National Statistics Health Survey for England 2004

Health Survey for England

2004 Volume 1

The health of minority ethnic groups A survey carried out on behalf of The Information Centre Edited by Kerry Sproston and Jennifer Mindell

Joint Health Surveys Unit

National Centre for Social Research

Department of Epidemiology and Public Health at the Royal Free and University College Medical School

National Centre for Social Research The National Centre for Social Research is the largest independent social research institute in Britain, specialising in social survey and qualitative research for the development and evaluation of policy. NatCen specialises in research in public policy fields such as health, housing, employment, crime, education and political and social attitudes. Projects include ad hoc and continuous surveys, using face-to-face, telephone and postal methods; many use advanced applications of computer assisted interviewing. NatCen has approximately 300 staff, a national panel of over 1,000 interviewers and 200 nurses who work on health-related surveys. Department of Epidemiology and Public Health at the Royal Free and University College Medical School The Department houses over 160 staff, in 13 main research groups, including: the Joint Health Surveys Unit, part of the Health and Social Surveys Research Group; Cancer Research UK Health Behaviour Unit (including Weight Concern); Central and Eastern Europe Research Group; Dental Public Health; Healthcare Evaluation Group; Life Course Modelling Research Group (including the ESRC Priority Network: Capability and Resilience Research); MRC National Survey of Health and Development Unit; Psychobiology Group; Public Health Research Group; Social Epidemiology; and the Whitehall II Group. The Department also includes a Medical Statistics Unit. Joint posts link the Department to the Departments of Statistical Science and Economics and The Wolfson Institute for Biomedical Research at UCL, whilst a great deal of collaborative research is conducted through the International Centre for Health and Society, housed within the Department. Its research programme is concerned particularly with social factors in health and illness, including longitudinal studies of cardiovascular disease (Whitehall studies) and the English Longitudinal Study of Ageing (ELSA); international studies of cardiovascular disease and diabetes; the socio-dental indicators of need; and the socio-economic and policy implications of an ageing population.

Health Survey for England 2004

Volume 1

Copyright © 2006, The Information Centre. All rights reserved

The health of minority ethnic groups

A survey carried out on behalf of The Information Centre

Health Survey for England

2004 Volume 1

The health of minority ethnic groups

Edited by Kerry Sproston and Jennifer Mindell

Copyright © 2006, The Information Centre. All rights reserved

Principal authors Elizabeth Becker, Richard Boreham, Moushumi Chaudhury, Rachel Craig, Claire Deverill, Melanie Doyle, Bob Erens, Emanuela Falaschetti, Elizabeth Fuller, Amy Hills, Vasant Hirani, Dhriti Jotangia, Jennifer Mindell, Lucy Natarajan, Emmanuel Stamatakis, Heather Wardle, Paola Zaninotto Joint Health Surveys Unit National Centre for Social Research Department of Epidemiology and Public Health at the Royal Free and University College Medical School

THE INFORMATION CENTRE

Published by The Information Centre Summary booklet available from: Online www.ic.nhs.uk Mail, Telephone & E-mail The Information Centre 1 Trevelyan Square, Boar Lane, Leeds LS1 6AE Telephone orders/General enquiries: 0845 300 6016 E-mail: [email protected] The full text of this publication has been made available to you on the Internet at www.ic.nhs.uk/pubs Copyright © 2006, The Information Centre. All rights reserved. This work remains the sole and exclusive property of The Information Centre and may only be reproduced where there is explicit reference to the ownership of The Information Centre. This work may only be reproduced in a modified format with the express written permission of The Information Centre.

Designed by Davenport Associates

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First published 2006

Contents

Volume 1: The health of minority ethnic groups Foreword

9

Editors’ acknowledgements Notes

10

11

1 Introduction

13

1.1

The Health Survey for England

13

1.2

The 2004 Health Survey for England

1.3

Ethical clearance

1.4

This report

1.5

2004 survey design

1.6

Data analysis

1.7

Content of this report

14

14

15 15

19 23

2 Self-reported health and psychosocial wellbeing 2.1

Introduction

2.2

Self-reported general health

2.3

Self-reported longstanding illness and limiting longstanding illness

2.4

Self-reported acute sickness

2.5

Self-reported psychosocial health

2.6

Prescribed medications

Tables

26 27

29 30

33

34

3.1

Cardiovascular disease

3.2

Diabetes

Tables

25

26

3 Cardiovascular disease and diabetes

Jennifer Mindell & Paola Zaninotto

65

77 Heather Wardle

95

4.1

Introduction

4.2

Cigarette smoking

4.3

Number of cigarettes smoked

4.4

Self-reported use of chewing tobacco and other tobacco products

4.5

Cotinine

4.6

Prevalence and cotinine-adjusted prevalence of use of tobacco products

Tables

63

71

4 Use of tobacco products Copyright © 2006, The Information Centre. All rights reserved

Lucy Natarajan

105

97 98 100 101

102 103

5 Alcohol consumption

Elizabeth Becker, Amy Hills & Bob Erens

131

5.1

Introduction

5.2

Measures

5.3

Usual drinking frequency

5.4

Frequency of drinking in the past week

5.5

Amount consumed on the heaviest drinking day in the past week

132 133 134

140

6 Anthropometric measures, overweight and obesity

Vasant Hirani & Emmanuel Stamatakis

6.1

Introduction

6.2

Anthropometric measures by minority ethnic groups

6.3

Overweight, obesity, waist-hip ratio and waist circumference, by equivalised household income tertile 172

6.4

Comparisons between 1999 and 2004

Tables

136

165 167

174

177

7 Blood pressure

Moushumi Chaudhury & Paola Zaninotto

205

7.1

Introduction

7.2

Methods and definitions

7.3

Response rates

7.4

Blood pressure measurements

7.5

Hypertension

7.6

Urinary sodium and potassium and their relationship with blood pressure

7.7

Blood pressure levels by equivalised household income

7.8

Comparison of systolic and diastolic blood pressure in 2004 and 1999

7.9

Comparison of prevalence of hypertension (140/90 mmHg) in 2004 and 1999

Tables

206 206

207 208

210 212

212 213

Emmanuel Stamatakis

237

8.1

Introduction

8.2

Methods

8.3

Participation in different types of physical activity, and summary activity levels

8.4

Physical activity comparisons between 1999 and 2004

238

238 239

245

248

9 Eating habits

Rachel Craig, Melanie Doyle and Dhriti Jotangia

9.1

Introduction

9.2

Methodology

9.3

Fruit and vegetable consumption

9.4

Fat intake

9.5

Use of salt in cooking and at the table

Tables

213

215

8 Physical Activity

Tables

163

276

265 266 267

271 272

263

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Tables

132

10 Blood analytes

Emanuela Falaschetti & Moushumi Chaudhury

10.1 Introduction

301

303

10.2 Response to non-fasting and fasting blood samples and percentage of valid samples for each analyte 303 10.3 Total cholesterol and HDL-cholesterol 10.4 C-reactive protein 10.5 Fibrinogen

306

306

10.6 Haemoglobin 10.7 Ferritin

307

308

10.8 Glycated haemoglobin

309

10.9 Fasting blood samples

309

10.10 LDL-cholesterol 10.11 Triglycerides 10.12 Glucose Tables

303

310

311

312

315

11 Complementary and alternative medicines and therapies (CAM) Richard Boreham 345 11.1 Introduction and measures 11.2 Ever used CAM

346

346

11.3 Used CAM in last 12 months

347

11.4 Consulted a CAM practitioner in last 12 months

349

11.5 Relationship between ever using CAM, use of CAM in the last 12 months, and consulting a CAM practitioner in the last 12 months 351 Tables

353

12 Children’s health 12.1 Introduction

Elizabeth Fuller

377

379

12.2 General health

380

12.3 Psychosocial health

382

12.4 Respiratory symptoms and lung function 12.5 Cigarette smoking 12.6 Drinking alcohol Copyright © 2006, The Information Centre. All rights reserved

