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CHAPTER FOUR: GENERAL HEALTH AND LIFESTYLE

4.1 This chapter considers respondents' self assessed general health and their experience of any long-standing limiting conditions. It also examines their informal support networks and the extent to which they are involved in their local communities.

General Health

4.2 Around three quarters (76%) of respondents rated their general health as good (42%) or very good (34%). Meanwhile, 18% said their general health was fair and 6% said it was bad or very bad (figure 4.1 below). It is difficult to compare these results directly with findings from the previous surveys due to changes in the question wording. Nonetheless, they appear to be consistent with the 2004 survey findings, when 83% of respondents rated their health as either very good or fairly good. Furthermore they are comparable with results from the 2003 Scottish Health Survey in which 74% rated their general health as good or very good, 18% rated it as fair and 4% as bad or very bad (Scottish Executive 2005).

Figure 4.1: Ratings of general health

4.3 Predictably, and as can be seen in table 4.2 (below), the proportion rating their general health as good or very good decreased with age, from 90% among people aged 16 to 24 years, to 77% of those aged 45 to 54 years and 41% of those aged 75 and over.

4.4 There were also some differences by key economic indicators. Respondents in higher income brackets (i.e. those with a net income of £15,600 per annum or more) were more likely than those with lower incomes to rate their general health as good or very good, and people living in the least deprived areas of the country were more likely to do so than those in more deprived areas. Similarly, people who said they found it easy to manage on their income were more likely to rate their health as good or very good than those who said they found it difficult. Indeed, of those who said they found it difficult to manage, 1 in 5 rated their general health as poor, which is three times higher than average (21% versus 4% of those who found it easy to manage).

4.5 Analysis by NHS Board area reveals that respondents living in Lothian and Fife and the North East were more likely to rate their general health as good or very good than those in the West Central Belt and Highlands and Islands.

4.6 People displaying no or few signs of psychiatric disorder (as reflected in their scores on the GHQ12) gave more positive ratings of their general health than those with a possible psychiatric disorder ¹⁰. Conversely, those with good mental wellbeing (according to their WEMWBS score) gave better general health ratings that those with poor mental wellbeing. ¹¹

Table 4.1: Ratings of general health by sub-group

Source: Ipsos MORI

Long standing limiting conditions

4.7 As in the 2004 survey, a third (32%) of respondents had a long standing illness or disability. This is consistent with the result from the 2004 survey (31%) but eight percentage points fewer than in the 2003 Scottish Health Survey (40%). As would be expected, in broad terms, experience of long standing illness or disability increases with age (see table 4.2 below). There were no differences by gender.

Table 4.2: Experience of long standing illness or disability, by age

Source: Ipsos MORI

4.8 Of those who have a long standing illness or disability, almost 7 in 10 (66%) said it limits their activities in some way. This is consistent with the comparable result from the 2004 'Well? What do you think?' study (63%) and from the Scottish Health Survey.

Length of residency in and satisfaction with local neighbourhood

4.9 The environment in which people live may have an important impact on their mental wellbeing. Accordingly respondents were asked both how long their had lived in their current neighbourhoods and how satisfied they were with their neighbourhoods.

4.10 The majority of respondents - seven in ten - had lived in their current neighbourhoods for at least five years. This includes 35% who had lived in their neighbourhoods for between 5 and 20 years and 36% who had done so for more than 20 years. Thirteen per cent had lived in their neighbourhood for between 2 and 5 years, 7% for between one and two years and 9% for less than a year.

4.11 Younger respondents, aged 16 to 34 years, were more likely than those aged 35 and over to have lived in their neighbourhood for only one to two years. This is perhaps unsurprising as it is between the ages of 16 and 34 that young people are likely to move away from home, whether to attend university or college, and/or to set up their own home. Mobility was also higher among those in the most urban area than in the most rural area. There were no differences in length of residency by self-reported experience of mental ill-health, mental ill-health score or mental wellbeing.

4.12 Around nine in ten (91%) respondents were satisfied with their local neighbourhood, with 57% saying they were very satisfied. Of those remaining, 6% said they were dissatisfied with their local neighbourhood and 4% said they were neither satisfied nor dissatisfied. These figures represent a positive trend in neighbourhood satisfaction since 2004, when 87% were satisfied with their neighbourhoods - with 52% very satisfied - 6% were dissatisfied and 4% were neither satisfied nor dissatisfied.

4.13 Those living in less deprived areas of the country (bands 4 and 5) were significantly more likely to be satisfied with their neighbourhoods than those in the most deprived areas (94% and 94% versus 82% respectively). There were also differences by rurality/urbanity, with those in the most rural locations being significantly more satisfied that those in the most urban locations (98% versus 80%). Meanwhile, people living in the North East NHS Board area tended to be more positive about their neighbourhoods than those in the Borders and South, Central Belt West, and Highlands and Islands NHS Board areas (96% versus 90%, 87% and 93% respectively). All of these findings are consistent with results from the 2004 survey.

