1. Scottish Health Survey What we know so far
Sonnda Catto
Public Health Surveys Manager

2. Outline Focus on adults (published September 2009) Change over time
Children’s web-published 24th November
Change over time
Short term post LMSMA ( )
Longer term ( )
2008 performance against target: 50% active by 2022
Inequalities
Implications for future action
Adults
Change over time, over both the short term ( ) since release of the strategy, and the longer term ( ), which provides some context
Performance against the national target in 2008
Current survey runs from
2008 results published in September 2009, included headline physical activity results for adults
Children’s results will be web published in mid-November

3. A few methodological points to note
Time trends reported for 1998, 2003 and 2008
2008: added bouts of activity of minutes
Time trends based upon previous 15-minute threshold
Detailed analysis of 2008 data (gender, sex, SES) based on 10-minute threshold
Impact of change on estimates was small: % meeting the recommendations up by 1% or 2%
1998 and 2003 figures differ from those presented in the in 2003 report!!!
Time trends reported for 1998, 2003 and 2008
Physical activity questionnaire was changed substantially in 1998 so not comparable with 1995 results
1998 and 2003 figures differ from those in last report!!!
Some changes have been made to the way in which some of the sporting activities are classified which means that the 1998 and 2003 figures presented in the 2008 report differ to those published in the last report. The method used to estimate summary activity levels in the last report incorrectly classified some low intensity activities as mod or vig which resulted in an overestimation of the proportion mtg the recs in ’98 and ’03.

4. Trends over time This presentation will therefore focus opon: Adults
Change over time, over both the short term ( ) since release of the strategy, and the longer term ( ), which provides some context
Performance against the national target in 2008

5. * *
Significance
= sig for both men and women, ie sig in long term
= reported as being on the margins of sig in the report, ie almost statistically sig but note quite. This is based upon comparison of the 95% CIs for the two individual proportions (ie the CI for a proportion). Which is not as sensitive to difference as the 95% CI for the difference between proportions. Not done for report because lengthier to compute, but done on request for us and it shows that the increase between 2003 and 2008 is significant for both men and women.
Men: 42% to 46%, diff=4.5% points (95% CI 1.1% to 7.9%)
Women: 32% to 35%, diff=3.5% points (95% CI 1.1% to 5.9%)
Men
6% increase over 10 years
2% increase from and 4% increase (is act’ly 4.5% based on requested info) from
So for men, is good news in that rate of improvement has increased since launch of the strategy in 2003
And at 4.5% is almost consistent with the desired 1% increase per year (95%CI is from 1.1% to 7.9%, so worst case scenario is that increase has only been 1% over 5 years, best case is almost 8%)
With best estimate of 4.5%, need to slightly increase rate of improvement
Women
Also a 6% increase over 10 years
But equally spread between the surveys: 3% increase from and 3% increase (is act’ly 3.5% based on requested info) from
So for women, not so good news in that has been no change in the rate of improvement since launch of the strategy in 2003
And with a best estimate of 3.5%, it falls further short of the desired 1% increase per year (95%CI is from 1.1% to 5.9%, so worst case scenario is that increase has only been 1% over 5 years, best case is almost 6%)
With best estimate of 3.5% and no increase in the rate of improvement compared to 5 yrs pre-strategy, is an even greater need to turn up the volume on action targeted towards women

6. Rise of 3% for men over series, rise of 2% for women.
But NO CHANGE for either sex in last 5 yrs.
Shows that the increase in compliance with the recs has not occurred because more people are taking part in activity, rather the nature of people’s activities has changed (ie either have increased intensity, duration, or frequency of their activities).
* Heavy housework; heavy manual/gardening/DIY; walking; sports and exercise

7. Over the 10-year period, was no change at all amongst 16-24s = 57% in all 3 surveys.
Were increases amongst all remaining age groups with the largest increases among those aged and (+10% points for each).