12.7 Blood pressure

386 387

389

12.8 Anthropometric measures 12.9 Physical activity

390

393

12.10 Fruit and vegetable consumption Tables

400

396

383

Foreword

This report presents the findings of the fourteenth annual survey of health in England. I am pleased to present this important research which has been undertaken on behalf of The Information Centre for health and social care. The Health Survey for England is conducted annually and collects information about a representative sample of the general population. It is vital to our understanding of the health situation and behaviours of the public in England and helps to ensure that policies are informed by these data. The survey combines information gathered through interviewing the sampled respondents, including a wealth of socio-demographic variables, with objective measures of health, such as blood pressure measurements, and analyses of blood samples. Thus we can study the inter-relationship of the characteristics and circumstances of adults and their children, with their health situation. It is an important source of information on health equity, and the survey from 2004 is especially valuable in this regard since there is a focus on the health of ethnic minorities (Black Caribbean, Black African, Pakistani, Indian, Bangladeshi, Chinese and Irish) gathered through a sample augmented in respect of people in these categories. I am honoured to welcome this valuable report and to thank all my colleagues in the Information Centre and our counterparts in the Joint Health Surveys Unit for their work. Surveys of this complexity are a team effort. The dedication of the skilled interviewing force is especially noteworthy. May I also thank the anonymous respondents across England who gave up their time to take part in the survey and who were willing to submit to various health tests. Without their help we would lose a public tool of enormous potential to benefit and protect the health of every one of us.

Professor Denise Lievesley Chief Executive

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The Information Centre for health and social care

HSE 2004 | VOL 1: THE HEALTH OF MINORITY ETHNIC GROUPS

9

Editors’ acknowledgements

We wish to thank, first of all, all those who gave up their time to be interviewed and who welcomed interviewers and nurses into their homes. We would also like to acknowledge the debt the survey’s success owes to the commitment and professionalism of the interviewers and nurses who worked on the survey throughout the year. We would like to thank all those colleagues who contributed to the survey and this report. In particular we would like to thank: ●

The authors of all the chapters: Elizabeth Becker, Richard Boreham, Moushoumi Chaudhury, Rachel Craig, Claire Deverill, Melanie Doyle, Bob Erens, Emanuela Falaschetti, Elizabeth Fuller, Vasant Hirani, Amy Hills, Dhriti Jotangia, Lucy Natarajan, Emmanuel Stamatakis, Heather Wardle and Paola Zaninotto.

●

Claire Deverill and Laura Ringham, whose hard work and support has been crucial in putting this report together.

●

Other research colleagues: Shaun Scholes, Kevin Pickering, Paola Primatesta, James Nazroo, Martin Jarvis and Professor Sir Michael Marmot.

●

Operations staff, especially Lesley Mullender, Sue Roche and the Area Managers at NatCen and Barbara Carter-Szatnyska at UCL.

●

All the field interviewers and nurses who worked on the project.

●

The principal programmers: Jo Periam and Sven Sjodin.

We would also like to express our thanks to the staff of the Department of Clinical Biochemistry at the Royal Victoria Infirmary in Newcastle upon Tyne for their helpfulness and efficiency. Last, but certainly not least, we wish to express our appreciation of the work of the Health and Social Care Information Centre staff at all stages of the project, and in particular the contribution made by Patrick Tucker and Richard Bond.

10

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Kerry Sproston and Jennifer Mindell

Notes

1. The data used in the report have been weighted. The weighting is described in Chapter 7, in Volume 2 of this report. Both unweighted and weighted sample sizes are shown at the foot of each table. The weighted numbers reflect the relative size of each group in the population, not numbers of interviews made, which are shown by the unweighted bases. 2. Three different non-response weights have been used: one for non-response at the interview stage, one for non-response to the nurse visit, and one for non-response to the blood sample. 3. The following conventions have been used in tables: - No observations (zero value) 0 Non-zero values of less than 0.5% and thus rounded to zero [ ] Used to warn of small sample bases, if the unweighted base is less than 50. If a group’s unweighted base is less than 30, data are normally not shown for that group. 4. Because of rounding, row or column percentages may not add exactly to 100%. 5. A percentage may be quoted in the text for a single category that aggregates two or more of the percentages shown in a table. The percentage for the single category may, because of rounding, differ by one percentage point from the sum of the percentages in the table. 6. Values for means, medians, percentiles and standard errors are shown to an appropriate number of decimal places. Standard Error may sometimes be abbreviated to SE for space reasons. 7. ‘Missing values’ occur for several reasons, including refusal or inability to answer a particular question; refusal to co-operate in an entire section of the survey (such as the nurse visit or a self-completion questionnaire); and cases where the question is not applicable to the informant. In general, missing values have been omitted from all tables and analyses.

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8. All minority ethnic date related to 2004 (except for comparisons with results from HSE 1999 which also focused on the health of minority ethnic groups). General population data normally related to 2004, but because the general population sample in 2004 did not have a nurse visit, comparative data about the general population have, in some cases, been taken from the previous year (2003). Where this has been the case, it is indicated. 9. Some tables and charts who data in the form of risk ratios, or ratios of means. In all chapters, except chapter 12, these ratios have been age-standardised. In the charts, ratios have been plotted using a logarithmic scale on the vertical (y) axis. The range is normally from 0.1 to 10.0 (the general population being set at 1.0). The lower and upper 95% confidence limits are also plotted, as a vertical line with markers at the lower and upper ends. 10. The group to whom each table refers is stated at the upper left corner of the table. 11. The term ‘significant’ refers to statistical significance (at the 95% level) and is not intended to imply substantive importance.

HSE 2004 | VOL 1: THE HEALTH OF MINORITY ETHNIC GROUPS

11

Introduction

1

1.1 The Health Survey for England This is the fourteenth annual survey of health in England. Each survey has covered adults aged 16 and over living in private households in England. Since 1995, the surveys have included children aged two to 15, and since 2001, infants under two years old, who live in households selected for the survey. Results for adults and children from previous surveys are also available on the Department of Health’s website: (http://www.dh.gov.uk/PublicationsAndStatistics/PublishedSurvey/fs/en ). Like the 1999 survey,1 this year focuses on the health of adults from various minority ethnic groups in England. Additional households were included in the survey to increase the number of Black Caribbean, Indian, Pakistani, Bangladeshi, Chinese and Irish participants, as in 1999. For 2004, the representation of Black African informants was also increased. This report compares results for each of these groups with the general population in England. The Health Survey for England (HSE) is part of a programme of surveys commissioned by the Department of Health, and provides regular information that cannot be obtained from other sources on a range of aspects concerning the public’s health, and many of the factors that affect health. Since April 2005 this function has been taken over by the new Health and Social Care Information Centre. More details about the Information Centre are available from its website (www.ic.nhs.uk). Results for adults and children from the general population in 2004 are also available on the Information Centre’s website: (www.ic.nhs.uk/pubs/hlthsvyeng2004upd ). The series of Health Surveys for England was designed to: 1. Provide annual data for nationally representative samples to monitor trends in the nation’s health; 2. Estimate the proportion of people in England who have specified health conditions; 3. Estimate the prevalence of certain risk factors associated with these conditions; 4. Examine differences between subgroups of the population (by age, sex, income or ethnicity) in their likelihood of having specified conditions or risk factors;

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5. Assess the frequency with which particular combinations of risk factors are found, and in which groups these combinations most commonly occur; 6. Monitor progress towards selected health targets; 7. (Since 1995) measure the height of children at different ages, replacing the National Study of Health and Growth; and 8. (Since 1995) monitor the prevalence of overweight and obesity in children. Each survey in the series includes core questions and measurements (such as blood pressure and anthropometric measurements and analysis of blood, saliva and urine samples), as well as modules of questions on specific issues that vary from year to year. In recent years, the core sample has also been augmented by an additional boosted sample from a specific population subgroup, such as children, older people or, as this year, those from the largest minority ethnic groups in England. HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 1: INTRODUCTION

13

The Health Survey for England has been carried out since 1994 by the Joint Health Surveys Unit of the National Centre for Social Research (NatCen) and the Department of Epidemiology and Public Health at the Royal Free and University College Medical School (UCL).