4.14 Again, there were no differences by experience of mental ill-health or mental ill-health scores, but people displaying good mental wellbeing were more likely than those with poor mental wellbeing to be satisfied with their neighbourhood (73% of those with good mental wellbeing said they were very satisfied, compared with 40% of those with poor mental wellbeing).

Contact with friends/relatives informal support networks and civic participation

4.15 Having few close friends or relatives has been associated with a greater likelihood of experiencing symptoms of mental ill-health across the lifespan (see, for example, Cattan et al., 2005; Miller, 1979; Ueno, 2005: Putnam 2000). Accordingly, the survey includes questions to gauge how often respondents see friends and relatives who do not live with them and whether they have people they could rely on if they were experiencing personal difficulties.

4.16 With regard to how often they see friends or relatives who are not living with them, two in five (41%) respondents said on most days, and roughly the same proportion (42%) said once or twice a week. Meanwhile 12% said once or twice a month and 5% less often than once a month.

4.17 The youngest and oldest age groups were among those most likely to see friends and relatives on most days (58% of people aged 16 to 24 years and 45% of people aged 75 or over versus, for example, 33% of people aged 35 to 44 years). To some degree, these findings are intuitive. The youngest group may be more likely than other respondents to be in education and thus in contact with classmates on a frequent basis. They may also be more likely to have the spare time to spend with friends. The oldest group, meanwhile, may be receiving ongoing care from family members and/or seeing friends regularly at day centres and other similar social gatherings. In contrast, people in the middle age ranges may be too busy with work and family commitments to see friends and relatives with such regularity.

4.18 People living in the Highlands and Islands were more likely than those in other NHS Board areas to see their friends and relatives on most days (54% versus 37% in the Central Belt West and Lothian and Fife). This may reflect the existence of stronger social networks in more rural areas, as well as the higher than average proportions of elderly residents.

4.19 There are no differences by self-reported experience of mental health or mental ill-health scores but people with good mental wellbeing were more likely than those with poor mental wellbeing to see friends or relatives at least once or twice a week (91% versus 73%).

4.20 The majority of respondents also felt they had people they could turn to if they were experiencing personal difficulties. Specifically, 93% said they would have someone to turn to if they were ill in bed and 84% said they would have someone to turn to if they were experiencing financial difficulties and needed to borrow money. The average number of people respondents felt they would be able to turn to in the event of a serious personal crisis was six. There was little variation in the findings by key sub-group but consistent with the research cited above, people who had had personal experience of mental ill-health were less likely than those with no such experience to say they had people they could rely on if they were ill in bed (89% versus 94%) or in financial difficulty (79% versus 87%).

4.21 Again, all of these findings are consistent with results from the 2004 survey. (The questions were not asked in 2002).

4.22 As well as considering respondents' informal support networks, the survey included a question to gauge their level of civic participation, and specifically whether they had given up free time to be a volunteer or organiser for any charities, clubs or organisation. As in 2004, one in five (20%) said they had done so - although the figure was significantly higher among people aged 60 to 64 years old (26%), those with a household income of £36,400 or more per annum (34%) and those living in the most rural areas of the country (35%). Additionally, those with good mental wellbeing appear to be more likely to have given up time to be a volunteer or organiser than those with poor mental wellbeing (29% versus 14%). While we cannot tell from the data whether people with good mental wellbeing are more likely to get involved in volunteering and organising, or whether these activities themselves contribute to positive mental wellbeing, the findings are nonetheless consistent with Putnam's assertion that regular club attendance, volunteering, entertaining or church attendance is a key predictor of life happiness (Putnam 2000: 333).

4.23 To explore further the data on informal support networks and civic participation, an analysis was undertaken aimed at identifying whether there is a link between the number of people respondents feel they can turn to in a crisis and the extent to which they are socially engaged. For the purposes of the analysis, a composite social engagement variable was created using the four measures analysed above namely:

• The frequency with which respondents saw friends or relatives who are not living with them
• Whether respondents felt they had someone they could turn to if they were experiencing financial difficulties
• Whether respondents felt they had someone they could turn to if they were ill in bed
• Whether they had given up time to work as a volunteer or organiser

4.24 Respondents were coded as 'more socially engaged' if they gave a positive response on at least 3 ¹² of these measures, and 'less socially engaged' if they gave a positive response on fewer than 3. For the first measure a positive response was defined as: 'on most days' or 'once or twice a week'. It was hypothesised that there would be a positive relationship between the number of people respondents felt they could turn to in a crisis and their level of social engagement. As table 4.3 (below) shows, bivariate analysis confirmed this hypothesis: Respondents who were more socially engaged had significantly more people they could turn to than those who were less so. Indeed, respondents who were less socially engaged were three times more likely than those who were more socially engaged to say they had nobody they could turn to in the event of a serious personal crisis. Although this finding is intuitive, it is nonetheless important as it illustrates that civic participation can have psychosocial benefits when one encounters stressful life events.

Table 4.3: Number of people you can turn to by 'social engagement'

Source: Ipsos MORI

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