State of the Nation's Health

(Pic : Wales Online)

As reported from Wales Online towards the end of last week, the latest National Health Survey results, for 2014, were published by the Welsh Government. It comes as the Assembly scrutinises the Public Health Bill (Tattoos, Bans & Bogs).

Here's a summary of what the survey found :

Smoking

I'm going to return to smoking and e-cigarettes in more detail (in the same way as I did for alcohol earlier this year). I'm making good progress so far and it should be posted at the end of October.

• 51% of adults have never smoked; just 16% of adults are daily smokers and 4% occasional smokers. The number of smokers has broadly declined since 2003-04.
• 29% of adults are ex-smokers, while 70% of smokers would like to give up.
• Men (22%) are more likely to smoke than women (19%), and smoking peaks in the 25-34 year old age group.
• 29% of adults in the most-deprived areas are smokers, compared to just 13% in the least-deprived.
• There's a fairly even geographic spread of smokers, but the most are in Blaenau Gwent (25% of adults) and the least in the Vale of Glamorgan (18%).

Alcohol

(Pic : Yale University)

See also : Vice Nation : Alcohol Parts I, II & III

• 40% of adults said they exceeded recommended intake of alcohol at least one day a week.
• Men (46%) were more likely than women (35%) to exceed the recommended guidelines. 14% of adults consider themselves non-drinkers. Heavy drinking is most prevelant amongst 45-54 year olds.
• Heavy drinking is more prevelant in the least-deprived areas when compared to the most-deprived areas – which goes against most public health trends.
• The areas with the highest proportion of adults who exceed drinking guidelines are Monmouthshire (45%), Flintshire (44%), Swansea, the Vale of Glamorgan and Cardiff (all 42%).
• The areas with the lowest proportions are Pembrokeshire (36%), Neath Port Talbot (37%) and Torfaen (37%).

Diet

• 32% of adults report eating at least five portions of fruit and vegetables a day.
• 37% of adults in least-deprived areas reported meeting the guidelines, while only 27% of the most-deprived did.
• Apart from the over-75s, women are more likely to eat the recommended intake than men.
• Rates were lowest in Neath Port Talbot (27%), Bridgend and Caerphilly (both 28%)
• Rates were highest in Ceredigion (39%), Pembrokeshire (37%), Conwy and Anglesey (both 36%).
• 68% of children ate fruit every day and 56% ate vegetables. Just 28% ate sweets every day.
• 74% of children drank water every day, only 8% drank soft drinks containing sugar every day.

Physical Activity

• 31% of adults did at least 30 minutes of exercise for 5 days a week, and there's been little change since 2003-04.
• Significantly more men (38%) met this than women (25%) across all age groups.
• 51% of children undertook at least an hour of physical activity on at least five days a week and 35% did so every day of the week.
• People in the most-deprived areas were more likely to have zero active days.
• The highest levels of activity were in Ceredigion (36%), Gwynedd (35%) and Powys (35%).
• The highest levels of inactivity - zero active days - were in Rhondda Cynon Taf (41%), Merthyr Tydfil and Neath Port Talbot (both 40%).

Body Mass Index

See also : Lard of my fathers - A Welsh obesity crisis? and Fat of the Land

Body Mass Index (BMI) is calculated by dividing the weight of a person (in kilograms) by their height (in metres) squared. It's used to determine how someone's mass/size deviates from the norm.

• 35% of adults were overweight (BMI of 25-29.9), and 22% were obese (BMI >30). 40% of adults had a healthy weight (BMI 18.5-24.9), while 2% of adults were underweight (BMI <18.5).
• The average height and weight of men in Wales is 5' 10'' (177cm) and 13st 4lbs (84kg).
• The average height and weight of women in Wales is 5' 4'' (163cm) and 11st 1lb (70kg).
• Men are more likely to be overweight or obese than women.
• Obesity levels have generally increased since 2003-04 but have stabilised over the last two years.

General Mental & Physical Health

• 81% of adults said their physical and mental health was excellent (15%), very good (35%) or good (31%). 6% described their health as poor, and these were predominantly over-55s. Women generally gave poorer health scores than men.
• 33% said they were limited in their day to day activities because of a health problem.
• The most common conditions people were receiving treatment for were : high blood pressure (20%), hearing difficulties (15%), respiratory illnesses (12%), arthritis (12%) and mental illness (12%).
• Men were more likely to be receiving treatment for high blood pressure, diabetes and hearing problems.
• Women were more likely to be receiving treatment for respiratory illnesses, mental illness (significantly higher than men), arthritis and eyesight problems.
• 75% of children had used a dentist in the last year, though just 34% had been to an optician.
• 21% of children had a long-standing health condition. More boys than girls were being treated – including mental health.
• People who said their activities were limited are more likely to live in more-deprived areas than least-deprived, ranging from 28% in Monmouthshire to 40% in Merthyr Tydfil.

What does this tell us?

While childrens' health made the headlines it was a familiar story for adults.
(Pic : Wales Online)

To be frank, nothing we didn't already know.
Men are more likely to live perceivably unhealthy lifestyles, but (contradictory) are equally more likely to say they're healthy. You can't really rely on survey alone here, and men's poor track record of looking after their own health or seeking out medical help is a trope that refuses to die (excuse the pun). Mental illness in particular might be vastly under-reported and under-diagnosed amongst men.

Excess drinking is increasingly a middle-class problem. This is something I've covered before and it applies to narcotics too (Wales on Drugs II). Needless to say that, with some irony, the medical profession is one of those occupations with greater predeliction for alcoholism. It perhaps hints that minimum prices per unit might not work because a higher prices clearly aren't going to deter older, wealthier drinkers who seem to have the biggest problems.

On the whole, women are under-exercising. This is something that's been picked up by the National Assembly (Off the Bench) and has become a key priority for Sport Wales. Sport development is a topic that I really, really want to do in more detail at another time, but the shorthand reasons as to why it's happening are : a lack of role models, body image concerns and a lack of suitable activities.

This is somewhat contradicted by the body mass figures as you would presume that because men exercise more they should, logically, have lower BMIs in general. Women are lighter and less likely to be obese or overweight, but muscle is generally denser than fat and men generally carry more muscle than women. So men (and some women) who exercise regularly - particularly exercises that promote muscle development - are just as likely to show up on BMI as overweight or obese as a sedentary obese person.

A clear link between deprivation and both ill-health and unhealthy lifestyles. Another thing we already knew and, again, the reasons why are complicated but likely to come down to lack of education, and over-reliance on cheap processed foods and the expense of taking part in structured sporting activities/exercise.

Children are getting (a bit) healthier? Despite Wales Online's headlines, the results for children were somewhat encouraging – in particular low consumption of sugary drinks and sweets and relatively high levels of exercise. This could mean that healthy living messages in schools are starting to get through. Also, only 1% of children's health was described as poor.

What's most worrying here are low optician attendance rates and what seems to be a spike in boys being treated for mental health issues, which could be a result of an over-diagnosis of autistic spectrum disorders (Assembly debates future of autism services) and hyperactivity.