1.2 The 2004 Health Survey for England Health varies significantly between different ethnic groups,1,2 but while the variations are well established, less is known about why they occur and the extent to which ethnicity is related to health independently of other circumstances such as income and social class. There are also concerns about inequalities in risk factors and in access to health care between different groups. This is the second health survey in the series to consider the health of minority ethnic groups in this country. It was designed to build on the information obtained in the 1999 survey. A large-scale representative sample of adults and children from minority ethnic groups across England was interviewed; information obtained was complemented by objective physical measurements and analysis of blood, urine and saliva samples. The general household sampling method does not yield sufficient numbers of households from minority ethnic groups to analyse their responses separately. Therefore, only half of the usual sample number of adults and children was selected in the usual way. This provided a representative sample of the whole population (including members of minority ethnic groups who happened to be included in this general sample), with whom the specific minority ethnic groups could be compared. 6,552 addresses were selected in 312 wards, issued over twelve months from January to December 2004. Up to ten adults and up to two children in each household were interviewed, and a nurse visit arranged for those participants in minority ethnic groups who consented.

The content of the survey (household interview, individual interviews, and height and weight measurements) was similar for both the core and the boost samples. The ethnic boost sample was asked additional questions about fungus, damp, and pets in the household; cardiovascular disease; country of birth, religion, languages, and cultural identity (adults aged 16+); and asthma and wheezing (children). Only informants in the seven target minority ethnic groups (in either the core or boost sample) had a nurse visit, measuring infant length (aged at least six weeks and under two years), blood pressure (aged 5+), lung function (aged 7-15), and waist and hip circumference (aged 11+). Nurses also took a saliva sample for cotinine assay (aged 4-15), a non fasting blood sample (aged 11+), a fasting blood sample (16+), and a spot urine sample (16+) for analysis. Nurses obtained written consent before taking samples from adults, and parents gave written consent for their children’s samples, while children also signed consent for their blood samples. Consent was also obtained from adults to send results to their GPs, and from parents to send their children’s results to GPs.

1.3 Ethical clearance Ethical approval for the 2004 survey was obtained from the London Multi-centre Research Ethics Committee (MREC).

14

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The other part of the sample for the 2004 survey was a ‘boost’ sample designed to include additional interviews with members of the seven largest minority ethnic groups in England: Black Caribbean, Black African, Indian, Pakistani, Bangladeshi, Chinese and Irish. 41,436 addresses were selected from another 483 wards, issued over the same 12 month period, January to December 2004. For these addresses, only those from the specified minority ethnic groups were eligible for inclusion: up to four adults and three children were included from each eligible household in the boost sample, with a random selection of participants if there was more than this number in an eligible household.

1.4 This report The 2004 Health Survey for England was designed primarily to provide information about the seven largest minority ethnic groups in England. Comparisons are made between these groups and the results from the general population sample where these exist. Comparisons for information from the nurse visit are made with the results from the 2003 survey for adults, and the 2001/2002 survey for children, as there was no nurse visit for the general population sample in 2004. When reading this report, it should be noted that the ‘general population’ refers to the whole population of England, regardless of minority ethnic group. It should not be interpreted as ‘the remainder of the population’, excluding those from the seven minority ethnic groups on whom this report focuses.

1.5 2004 survey design 1.5.1

Introduction The survey was designed to yield a representative sample of the general population of any age living in private households, plus a similar sample of the seven most populous minority ethnic groups in England. More detailed information about survey design is presented in Volume 2 of this report. Those living in institutions were excluded from the survey: this should be considered when interpreting the findings. Those living in institutions, whether prisons or care homes, generally have poorer health than average. This will affect ethnic groups in different ways. For example many minority ethnic groups have a younger age profile than the English average, and more families in minority ethnic groups may care for elders within private households. Thus excluding people living in institutions may affect assessment of the overall health of minority ethnic groups to a lesser extent than that of the general population.

1.5.2

The core general population sample A random sample of 6,552 addresses was selected from the Postcode Address File (PAF), using a multi-stage sample design with appropriate stratification. This was to ensure that households were sampled proportionately across the nine Government Office regions of England. 312 wards were selected, and 21 addresses selected within each ward. Where an address was found to have multiple households, up to three households were included, and if there were more than three, a random selection was made. Each individual within a selected household was eligible for inclusion. Where there were more than two children, two were randomly selected for inclusion, to limit the burden on any household. A maximum limit of ten adults per household was also imposed, although there were no cases where there were more than ten adults in a selected household.

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1.5.3

The ‘boost’ sample of minority ethnic groups To increase the number of participants from Black Caribbean, Black African, Indian, Pakistani, Bangladeshi, Chinese and Irish groups, a boost sample was used. For the minority ethnic boost sample, 408 wards were selected after stratification into 13 groups based on 2001 Census estimates of the proportion of residents in the required minority ethnic groups. 37,535 addresses were randomly selected from the Postcode Address File. In addition, a special Chinese boost was used (see below). In one of the 13 groups of wards ‘focused enumeration’ was used (see below), while in the remaining twelve, the number of addresses within each selected ward varied from 40 to 115 depending on the density of minority ethnic groups recorded in Census estimates. Sampled addresses were visited to ascertain whether they contained residents from any of the seven specified minority ethnic groups. In order to control achieved sample sizes, not all those HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 1: INTRODUCTION

15

identified as being Black Caribbean or Indian were included in some sample groups, and in one group only Irish informants were included (see table below). A different procedure, focused enumeration, was followed in 40 of the selected wards with the lowest density of people from Black and Asian backgrounds (at least 2% but less than 10% of the total resident population). In each of these wards, 80 ‘seed’ addresses were selected, and as well as establishing eligibility at these addresses, interviewers asked about people from minority ethnic backgrounds at the two addresses on either side of the address (‘adjacent addresses’). This technique is only appropriate for identifying ‘visible’ minority ethnic groups, and therefore was not used to identify people of Irish origin. If the householder at the seed address stated that there was no-one from one of the minority ethnic groups at any of the adjacent addresses, then they were screened out and the interviewer made no attempt to make contact. Otherwise, the interviewer attempted to make contact at the adjacent addresses to undertake screening for eligible households. The table below shows the 13 sampling groups, the number of addresses issued in each, and any restrictions imposed on minority ethnic groups to be sampled. Table 1.1: Number of wards and addresses selected per sample group Number of Number of wards addresses selected per ward

Total number of addresses

Proportion of wards screened: Black Caribbean

Indian

Others

Stratum 1

70

45

3150

all

half

all

Stratum 2 Stratum 3 Stratum 4 Stratum 5 Stratum 6 Stratum 7 Stratum 8 Stratum 9 Stratum 10 Stratum 11 Stratum 12

62 60 31 30 16 18 13 2 6 34 40

60 40 115 60 50 60 50 80 40 90 80+3201

3720 2400 3565 1800 800 1080 650 160 240 3060

all half 16/31 half all all 7/13 half half half

half all half half half half all half half half

all all all all all all all all all all

Stratum 13 Total

26 408

35

16000 910 37535

all none

all none

all2 Irish only

180 seed addresses and 320 adjacent focused enumeration addressees. 2Irish informants included from seed address only.

