Scottish Government Equality Outcomes: Religion and Belief Evidence Review

11 HEALTH

11.1 This section explores health outcomes and health behaviours, as recorded for different religious groups. It closes with a review of inpatient experience.

Health outcomes

11.2 According to the Scottish Health Survey^[50], Hindus had the highest rate of self-reported good health (92% rated their health as good or very good), whilst those who reported their religious faith as 'Other' were the least likely to rate their health as good or very good (67%). Respondents whose religion was Church of Scotland were slightly more likely to rate their health as good or very good (78%) than the Scottish average (76%), and Roman Catholics were significantly less likely to do so (72%).

11.3 Mental wellbeing was measured using the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), which has a lowest possible score of 14 and the highest score possible is 70. Hindus also had the highest levels of positive mental wellbeing (53.2), but this was not statistically significantly different from the Scottish average (49.9). Roman Catholics had significantly lower than average wellbeing (49.4), and Other Christians had slightly higher wellbeing (50.9).

11.4 GHQ126 is a widely used standard measure of mental distress and psychological ill-health. On a range from zero to twelve, a score of four or more (referred to as a 'high' GHQ12 score) has been used here to indicate the presence of a possible psychiatric disorder. Regarding freedom from mental ill-health, Hindus (7%) and Church of Scotland (14%) were the only religious groups to have a significantly lower proportion of high GHQ12 scores than the Scottish average. Roman Catholics were significantly more likely than the average to have a GHQ12 score of 4 or more (17%), indicating a relative prevalence of mental ill-health.

11.5 Buddhist and Hindu respondents had the lowest prevalence of obesity (both 15%); significantly lower than the national average (27%). People who said they belonged to no religion also had a slightly, but significantly, lower prevalence of obesity than the average (26%). Respondents who were members of the Church of Scotland were most likely to be obese (30%), significantly more so than average. These patterns were similar but less marked, in relation to overweight including obesity prevalence. The only religions which stood out as significantly different to the national average (65%) were Church of Scotland (67%) and Buddhist (42%).

11.6 Muslims (9%), Hindus (3%) and those who said they belonged to no religion (14%) had significantly lower prevalence of cardio-vascular disease than the national average (15%) whilst Roman Catholics (17%) were significantly more likely to have a cardio-vascular disease related condition. Muslim respondents had a much higher prevalence of diabetes (18%) than the national average. Diabetes prevalence among those who reported 'Other' religion was also significantly higher than average (8%). Prevalence among those who reported belonging to no religious group was very slightly, but significantly, lower than average.

11.7 Regarding dental health, the survey suggests that religious faith appears to have a strong association with how many natural teeth respondents have. Only 69% of Roman Catholics had 20 or more natural teeth, which was significantly lower than the national average of 72%. Muslims were the most likely to have twenty or more natural teeth (95%) followed by Hindus (93%) and Buddhists (89%). There was no significant association between toothache and religion.

11.8 There is a small but growing field of research into the relationship between religion and health and wellbeing. There is some suggestion that religious faith may be a pathway to better health. In the Chief Medical Officer's Annual Report for 2009^[51], he argued strongly for the health importance of having resources for ordering and making sense of the environment in which people live. Religion may be such a resource in that faith provides ways of ordering and understanding the world. Furthermore, religious practice also has a related religious community with benefits to social capital.

Health behaviours

11.9 Muslims, Hindus and Buddhists were the least likely religious groups to drink at hazardous or harmful levels with 5%, 6% and 10% doing so respectively. Christian faiths (Church of Scotland, Roman Catholic and other Christians) were significantly more likely to drink at hazardous or harmful levels than Muslims, Hindus and Buddhists. A notable finding is that respondents who did not belong to any religious group were the most likely to drink excessively. 26% reported drinking at hazardous or harmful levels, significantly higher than the average (23%) and 41% exceeded daily limits compared to the average of 39%. The difference in alcohol consumption between religious and non-religious adults has been noted in previous research. For example, in a study of drinking behaviours in greater Glasgow, those who professed a religious belief were found to drink less alcohol.

11.10 There were notable differences in prevalence of smoking by religious faith. 28% of Roman Catholic respondents and respondents who did not belong to any religion were smokers, significantly higher than the national average of 25%. Muslims and Other Christians had the lowest smoking prevalence at 16% and Church of Scotland was also significantly lower than average with 21% smoking within this group. Of those who smoked, respondents belonging to no religion, and Church of Scotland, Roman Catholic and other Christian respondents all smoked around 14 cigarettes a day on average. Muslim smokers and those from other religions smoked the least, averaging 8.6 and 11.6 cigarettes a day respectively. There was little difference in the age of starting smoking between the religious groups.

11.11 For consumption of fruit and vegetables, Buddhists (63%), Muslims (49%) and Hindus (44%) were most likely to meet the 5-a-day recommendation and consumed the highest mean daily portions (6.8, 5.1 and 4.5 portions respectively), significantly greater than the national average (22% and 3.2 portions). Although Buddhism in general does not have a strict dietary code, some schools of Buddhism forbid eating meat and many Buddhists are vegetarian, which may explain the high fruit and vegetable intake. It has been suggested that religious belief may well impact on the health of the members, because of the dietary requirements of many denominations^[52]. Church of Scotland and Roman Catholic respondents ate slightly fewer portions per day than the national average (3.1 compared with 3.2) and Roman Catholics were significantly less likely to eat 5 or more portions per day than the national average (20% compared with 22%).

Inpatient experience

11.12 The 2010 Inpatient Experience Survey^[53] largely compared Christians as a single category to other religious or non-religious groups, because initial analysis had found that there were no differences in reported experience between Church of Scotland, Roman Catholic and other Christian patients. Agnostic patients, patients answering "none" for religion, and patients with other non-Christian religions and belief systems, were all generally less likely than Christian patients to report a positive experience. The survey report finds it likely that many of these differences will be due to differences in expectation and perception for different groups.