Inequalities and health behaviours

Consultants, I believe, are fond of saying, "If you can't measure it, you can't manage it," and I have a lot of sympathy with that view. So, while Government target-setting may be reduced, the need for recent, local figures is not.
We have often been asked to investigate the differences in the patterns of habits between members of different schools and different counties. Of greater recent interest has been to examine differences between pupils of different backgrounds or different identities. Through these analyses it may be hoped that clients get a better grasp of local patterns, and an insight into what to do about them.
An example of this analysis is shown here. We selected a number of measures of inequality:

  • Living in an area of known high deprivation (two parishes)
  • Few books at home
  • Ethnic minority
  • Single parent family
  • Young carer
  • Own mobile phone and have Internet at home

We then looked at a variety of measures to see if the selected groups seemed any different from the whole sample. The last group of course we might hope is free of deprivation.

 

All Y10

Deprivation area

Few books at home

Ethnic minority

Single parent

Young carer

Mobile+ Internet

Generally happy with life

66

63

56

46

59

79

68

Want to be in education full-time post-16

48

43

*32

50

*30

16

49

Regular paid job during term-time

42

39

56

42

40

26

42

Nothing at all to eat or drink

14

18

11

19

10

17

15

5+ portions of fruit/vegetables yesterday

21

21

13

38

13

26

22

Consider health when choosing what to eat

15

13

8

6

9

16

16

Exercised hard 3+ times last week

28

24

22

33

22

5

29

Main source of sex information = ideal source

62

65

62

71

64

53

56

Sexually active

25

29

*45

*50

33

32

23

Aware of local sexual health service

78

81

67

86

85

74

80

Often feel afraid going to school because of bullying

3

5

*10

0

2

5

3

Victim of violence or aggression last year

10

10

22

23

17

5

9

Carry protection when going out

7

6

10

8

2

11

6

Drank alcohol last week

47

48

56

64

45

53

46

Smoked last week

44

*55

*62

50

*58

45

40

Ever used drugs

14

20

*30

27

23

16

12

N

447

152

74

21

59

19

354

* Difference from whole Y10 result is statistically significant (p<0.05)
Some points to note:

  • Deprivation generally is associated with more health-risky behaviour and less health-promoting behaviour.
  • Some of the unmarked differences look quite interesting (particularly in the Ethnic Minority column) but the sample sizes are not large enough for us to say with sufficient confidence that the differences are real and not due to chance
  • Of all the measures of inequality, the one producing the most significant differences is how many books are there at home: we have no direct measure of social class or deprivation in this particular study, but when we do, this is usually found to be a major source of differences.