The Scottish Health Survey 2024 - volume 1: main report

Summary

Chapter 1: Mental Health and Wellbeing

In 2024:

• After increasing for the first time since the pandemic in 2023 (48.9), mental wellbeing (mean WEMWBS scores[1]) for adults remained at a similar level (48.5).

• The proportion of adults with a possible psychiatric disorder (22%) (GHQ-12 score of 4 or more[2]) remained at a similar level to 2023 (21%) following a decrease from 2022 (27%).
• One in four (25%) females reported a possible psychiatric disorder (GHQ-12 score of 4 or more), significantly more than males (18%).
• The proportion of adults with a possible psychiatric disorder (GHQ-12 score of 4 or more) was highest among those living in the most deprived areas (31%) compared with those living in the least deprived areas (17%).
• The proportion of adults who reported having felt lonely ‘most’ or ‘all of the time’ decreased from 10% in 2023 to 7%, similar to the proportion in 2021 (8%).

• Thirteen per cent of adults self-reported eating behaviours and feelings related to food that could be indicative or a possible eating disorder[3]. This was highest for those aged 16-24 (26%) and lowest for those aged 65 and over (4%-5%).

• Adults with self-reported eating behaviours and feelings related to food that could be indicative of a possible eating disorder had a significantly lower mean WEMWBS score (42.2) compared with those who did not (49.4).

In 2023/2024 combined:

• The prevalence of two or more symptoms of depression[4] among adults was 10%, a decrease from 13% in 2021/2022 combined.  
• The prevalence of two or more symptoms of depression was much higher among adults living in the most deprived areas (23%) than among those living in the least deprived areas (4%).
• Consistent with previous years, a larger proportion of females reported two or more symptoms of anxiety[5] (18%) compared with males (13%).
• Adults aged 16-34 were most likely to have intentionally self-harmed, 17%-18% compared with 0%-1% among those aged 65 and over.

Chapter 2: General Health, Cardiovascular Conditions, and Caring

In 2024:

• Seven in ten adults reported their general health to be 'very good/good' (70%), a proportion at the lowest end of range 70%-77% recorded since 2008.

• The prevalence of self-reported very good/good general health in adults decreased with age, from 88% among those aged 16-24 to 53% among those aged 75 and over.
• Half of all adults reported having a long-term condition (50%), the highest proportion in the timeseries. Almost two in five adults (39%) reported having a long-term condition that limited their activities.
• Over four in five adults (81%) who reported living with a long-term condition experienced at least one impairment as a result, most frequently related to mobility (32%), stamina/breathing/fatigue (28%) and/or mental health (26%).
• The proportion of adults with doctor-diagnosed diabetes rose to 8%, the highest level recorded.
• Prevalence of cardiovascular diseases, diabetes and IHDs increased with age, with highest prevalence among adults aged 75 and over (42%, 20% and 20% respectively).

In 2023/2024 combined:

• Fifteen per cent of adults reported being unpaid carers, a proportion which was higher among females (17%) compared with males (12%).
• Among those who provided unpaid care, mean WEMWBS scores ranged from 45.5 among those providing 20-34 hours of unpaid care per week to 49.4 among those providing unpaid care for up to four hours per week.

Chapter 3: Perimenopause and Menopause

In 2024:

• Just under three quarters of those aged 45-55 (72%) and around half of those aged 56 and over (53%) for whom questions on menopause and perimenopause were applicable had experienced symptoms of menopause or perimenopause in the last 12 months.

• Around one in fourteen (7%) of those for whom questions on menopause and perimenopause were applicable had surgical/medical treatment or a medical condition that resulted in early menopause.
• Surgical intervention only was the most frequently reported reason for early menopause (57% of those who had experienced this) with a further 10% reporting the cause as both a surgical intervention and medical treatment and 12% as medical treatment only.
• Around six in ten of those who had experienced menopause or perimenopause symptoms had been in contact with a healthcare professional in the last 12 months (58%), with the largest proportion having consulted a General Practitioner (GP) (45%).
• The majority of those who had not contacted a healthcare professional about their menopause or perimenopause symptoms indicated that they felt able to manage symptoms themselves (58%). Around a quarter felt they had been able to manage symptoms in other ways (27%) and/or that it was too soon to seek advice (25%).
• Physical activity (40%), hormone replacement therapy (HRT) (38%), and use of vitamins, minerals or supplements (35%) were the most common ways used to manage symptoms of menopause or perimenopause.
• Significant variations were evident by age with regard to menopause or perimenopause symptom management. Those aged 45 and over were more likely to have used HRT (44%-45%) compared with those aged 30-44 (10%).