8. In contrast, were increases amongst all age groups for women over the 10 year period ( ) with the largest increases in the oldest groups:
+9% percentage points (from 20% to 29%) in women aged 55-64
+12% percentage points (8% to 20%) among those aged 65-74

9. 2008 performance against target

10. Target
PERFORMANCE IN RELATION TO TARGET: 50% of adults to meet the recs by 2022
Overall, ie looking at the whole adult population (aged 16+), 45% of men and 33% of women met the current p.a. recs in 2008
The figure for all adults is 39%
So target not being met amongst either male or female populations overall (ie when don’t break down by age)
That’s 11% away from the 50% target to be achieved by 2022 (over 14 years from 2008)
That allows a 1% increase per year in accordance with the target, but is faster than the rate of progress observed over the last 5 years (+4% points for men and +3% for women)
Conc
So the target is still achievable based upon a 1% per year, but we need to turn up the volume to see that

11. Target PRIORITY TARGET GROUPS Men
PERFORMANCE IN RELATION TO TARGET: 50% of adults to meet the recs by 2022
Already being met by men aged 16-44
Suggests that in order to meet the overall target, need to focus efforts towards men aged 45+, they’re the priority group amongst men
Whilst also maintain current levels of activity amongst year-olds
PRIORITY = men aged 45+, with maintenance in younger age groups
Women
The overall target is not being met by women of ANY age
Suggests that in order to meet the overall target, need to focus efforts towards ALL women, regardless of their age
As for men, is greatest scope for improvement amongst older age groups
PRIORITY = all women regardless of age, tho greatest scope for improvement among older age groups
Age and gender effects
Men more likely than women to meet the recs regardless of age, tho difference is v small for 65-74s (21% vs 20%). Gap between the sexes is most marked up to the age of 34 (diff of 16% points for 16-24, 21% points for 24-34)
Younger age groups more likely to meet recs than their older counterparts.
For men, peaked at 25-34yrs with 63% mtg recs, before steadily declining to 13% among those aged 75+
For women, similar levels amongst 16-44s (42-43%) declining to just 4% of women aged 75+

12. * Quintile SHeS uses 2 measures of SIMD quintiles, to left of graph
and comparison of the most deprived 15% of areas with the rest of Scotland, identified as being of particular concern by SG, to the 85% least deprived areas, the bars to the far right of the graph
For both, increasing deprivation as move from left to right of graph
Again, the 50% target is drawn across the horizontal
Only group meeting the target are men in the middle quintile (51%)
Quintiles
Those living in the most deprived quintile were least likely to meet the recs, for both men and women (but when looking at the proportion mtg the recs, the diff between the most and least deprived quintiles is sig only for women and not men)
Otherwise no clear relationship between SIMD and mtg the recs for men
Clearer pattern evident for women: highest in least deprived quintile, lower but levelling off in middle quintiles (32% and 33%), slightly lower still in the
most deprived quintile
SIMD 85/15%
Those living in 15% most deprived less likely to have met the recs.
Difference is particularly marked for men (47 vs 35%) (Women 34 vs 28%)
Quintile

13. * *
Low levels of activity are more clearly patterned by deprivation. Is a sig difference in the proportions with low levels of activity between the most and least deprived quintiles for both men and women.
NOTE
Because we also requested these data for 2003, they are based on the 15-min threshold rather than 10. Therefore not consistent with the previous few tables. %s wd be very slightly higher if based on activities of 10 mins duration or more.
*Based on activities done for at least 15 minutes, therefore not consistent with remaining 2008 results which are based on 10-minute or more duration

14. Conclusions
Have been significant improvements in adult compliance with the recommendations over both the short and long term (ie and )
Inequalities still exist with patterns the same as in previous surveys (gender, age, SIMD)
Target remains achievable but we need to accelerate the rate of progress

15. Priority areas for action
Men aged 45+ (with maintenance in the 16-44s)
Women of all ages
Older individuals
Reducing the gender gap in younger men and women (16-34 years)
Those living in the most deprived areas
Priority target groups:
men aged 45+
all women
Older individuals (with lowest % mtg the recommendations amongst elderly, is greater scope for improvement among these groups)
those living in the most deprived areas