.5	254,500	1,556
Male 16-24	89.1	8.0	2.8	316,200	799
Male 25-34	84.9	11.9	3.1	334,000	1,243
Male 35-44	84.0	11.6	4.3	344,300	1,410
Male 45-54	73.5	18.1	8.3	387,800	1,671
Male 55-64	66.6	21.4	11.9	324,000	1,673
Male 65-74	61.1	27.5	11.4	239,000	1,460
Male 75+	53.5	33.0	13.2	164,000	1,027

Footnotes

Ethnic Groups

* 'White: Other' includes ‘White: Irish’, ‘White: Gypsy/Traveller’ and ‘White: Other White Ethnic Group’
** 'Asian' includes the categories Asian, Asian Scottish or Asian British
*** 'All other ethnic groups' includes categories within the 'Mixed or Multiple Ethnic Group', ‘African’, ‘Caribbean or Black’, and ‘Other Ethnic Group’ sections.

Key to education levels

Level 1 - O Grade, Standard Grade or equiv (SVQ level 1 or 2)
Level 2 - Higher, A level or equivalent (SVQ Level 3)
Level 3 - HNC/HND or equivalent (SVQ Level 4)
Level 4 - Degree, Professional qualification (Above SVQ Level 4)

1.2 Disability and limiting long-term conditions

In 2013, 23% of adults reported having a long-term condition which limits their daily activities. Respondents to the Scottish Health Survey (SHeS) were more likely to say that they suffer from a long-term limiting health condition than respondents to the other sources SSCQ surveys (see Table B.3).

Figure 3: Percentage of people reporting a long-term limiting condition by sex and age group and Scottish Index of Multiple Deprivation (SIMD) quintiles

The proportion of adults with a limiting condition increased with age, as shown in Figure 3. For example, only 9% of adults aged 16-24 reported having a limiting long-term condition. This increased to 20% of adults aged 45-54, and around 50% of adults aged 75+ (53% of women and 45% of men).

In the most deprived fifth of areas in Scotland, 31% of adults reported a limiting long-term condition. This was double the reported proportion in the least deprived areas (15%)^[15].

Patterns by age and deprivation are likely to have influenced some other results, for example the relatively high proportion of adults reporting a limiting condition whose home is 'social rented' (39%) 'owned outright' (27%) or, are 'widowed / bereaved civil partner' (48%) and who hold 'no qualifications' (43%).

Despite being a group made up of younger people, unemployed people were around twice as likely to report a limiting long-term condition (19%) compared to employed people (9.2%).

Smokers were also significantly more likely to report a limiting long-term condition (28%) than non-smokers (21%).

Table 1.2 Limiting long-term health condition

	Limiting condition	No limiting condition	Adults	Sample
All	22.6	77.1	4,398,900	21,038
Scottish Index of Multiple Deprivation
1: most deprived fifth of households	31.4	68.2	859,800	3,942
2	27.4	72.2	871,600	4,305
3	22.4	77.3	902,300	4,615
4	16.9	82.8	891,700	4,454
5: least deprived fifth of households	15.0	84.7	873,500	3,722
Detailed Tenure
Owned outright	27.2	72.4	1,265,100	6,894
Mortgaged	11.7	88.0	1,543,600	6,445
Social rented	38.6	60.9	950,900	4,889
Private rented	14.3	85.4	583,300	2,558
Unknown rented	31.8	67.6	46,800	222
Car Access
No car	36.8	62.7	1,090,800	5,780
1 car	22.2	77.3	1,834,300	9,200
2 cars	12.1	87.6	1,152,900	4,918
3 or more cars	13.3	86.7	320,600	1,139
Ethnic Group
White: Scottish	24.0	75.7	3,501,200	16,949
White: Other British	21.6	78.1	531,400	2,631
White: Polish	6.8	93.0	55,800	211
White: Other*	11.5	87.7	155,300	661
Asian**	8.1	91.5	99,800	359
All other ethnic groups***	11.8	87.3	51,300	209
Respondent Economic Activity
In employment	9.2	90.5	2,427,100	10,762
Unemployed	18.9	80.8	190,200	804
Inactive	41.1	58.4	1,778,200	9,457
Highest Qualification Held
No qualifications	43.4	56.1	833,600	4,453
Level 1	19.7	80.0	859,400	3,928
Level 2	15.6	84.1	745,000	3,234
Level 3	16.8	82.9	477,200	2,198
Level 4	13.8	85.9	1,219,400	5,768
Other qualification	39.1	60.8	228,500	1,293
Currently Smokes Cigarettes
Yes	28.4	71.2	999,400	4,879
No	20.9	78.8	3,391,200	16,131
Respondent Age and Sex
Female 16-24	9.9	90.1	312,600	981
Female 25-34	11.6	88.1	346,000	1,730
Female 35-44	15.3	84.4	363,100	1,800
Female 45-54	20.4	79.4	407,200	2,077
Female 55-64	30.3	69.4	337,900	1,920
Female 65-74	38.6	61.1	268,300	1,691
Female 75+	53.1	45.9	254,500	1,556
Male 16-24	8.7	90.7	316,200	799
Male 25-34	9.2	90.6	334,000	1,243
Male 35-44	13.0	86.6	344,300	1,410
Male 45-54	20.1	79.7	387,800	1,671
Male 55-64	30.3	69.5	324,000	1,673
Male 65-74	37.2	62.2	239,000	1,460
Male 75+	44.9	54.6	164,000	1,027

Footnotes

Ethnic Groups

* 'White: Other' includes ‘White: Irish’, ‘White: Gypsy/Traveller’ and ‘White: Other White Ethnic Group’
** 'Asian' includes the categories Asian, Asian Scottish or Asian British
*** 'All other ethnic groups' includes categories within the 'Mixed or Multiple Ethnic Group', ‘African’, ‘Caribbean or Black’, and ‘Other Ethnic Group’ sections.