Chapter 4: Respiratory

In 2024:

• Prevalence of doctor-diagnosed asthma amongst adults reached 18%, the highest proportion recorded since the timeseries began in 2003.

• The age-standardised proportion of adults with doctor-diagnosed asthma varied by smoking status, from 25% of non or occasional smokers to 56% of adults who smoked 20 or more cigarettes a day.
• Almost one in ten (9%) of adults aged 65 and over had been diagnosed with COPD, compared to less than 1% of adults aged 16-44.
• Seven per cent of adults reported currently having long COVID[6], consistent with 2023 (8%) and remaining higher than in 2021 (5%).
• Almost three in five adults (59%) who reported having long COVID felt that their symptoms worsened after physical and/or mental effort.
• A small proportion of adults (2%) reported having doctor-diagnosed sleep apnoea, with prevalence most common among males aged 55-64 (7%).

Chapter 5: Dental Health

In 2024:

• Over nine in ten adults (93%) had at least some natural teeth, towards the top end of the range recorded since 2008 (88%-96%).

• The majority (90%) of adults reported having no issues with their mouth, teeth, or dentures. This proportion has remained broadly consistent since 2018 (89%-91%).
• Mental wellbeing scores for adults who reported having issues with their mouth, teeth, or dentures were much lower than for those who reported having no issues (mean WEMWBS scores of 43.3 and 49.1 respectively).

Chapter 6: Diet & Food Insecurity

In 2024:

• Just over one in ten adults (11%) ate the SDG of five or more portions of fruit and vegetables per day, with a mean intake of 2.9 portions per day. The proportion eating five portions or more per day was the lowest in the timeseries, with prevalence in the range 20%-24% between 2003 and 2021[7] [8].

• Less than one in five adults (19%) met the energy density SDG of no more than 125 kcal/100g/day. The average energy intake per day was 1,538 kcal.
• Less than a quarter (22%) of adults met the SDG of free sugars accounting for no more than 5% of energy excluding ethanol. On average, free sugars were double the recommendation, making up 10% of energy intake.
• Almost three quarters (74%) of adults met the 70g or lower SDG for red and red processed meat, a proportion that was higher among females (84%) compared with males (63%).
• Thirteen per cent of adults met the SDG for saturated fat of no more than 10% of energy excluding ethanol. Only 3% of those aged 75 and over met the goal.

• Less than 1 in 20 (3%) adults met the SDG fibre target of 30g or more per day, with an average intake of 15g per day.
• Eight per cent of adults worried about running out of food due to a lack of money or other resources in the last 12 months, a decrease from 14% in 2023 which was the highest level in the timeseries.
• Just over a third (36%) of adults in single parent households had worried that they would run out of food in the last 12 months for 2023/2024 combined.

Chapter 7: Physical Activity

In 2024:

• Around six in ten adults met the guidelines for moderate or vigorous physical activity (MVPA)[9] (62%), a similar proportion as recorded in 2023 (63%) and within the overall range of 62% - 69% recorded since 2012.

• The proportion of adults meeting the MVPA guidelines decreased as area deprivation increased, from 73% of those living in the least deprived areas to  50% of those living in the most deprived areas.
• Almost seven in ten (68%) children met the physical activity guidelines[10] (including activity at achool).
• Older children were less likely to meet the physical activity guidelines with 66%-77% of children aged 2-12 meeting the guidelines (including activity at school), compared to 54% of children aged 13-15.
• The most common reasons given by adults for taking part in physical activity were to keep fit (not just to lose weight) (68%), for enjoyment (61%), to de-stress/relax/unwind (47%), for health reasons/to improve health (38%) and to socialise (37%).
• The most common barriers to physical activity mentioned were health not being good enough (39%), difficulty finding the time (27%) and/or not being interested (16%).
• Sedentary time for adults was at the higher end of the range recorded across the time series for both weekdays and weekends (5.7 and 6.4 hours on average respectively).
• A steady increase in time spent on sedentary leisure activities has been recorded for children since 2013 with weekdays ranging from 3.3 – 3.8 hours, and weekends ranging from 4.4 – 5.2 hours on average. 

Chapter 8: Smoking

In 2024:

• Fourteen per cent of adults were current smokers, the same level as in 2023, maintaining the overall downward trend in prevalence recorded since 2003 (28%).

• Smoking prevalence was much higher among adults living in the most deprived areas in Scotland (23%), than among those living in the least deprived areas (7%).
• Current use of e-cigarette or vaping devices has increased from the range 5%-7% between 2014 and 2021, to 10%-12% since 2022 (10% in 2024).
• E-cigarette or vaping device use was most prevalent among young adults aged 16-24 (18%), decreasing by age to 2% among those aged 75 and over.
• Around half (52%) of current adult smokers would like to give up smoking.

