FMR letter
7 Health 7.1
Introduction
This section looks at health information as it applies to the NGSIP Board area and North Glasgow SIP (where available), combining primary survey based data and secondary data from Greater Glasgow NHS Board. Note that although the secondary data are available at the individual SIP level, they are not available specifically for the NGSIP Board area or the non-SIP part of the NGSIP Board area.
7.2
Secondary data on health and wellbeing
There are three CCIs relating to health. The first of these is CCI 3 - the total number and rate of women breastfeeding at 6 to 8 weeks after the birth of their child. Figure 64 shows the percentages of mothers breastfeeding at birth, at first health visitor visit and at the 6 week health visitor visit. In North Glasgow SIP, the percentage of babies being breastfed at the 6 week health visitor visit is 33%, down 4% on the level recorded at the first health visitor visit. The six week visit rate is three times that of the other two SIPs, and very slightly above the Glasgow-wide rate of 32%. Figure 64
Child Health Data – CCI 3 NGSIP
% of live births where baby is breastfed at birth % of live births where baby is breastfed at first health visitor visit % of live births where baby is breastfed at 6 weeks health visitor exam – CCI 3 Source: GGNHSB, 2002
Glasgow SIP
Glasgow non-SIP
All Glasgow
51%
39%
64%
53%
37%
26%
50%
39%
33%
20%
42%
32%
CCI 4 measures the total number and percentage of self-reported smoking pregnant women when booking their first antenatal appointment. These data are presented in Figure 65 below, along with other related data. Most noticeable is the range in these data across the different geographical study areas: 33% of mothers in North Glasgow SIP smoked during pregnancy, in comparison to just 20% in the non-SIP parts of (the whole of) Glasgow. Figure 65
Child Health Data – CCI 4 NGSIP
% of live births which are low birthweight babies % of live births where mother smoked during pregnancy – CCI 4 % of live births where anyone in the household smokes at 6-8 weeks post-natally % of anyone in the household smoking at 6 weeks exam by health visitor Source: GGNHSB, 2002
Glasgow SIP
Glasgow non-SIP
All Glasgow
6%
10%
8%
9%
33%
39%
20%
28%
36%
42%
23%
32%
29%
37%
21%
28%
Reducing the rate of unplanned conceptions among teenage girls is a nationwide priority that also has implications for improving the sexual health of young people. Figure 66 shows the rate of all teenage pregnancies (including planned and unplanned pregnancies resulting in birth or abortion) broken down by age.
FMR RESEARCH LTD
Figure 66
Health of young people – rate per 1000 population NGSIP
Teenage pregnancy rate under 16
Glasgow SIP
Glasgow non-SIP
All Glasgow
3.2
5.2
4.6
4.9
Teenage pregnancy rate 16-19
71.7
90.4
47.8
66.0
Teenage pregnancy rate total under 20
49.7
54.9
31.8
42.1
Source: GGNHSB, 2001. n.b. pregnancies includes all births and abortions. These figures are provisional at the time of writing.
CCI 8 concerns standardised mortality rates due to coronary/ischaemic heart disease, all cancers and specifically lung cancer. The figures presented in figure 67 below are ‘standardised mortality rates’, or SMRs. The figures do not represent actual numbers of deaths, but rather the rate of mortality in a population relative to a wider population. In this case all mortality rates are presented relative to the appropriate Scotland-wide level in 1997-1999 (n.b. years are combined into two year rolling totals in order to keep the sample sizes high to maintain statistical power). The data are adjusted so that the mortality rates for the different causes are all equal to 100 for Scotland as a whole in 1997-99. The data below therefore show the change relative to Scotland as a whole in 1997-99. For example, mortality from lung cancer is down 5.7% on the 1997-99 figure in Scotland as a whole (94.3-100). The 1999-2001 figures for cancer in North Glasgow SIP indicate that mortalities from all cancers were 1.62 times higher (62%) than the Scotland-wide level of 1997-99, and mortality specifically from lung cancer was 2.3 times higher (130%) than the Scotland-wide level of 1997-99. Figure 67
Family health & mortality rates – CCI 8 (1999-01 SMRs, relative to Scotland 1997-99) Glasgow SIP
Glasgow non-SIP
All Glasgow
Scotland
189.4
159.9
106.2
126.0
95.2
ischaemic heart disease
166.4
140.2
92.6
110.0
86.5
all cancers
162.3
141.7
101.6
116.4
97.3
lung cancer
226.6
185.4
113.6
140.0
94.3
NGSIP all causes
Source: GGNHSB, 1999-01. n.b. These figures are Standardised Mortality Ratios for 1999-01, standardised to the Scotland wide level in 1997-99. The figures above represent levels of disease in particular geographical areas relative to what would be expected from the Scotland wide picture in 1997-99 (baseline equals 100).
7.3
Residents’ perception of their health and wellbeing
7.3.1
Perceived quality of life
Interviewees in the 2003 residents’ survey were asked how they rated their overall quality of life (figure 68). Eleven percent of North Glasgow SIP respondents rated themselves at the highest point on the scale, lower than the NGSIP Board area as a whole (18%). Seventy-nine percent of North Glasgow SIP residents rated their quality of life as positive to some degree, slightly lower than the NGSIP Board area figure of 82%. Eight percent of North Glasgow SIP residents indicated that their quality of life was poor to some degree (a score of -1, -2 or -3). The corresponding figure for SIP based residents was 9% and for non-SIP residents, 4%.
FMR RESEARCH LTD
Figure 68
How would you best describe your overall quality of life? NGSIP
☺
SIP area
Non SIP area
Whole area
11%
14%
24%
18%
31%
32%
32%
32%
1
36%
32%
31%
32%
0 -1
13%
13%
9%
11%
5%
5%
2%
4%
-2
1%
1%
1%
1%
-3 Total
2%
3%
1%
2%
100%
100%
100%
100%
3 2
Source: 2003 residents’ survey
Figure 69
How would you best describe your overall quality of life?
