Health and Lifestyle Surveys: Regrettably Ireland is following a US model of greater obesity, writes Dr Muiris Houston
While it may lack the true innovation of the 1999 launch, the publication yesterday of the second National Health & Lifestyles Surveys is in many ways even more interesting than the first. It gives us the opportunity to map trends in our lifestyle attitudes and behaviours. We now have a picture not just of our health at the time of the survey in 2002 but a good indication as to the direction we are travelling on the road to health or disease.
Firstly we can say with some accuracy that we are a more over-weight nation than four years ago. We smoke less but appear to be drinking more alcohol.
On the question of how much we exercise, the report card would have to say "can do better". Only 50 per cent of adults are engaging in some form of physical activity. Indeed, the percentage of women and men reporting no activity at all has increased significantly.
Overall, the Republic is leaning towards Boston rather than Berlin in terms of health behaviour. Regrettably we are following a US model of greater obesity and its attendant health risks.
We are more sedentary than four years ago, which, of course, contributes to obesity as well as being harmful in its own right. A damaging pattern of alcohol intake appears to be in no danger of receding.
Both the Slán survey of adults and the HBSC research into schoolchildren show that negative health behaviour is especially prevalent in lower socio-economic groups.
If you live in the inner city, have low educational attainment and earn less money, then it seems that the health promotion message has passed you by. Or has it?
There is evidence, separate from yesterday's research, to suggest that such inequalities can be reversed if approached in an innovative way. In other words, many people hear the message but are not being given the practical help they need in order to change.
On a positive note the Slán survey reveals that more people now report having their blood pressure and cholesterol checked.
A deeper examination of the report reveals other pieces which make up the jigsaw of community health. Eighty-eight per cent of Irish people are fully mobile and 97 per cent have no problem with self-care. A healthy 83 per cent of women had their blood pressure checked, up from 75 per cent four years previously. In keeping with international trends numbers with diabetes increased, a finding which can be partly related to the statistics on obesity.
The number of men with a diagnosis of depression increased from 5 to 7.5 per cent - a reflection on improved health-seeking behaviour rather than a true increase in prevalence. Those regularly taking prescribed medication increased since the last survey; women in particular consumed more drugs.
Of sexually active women there was a 10 per cent increase in the use of contraception. The average number of years a women spent on the pill rose from 4.8 to 5.4 years. All of these figures point to increased health service usage. When asked, do you use a car as transport when shopping, over 70 per cent of both sexes said Yes.
This is an indirect way of inquiring about exercise levels; the 5 per cent increase in car usage for shopping reflects the drop in those taking even mild exercise.
This trend must be a source of concern, especially given the ongoing health promotion campaign outlining the life-saving benefits of exercise. Clearly we need to devise stronger messages extolling the absolute necessity for regular exercise.
Although the overall increase in those using recreational drugs is small, the 10-fold increase in women injecting drugs of abuse is striking and needs further study.
The consumption of fruit and vegetables by schoolchildren plummeted between 1998 and 2002. And surely the quirkiest statistic from the entire survey relates to the number of people who use a recommended pea-sized amount of toothpaste. The percentage of males who successfully negotiate this challenge has almost doubled.
An in-depth analysis of what these lifestyles statistics say about us will have to wait. But the very fact that we now conduct research on a cyclical basis reflects well on our commitment to health promotion.