In addition, a special Chinese boost sample was used, which involved screening the Electoral Register for people with ‘Chinese sounding’ surnames. 75 wards, identified from the 2001 Census as containing 15 or more Chinese people, were selected. For each selected ward, all households on the restricted Electoral Register (i.e. where people had agreed to have their names included in the public listing of the register) with at least one resident with a Chinese sounding surname were identified for screening. This sampling approach followed methodology devised by the Office for National Statistics (ONS), based on a list of the 1,300 most common Chinese surnames appearing in the English version of the 1991 Hong Kong telephone directory. A total of 3,901 addresses were issued, and interviewers visited the selected addresses to establish whether any Chinese informants were resident. It should be noted that the sampling methodology for the Chinese differed in 2004 and 1999. The 2004 survey identified Chinese informants from the core general population sample, the minority ethnic boost sample and the special Chinese boost sample, as described above. In 1999, apart from Chinese informants identified in the general population sample, the sample of Chinese informants was not selected independently. It was obtained by following up addresses with Chinese residents in a survey carried out by the National Centre on behalf of the Health Education Authority (HEA) in 1998. This study looked at the health and lifestyles of Chinese residents aged 16-74 in England; it was 16

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Special Chinese boost sample

restricted to areas of the country identified in the 1991 Census as having the highest proportions of Chinese residents, and involved screening the Electoral Register for ‘Chinese sounding’ names.3 The different methodologies adopted for the two surveys may affect comparability of results for the Chinese population, and should be taken into account when interpreting the findings. Selecting individuals in the minority ethnic sample Each individual in a selected household with one or more residents from the target minority ethnic groups was eligible to participate. As minority ethnic groups more commonly live in larger households than the general population, the rules for selecting individuals were different from those in the core general population sample. Up to four minority ethnic adults were included in the survey, to limit the survey burden for these households (rather than up to ten adults in the core sample). However, up to three children were included (rather than two in the core sample) to ensure that sufficient numbers of interviews with children from minority ethnic backgrounds were achieved. Where there were more than these numbers of eligible adults or children, participants were randomly selected. 1.5.4

Minority ethnic groups in the general population sample In addition to those identified in the boost sample, a number of informants from the eligible minority ethnic groups were identified in the general population sample. To obtain the total minority ethnic group sample that is reported here, informants from eligible groups who were identified in the general population sample were included with those from the boost sample. Thus, minority ethnic informants identified in the general population sample are included in both the general population sample and the minority ethnic sample in this report.

1.5.5

Establishing ethnicity Ethnicity was established during the screening process by the interviewer reading a list of minority ethnic groups and asking, for each one, whether anyone in the household was of that origin. The descriptions for all the target minority ethnic groups, apart from the Irish, were as defined in the Census. People were included as being of Irish origin if they were born in Ireland, or their father or mother was born there. Informants of mixed origin including one of the target minority ethnic groups were included as eligible. At the screening stage, an adult member of the household provided information, including ethnic origin, about all household members. Each individual selected for interview was later asked to confirm their ethnic origin, and his/ her own classification was definitive. If informants were not able to speak English, language cards were used to indicate the languages for which translations were available (Urdu, Punjabi, Gujarati, Hindi, Bengali, Mandarin, Cantonese). Informants who were able to read one of the translated languages were given a card in that language with the appropriate screening questions to establish whether they and other household members belonged to an eligible group.

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All adults and children in any of the target minority ethnic groups were identified in a household, and if there were more than four adults and three children, the CAPI (computer assisted interview programme) selected informants at random. 1.5.6

Fieldwork Interview A letter stating the purpose of the survey was sent to each sampled address prior to the interviewer visiting; the only exception was for adjacent addresses in the wards in the minority ethnic boost sample where focused enumeration was carried out. Letters to addresses for the minority ethnic boost sample also explained that the survey’s focus was the health of people from different ethnic and cultural groups, so the interviewer would check if any household members were eligible to participate. The interviewer sought the permission of each eligible selected adult in the household to be interviewed, and parents’ and children’s consent to interview selected children aged up to 15. HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 1: INTRODUCTION

17

Computer-assisted interviews were conducted. The content of the interview is detailed in Volume 2; full documentation is provided in the Appendices to Volume 2. Interview topics included general health, fractures, physical activity (aged 2+), fruit and vegetable consumption (aged 5+), smoking and alcohol use (aged 8+), and psychosocial health (aged 13+). Adults (aged 16+) were also asked about use of complementary and alternative medicine, social support, and use of hormone replacement therapy and the contraceptive pill. Adults aged 16 and 17 were given a self-completion questionnaire to provide information about smoking and alcohol use, to respect their privacy and avoid potential embarrassment or unwillingness to answer if parents were present. For children under 13, one of the child’s parents or guardians was interviewed about the child, with the child present during the interview. Additional questions about children included reported birth weight and use of cycle helmets. To protect privacy for some topics, self-completion questionnaires were given to children aged eight to 15 to enquire about smoking and alcohol consumption. Children aged 13-15 were interviewed in person, after permission was obtained from a parent or guardian. Parents of children aged four to 15 were also given a self-completion questionnaire to complete about strengths and difficulties their child experienced. The ethnic boost sample was asked additional questions about fungus, damp and pets in the household; cardiovascular disease, country of birth, religion, languages, and cultural identity (adults aged 16+); and asthma and wheezing (children). At the end of the interview, the interviewer measured the participants’ height (aged 2+) and weight. Non-English speaking participants All survey materials were translated into seven languages: Bengali, Gujarati, Hindi, Punjabi, Urdu, Mandarin and Cantonese. Wherever possible, participants who were unable to be interviewed in English were visited by an interviewer who could speak the relevant language, and this interviewer accompanied the nurse for her visit if the nurse did not speak the relevant language. Nurse visit

1.5.7

Survey response Interviews were held in 4,119 households with 6,704 adults aged 16 or over, and 1,650 children from the general population, including 876 adults and 393 children from minority ethnic groups. The minority ethnic boost sample resulted in an additional 5,940 adults and 2,905 children being interviewed. Among minority ethnic informants, 3,540 adults and 1,743 children agreed to a nurse visit, with 2,325 adults and 174 older children (11+) giving a blood sample. Response to the survey can be calculated in two ways: at a household level and at an individual level. A summary of responses obtained to each component of the survey is given below for the general population as well as for each minority ethnic group. 18

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All participants from any of the seven minority ethnic groups, whether in the core or boost samples, were eligible for a nurse visit. The nurse obtained information on current medication and gave participants aged 16+ a self-completion booklet on their eating habits. Nurses then took various measurements, depending on the participant’s age: measuring infant length (aged at least six weeks and under two years), blood pressure (aged 5+), lung function (aged 7-15), waist and hip circumference (aged 11+). Non fasting blood samples were collected for the analysis of total and house dust mite specific IgE (aged 11-15); total and HDL cholesterol, glycated haemoglobin, haemoglobin, and ferritin (aged 11+); and fibrinogen and c-reactive protein (aged 16+). Where possible, fasting blood samples were obtained from adults (aged 16+) to be analysed for triglycerides, LDL cholesterol and glucose. A urine sample was also requested from adults to assess dietary sodium and a saliva sample from children aged 4-15 for cotinine, to assess smoking and exposure to tobacco smoke.

Interviews were carried out at 72% of households in the general population, at 69% of known eligible boost sample households (66% of estimated eligible households). Within the general population sample, interviews were obtained with 90% of adults and 94% of (sampled) children in interviewed households. The equivalent figures for the total minority ethnic sample were 88% of adults and 92% of children. Table 1.2: Adult response rate in co-operating households Black Caribbean

Black African

Indian

%

%

%

%

88 70 67 45

89 71 69 40

87 78 77 51

43

37

44

Interviewed Height measured Weight measured Saw nurse Waist-hip measured Blood pressure measured Non fasting blood sample obtained Fasting blood sample obtained Saliva sample obtained Urine sample obtained

Chinese

Irish

General population

%

%

%

%

84 69 66 42

89 73 69 33

84 74 72 44

92 81 79 59

90 79 77 n/a

49

38

31

43

57

n/a

38

50

39

31

43

58

n/a

28

24

37

25

19

26

45

n/a

18

14

21

13

8

17

28

n/a

38

34

45

33

28

37

54

n/a

36

33

43

30

25

35

51

n/a

Pakistani Bangladeshi

Chinese

Irish

General population

Pakistani Bangladeshi

Table 1.3: Child response rate in co-operating households Black Caribbean

Black African

Indian

%

%

%

%

%

%

%

%

92 65 62 45

92 72 69 43

93 81 80 57

92 74 74 53

91 68 67 35

95 81 79 54

94 79 75 60

94 80 78 n/a

41

40

55

43

20

35

55

n/a

43

38

55

45

30

47

58

n/a

34

35

48

34

26

41

51

n/a

15

22

24

10

10

10

26

n/a

36

36

51

38

27

36

51

n/a

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Interviewed Height measured Weight measured Saw nurse Waist-hip measured (aged 11 and over) Blood pressure measured (aged 5 and over) Lung function measured (aged 7 and over) Non fasting blood sample obtained (aged 11 and over) Saliva sample obtained (aged 4 and over)

