Is the Scottish population living dangerously? Prevalence of multiple risk factors: the Scottish Health Survey 2003

Diane Stockton,Alan Finlayson,David H Brewster,Richard Lawder,Jim Chalmers,Oliver Harding,David I Conway,Colin Fischbacher

doi:10.1186/1471-2458-10-330

Abstract

BackgroundRisk factors are often considered individually, we aimed to investigate the prevalence of combinations of multiple behavioural risk factors and their association with socioeconomic determinants.MethodsMultinomial logistic regression was used to model the associations between socioeconomic factors and multiple risk factors from data in the Scottish Health Survey 2003. Prevalence of five key risk - smoking, alcohol, diet, overweight/obesity, and physical inactivity, and their risk in relation to demographic, individual and area socioeconomic factors were assessed.ResultsFull data were available on 6,574 subjects (80.7% of the survey sample). Nearly the whole adult population (97.5%) reported to have at least one behavioural risk factor; while 55% have three or more risk factors; and nearly 20% have four or all five risk factors. The most important determinants for having four or five multiple risk factors were low educational attainment which conferred over a 3-fold increased risk compared to high education; and residence in the most deprived communities (relative to least deprived) which had greater than 3-fold increased risk.ConclusionsThe prevalence of multiple behavioural risk factors was high and the prevalence of absence of all risk factors very low. These behavioural patterns were strongly associated with poorer socioeconomic circumstances. Policy to address factors needs to be joined up and better consider underlying socioeconomic circumstances.

Highlights

Risk factors are often considered individually, we aimed to investigate the prevalence of combinations of multiple behavioural risk factors and their association with socioeconomic determinants
The World Health Organisation's Global Burden of Diseases Project identified five risk factors which contribute around 90% of the total burden of disease in high income country populations: tobacco use, alcohol consumption, poor diet, physical inactivity, overweight and obesity [1]
We aim to use population data from the Scottish Health Survey to assess the prevalence of different combinations of multiple behavioural risk factors and to examine how these combined behaviours relate to area-based and individual socioeconomic factors

Summary

Introduction

Risk factors are often considered individually, we aimed to investigate the prevalence of combinations of multiple behavioural risk factors and their association with socioeconomic determinants. While epidemiological evidence is usually gathered on a single-risk factor basis [2,3], risk factors occur in individuals and populations in different combinations, and may show additive or multiplicative interactions [4,5]. This has implications for interventions - is it better to focus on one risk factor at a time, or to encourage motivated individuals to make more wholesale changes in their lifestyle to address more than one risk factor at a time?. Most studies focus on smoking; and while there is abundant evidence of the association with lifestyle and socioeconomic status, there is limited consideration of the relationship between combinations of multiple behaviours and socioeconomic factors. We aim to use population data from the Scottish Health Survey to assess the prevalence of different combinations of multiple behavioural risk factors and to examine how these combined behaviours relate to area-based and individual socioeconomic factors

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Conclusion