40% NGSIP
35%
Non SIP
30% 25%
Whole area
20% 15% 10% 5% 0% 3
7.3.2
2
1
0
-1
-2
-3
Perceived physical health
Residents were also asked to rate their perception of their physical health on the same seven point scale (figure 70). Eighteen percent of North Glasgow SIP residents rated this at the highest point on the scale, slightly lower in comparison to the whole area (23%). Seventy-three percent of North Glasgow SIP residents rated their physical health as being positive to some degree, the same as for the aggregated SIP areas and the whole NGSIP Board area. Figure 70
How would you best describe your physical health at present? NGSIP
☺
SIP area
Non SIP area
Whole area
18%
20%
27%
23%
26%
27%
25%
26%
1
29%
25%
22%
24%
0 -1
11%
12%
12%
12%
11%
10%
9%
10%
-2
2%
3%
2%
2%
-3 Total
2%
3%
3%
3%
100%
100%
100%
100%
3 2
Source: 2003 residents’ survey
FMR RESEARCH LTD
Figure 71
How would you best describe your physical health at present?
35% NGSIP
30% Non SIP
25%
Whole area
20% 15% 10% 5% 0% 3
7.3.3
2
1
0
-1
-2
-3
Perceived mental and emotional wellbeing
Residents were asked to assess their general mental and emotional wellbeing on the same seven point scale (figure 72 & 73). The proportion of North Glasgow SIP residents rating this at the top point of the scale was 16%, in comparison to 23% for the NGSIP Board area. Eighty percent of North Glasgow SIP respondents rated their mental and emotional wellbeing as positive to some degree (differing little from the NGSIP Board area figure of 81%), and there was little distinction between SIP and non-SIP residents in this regard. Figure 72
How would you best describe your general mental and emotional well being? NGSIP
☺
SIP area
Non SIP area
Whole area
16%
19%
29%
23%
35%
33%
29%
31%
1
29%
27%
27%
27%
0
12%
12%
7%
10%
-1
4%
4%
5%
5%
-2
1%
1%
2%
2%
-3
3%
3%
1%
2%
100%
100%
100%
100%
3 2
Total
Source: 2003 residents’ survey
FMR RESEARCH LTD
Figure 73
How would you best describe your general mental and emotional well being?
40% 35%
NGSIP
30%
SIP area
25%
Non SIP
20% 15% 10% 5% 0% 3
2
1
0
-1
-2
-3
Respondents to the 2003 residents’ survey were asked if they or anyone else in their household had a long standing illness, health problem or disability that affected their daily activity or the type of work that they could do (figure 74). In North Glasgow SIP, 30% of households had at least one person in this category, slightly lower than the NGSIP Board area (33%). Figure 74
Do you, or does anyone in your household, have any long standing illness, health problem or disability that limits your/their daily activity or the kind of work that you/they can do? NGSIP
Yes, me Yes, me and others Yes, others in household No Total
Non SIP area
Whole area
15%
SIP area 18%
14%
16%
3%
4%
4%
4%
12%
12%
14%
13%
70%
66%
68%
67%
100%
100%
100%
100%
Source: 2003 residents’ survey
7.4
Diet and exercise
In the course of the 2003 study, residents were asked about their exercise habits (figure 75). The first question asked residents to give the number of days in a week on which they took at least 20 minutes of vigorous and continuous exercise. Fiftythree percent of North Glasgow SIP residents said that they never did this, in comparison to 64% of respondents for the whole area. The recommended level of vigorous exercise of 20 or more continuous minutes on at least 3 days a week was achieved by 23% of NGSIP Board area respondents, and by 33% of North Glasgow SIP residents. The second part of this question explored habits relating to moderate exercise spread over the course of a day. Seventeen percent of North Glasgow SIP residents said they never took exercise at this level, in contrast to 26% of respondents across the NGSIP Board area.
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The recommended level of exercise of 30 minutes or more of accumulated moderate physical exercise on at least 5 days a week was taken by 68% of North Glasgow SIP residents, and by 57% in the NGSIP Board area. Figure 75
On how many days of the week do you… NGSIP
take at least 20 minutes of continuous and vigorous exercise (enough to make you sweaty and out of breath)? take at least 30 minutes moderate exercise, such as brisk walking? This doesn’t have to be 30 minutes all at once.
Non SIP area
SIP area
Whole area
0
53%
63%
66%
64%
1-2
13%
12%
13%
13%
3 or more
33%
26%
21%
23%
100%
100%
100%
100%
0
17%
23%
29%
26%
1-4
14%
14%
22%
17%
5 or more
68%
64%
39%
57%
100%
100%
100%
100%
Total
Total
Source: 2003 residents’ survey
Figure 76
On how many days of the week do you take vigorous exercise?
70% 60% 50%
NGSIP
40%
Non SIP area
30%
Whole area
20% 10% 0% 0
Figure 77
1
2
3
4
5
6
7
On how many days of the week do you take moderate exercise?
50% 45% 40%
NGSIP
35% 30%
Non SIP area
25%
Whole area
20% 15% 10% 5% 0% 0
FMR RESEARCH LTD
1
2
3
4
5
6
7
Respondents in the 2003 survey were asked their views on the proposition that they would exercise more if there were facilities nearby. Forty-nine percent of North Glasgow SIP residents agreed that they would, in contrast to 34% of NGSIP Board area residents. In the 2003 residents’ survey, respondents were asked their views on healthy eating and lifestyles (figure 78). The first question in this series explored the perceived impact of sensible eating on health. Four percent of North Glasgow SIP residents (the same as the overall NGSIP Board area rate) agreed strongly with the idea that they could be healthier if they ate more sensibly. Respondents were asked their attitudes to the statement ‘I don’t have time to make healthy food’, and results were similar across the different study areas. Eighty-nine percent of North Glasgow SIP residents did not agree with this statement, in line with the whole area figure of 85%. This suggests that for most people, time is not a limiting factor in healthy eating. Respondents were asked if they agreed with the statement ‘I cannot get healthy food in my local shops’. Sixteen percent of North Glasgow SIP residents and 18% of the NGSIP Board area residents in the 2003 survey agreed with this statement. Related to this point, residents were asked to comment on the cost of buying healthy food in their neighbourhood. Twenty-eight percent of North Glasgow SIP residents and one third (33%) of respondents in the whole area agreed that this was an issue.