1.6 Data analysis 1.6.1

Introduction As a cross-sectional survey, the Health Survey for England gives information on the proportions of the population with certain characteristics. It also examines associations between various health states, personal characteristics and behaviours, but cannot comment on whether these are causal. It should be noted that current health status often reflects previous rather than current behaviour. For example, a cross-sectional survey may find that ex-smokers are more likely to have heart disease than current smokers. This is probably because smokers who develop heart disease are more likely to stop smoking, so

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 1: INTRODUCTION

19

ex-smokers include a disproportionate number of people who already had heart disease. In addition current smokers include many individuals who will not develop heart disease or who have not yet done so, and those smokers whose heart disease is most closely related to smoking may have died prematurely. Weighting the samples The general population sample For the general population sample, weights were calculated at the household level and at the individual informant level. The household weights corrected for the probability of selection where additional households were identified at a selected address. Calibration weighting was also used for adults to reduce non-response bias resulting from differential non-response at the household level, based on the age and sex profile of the residents and the region in which the household was situated. Weights were also calculated at an individual level for adults to correct for non-response within participating households. For children, selection weights were calculated so that children in larger households were not under-represented in the sample, since a maximum of two children were interviewed in a household. Adjustment weights were also calculated for children at the individual level by age within sex to reduce any non-response bias resulting from the age profile of the sample. There was no nurse visit for adults in the general population core sample who were not from a minority ethnic background, and therefore no further weighting was required. The minority ethnic boost sample The minority ethnic sample was obtained from three sources: minority ethnic informants in the general population core sample; the boost sample for minority ethnic groups; and the Chinese special boost sample for Chinese informants. The household selection weights for the boost were calculated in the same way for the core sample, with the exception of sample points where focused enumeration was carried out. In these sample points the household selection weight was set to be 1 for all households in the sample. Selection weights were calculated for adults and children to adjust for the probability of being included, since a maximum of four adults and three children were selected. Selection weights for addresses were also calculated for each informant separately, because each informant from a minority ethnic group had a chance of being selected either from the general population or the boost sample, with the probability of being interviewed for the boost sample depending on their ethnic group. Therefore the probability of selection for an informant would be the same whether they were selected for the core sample or the boost sample. The weighted distribution of the minority ethnic groups using the combination of these selection weights was treated as the best estimate of the population distribution, and this distribution was therefore used to ‘correct’ weights at each stage of the weighting process. For the Chinese sample, the combined weights for Chinese people from the core and boost samples were re-scaled so that they summed to the number of Chinese informants from those samples. The weights for the informants from the Chinese special boost were all set to be equal to 1, so that they summed to the number of informants in the Chinese special sample. The Chinese special sample was then added to the minority ethnic sample and the weights for the Chinese informants in the combined minority ethnic sample re-scaled to be equal to the best estimate of the proportion of Chinese people in the population, derived from the survey data. Non-response weighting for the nurse visit and blood sample For the minority ethnic sample, as well as weights at the interview stage, two further weights were calculated to adjust for non-response to the nurse visit, and for obtaining a blood sample.

20

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 1: INTRODUCTION

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1.6.2

1.6.3

Weighted and unweighted data and bases in the report All 2004 data in this report are weighted. Both weighted and unweighted bases are given in each table. The unweighted bases show the number of participants involved. The weighted bases show the relative sizes of the various sample elements after weighting, reflecting their proportions in the English population, so that data from different columns can be combined in their correct proportions. Where data from 2002 or 2003 have been used as a general population comparator, the weightings from those years were applied: selection weights only in 2002, and selection and non-response weighting in 2003.

1.6.4

Age as an analysis variable Age is a continuous variable but results are presented by age groups. Age in Health Survey for England reports always refers to age at last birthday.

1.6.5

Age standardisation and risk ratios Age distribution varies considerably between ethnic groups. Data were therefore agestandardised for comparisons between different ethnic groups for factors that vary by age, to examine whether differences observed reflect ethnic differences and not merely differences in the age profiles of participants. It should be noted that all analyses in the report are presented separately for men and women. All age standardisation has been undertaken separately within each sex, expressing male data to the overall male population and female data to the overall female population. When comparing data for the two sexes, it should be remembered that no age standardisation has been introduced to remove the effects of the sexes’ different age distributions. The direct standardisation method has been used. Instead of showing the agestandardised figures themselves, the results are presented in the form of risk ratios that compare the prevalence or mean for a given minority ethnic group with the prevalence or mean in the general population, after adjusting for age in each group. For example, a risk ratio of 2.0 means that group is twice as likely as the general population to have that condition, allowing for age differences; a risk ratio of 0.5 means that group is half as likely as the general population to have that condition, allowing for age differences. Risk ratios were calculated separately for men and women. Standard errors of the ratios are also given in the tables. The age distribution to which each minority ethnic group and the general population are standardised was the same distribution used in analysis of the 1999 survey. This is an artificial distribution that was designed to minimise the percentage increase in standard errors that the standardised weights introduced.

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Table 1.4: Adult response in co-operating households

Men 16-34 35-54 55 and over Women 16-34 35-54 55 and over

Black Caribbean

Black African

Indian

Chinese

Irish

General population

%

%

%

%

%

%

%

%

29 41 30

47 42 11

36 43 21

49 36 15

51 37 12

49 33 18

23 38 39

32 36 32

32 43 24

50 42 8

38 44 18

55 32 12

65 25 10

39 48 14

21 44 35

30 35 35

Pakistani Bangladeshi

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 1: INTRODUCTION

21

1.6.6

Equivalised income Household income was established by means of a card shown to informants (see Appendix A, Volume 2) on which banded incomes were presented. Information was obtained from the household reference person (HRP) or their partner. Initially they were asked to state their own (HRP and partner combined) aggregate gross income, and were then asked to estimate the total household income including that of any other persons in the household. Household income can be used as an analysis variable, but there has been increasing interest recently in using measures of equivalised income that adjust income to take account of the number of persons in the household. Thus equivalised annual income scores were calculated, and the equivalised annual household income was attributed to all members of the household, including children. Data in the report are presented in equivalised income tertiles. Equivalised income tertiles have been calculated separately for two groups of households, one group being Black, Asian and Chinese households, and one being households in the general population. This is because household income amongst minority ethnic groups is, on average, considerably lower than that for the general population. The general population tertiles have been used for analysis of the Irish group. Categorising minority ethnic groups to tertiles based on the general population income distribution would give only very small sample sizes in the highest income tertile for most minority ethnic groups. This would reduce the likelihood of observing associations between ethnicity, income and health. It should be noted that even when tertiles for Black, Asian and Chinese households were calculated, the number of Bangladeshi informants in the highest tertile was relatively small.

1.6.7

Comparison of results from 1999 and 2004 In most cases, data from the 1999 survey are presented for comparison when available. The results shown for 1999 may differ from those presented in the published report for 1999 due to weighting or use of different thresholds. When comparisons are made between data for 2004 and 1999, it should also be noted that the age profiles of minority ethnic groups may differ between the two years. This should be taken into account when interpreting differences in results over time. Comparisons over time will be more valid within specific age groups, therefore, and where base sizes allow, results are presented broken down by age.

1.6.8

Presentation of results

●

Comparison of the variable for minority ethnic groups with the general population, showing weighted observed values, with risk ratios for most variables;

●

Age-specific rates for set age-groups within each minority ethnic group, without age standardisation;

●

Observed and age-standardised results by tertile of equivalised household income; and

●

Comparisons with 1999, showing age within minority ethnic group.

