Health Survey for England

Rachel Craig

Health Survey for England

• Commissioned by the NHS Information Centre for health and social care

• Conducted by NatCen and UCL

• 2006 report: Cardiovascular disease• 2007 report: Knowledge and attitudes about health

Impact of the smoking ban• 2008 report: Physical activity

2006 focus:Cardiovascular disease• CVD: ever had angina, heart attack, stroke, heart

murmur, or irregular heart rhythm, confirmed by a doctor

• Ischaemic heart disease (IHD): angina or a heart attack confirmed by a doctor

• Rose Angina questionnaire identifies those who had symptoms of angina, or possible myocardial infarction (heart attack)

Cardiovascular disease

• A leading contributor to the global disease burden• Main cause of death in England - but rates falling

In 2006

• 13.6% of men, 13.0% of women diagnosed with CVD• Prevalence increases with age• IHD or stroke more common in men than women

(8.1% and 5.6%)

Prevalence of any CVD, IHD or strokeAge 35 and over

0

10

20

30

40

50

35-44 45-54 55-64 65-74 75+

Age

Perc

ent

Men

0

10

20

30

40

50

35-44 45-54 55-64 65-74 75+

Age

Perc

ent

Any CVD

IHD

Stroke

Women

Prevalence of heart attack: doctor diagnosis and the Rose Angina questionnaire

Men

0

24

6

810

12

1416

18

16-24 25-34 35-44 45-54 55-64 65-74 75+

Age

Perc

ent

Women

0

2

46

8

10

1214

16

18

16-24 25-34 35-44 45-54 55-64 65-74 75+

Age

Perc

ent

Doctor diagnosis

Rose angina

Prevalence of overweight and obesity

0

10

20

30

40

50

60

70

80

90

16-24 25-34 35-44 45-54 55-64 65-74 75+

Age

Perc

ent

Men

0

10

20

30

40

50

60

70

80

90

16-24 25-34 35-44 45-54 55-64 65-74 75+

Age

Perc

ent

Obese (BMI 30 or more)

Overweight (BMI 25-29.9)

Women

Physical activity levels

0

20

40

60

80

100

16-24 25-34 35-44 45-54 55-64 65-74 75+

Age

Per

cen

t

Men

0

20

40

60

80

100

16-24 25-34 35-44 45-54 55-64 65-74 75+

Age

Per

cen

t

Low MediumHigh

Women

Girls aged 11-15: physical activity by parental activity

0

20

40

60

80

100

Father high Mother high Father low Mother low

Parental physical activity

Per

cen

t

Low

Medium

High

Trends in prevalence of strokes, 1994-2006

Men

0

2

4

6

8

10

12

14

All 16+ 55-64 65-74 75+

Age

Perc

ent

Women

0

2

4

6

8

10

12

14

All 16+ 55-64 65-74 75+

Age

Perc

ent

1994199820032006

Trends in child overweight and obesity, 1995-2006 (moving averages)

0

5

10

15

20

25

30

35

40

45

50

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Pe

rce

nt

Boys Overweight incl. Obese

Boys Obese

Girls Overweight incl. Obese

Girls Obese

Trends in smoking prevalence 1993-2006 (moving averages)

15

20

25

30

35

1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Year (mid year of moving average)

Perc

ent

Men

Women

Cigarette smoking prevalence by equivalised household income 2006 (age standardised)

0

5

10

15

20

25

30

35

40

Highest Middle Lowest

Equivalised household income quintiles

Perc

ent

Men

Women

Drinking on five or more days last week (age standardised)

0

5

10

15

20

25

30

35

Highest Middle Lowest

Equivalised household income quintile

Perc

ent

Men

Women

Eat five or more portions of fruit and vegetables per day(age standardised) Age 16+

0

5

10

15

20

25

30

35

40

Highest Middle Lowest Equivalised household income quintile

Perc

en

t

Men

Women

Eat five or more portions of fruit and vegetables per dayAge 5-15

0

5

10

15

20

25

30

35

40

Highest Middle LowestEquivalised household income quintile

Perc

ent

Boys

Girls

HSE 2007

• Sample around 7500 adults, and child boost sample

• Focus on:• knowledge and attitudes (adults and children

aged 11+)• children’s health and lifestyles (obesity)• monitoring the effect of smoke free legislation

• …reporting end of 2008

Knowledge and attitudes• Important to understand knowledge and attitudes

about • Healthy eating• Physical activity• Drinking• Smoking

• Link behaviour and health to knowledge and attitudes

• Link parental and child knowledge and attitudes

• …Help to target health messages effectively

HSE 2008

• Sample around 16,000 adults, and child boost sample

• Focus on physical activity:• Questions on activities, sport and exercise in

the last 4 weeks• Objective measure of activity• Nurse visit includes objective measure of

fitness

• …reporting end of 2009

The actigraph

• Objective measure of physical activity• Physical activity monitor worn on a belt • Like a pedometer• Respondents wear it for 7 days

The step test:objective measure of fitness

• Indicator of health risk independent of obesity

• Measure of functional aerobic work capacity (Vo2max)

• Stepping exercise to a set rhythm, getting faster

• Heart rate recorded while stepping and afterwards

An area of exploration: Demi-span

• For older adults, height can be a difficult measurement

• How accurate is the formula linking demi-span and ‘true’ height?

• Is the relationship the same among younger adults and 65+?

• How accurately can older adults’ recall their height when they were aged 25 – ‘peak height’?

Thank you

Questions?