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Figure 78
Would you agree or disagree with the following statements about health? NGSIP Strongly agree
I could be healthier if I ate more sensibly
4%
4%
Agree
46%
50%
52%
51%
Neither/ nor
16%
18%
19%
18%
Disagree
33%
27%
23%
25%
0%
1%
2%
2%
100%
100%
100%
100%
1%
1%
1%
1%
Agree
10%
12%
17%
14%
Neither/ nor
18%
22%
24%
23%
Disagree
63%
58%
51%
55%
8%
8%
7%
8%
100%
100%
100%
100%
Strongly agree
Strongly disagree Total Strongly agree Agree I cannot get healthy food Neither/ nor in my local shops Disagree Strongly disagree Total Strongly agree
1%
2%
14%
16%
22%
25%
31%
28%
58%
51%
48%
50%
4%
5%
5%
5%
100%
100%
100%
100%
5%
5%
4%
4%
30%
28%
29%
Neither/ nor
35%
32%
37%
34%
Disagree
36%
30%
27%
29%
2%
3%
4%
3%
100%
100%
100%
100%
7%
5%
8%
6%
Agree
42%
32%
24%
28%
Neither/ nor
16%
20%
29%
24%
Disagree
29%
35%
35%
35%
6%
7%
4%
6%
100%
100%
100%
100%
Strongly agree
Strongly disagree Total Strongly agree
9%
6%
6%
6%
Agree
41%
32%
21%
27%
Neither/ nor
17%
21%
33%
26%
Disagree
27%
32%
36%
34%
6%
8%
4%
6%
100%
100%
100%
100%
Strongly disagree Total Source: 2003 residents’ survey
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2% 18%
23%
Total
I would take part in exercise if it was affordable
2% 14%
Agree
Strongly disagree
I would exercise if there were facilities nearby
Whole area
4%
Total
Healthy food is too expensive around here
Non SIP area
4%
Strongly disagree
I don't have time to make healthy food
SIP area
These results are summarised in the following chart. Figure 79
Would you agree or disagree with the following statements about health? (those agreeing)
I could be healthier if I ate more sensibly I don't have time to make healthy food
S/EB SIP Non SIP
I cannot get healthy food in my local shops
Whole area
Healthy food is too expensive around here I would exercise if there were facilities nearby I would take part in exercise if it was affordable 0%
20%
40%
60%
National targets are for people to eat at least five portions of fruit or vegetables each day. In the 2003 residents survey, residents of the NGSIP Board area were asked how many portions they ate each day on average. Fifteen percent of North Glasgow SIP residents stated that they ate no fruit/veg (slightly higher than the whole area figure of 13%) and 7% stated that they ate five or more portions each day. The percentage achieving the target intake is one percent below the background NGSIP Board area level. Figure 80
On average, how many portions of fruit, veg or salad do you eat each day? NGSIP
SIP area
Non SIP area
Whole area
0
15%
14%
12%
13%
1
15%
18%
15%
16%
2
30%
31%
26%
29%
3
13%
15%
20%
17%
4
20%
15%
18%
16%
5
6%
6%
6%
6%
6
1%
1%
3%
2%
7
0%
0%
0%
0%
8
0%
0%
0%
0%
100%
100%
100%
100%
Total
Source: 2003 residents’ survey
FMR RESEARCH LTD
Figure 81
On average, how many portions of fruit, veg or salad do you eat each day?
30%
NGSIP Non SIP
25%
Whole area
20%
15%
10%
5%
0% 0
7.5
1
2
3
4
5
6+
Residents’ perception of healthcare
In the 2003 residents’ survey, respondents were asked if they felt that doctors’ appointments systems could be more flexible (figure 82). Thirty-six percent of North Glasgow SIP residents agreed to some extent that there could be more flexibility, lower than the NGSIP Board area figure of 41%. Figure 82
Some of the appointment systems for doctors could be more flexible NGSIP
SIP area
Non SIP area
Whole area
Strongly agree
12%
11%
10%
10%
Agree
24%
28%
34%
31%
Neither/ nor
29%
32%
29%
31%
Disagree
32%
27%
24%
25%
2%
2%
3%
3%
100%
100%
100%
100%
Strongly disagree Total
Source: 2003 residents’ survey
Figure 83 shows the results of a series of questions exploring difficulties in accessing different aspects of the services of doctors and dentists in the 2003 residents’ survey. Only 5% of North Glasgow SIP residents said that they had experienced difficulties in gaining access to their GP, compared to 9% for the whole area. However, 24% of North Glasgow SIP residents experienced difficulties in making appointments with their GP, a figure that was very consistent across all study areas and similar to the whole area rate of 27%. It was uncommon for residents to experience problems in accessing their dentist, with only 2% of North Glasgow SIP residents (who had tried) citing any difficulties. Three percent of North Glasgow SIP residents said they found difficulties in making appointments with their dentist, slightly lower than the NGSIP Board area level of 5%.