Commentary in the report highlights differences that are statistically significant at the 95% level. It should be noted that statistical significance is not intended to imply substantive importance. 1.6.9

Availability of unpublished data As with the previous surveys, an anonymised copy of the 2004 Health Survey for England data will be deposited at The Data Archive at the University of Essex. Copies of the data files can be obtained for specific research projects from the Archive: www.data-archive.ac.uk

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HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 1: INTRODUCTION

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There are four main types of table in this report:

1.7 Content of this report Volume 1 Chapter 2

Self-reported health and psychosocial well-being

Chapter 3

Cardiovascular disease and diabetes

Chapter 4

Use of tobacco products

Chapter 5

Alcohol consumption

Chapter 6

Anthropometric measures, overweight, and obesity

Chapter 7

Blood pressure

Chapter 8

Physical activity

Chapter 9

Eating habits

Chapter 10

Blood analytes

Chapter 11

Complementary and alternative medicines and therapies (CAM)

Chapter 12

Children’s health

Volume 2 Chapters 1-9 Survey method and response: A detailed account of the survey design and response rates; sampling errors; analysis of non-response; description of weighting procedures; information on laboratory techniques and quality control of blood analytes and salivary cotinine. Appendix A

Questions asked by interviewers and nurses and copies of other key fieldwork documents

Appendix B

Protocols for measurements

Appendix C

Summary of the system for classifying prescribed medicines.

Appendix D

Glossary

Appendix E

Weighting outlines

References and notes 1 Erens B, Primatesta P, Prior G (eds). Health Survey for England. The Health of Minority Ethnic Groups ’99. London: TSO, 2001. 2 Aspinall P, Jacobson B. Ethnic disparities in health and healthcare. London: London Health Observatory, 2004.

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3 Sproston K, Pitson L, Whitfield G, Walker E. Health and Lifestyles of the Chinese Population in England. 1999. London: Health Education Authority.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 1: INTRODUCTION

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Self-reported health and psychosocial well-being

2

Lucy Natarajan

Summary Self-reported general health ●

In the general population 6% of men and 7% of women reported bad or very bad general health, and 77% of men and 74% of women reported good or very good health.

●

Bangladeshi and Pakistani men and women, and Black Caribbean women, were more likely to report bad or very bad health than the general population. In relation to the general population (set at 1.0) the risk ratios for bad or very bad health were 3.77 for Bangladeshi men, 4.02 for Bangladeshi women, 2.33 for Pakistani men, 3.54 for Pakistani women, and 1.90 for Black Caribbean women.

●

Among the general population, there was no change in the prevalence of bad or very bad self-reported general health between 1999 and 2004. The same was true for all minority ethnic groups, with the exception of Indian women, where the prevalence of bad or very bad health decreased to 8% in 2004 from 12% in 1999.

Longstanding illness and limiting longstanding illness ●

In the general population 43% of men and 47% of women reported longstanding illness, and 23% of men and 27% of women reported limiting longstanding illness. These were around the same prevalences as found in previous years.

●

Pakistani women (risk ratio of 1.60) and Bangladeshi men (risk ratio of 1.52) were more likely than those in the general population to report a limiting longstanding illness.

●

The levels of longstanding illness and limiting longstanding illness were significantly higher for Pakistani women in 2004 than they were in 1999. For this group the prevalence of longstanding illness rose from 32% to 41%, and the prevalence of limiting longstanding illness rose from 23% to 30%.

Acute sickness ●

Among the general population, 14% of men and 19% of women reported that they had had an acute sickness in the past two weeks. Pakistani men and women were more likely to report acute sickness than the general population, with risk ratios of 1.42 and 1.39 respectively.

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GHQ12 ●

The prevalence of high GHQ12 scores among the general population was lower in 2004 (11% for men and 15% for women) than in 1999 (15% for men and 19% for women), this was also true for Irish and Bangladeshi men and women, and Black Caribbean and Indian women.

Social support ●

A minority (16% of men and 11% of women) of the general population reported a severe lack of support. Prevalence of severe lack of social support was much higher among men and women in all minority ethnic groups, except Irish men and women. This was particularly marked among the Pakistani men (38%) and women (30%) and Bangladeshi men (35%) and women (33%).

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

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2.1 Introduction This chapter covers self-reported general health, acute sickness, longstanding illness, limiting longstanding illnesses, psychosocial measures (GHQ12 and perceived social support), and prescribed medicines. These are subjective measures, and the survey included people with a variety of first languages. Therefore, it should be noted that issues of culture and interpretation may influence the survey results. The meanings and values that each minority ethnic group and the general population give to the question terms are not necessarily identical. Moreover, subjective health assessments do not necessarily correspond with medical diagnoses, or prescriptions.

2.2 Self-reported general health Self-reported general health, by minority ethnic group Informants were asked to rate their general health selecting one of five categories: very good, good, fair, bad, or very bad. Results are presented for the best two categories combined (‘good or very good’) and the worst two categories combined (‘bad or very bad’). Among the general population, the levels of general health reported by men and women were the same as in the previous HSE year. Around three quarters of the general population (77% of men and 74% of women) reported good or very good health, and 6% of men and 7% of women reported bad or very bad health. Table 2.1 Overall the minority ethnic groups followed this pattern, with the majority of people reporting good or very good general health, and a much lower proportion reporting bad or very bad health. Age-standardised risk ratios were analysed in order to control for differences in the age profiles of different ethnic groups (since age is related to health outcomes and behaviours). See Chapter 1 for more information. As in 1999, Bangladeshi and Pakistani men and women and Black Caribbean women were more likely to report bad or very bad health than the general population. In relation to the general population the risk ratios for bad or very bad health were 3.77 for Bangladeshi men, 4.02 for Bangladeshi women, 2.33 for Pakistani men, 3.54 for Pakistani women, and 1.90 for Black Caribbean women. Chinese women were the only group less likely to report bad or very bad health (with a risk ratio of 0.55) than the general population. Figure 2A Figure 2A Self-reported bad or very bad general health, by minority ethnic group 10.0

10.0

2.0

2.0

1.0

1.0

0.5

0.5

0.10

0.10 h

e

i

es

ad

gl

an

st

n

hi

an

an

an

be

hi

ib

ric

Af

ar

C

s ne

hi

s Iri

C

n Ba

ki

Pa

ia

k

k

ac

d In

Bl

ac

Bl

h

e

i

es

ad

gl

an

st

n an

be

ib

ric

ar

Af

C

s ne

hi

s Iri

C

n Ba

ki

Pa

ia

k

k

ac

d In

Bl

ac

Bl

General population = 1.0. Error bars indicate 95% confidence limits.

26

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

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Women

Men

Risk ratio, logarithmic scale

2.2.1

2.2.2

Self-reported general health by age As with previous HSE reports, levels of bad or very bad self-reported health increased with age. In the general population, 2% of men and women aged 16-34 reported bad or very bad health, and this proportion rose to 6% for men and women aged 35-54, and 12% of men and women aged 55 and older. Table 2.2 As with the general population, the prevalence of bad or very bad health increased with age among minority ethnic groups. As in 1999, the association of bad or very bad self-reported health with older age was strongest in the Bangladeshi and Pakistani groups. The proportion reporting bad or very bad health in the oldest age group was 34% for Pakistani men, 45% for Pakistani women, 53% for Bangladeshi men and 44% for Bangladeshi women, although the base size for Bangladeshi men is small.

