No dramatic decline in cardiovascular disease risk factors amongst Scots over the last 13 years and inequalities remain as wide as ever
posted on: Aug 22, 2011
In Scotland, over a thirteen year period between 1995 and 2008, there has been, at best, only a moderate decline in behavioural risk factors for cardiovascular disease, for example smoking. At the same time there have been increases in the proportion of the population with self-reported diabetes and hypertension. There has been persistence of adverse socioeconomic gradients in which the most disadvantaged within the population have the highest levels of harmful risk factors. Since the 1970’s there has been a dramatic decline in coronary heart disease mortality rates but in recent years this decline may have slowed. The findings of this study could help explain this recent stagnation and the persistence of socioeconomic inequalities in Scotland, and elsewhere.
The study was led by Dr Joel Hotchkiss
at the MRC/CSO Social and Public Health Sciences unit and was conducted in collaboration with colleagues in the Unit and at the University of Liverpool and the Scottish Centre for Social Research. The research, published in the online journal BMJ Open, was funded by the Chief Scientist Office of the Scottish Government Health Directorate within a programme funded by both the
Medical Research Council and the Chief Scientist Office.
The study was based on 22,545 respondents to the 1995, 1998, 2003 and 2008 Scottish Health Surveys. These are representative surveys of the Scottish population that anonymously record information on participants’ health, their lifestyle choices and medical measurements. Using these surveys it was possible to estimate the proportion of the population with each of a number of cardiovascular disease risk factors, namely: smoking, excess alcohol consumption, low physical activity, low fruit and vegetable consumption, high discretionary salt use and self-reported diabetes or hypertension. Changes in the prevalence of these risk factors was determined over time, along with their socio-economic patterning.
There were moderate declines in the prevalence of smoking, excess alcohol consumption and physical inactivity. Increases in prevalence were noted for self-reported diabetes and hypertension. Socioeconomic inequalities were evident for almost all risk factors. These social gradients appeared to be maintained over the four surveys. An exception was self-reported diabetes where, although inequalities were small, the inequalities increased over time. Alcohol consumption was unique in consistently showing an inverse gradient, especially for women.
The full paper is published in BMJ Open