FMR RESEARCH LTD
Figure 83
Do you have difficulty gaining access to, making appointments with, or arranging visits with your GP or Dentist? NGSIP
GP - gaining access GP - making appointments GP - arranging visits Dentist - gaining access Dentist - making appointments
SIP area
Non SIP area
Whole area
Yes
5%
8%
12%
9%
No
95%
92%
88%
91%
Yes
24%
27%
26%
27%
No
76%
73%
74%
73%
Yes
22%
19%
25%
22%
No
78%
81%
75%
78%
Yes
2%
2%
4%
3%
No
98%
98%
96%
97%
Yes
3%
3%
7%
5%
No
97%
97%
93%
95%
Source: 2003 residents’ survey
Residents were asked when they had last visited the dentist. Fifty-nine percent of North Glasgow SIP respondents had seen their dentist within the last 15 months. Figure 84
When did you last attend the dentist? Non SIP area
Whole area
0-6 months ago
NGSIP 42%
37%
46%
41%
7-15 months ago
17%
19%
16%
18%
More than 15 months ago
41%
44%
38%
41%
100%
100%
100%
100%
Total
SIP area
Source: 2003 residents’ survey
7.6
Tobacco and alcohol consumption
According to the 2003 residents’ survey, 50% of North Glasgow SIP residents smoked (figure 85). This was slightly higher than the rate for the NGSIP Board area of 43%, which represented an apparent decrease on the 1998 rate of 56%. The latest available comparative data for Glasgow as a whole (1999/00) indicated that 41% of adults smoked. Figure 85
Which of the following best describes you at present? NGSIP
I have never smoked tobacco I have only tried smoking once or twice I have given up smoking
Non SIP area
Whole area
38%
SIP area 36%
46%
40%
1%
2%
6%
3%
11%
13%
12%
13%
I smoke some days
2%
3%
4%
3%
I smoke every day
48%
46%
32%
40%
100%
100%
100%
100%
Total Source: 2003 residents’ survey
Of those who smoked, 49% of North Glasgow SIP residents (compared to 42% for the whole NGSIP Board area) said they smoked between 10 and 20 cigarettes each day (in 1998 the figure for 11 to 20 cigarettes per day was 30% for the whole area). Thirtysix percent of smokers in North Glasgow SIP smoked more than 20 cigarettes each day.
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Figure 86
If you smoke, how many do you smoke each day? Non SIP area
Whole area
Less than 10
NGSIP 15%
17%
34%
23%
Between 10 and 20
49%
48%
33%
42%
More than 20
36%
36%
34%
35%
100%
100%
100%
100%
Total
SIP area
Source: 2003 residents’ survey
Forty-eight percent of North Glasgow SIP residents said that they would like to stop smoking. For the NGSIP Board area the figure was 45%, and females were more likely to want to quit (51%) than males (39%). Figure 87
If you smoke, would you like to quit? NGSIP
SIP area
Non SIP area
Whole area
Yes
48%
51%
36%
No
52%
49%
64%
55%
100%
100%
100%
100%
Total
45%
Source: 2003 residents’ survey
Respondents were asked about their patterns of alcohol consumption in the 2003 study (figure 88). Forty-six percent of North Glasgow SIP residents said they had not drunk alcohol in the past week at all, in comparison to 50% for the NGSIP Board area. There is no directly comparable data from the 1998 survey. At that time residents were asked about the number of occasions on which they had drunk, as opposed to the number of days in the present survey. Figure 88
How many days did you drink in the past week?
NGSIP
SIP area
Non SIP area
Whole area
0
46%
48%
52%
50%
1
12%
15%
18%
16%
2
20%
18%
19%
18%
3
11%
9%
5%
7%
4
6%
5%
1%
3%
5
1%
1%
0%
1%
6
0%
0%
0%
0%
7
4%
4%
5%
4%
100%
100%
100%
100%
Total
Source: 2003 residents’ survey
Interviewees in the 2003 residents survey were asked about the type and quantity of alcohol that they consumed, and their weekly consumption in standard units was calculated. With reference to the Department of Health’s recommendations on alcohol intake, figure 89 indicates the proportions of people who are drinking within the recommended limits and those exceeding it. These percentages relate to all interviewees, and not only those who signalled that they had drunk in the previous week. In the whole NGSIP Board area, half of respondents had not drunk alcohol in the previous week (which does not imply that they do not drink). Thirty-two percent of North Glasgow SIP residents had drunk alcohol but had remained within the recommended limits. Twenty-two percent had exceeded the recommended limit, 1% by more than five times.
FMR RESEARCH LTD
Figure 89
Weekly alcohol intake compared to recommended maximum levels (14 units for a female and 21 for a male). NGSIP
Total units per week
SIP area
Non SIP area Whole area
None
46%
48%
52%
50%
at or below rec. level
32%
33%
39%
35%
up to twice rec. level
14%
12%
5%
9%
up to three times rec. level
5%
4%
2%
3%
up to four times rec. level
2%
2%
1%
2%
up to five times rec. level
0%
0%
1%
0%
more than five times rec. level
1%
1%
0%
1%
100%
100%
100%
100%
Total Source: 2003 residents’ survey
7.7
Summary
This section gives an overview of the health and emotional wellbeing of the residents of North Glasgow SIP and the NGSIP Board area, combining primary perceptionbased data from the 2003 survey, and secondary data collected by Greater Glasgow NHS Board and NHS Scotland. While the majority of respondents were positive about their overall quality of life, there was however variation among areas in the proportion of people rating their quality of life at the lowest point on the scale. Peoples’ attitudes to health and lifestyle were examined, revealing that 17% of people living in North Glasgow SIP considered that they take no (moderate) exercise whatsoever. Forty-nine percent of North Glasgow SIP residents felt that the availability of nearby facilities was a barrier to them taking part in exercise activities, which was lower than the whole area figure of 34%. National guidelines suggest that to maintain good health and prevent diseases, particularly cancer, we should all consume at least 5 portions of fruit and vegetables each day. In North Glasgow SIP, 7% indicated that they met this target, marginally lower than the whole area rate of 8%. Encouraging smoking cessation and discouraging young people from starting smoking are priorities on the national health agenda. Fifty percent of North Glasgow SIP residents admitted to being regular smokers, higher than the whole area rate of 43%. Forty-eight percent of North Glasgow SIP residents stated that they wished to stop, only higher than the whole area rate of 45%. Almost half of North Glasgow SIP respondents said they had not drunk alcohol in the week before the survey. Of those that had drunk some alcohol, 41% had exceeded the recommended safe levels, and 15% had engaged in binge drinking (defined as three or more times the recommended daily safe limit).