2.2.3

Comparison of self-reported general health in 1999 and 2004 Among the general population, there was no change in the prevalence of bad or very bad self-reported general health between 1999 and 2004. The same was true for all minority ethnic groups, with the exception of Indian women, where the prevalence of bad or very bad health decreased to 8% in 2004 compared with 12% in 1999. Table 2.3, Figure 2B Figure 2B Comparison of self-reported bad or very bad general health in 1999 and 2004 Women

Percent

Men 20

20

18

18

16

16

14

14

12

12

10

10

8

8

6

6

4

4

2

2

0

0

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al er on en ti G ula p po sh Iri se i ne hi sh C de la ng Ba ni a st ki Pa an di In k n ac ea Bl ibb ar C

al er on en ti G ula p po sh Iri se i ne hi sh C de la ng Ba ni a st ki Pa an di In k n ac ea Bl ibb ar C

2.2.4

1999 2004

Self-reported general health, by household income Equivalised household income is a measure of household income that takes account of the number of persons in a household. The same strong association found in previous years between income and self-reported health was seen in 2004. Those in the lowest income tertile were more likely to report bad or very bad health than those in the middle and highest tertile. In the general population the risk ratios for the highest, middle and lowest tertile, respectively, were 0.37, 1.20 and 2.44 for men, and 0.37, 1.20 and 2.44 for women. A similar relationship was seen in most of the minority ethnic groups for both men and women, but this is a tentative conclusion due to the small base sizes in some tertiles. Table 2.4

2.3 Self-reported longstanding illness and limiting longstanding illness 2.3.1

Prevalence of self-reported longstanding illness, by minority ethnic group Since 1991 the prevalence of longstanding illness, and since 1996 limiting longstanding illnesses, have been measured. Longstanding illnesses are illnesses, disabilities and HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

27

infirmities that have affected or are likely to affect a person over a period of time. People who said they had a longstanding illness were asked if their activities were limited in any way by the longstanding illness, and such illnesses are classified as ‘limiting longstanding illness’. In the general population 43% of men and 47% of women reported a longstanding illness, and 23% of men and 27% of women reported a limiting longstanding illness. These were around the same prevalences as found in previous years. Pakistani women were more likely than the general population to report a longstanding illness, with a risk ratio of 1.17. Black African and Chinese men and women and Indian women were less likely than the general population to report a longstanding illness. Their risk ratios as compared with the general population were 0.67 for Black African men, 0.66 for Black African women, 0.61 for Chinese men and women, and 0.73 Indian women. For the other minority ethnic groups, the levels reporting a longstanding illness were around the same as in the general population. Table 2.5, Figure 2C Figure 2C Longstanding illness, by minority ethnic group Women

Risk ratio, logarithmic scale

Men 10.0

10.0

2.0

2.0

1.0

1.0

0.5

0.5

0.10

0.10 sh

i

i

sh

de

se

ne

hi

Iri

C la

an

st

ng

an

be

an

ric

ib

i

sh

ar

Af

C

an

ki

Ba

Pa

k

k

ac

di

In

Bl

ac

Bl

sh

i

de

se

ne

hi

Iri

C la

an

st

ng

an

be

an

ric

ib

ar

Af

C

an

ki

Ba

Pa

di

In k

k

ac

ac

Bl

Bl

General population = 1.0. Error bars indicate 95% confidence limits.

2.3.2

Prevalence of self-reported limiting longstanding illness, by minority ethnic group

2.3.3

Prevalence of self-reported longstanding illness and limiting longstanding illness, by age The prevalence of longstanding and limiting longstanding illness increased with age in all groups. Among the general population, the prevalence of longstanding illness increased from 23% of men and 28% of women aged 16-34, to 67% of men and women aged 55 and older. For limiting longstanding illnesses, the rise was steeper, from 9% of men and 15% of women aged 16-34, to 40% of men and 43% of women aged 55 and older. The same relationship was found for all minority ethnic groups, although the base sizes for the Black African and Bangladeshi groups are small. Table 2.6

28

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

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Pakistani women (risk ratio of 1.60) and Bangladeshi men (risk ratio of 1.52) were more likely than those in the general population to report a limiting longstanding illness. In contrast, Black African men and Chinese men and women were all less likely than the general population to report having a limiting longstanding illness. The risk ratios for having limiting longstanding illnesses were 0.63 for Black African men, 0.57 for Chinese men and 0.46 for Chinese women. Table 2.5

2.3.4

Comparison of self-reported longstanding illness and limiting longstanding illness, in 1999 and 2004 The prevalence of longstanding illness and limiting longstanding illness among men and women in the general population was around the same as in 1999. For Indian women, the levels of longstanding illness and limiting longstanding illness reported were significantly lower in 2004 than they were in 1999. For that group, the prevalence of longstanding illness fell from 37% to 30%, and limiting longstanding illness fell from 25% to 19%. By contrast, for Pakistani women, the levels of longstanding illness and limiting longstanding illness were significantly higher in 2004 than they were in 1999. For that group, the prevalence of longstanding illness rose from 32% to 41%, and limiting longstanding illness rose from 23% to 30%. Table 2.6

2.3.5

Type of self-reported longstanding illness, by minority ethnic group Informants with longstanding illness also reported the details of their condition. This information was used to categorise the types of illnesses according to the ICD10 coding system, by rates per thousand reporting. As in the 1999 report the three most common types of condition for men and women in the general population were disorders of the musculoskeletal system (173 and 208 per thousand), the heart and circulatory system (123 and 118 per thousand), and the respiratory system (96 and 93 per thousand). Disorders of the heart and circulatory system, and the respiratory system were also among the three most common types of condition for all the minority ethnic groups. The other most common type of condition was endocrine and metabolic disorders for Black Caribbean, Bangladeshi and Indian men and women, Black African men, and Chinese women, and disorders of the musculoskeletal system for the rest. Musculoskeletal disorders were the most common condition for all groups except Chinese men. For most minority ethnic groups the levels of the four most common conditions were around the same as for men and women in the general population, with some exceptions. Bangladeshi men (risk ratio of 1.66) and women (risk ratio of 2.00) and Pakistani (1.69) and Black Caribbean women (1.48) were more likely to report disorders of the heart and circulatory system than the general population. Pakistani men (risk ratio of 2.01) and women (risk ratio of 2.51) and Bangladeshi men (2.63) and women (1.79), as well as Indian men (1.53) and Black Caribbean women (1.59) were more likely to report disorders of the endocrine and metabolic system than the general population. Chinese men (risk ratio of 0.48) and women (risk ratio of 0.45) and Black African men (0.46) were less likely to report disorders of the musculoskeletal system than the general population. Black African men (0.36) and women (0.60), and Indian (0.57) and Chinese women (0.40) were less likely to report disorders of the respiratory system than the general population. Table 2.7

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2.3.6

Self-reported longstanding illness, by household income As in previous years there was an inverse association between longstanding illness and equivalised household income for both men and women in the general population. For men in the highest income tertile, the prevalence of longstanding illness was 38%, compared with around 50% in the other two categories. For women in the highest income tertile the prevalence of longstanding illness was 39%, compared with 56% in the middle and 54% in the lowest category. The same pattern could be seen for Black Caribbean, Indian and Irish groups. Table 2.8

2.4 Self-reported acute sickness 2.4.1

Prevalence of self-reported acute sickness, by minority ethnic group Acute sickness was defined as a person having to cut down on their usual domestic, workrelated or other activities due to sickness in the two weeks prior to the interview. The number of days on which activities were affected was recorded as an indicator of the severity of the acute sickness. HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

29

Among the general population, 14% of men and 19% of women reported that they had had any acute sickness in the past two weeks. Chinese men and women were significantly less likely than the general population (with risk ratios of 0.64 for men and 0.56 for women) to report acute sickness. The only other groups significantly different from the general population were Pakistani men and women, who were more likely to report acute sickness, with risk ratios of 1.42 and 1.39 respectively. Table 2.9, Figure 2D Figure 2D Acute sickness, by minority ethnic group Women

Risk ratio, logarithmic scale

Men 10.0

10.0

2.0

2.0

1.0

1.0

0.5

0.5

0.10

0.10 sh

i

i

sh

de

se

ne

hi

Iri

C la

an

st

ng

an

an

be

an

ric

ib

i

sh

ar

Af

C

an

ki

Ba

Pa

di

In k

k

ac

ac

Bl

Bl

sh

i

de

se

ne

hi

Iri

C la

an

st

ng

an

be

ib

ric

Af

ar

C

an

ki

Ba

Pa

di

In k

k

ac

ac

Bl

Bl

General population = 1.0. Error bars indicate 95% confidence limits.

