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Health Education Population Survey (HEPS): Update from 2004 Survey - Final Report

Summary

Background

• This report presents an update on time trends in health-related knowledge, attitudes, motivations and behaviours in Scotland over the period 1996-2004, providing data from the Health Education Population Survey in 2004. This report focuses on areas where there has been a change, or consolidation of an earlier change, in 2004.
• In 2004, 1784 interviews were achieved, representing a response rate of 2004.
• More information on the survey can be found in the 1996-2003 HEPS report published by NHS Health Scotland.
• While the aim of the analysis is to assess the degree of significant change in these indicators over time, the sample size and design mean that it is sometimes difficult to distinguish observed variations due to actual small changes from those due to random sampling error.

Overview – 2004 update

• The belief that people can influence their own health continued to increase (82% in 2004)
• The slight decrease over time in sedentary behaviour has been consolidated in 2004 (30%), although the apparent increase in protective behaviour in 2002/2003 has not (39%).
• Reported consumption of fruit and vegetables and knowledge of recommended levels of consumption continued to increase. In 2004 one in three met the recommended levels and reported consumption increased for men and the lower social grades, both groups previously slower to change.
• Smoking prevalence appears to have continued to decrease (27%) and this is backed up by the Scottish Household Survey.
• The proportion of men exceeding the recommended alcohol limit appears to have fallen from a quarter to a fifth. However, motivation to cut down drinking has also dropped (23%), reversing a previously increasing trend.
• There were no discernible changes in mental health over time, and the apparent increase in mental health disorder in 2003 appears to have been a random fluctuation.
• 2004 saw consolidation of the increases observed previously in the proportion attending the dentist in the past year (74%), in the past six months for a routine check-up (48%) and intended visits in the next six months (77%).
• There was a declining demand for more information on recognising the symptoms of STIs (20%), having an HIV test (13%), HIV transmission (9%) and emergency contraception (7%). There were more decreases in demand for the 16-24 age group than in previous years.
• Seven in ten were aware that there had been a change in legislation but only four in ten knew that cannabis is still illegal to use and possess. Men, younger respondents cannabis users and those in the highest social grades were most likely to know the broad content of the legislation

Attitudes to own health

• Three quarters of people felt that their health was good, although around a third reported a long-standing illness or disability and this has not changed over time.
• Most people felt that they could influence their own health and this increased from 76% in 1996 to 82% in 2004.
• As in previous years, those in the lowest social grades and, in particular, older people were least likely to think their health was good, most likely to report a long-standing illness and least likely to feel they have any influence over their own health. This means that those groups most in need of improvements to their health are also likely to be those who are least open to health education messages because they don’t believe they can influence their own health.

Physical activity

• Three in ten adults were sedentary. Younger respondents were least likely to have a sedentary lifestyle, as were those from higher socio-economic groups.
• The slight decrease over time in sedentary behaviour has been consolidated in 2004 (30%), although the apparent increase in protective behaviour in 2002/2003 has not (39%).
• Men were more likely than women to achieve the recommended levels of physical activity, but no less likely to be sedentary.
• Around one third were aware of the minimum daily recommended levels of moderate intensity physical activity; there has been no change in these knowledge levels. Only one in ten knew that moderate activity was recommended five times a week to stay healthy, with three in ten believing daily exercise was needed.
• Those in the lower social grades were more likely to be sedentary and less likely to be aware of the recommended levels of moderate activity. However, they were most likely to walk more than 30 minutes on an average day, possibly out of necessity rather than as a health-related choice.
• Levels of motivation to take more exercise remain largely unchanged from 2002 to 2004.

Diet

• Consumption of fruit and vegetables was higher among women, older respondents and those from higher socio-economic groups.
• There was continued increase among all respondents in terms of consuming the recommended amount of fruit and vegetables (reaching 33% in 2004) with the exception of the youngest age group (aged 16-24) and those living in more deprived areas.
• In 2004 there have been particular increases in reported fruit and vegetable consumption for men and those in the lower social grades. These should be monitored in the future to determine if they will be sustained.
• There have been continued increases in knowledge levels regarding the current recommendation for fruit and vegetable intake (63%).

Smoking

• A clear social gradient in smoking patterns is apparent by social grade and deprivation, with respondents from social grade AB showing the lowest prevalence.
• There appears to be a decrease in smoking prevalence over time, down from a third in 1997 to just over a quarter (27%) in 2004. Whilst this seems to be backed up by the Scottish Household Survey, future years’ data will help to confirm this trend.
• Most regular smokers (80%) are motivated to cut down or quit smoking; there has been no significant change in levels of motivation over time.

Alcohol

• Men were more likely to exceed the recommended weekly limits and to binge drink than women. In 2004, however, the proportion of men exceeding the recommended limit appears to have fallen from a quarter to a fifth.
• There was a significant increase in knowledge levels regarding the recommended weekly limits between 1996 and 1997, but these levels are still relatively low and have shown no further significant increases. Women were more likely than men to be aware of the recommended limits for the first time in 2004.
• A slight decrease in motivation to cut down alcohol consumption in 2004 (23%) means that levels of motivation are not significantly higher than they were in 1996, reversing the apparent increase in motivation recorded over the past few years.

Mental health

• Women were more likely than men to report symptoms of potential mental distress.
• There was a marked social gradient in symptoms of mental distress and disorder, with those living in more deprived areas and in social grade E reporting more symptoms.
• There were no discernible changes over time, and the apparent increase in mental health disorder in 2003 appears to have been a random fluctuation.

Oral health

• 2004 saw consolidation of the increases observed previously in the proportion attending the dentist in the past year (74%), in the past six months for a routine check-up (48%) and intended visits in the next six months (77%).
• Older people, and those from lower socio-economic groups were less likely to have visited a dentist and there is no sign of the gap reducing between those in the highest and lowest social grades.

Sexual health information needs

• There was a declining demand for more information on recognising the symptoms of STIs (20%), having an HIV test (13%), HIV transmission (9%) and emergency contraception (7%).
• In 2004 there was a decrease in demand amongst those aged 16-24 for information on HIV/AIDS transmission (16%) and emergency contraception (9%).

Cannabis legislation

• Seven in ten were aware that there had been a change in legislation but only four in ten knew that cannabis is still illegal to use and possess.
• Men, younger respondents and those in the highest social grades were most likely to know the broad content of the legislation
• Seven per cent of respondents said the legislation would make them more likely to use cannabis, rising to 22% of recent users of the drug. Correct understanding of the legislation had little effect on this.