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Introduction
This section looks at health information as it applies to the NGSIP Board area and North Glasgow SIP (where available), combining primary survey based data and secondary data from Greater Glasgow NHS Board. Note that although the secondary data are available at the individual SIP level, they are not available specifically for the NGSIP Board area or the non-SIP part of the NGSIP Board area.
7.2
Secondary data on health and wellbeing
There are three CCIs relating to health. The first of these is CCI 3 - the total number and rate of women breastfeeding at 6 to 8 weeks after the birth of their child. Figure 64 shows the percentages of mothers breastfeeding at birth, at first health visitor visit and at the 6 week health visitor visit. In North Glasgow SIP, the percentage of babies being breastfed at the 6 week health visitor visit is 33%, down 4% on the level recorded at the first health visitor visit. The six week visit rate is three times that of the other two SIPs, and very slightly above the Glasgow-wide rate of 32%. Figure 64
Child Health Data – CCI 3 NGSIP
% of live births where baby is breastfed at birth % of live births where baby is breastfed at first health visitor visit % of live births where baby is breastfed at 6 weeks health visitor exam – CCI 3 Source: GGNHSB, 2002
Glasgow SIP
Glasgow non-SIP
All Glasgow
51%
39%
64%
53%
37%
26%
50%
39%
33%
20%
42%
32%
CCI 4 measures the total number and percentage of self-reported smoking pregnant women when booking their first antenatal appointment. These data are presented in Figure 65 below, along with other related data. Most noticeable is the range in these data across the different geographical study areas: 33% of mothers in North Glasgow SIP smoked during pregnancy, in comparison to just 20% in the non-SIP parts of (the whole of) Glasgow. Figure 65
Child Health Data – CCI 4 NGSIP
% of live births which are low birthweight babies % of live births where mother smoked during pregnancy – CCI 4 % of live births where anyone in the household smokes at 6-8 weeks post-natally % of anyone in the household smoking at 6 weeks exam by health visitor Source: GGNHSB, 2002
Glasgow SIP
Glasgow non-SIP
All Glasgow
6%
10%
8%
9%
33%
39%
20%
28%
36%
42%
23%
32%
29%
37%
21%
28%
Reducing the rate of unplanned conceptions among teenage girls is a nationwide priority that also has implications for improving the sexual health of young people. Figure 66 shows the rate of all teenage pregnancies (including planned and unplanned pregnancies resulting in birth or abortion) broken down by age.
FMR RESEARCH LTD
Figure 66
Health of young people – rate per 1000 population NGSIP
Teenage pregnancy rate under 16
Glasgow SIP
Glasgow non-SIP
All Glasgow
3.2
5.2
4.6
4.9
Teenage pregnancy rate 16-19
71.7
90.4
47.8
66.0
Teenage pregnancy rate total under 20
49.7
54.9
31.8
42.1
Source: GGNHSB, 2001. n.b. pregnancies includes all births and abortions. These figures are provisional at the time of writing.
CCI 8 concerns standardised mortality rates due to coronary/ischaemic heart disease, all cancers and specifically lung cancer. The figures presented in figure 67 below are ‘standardised mortality rates’, or SMRs. The figures do not represent actual numbers of deaths, but rather the rate of mortality in a population relative to a wider population. In this case all mortality rates are presented relative to the appropriate Scotland-wide level in 1997-1999 (n.b. years are combined into two year rolling totals in order to keep the sample sizes high to maintain statistical power). The data are adjusted so that the mortality rates for the different causes are all equal to 100 for Scotland as a whole in 1997-99. The data below therefore show the change relative to Scotland as a whole in 1997-99. For example, mortality from lung cancer is down 5.7% on the 1997-99 figure in Scotland as a whole (94.3-100). The 1999-2001 figures for cancer in North Glasgow SIP indicate that mortalities from all cancers were 1.62 times higher (62%) than the Scotland-wide level of 1997-99, and mortality specifically from lung cancer was 2.3 times higher (130%) than the Scotland-wide level of 1997-99. Figure 67
Family health & mortality rates – CCI 8 (1999-01 SMRs, relative to Scotland 1997-99) Glasgow SIP
Glasgow non-SIP
All Glasgow
Scotland
189.4
159.9
106.2
126.0
95.2
ischaemic heart disease
166.4
140.2
92.6
110.0
86.5
all cancers
162.3
141.7
101.6
116.4
97.3
lung cancer
226.6
185.4
113.6
140.0
94.3
NGSIP all causes
Source: GGNHSB, 1999-01. n.b. These figures are Standardised Mortality Ratios for 1999-01, standardised to the Scotland wide level in 1997-99. The figures above represent levels of disease in particular geographical areas relative to what would be expected from the Scotland wide picture in 1997-99 (baseline equals 100).
7.3
Residents’ perception of their health and wellbeing
7.3.1
Perceived quality of life
Interviewees in the 2003 residents’ survey were asked how they rated their overall quality of life (figure 68). Eleven percent of North Glasgow SIP respondents rated themselves at the highest point on the scale, lower than the NGSIP Board area as a whole (18%). Seventy-nine percent of North Glasgow SIP residents rated their quality of life as positive to some degree, slightly lower than the NGSIP Board area figure of 82%. Eight percent of North Glasgow SIP residents indicated that their quality of life was poor to some degree (a score of -1, -2 or -3). The corresponding figure for SIP based residents was 9% and for non-SIP residents, 4%.
FMR RESEARCH LTD
Figure 68
How would you best describe your overall quality of life? NGSIP
☺
SIP area
Non SIP area
Whole area
11%
14%
24%
18%
31%
32%
32%
32%
1
36%
32%
31%
32%
0 -1
13%
13%
9%
11%
5%
5%
2%
4%
-2
1%
1%
1%
1%
-3 Total
2%
3%
1%
2%
100%
100%
100%
100%
3 2
Source: 2003 residents’ survey
Figure 69
How would you best describe your overall quality of life?