In 2022/2023/2024 combined:

• Thirteen per cent of adults with a valid saliva cotinine measure self-reported as a current cigarette smoker, which increased to 17% when adjusted for cotinine levels. (Note: the use of products containing nicotine other than NRT or vapes – such as nicotine pouches – may be impacting these results).

• A significantly higher proportion of non-smokers who did not vape [11] had detectable levels of cotinine in their saliva[12] (26%) indicating potential exposure to second-hand smoke. This compares with 21% in 2018/2019 combined, and is similar to the level recorded in 2012/2013 combined to 2016/2017 combined (24%-26%). (note: the use of products containing nicotine other than vapes and NRT – such as nicotine pouches – and, potentially, exposure to second-hand vapour, may be impacting these results).

Chapter 9: Alcohol

In 2024:

• The prevalence of hazardous or harmful[13] alcohol consumption remained at 20% of adults, the same proportion as in 2023 and a decrease from 34% in 2003. The proportion of males that drank to hazardous or harmful levels was more than twice as high as that of females (29% and 13% respectively).

• The prevalence of hazardous or harmful weekly alcohol consumption varied with age, with the highest levels recorded for those aged 55-64 (28%).
• Adults living in the least deprived areas were more likely to drink to a hazardous or harmful level (26%) compared with those in the most deprived areas (15%).
• Of adults who consumed alcohol in the week prior to interview, 8% reported doing so every day in 2023/2024 combined. This proportion increased with age from 1% of those aged 16-24 to 20% of those aged 75 and over.

Chapter 10: Obesity

In 2024:

• A third of adults (31%) were living with obesity[14] in 2024, a similar proportion to 2023 (32%), with a significantly higher proportion of females (35%) living with obesity compared with males (27%). The mean BMI of adults in 2024 was 28.1 kg/m2, an increase from 27.1 kg/m2 in 2003.

• The highest prevalence of healthy weight[15] was for adults aged 16-24 (58%) compared with 23%-38% of those in other age groups.
• Almost two-thirds of children (65%) were within a healthy weight range[16] based on their BMI. This proportion has been in the range 64% - 72% since 1998.
• Just under a fifth of children (18%) were at risk of obesity[17], the same level as in 2021 and 2022 and the highest level in the timeseries (fluctuating between 13% and 18% between 1998 and 2024).
• A third of all children in 2024 were at risk of overweight (including obesity)[18] (33%).

References and notes 

[1] WEMWBS scores range from 14 to 70. Higher scores indicate greater wellbeing.

[2] GHQ-12 scores range from 0 to 12. Scores of 4 or more are indicative of a possible psychiatric disorder.

[3] Based on the five question The SCOFF questionnaire: a new screening tool for eating disorders - PMC. Two or more yes answers indicates eating behaviors and feelings related to food that could be indicative of a possible eating disorder.

[4] Depression symptom score: two or more symptoms indicate depression of moderate to high severity.

[5] Anxiety symptom score: two or more symptoms indicate anxiety of moderate to high severity.

[6] Long COVID is defined as experiencing symptoms more than 4 weeks after first had COVID-19, that were not explained by something else.

[7] Figures prior to 2021 were collected via a module included in the CAPI interview that did not use Intake24.

[8] Analysis of the Intake24 data for 2021 and 2024 was undertaken using a ‘usual intakes’ approach which mitigates against the effects of day-to-day differences in food intake.   The change to this methodology has reduced the proportion of adults consuming five or more portions of fruit and vegetables a day in 2021 from 22% (as reported in the 2021 report) to 20%.  The figure for 2024 may also be lower than it would have been under the previous approach.   For more information, see the SHeS 2024 Technical Report.

[9] At least 150 minutes of moderately intense physical activity or 75 minutes of vigorous activity per week or an equivalent combination of both.

[10] Moderate-to-vigorous intensity physical activity for an average of at least 60 minutes per day.

[11] Non-smokers are defined to be those both self-reporting being a non-smoker and having a saliva cotinine level lower than 12ng/ml. Excludes non-smokers who report current use of e-cigarettes or vapes and those who reported using Nicotine Replacement Therapy in the last 7 days, as these also affect cotinine levels.

[12] Non-smokers' exposure to cotinine is defined by a detectable level in their saliva of > 0.1ng/ml.

[13] Hazardous/harmful: Consumed more than 14 units of alcohol per week.

[14] BMI of 30kg/m2 or more.

[15] BMI of higher than 18.5kg/m2 and lower than 25kg/m2.

[16] BMI above 2nd percentile and below 85th percentile.

[17] BMI at or above 95th percentile.

[18] BMI at or above 85th percentile.