Abstract
BackgroundSocioeconomic inequalities in health outcomes have increased over the past few decades in some countries. However, the trends in inequalities related to multiple health risk behaviours have been infrequently reported. In this study, we examined the trends in individual health risk behaviours and a summary lifestyle risk index in New South Wales, Australia, and whether the absolute and relative inequalities in risk behaviours by socioeconomic positions have changed over time.MethodsUsing data from the annual New South Wales Adult Population Health Survey during the period of 2002–2012, we examined four individual risk behaviours (smoking, higher than recommended alcohol consumption, insufficient fruit and vegetable intake, and insufficient physical activity) and a combined lifestyle risk indicator. Socioeconomic inequalities were assessed based on educational attainment and postal area-level index of relative socio-economic disadvantage (IRSD), and were presented as prevalence difference for absolute inequalities and prevalence ratio for relative inequalities. Trend tests and survey logistic regression models examined whether the degree of absolute and relative inequalities between the most and least disadvantaged subgroups have changed over time.ResultsThe prevalence of all individual risk behaviours and the summary lifestyle risk indicator declined from 2002 to 2012. Particularly, the prevalence of physical inactivity and smoking decreased from 52.6% and 22% in 2002 to 43.8% and 17.1% in 2012 (p for trend<0.001). However, a significant trend was observed for increasing absolute and relative inequalities in smoking, insufficient fruit and vegetable consumption, and the summary lifestyle risk indicator.ConclusionsThe overall improvement in health behaviours in New South Wales, Australia, co-occurred with a widening socioeconomic gap.ImplicationsGovernments should address health inequalities through risk factor surveillance and combined strategies of population-wide and targeted interventions.
Highlights
Lifestyle risk behaviours, such as smoking, diet, and physical inactivity, are important contributors to morbidity and mortality worldwide [1]
We examined the trends in individual health risk behaviours and a summary lifestyle risk index in New South Wales, Australia, and whether the absolute and relative inequalities in risk behaviours by socioeconomic positions have changed over time
Socioeconomic inequalities were assessed based on educational attainment and postal area-level index of relative socioeconomic disadvantage (IRSD), and were presented as prevalence difference for absolute inequalities and prevalence ratio for relative inequalities
Summary
Lifestyle risk behaviours, such as smoking, diet, and physical inactivity, are important contributors to morbidity and mortality worldwide [1]. Studies have found that the co-occurrence of multiple health risk behaviours could exert synergistic effects on health [2] These risk behaviours consistently cluster among certain population subgroups, such as those with lower socioeconomic status (SES) [3, 4]. In the last few decades, public health interventions in many countries around the world, including in Australia, have led to population-level improvement in some individual health behaviours. We examined the trends in individual health risk behaviours and a summary lifestyle risk index in New South Wales, Australia, and whether the absolute and relative inequalities in risk behaviours by socioeconomic positions have changed over time
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