40% NGSIP
35%
Non SIP
30% 25%
Whole area
20% 15% 10% 5% 0% 3
7.3.2
2
1
0
-1
-2
-3
Perceived physical health
Residents were also asked to rate their perception of their physical health on the same seven point scale (figure 70). Eighteen percent of North Glasgow SIP residents rated this at the highest point on the scale, slightly lower in comparison to the whole area (23%). Seventy-three percent of North Glasgow SIP residents rated their physical health as being positive to some degree, the same as for the aggregated SIP areas and the whole NGSIP Board area. Figure 70
How would you best describe your physical health at present? NGSIP
☺
SIP area
Non SIP area
Whole area
18%
20%
27%
23%
26%
27%
25%
26%
1
29%
25%
22%
24%
0 -1
11%
12%
12%
12%
11%
10%
9%
10%
-2
2%
3%
2%
2%
-3 Total
2%
3%
3%
3%
100%
100%
100%
100%
3 2
Source: 2003 residents’ survey
FMR RESEARCH LTD
Figure 71
How would you best describe your physical health at present?
35% NGSIP
30% Non SIP
25%
Whole area
20% 15% 10% 5% 0% 3
7.3.3
2
1
0
-1
-2
-3
Perceived mental and emotional wellbeing
Residents were asked to assess their general mental and emotional wellbeing on the same seven point scale (figure 72 & 73). The proportion of North Glasgow SIP residents rating this at the top point of the scale was 16%, in comparison to 23% for the NGSIP Board area. Eighty percent of North Glasgow SIP respondents rated their mental and emotional wellbeing as positive to some degree (differing little from the NGSIP Board area figure of 81%), and there was little distinction between SIP and non-SIP residents in this regard. Figure 72
How would you best describe your general mental and emotional well being? NGSIP
☺
SIP area
Non SIP area
Whole area
16%
19%
29%
23%
35%
33%
29%
31%
1
29%
27%
27%
27%
0
12%
12%
7%
10%
-1
4%
4%
5%
5%
-2
1%
1%
2%
2%
-3
3%
3%
1%
2%
100%
100%
100%
100%
3 2
Total
Source: 2003 residents’ survey
FMR RESEARCH LTD
Figure 73
How would you best describe your general mental and emotional well being?
40% 35%
NGSIP
30%
SIP area
25%
Non SIP
20% 15% 10% 5% 0% 3
2
1
0
-1
-2
-3
Respondents to the 2003 residents’ survey were asked if they or anyone else in their household had a long standing illness, health problem or disability that affected their daily activity or the type of work that they could do (figure 74). In North Glasgow SIP, 30% of households had at least one person in this category, slightly lower than the NGSIP Board area (33%). Figure 74
Do you, or does anyone in your household, have any long standing illness, health problem or disability that limits your/their daily activity or the kind of work that you/they can do? NGSIP
Yes, me Yes, me and others Yes, others in household No Total
Non SIP area
Whole area
15%
SIP area 18%
14%
16%
3%
4%
4%
4%
12%
12%
14%
13%
70%
66%
68%
67%
100%
100%
100%
100%
Source: 2003 residents’ survey
7.4
Diet and exercise
In the course of the 2003 study, residents were asked about their exercise habits (figure 75). The first question asked residents to give the number of days in a week on which they took at least 20 minutes of vigorous and continuous exercise. Fiftythree percent of North Glasgow SIP residents said that they never did this, in comparison to 64% of respondents for the whole area. The recommended level of vigorous exercise of 20 or more continuous minutes on at least 3 days a week was achieved by 23% of NGSIP Board area respondents, and by 33% of North Glasgow SIP residents. The second part of this question explored habits relating to moderate exercise spread over the course of a day. Seventeen percent of North Glasgow SIP residents said they never took exercise at this level, in contrast to 26% of respondents across the NGSIP Board area.
FMR RESEARCH LTD
The recommended level of exercise of 30 minutes or more of accumulated moderate physical exercise on at least 5 days a week was taken by 68% of North Glasgow SIP residents, and by 57% in the NGSIP Board area. Figure 75
On how many days of the week do you… NGSIP
take at least 20 minutes of continuous and vigorous exercise (enough to make you sweaty and out of breath)? take at least 30 minutes moderate exercise, such as brisk walking? This doesn’t have to be 30 minutes all at once.
Non SIP area
SIP area
Whole area
0
53%
63%
66%
64%
1-2
13%
12%
13%
13%
3 or more
33%
26%
21%
23%
100%
100%
100%
100%
0
17%
23%
29%
26%
1-4
14%
14%
22%
17%
5 or more
68%
64%
39%
57%
100%
100%
100%
100%
Total
Total
Source: 2003 residents’ survey
Figure 76
On how many days of the week do you take vigorous exercise?
70% 60% 50%
NGSIP
40%
Non SIP area
30%
Whole area
20% 10% 0% 0
Figure 77
1
2
3
4
5
6
7
On how many days of the week do you take moderate exercise?
50% 45% 40%
NGSIP
35% 30%
Non SIP area
25%
Whole area
20% 15% 10% 5% 0% 0
FMR RESEARCH LTD
1
2
3
4
5
6
7
Respondents in the 2003 survey were asked their views on the proposition that they would exercise more if there were facilities nearby. Forty-nine percent of North Glasgow SIP residents agreed that they would, in contrast to 34% of NGSIP Board area residents. In the 2003 residents’ survey, respondents were asked their views on healthy eating and lifestyles (figure 78). The first question in this series explored the perceived impact of sensible eating on health. Four percent of North Glasgow SIP residents (the same as the overall NGSIP Board area rate) agreed strongly with the idea that they could be healthier if they ate more sensibly. Respondents were asked their attitudes to the statement ‘I don’t have time to make healthy food’, and results were similar across the different study areas. Eighty-nine percent of North Glasgow SIP residents did not agree with this statement, in line with the whole area figure of 85%. This suggests that for most people, time is not a limiting factor in healthy eating. Respondents were asked if they agreed with the statement ‘I cannot get healthy food in my local shops’. Sixteen percent of North Glasgow SIP residents and 18% of the NGSIP Board area residents in the 2003 survey agreed with this statement. Related to this point, residents were asked to comment on the cost of buying healthy food in their neighbourhood. Twenty-eight percent of North Glasgow SIP residents and one third (33%) of respondents in the whole area agreed that this was an issue.