Key to education levels

Level 1 - O Grade, Standard Grade or equiv (SVQ level 1 or 2)
Level 2 - Higher, A level or equivalent (SVQ Level 3)
Level 3 - HNC/HND or equivalent (SVQ Level 4)
Level 4 - Degree, Professional qualification (Above SVQ Level 4)

1.3 Smoking

In 2013, 23% of adults were current smokers. There was a strong association between smoking and area deprivation, with 10% of adults in the least deprived areas and 38% of adults in the most deprived areas reporting being a current smoker.

Almost half (47%) of unemployed people were current smokers, compared to around one in five (21%) people in employment. Smoking rates tailed off significantly with education level, with around one in three people with standard grade or equivalent reporting current smoking (32%) compared to around one in eight (12%) of people with a degree or professional qualification.

A higher proportion of people in rented accommodation were current smokers, including 29% of those in private rented and 42% of those in social rented accommodation. This was significantly higher than the proportions in 'owned outright' or 'mortgaged' accommodation (12% and 17% respectively).

Among people aged 35 to 44, significantly more men than women smoked. Over the age of 65, smoking rates tailed off significantly for both sexes, see Figure 4. This is likely due to generational differences, changes in habit with age and premature deaths among smokers.

Figure 4: Smoking rates by sex and age group and Scottish Index of Multiple Deprivation (SIMD) quintiles

Single parents and single adults were around twice as likely to be current smokers (45% and 41%) than people living in small or large families (19% and 20%). Similarly, people whose marital status was single (30%), separated (38%) and following a divorce / the dissolution of a civil partnership (35%) were more than twice as likely to be current smokers than people in marriages / civil partnerships (15%), see supplementary tables^[16].

Current smokers were significantly more likely than non-smokers to be in 'bad' or 'very bad' general health or to have a limiting long-term condition.

Table 1.3: Smoking

	Response %		Totals
	Yes	No	Adults	Sample
All	22.7	77.1	4,398,900	21,038
Scottish Index of Multiple Deprivation
1: most deprived fifth of households	37.8	62.0	859,800	3,942
2	27.8	71.9	871,600	4,305
3	21.7	78.1	902,300	4,615
4	16.3	83.6	891,700	4,454
5: least deprived fifth of households	10.4	89.5	873,500	3,722
Detailed Tenure
Owned outright	12.4	87.5	1,265,100	6,894
Mortgaged	16.7	83.1	1,543,600	6,445
Social rented	42.4	57.3	950,900	4,889
Private rented	28.7	71.3	583,300	2,558
Unknown rented	27.6	72.4	46,800	222
Car Access
No car	36.8	63.0	1,090,800	5,780
1 car	21.4	78.4	1,834,300	9,200
2 cars	13.9	85.9	1,152,900	4,918
3 or more cars	13.9	85.8	320,600	1,139
Ethnic Group
White: Scottish	23.8	76.0	3,501,200	16,949
White: Other British	17.3	82.5	531,400	2,631
White: Polish	29.5	70.5	55,800	211
White: Other*	22.5	77.2	155,300	661
Asian**	11.9	88.1	99,800	359
All other ethnic groups***	17.3	82.7	51,300	209
Respondent Economic Activity
In employment	21.3	78.7	2,427,100	10,762
Unemployed	46.6	53.1	190,200	804
Inactive	22.2	77.5	1,778,200	9,457
Highest Qualification Held
No qualifications	30.3	69.5	833,600	4,453
Level 1	32.2	67.6	859,400	3,928
Level 2	20.2	79.6	745,000	3,234
Level 3	23.1	76.9	477,200	2,198
Level 4	12.2	87.8	1,219,400	5,768
Other qualification	22.1	77.9	228,500	1,293
Limiting Long-term Health Condition
Limiting condition	28.6	71.3	992,300	5,644
No limiting condition	21.0	78.8	3,391,000	15,318
Respondent Age and Sex
Female 16-24	22.2	77.1	312,600	981
Female 25-34	24.3	75.7	346,000	1,730
Female 35-44	22.0	77.9	363,100	1,800
Female 45-54	25.4	74.6	407,200	2,077
Female 55-64	22.9	77.0	337,900	1,920
Female 65-74	15.8	84.2	268,300	1,691
Female 75+	8.4	91.5	254,500	1,556
Male 16-24	26.7	72.4	316,200	799
Male 25-34	28.7	71.1	334,000	1,243
Male 35-44	30.7	69.2	344,300	1,410
Male 45-54	27.5	72.3	387,800	1,671
Male 55-64	22.8	77.2	324,000	1,673
Male 65-74	17.5	82.4	239,000	1,460
Male 75+	7.8	91.8	164,000	1,027

Footnotes

Ethnic Groups

* 'White: Other' includes ‘White: Irish’, ‘White: Gypsy/Traveller’ and ‘White: Other White Ethnic Group’
* 'Asian' includes the categories Asian, Asian Scottish or Asian British
*** 'All other ethnic groups' includes categories within the 'Mixed or Multiple Ethnic Group', ‘African’, ‘Caribbean or Black’, and ‘Other Ethnic Group’ sections.

Key to education levels

Level 1 - O Grade, Standard Grade or equiv (SVQ level 1 or 2)
Level 2 - Higher, A level or equivalent (SVQ Level 3)
Level 3 - HNC/HND or equivalent (SVQ Level 4)
Level 4 - Degree, Professional qualification (Above SVQ Level 4)