FMR RESEARCH LTD
Figure 78
Would you agree or disagree with the following statements about health? NGSIP Strongly agree
I could be healthier if I ate more sensibly
4%
4%
Agree
46%
50%
52%
51%
Neither/ nor
16%
18%
19%
18%
Disagree
33%
27%
23%
25%
0%
1%
2%
2%
100%
100%
100%
100%
1%
1%
1%
1%
Agree
10%
12%
17%
14%
Neither/ nor
18%
22%
24%
23%
Disagree
63%
58%
51%
55%
8%
8%
7%
8%
100%
100%
100%
100%
Strongly agree
Strongly disagree Total Strongly agree Agree I cannot get healthy food Neither/ nor in my local shops Disagree Strongly disagree Total Strongly agree
1%
2%
14%
16%
22%
25%
31%
28%
58%
51%
48%
50%
4%
5%
5%
5%
100%
100%
100%
100%
5%
5%
4%
4%
30%
28%
29%
Neither/ nor
35%
32%
37%
34%
Disagree
36%
30%
27%
29%
2%
3%
4%
3%
100%
100%
100%
100%
7%
5%
8%
6%
Agree
42%
32%
24%
28%
Neither/ nor
16%
20%
29%
24%
Disagree
29%
35%
35%
35%
6%
7%
4%
6%
100%
100%
100%
100%
Strongly agree
Strongly disagree Total Strongly agree
9%
6%
6%
6%
Agree
41%
32%
21%
27%
Neither/ nor
17%
21%
33%
26%
Disagree
27%
32%
36%
34%
6%
8%
4%
6%
100%
100%
100%
100%
Strongly disagree Total Source: 2003 residents’ survey
FMR RESEARCH LTD
2% 18%
23%
Total
I would take part in exercise if it was affordable
2% 14%
Agree
Strongly disagree
I would exercise if there were facilities nearby
Whole area
4%
Total
Healthy food is too expensive around here
Non SIP area
4%
Strongly disagree
I don't have time to make healthy food
SIP area
These results are summarised in the following chart. Figure 79
Would you agree or disagree with the following statements about health? (those agreeing)
I could be healthier if I ate more sensibly I don't have time to make healthy food
S/EB SIP Non SIP
I cannot get healthy food in my local shops
Whole area
Healthy food is too expensive around here I would exercise if there were facilities nearby I would take part in exercise if it was affordable 0%
20%
40%
60%
National targets are for people to eat at least five portions of fruit or vegetables each day. In the 2003 residents survey, residents of the NGSIP Board area were asked how many portions they ate each day on average. Fifteen percent of North Glasgow SIP residents stated that they ate no fruit/veg (slightly higher than the whole area figure of 13%) and 7% stated that they ate five or more portions each day. The percentage achieving the target intake is one percent below the background NGSIP Board area level. Figure 80
On average, how many portions of fruit, veg or salad do you eat each day? NGSIP
SIP area
Non SIP area
Whole area
0
15%
14%
12%
13%
1
15%
18%
15%
16%
2
30%
31%
26%
29%
3
13%
15%
20%
17%
4
20%
15%
18%
16%
5
6%
6%
6%
6%
6
1%
1%
3%
2%
7
0%
0%
0%
0%
8
0%
0%
0%
0%
100%
100%
100%
100%
Total
Source: 2003 residents’ survey
FMR RESEARCH LTD
Figure 81
On average, how many portions of fruit, veg or salad do you eat each day?
30%
NGSIP Non SIP
25%
Whole area
20%
15%
10%
5%
0% 0
7.5
1
2
3
4
5
6+
Residents’ perception of healthcare
In the 2003 residents’ survey, respondents were asked if they felt that doctors’ appointments systems could be more flexible (figure 82). Thirty-six percent of North Glasgow SIP residents agreed to some extent that there could be more flexibility, lower than the NGSIP Board area figure of 41%. Figure 82
Some of the appointment systems for doctors could be more flexible NGSIP
SIP area
Non SIP area
Whole area
Strongly agree
12%
11%
10%
10%
Agree
24%
28%
34%
31%
Neither/ nor
29%
32%
29%
31%
Disagree
32%
27%
24%
25%
2%
2%
3%
3%
100%
100%
100%
100%
Strongly disagree Total
Source: 2003 residents’ survey
Figure 83 shows the results of a series of questions exploring difficulties in accessing different aspects of the services of doctors and dentists in the 2003 residents’ survey. Only 5% of North Glasgow SIP residents said that they had experienced difficulties in gaining access to their GP, compared to 9% for the whole area. However, 24% of North Glasgow SIP residents experienced difficulties in making appointments with their GP, a figure that was very consistent across all study areas and similar to the whole area rate of 27%. It was uncommon for residents to experience problems in accessing their dentist, with only 2% of North Glasgow SIP residents (who had tried) citing any difficulties. Three percent of North Glasgow SIP residents said they found difficulties in making appointments with their dentist, slightly lower than the NGSIP Board area level of 5%.
FMR RESEARCH LTD
Figure 83
Do you have difficulty gaining access to, making appointments with, or arranging visits with your GP or Dentist? NGSIP
GP - gaining access GP - making appointments GP - arranging visits Dentist - gaining access Dentist - making appointments
SIP area
Non SIP area
Whole area
Yes
5%
8%
12%
9%
No
95%
92%
88%
91%
Yes
24%
27%
26%
27%
No
76%
73%
74%
73%
Yes
22%
19%
25%
22%
No
78%
81%
75%
78%
Yes
2%
2%
4%
3%
No
98%
98%
96%
97%
Yes
3%
3%
7%
5%
No
97%
97%
93%
95%
Source: 2003 residents’ survey
Residents were asked when they had last visited the dentist. Fifty-nine percent of North Glasgow SIP respondents had seen their dentist within the last 15 months. Figure 84
When did you last attend the dentist? Non SIP area
Whole area
0-6 months ago
NGSIP 42%
37%
46%
41%
7-15 months ago
17%
19%
16%
18%
More than 15 months ago
41%
44%
38%
41%
100%
100%
100%
100%
Total
SIP area
Source: 2003 residents’ survey
7.6
Tobacco and alcohol consumption
According to the 2003 residents’ survey, 50% of North Glasgow SIP residents smoked (figure 85). This was slightly higher than the rate for the NGSIP Board area of 43%, which represented an apparent decrease on the 1998 rate of 56%. The latest available comparative data for Glasgow as a whole (1999/00) indicated that 41% of adults smoked. Figure 85
Which of the following best describes you at present? NGSIP
I have never smoked tobacco I have only tried smoking once or twice I have given up smoking
Non SIP area
Whole area
38%
SIP area 36%
46%
40%
1%
2%
6%
3%
11%
13%
12%
13%
I smoke some days
2%
3%
4%
3%
I smoke every day
48%
46%
32%
40%
100%
100%
100%
100%
Total Source: 2003 residents’ survey
Of those who smoked, 49% of North Glasgow SIP residents (compared to 42% for the whole NGSIP Board area) said they smoked between 10 and 20 cigarettes each day (in 1998 the figure for 11 to 20 cigarettes per day was 30% for the whole area). Thirtysix percent of smokers in North Glasgow SIP smoked more than 20 cigarettes each day.
FMR RESEARCH LTD
Figure 86
If you smoke, how many do you smoke each day? Non SIP area
Whole area
Less than 10
NGSIP 15%
17%
34%
23%
Between 10 and 20
49%
48%
33%
42%
More than 20
36%
36%
34%
35%
100%
100%
100%
100%
Total
SIP area
Source: 2003 residents’ survey
Forty-eight percent of North Glasgow SIP residents said that they would like to stop smoking. For the NGSIP Board area the figure was 45%, and females were more likely to want to quit (51%) than males (39%). Figure 87
If you smoke, would you like to quit? NGSIP
SIP area
Non SIP area
Whole area
Yes
48%
51%
36%
No
52%
49%
64%
55%
100%
100%
100%
100%
Total
45%
Source: 2003 residents’ survey
Respondents were asked about their patterns of alcohol consumption in the 2003 study (figure 88). Forty-six percent of North Glasgow SIP residents said they had not drunk alcohol in the past week at all, in comparison to 50% for the NGSIP Board area. There is no directly comparable data from the 1998 survey. At that time residents were asked about the number of occasions on which they had drunk, as opposed to the number of days in the present survey. Figure 88
How many days did you drink in the past week?
NGSIP
SIP area
Non SIP area
Whole area
0
46%
48%
52%
50%
1
12%
15%
18%
16%
2
20%
18%
19%
18%
3
11%
9%
5%
7%
4
6%
5%
1%
3%
5
1%
1%
0%
1%
6
0%
0%
0%
0%
7
4%
4%
5%
4%
100%
100%
100%
100%
Total
Source: 2003 residents’ survey
Interviewees in the 2003 residents survey were asked about the type and quantity of alcohol that they consumed, and their weekly consumption in standard units was calculated. With reference to the Department of Health’s recommendations on alcohol intake, figure 89 indicates the proportions of people who are drinking within the recommended limits and those exceeding it. These percentages relate to all interviewees, and not only those who signalled that they had drunk in the previous week. In the whole NGSIP Board area, half of respondents had not drunk alcohol in the previous week (which does not imply that they do not drink). Thirty-two percent of North Glasgow SIP residents had drunk alcohol but had remained within the recommended limits. Twenty-two percent had exceeded the recommended limit, 1% by more than five times.
FMR RESEARCH LTD
Figure 89
Weekly alcohol intake compared to recommended maximum levels (14 units for a female and 21 for a male). NGSIP
Total units per week
SIP area
Non SIP area Whole area
None
46%
48%
52%
50%
at or below rec. level
32%
33%
39%
35%
up to twice rec. level
14%
12%
5%
9%
up to three times rec. level
5%
4%
2%
3%
up to four times rec. level
2%
2%
1%
2%
up to five times rec. level
0%
0%
1%
0%
more than five times rec. level
1%
1%
0%
1%
100%
100%
100%
100%
Total Source: 2003 residents’ survey
7.7
Summary
This section gives an overview of the health and emotional wellbeing of the residents of North Glasgow SIP and the NGSIP Board area, combining primary perceptionbased data from the 2003 survey, and secondary data collected by Greater Glasgow NHS Board and NHS Scotland. While the majority of respondents were positive about their overall quality of life, there was however variation among areas in the proportion of people rating their quality of life at the lowest point on the scale. Peoples’ attitudes to health and lifestyle were examined, revealing that 17% of people living in North Glasgow SIP considered that they take no (moderate) exercise whatsoever. Forty-nine percent of North Glasgow SIP residents felt that the availability of nearby facilities was a barrier to them taking part in exercise activities, which was lower than the whole area figure of 34%. National guidelines suggest that to maintain good health and prevent diseases, particularly cancer, we should all consume at least 5 portions of fruit and vegetables each day. In North Glasgow SIP, 7% indicated that they met this target, marginally lower than the whole area rate of 8%. Encouraging smoking cessation and discouraging young people from starting smoking are priorities on the national health agenda. Fifty percent of North Glasgow SIP residents admitted to being regular smokers, higher than the whole area rate of 43%. Forty-eight percent of North Glasgow SIP residents stated that they wished to stop, only higher than the whole area rate of 45%. Almost half of North Glasgow SIP respondents said they had not drunk alcohol in the week before the survey. Of those that had drunk some alcohol, 41% had exceeded the recommended safe levels, and 15% had engaged in binge drinking (defined as three or more times the recommended daily safe limit).
FMR RESEARCH LTD