Among the general population, the duration that acute sickness most commonly affected informants’ usual activities was a two week period, with 6% of men and 7% of women having their usual activities affected for the whole fourteen days. The average number of days on which the general population had been affected was eight (8.1 for men and 7.9 for women). 2.4.2

Self-reported acute sickness, by age The prevalence of acute sickness increased with age. In the general population, 11% of men and 13% of women aged 16-34 reported acute sickness, and this proportion rose to 17% of men and 22% of women aged 55 and older. The same pattern was seen among all minority ethnic groups. Table 2.10 Self-reported acute sickness, by household income As in previous years, an inverse association was found between equivalised household income and acute sickness, with prevalence of sickness increasing as income decreased. In the general population, 13% of men and 15% of women in the highest income tertile reported acute sickness. These proportions rose to 17% of men and 26% of women in the lowest income tertile. The same pattern was also seen in the Black Caribbean, and Irish minority ethnic groups, and for Black African and Indian women. The base sizes in some tertiles for the Pakistani, Bangladeshi and Chinese groups were too low for reliable conclusions to be drawn. Table 2.11

2.5 Self-reported psychosocial health 2.5.1

Introduction The main measure of psychological health is the General Household Questionnaire (GHQ12), as in previous years of the survey. The questions cover general levels of happiness, depression, anxiety, sleep disturbance and ability to cope during the four weeks 30

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

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2.4.3

prior to interview. Scores are classified into three categories, with a ‘high’ score (4 or more) indicating possible psychiatric disorder. The GHQ12 was also used in 1999, and it should be noted that this instrument has been validated for a general population but not for specific minority ethnic groups. Subjectivity in individual interviews where informants’ interpretations of the questions are informed by cultural factors may affect comparability between minority ethnic groups. This should be noted particularly for the analysis of psychosocial health, since cultural norms surrounding the description of mental health problems are known to vary. 2.5.2

GHQ12 score by minority ethnic group In the general population, women were more likely than men to have a high GHQ12 score (15% compared with 11%). In 1999, women also had higher levels of high GHQ12 scores than men in the general population and in the Black Caribbean, Indian, Pakistani and Chinese groups. By contrast, in 2004 there was little variation by gender among the minority ethnic groups, with the exception of Black Africans. 19% of Black African women scored 4 or more compared with 11% of Black African men. Table 2.12 In 1999, Bangladeshi and Pakistani men and women had a higher relative risk of a high GHQ12 score than the general population. Differences for these groups were replicated in the 2004 risk ratios, for Pakistani men (1.56) and women (1.73) and Bangladeshi men (1.83) but not for Bangladeshi women. In 1999, Chinese men and women were found to have lower rates of high GHQ12 scores than the general population, but this difference was not replicated in the 2004 data. Table 2.13, Figure 2E Figure 2E High GHQ12 scores, by minority ethnic group Women

Risk ratio, logarithmic scale

Men 10.0

10.0

2.0

2.0

1.0

1.0

0.5

0.5

0.10

0.10 sh Iri se i ne hi sh C de la ng Ba ni ta is

k Pa

an

be

ib

ric

Af

ar

C

an

di In

ck

ck

a Bl

a Bl

sh Iri se i ne hi sh C de la ng Ba ni ta is

k Pa

an

be

ib

ric

Af

ar

C

an

di In

ck

ck

a Bl

a Bl

an

an

General population = 1.0. Error bars indicate 95% confidence limits.

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2.5.3

Comparison of prevalence of high GHQ12 score in 1999 and 2004 The prevalence of high GHQ12 scores among the general population was lower in 2004 than in 1999. A similar decrease in rates of high GHQ12 score was also seen for some of the minority ethnic groups: Irish and Bangladeshi men and women, and Black Caribbean and Indian women. For Chinese men, in contrast, the prevalence was higher in 2004 than it had been in 1999. Table 2.13

2.5.4

GHQ12 score, by household income In the general population, a relationship was found between income and prevalence of high GHQ12 scores. Those in the highest income tertile were least likely to have a high GHQ12 score. Risk ratios for men in the general population were 0.75 in the highest tertile, this rose

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

31

to 1.17 in the middle tertile and 1.72 in the lowest tertile. For women in the highest tertile the risk ratio was 0.80, rising to 1.06 in the middle tertile and 1.51 in the lowest tertile. This pattern was also seen amongst some of the minority ethnic groups. A lower prevalence of high GHQ12 scores was found in the highest income tertile amongst Irish (risk ratio of 0.62) and Indian (risk ratio of 0.58) men, and Black Caribbean (risk ratio of 0.83) women. The risk ratios rose significantly in the middle and lowest tertiles for those groups (with risk ratios in the lowest tertiles of 2.52 for Irish men, 2.22 for Indian men, and 1.55 for Black Caribbean women) but not for any of the other groups. Table 2.14 2.5.5

Perceived social support, by minority ethnic group Perceptions of social support were measured via a battery of questions, which have been included in most HSE years. The questions ask informants to rate the physical and emotional aspects of support they receive from family and friends, by comparing them to positive scenarios. The ratings are given on a three point scale (not true for me, partly true for me, and certainly true for me). A social support score, from 0-21, is then calculated. Scores are classified as follows: 0-17 or ‘severe lack of support’, 18-20 ‘some lack of support’, and 21 ‘no lack of support’. In 2004 most people in the general population (57% of men and 67% of women) reported no lack of support, and only a minority (16% of men and 11% of women) a severe lack of support. Prevalence of severe lack of social support was much higher among men and women in all minority ethnic groups, except Irish men and women. This was particularly marked among the Pakistani men (38%) and women (30%) and Bangladeshi men (35%) and women (33%). In previous HSE reports, men have had higher prevalence of severe lack of social support than women. This pattern was also seen in 2004 among the general population, and Indian, Pakistani and Irish groups. Table 2.15 The risk ratios of reporting severe lack of support, compared with men and women in the general population, were higher for men and women in all minority ethnic groups except Irish. Figure 2F Figure 2F Severe lack of social support, by minority ethnic group

Risk ratio, logarithmic scale

10.0

2.0

2.0

1.0

1.0

0.5

0.5

0.10

0.10

ric

an

be

ib

ar

Af

C

an

be

sh Iri se i ne hi sh C de la ng Ba ni a st ki Pa an

di

In

ck

ck

a Bl

a Bl

ric

ib

ar

Af

C

sh Iri se i ne hi sh C de la ng Ba ni a st ki Pa an

di

In

ck

ck

a Bl

a Bl

an

an

General population = 1.0. Error bars indicate 95% confidence limits.

2.5.6

Comparison of perceived social support in 1999 and 2004 The prevalence of severe lack of social support for men (16%) and women (11%) among the general population were the same in 1999 and 2004. Both Chinese men and women and Indian women reported lower levels of prevalence in 2004 than in 1999. By contrast, the

32

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

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Women

Men 10.0

prevalence of severe lack of social support was higher in 2004 than 1999 for Black Caribbean women, and Irish and Pakistani men. Table 2.16 2.5.7

Perceived social support, by household income A clear relationship was found between household income and severe lack of social support for men and women in the general population, and Black African, Indian and Irish minority ethnic groups. Those in the lowest tertile were more likely to report a severe lack of support. A similar association was also found in the 1999 HSE report for Black Caribbean, Pakistani, Chinese and Irish men and women. Table 2.17

2.6 Prescribed medications During the nurse visit, informants (who were not pregnant) were asked whether they were taking any medicines, pills, syrups, ointments, puffers or injections which a doctor or nurse had prescribed for them. The prevalence of taking prescribed medication was unchanged for men and women in the general population since 2003. Just under half of women (48%) and two fifths of men (40%) were taking prescribed medication in 2004. The average number of prescribed medicines among men and women (3.0 for both in 2004) in the general population who were taking any prescribed medication was also unchanged from 2003. This was also true for the average number of prescribed medicines amongst all men (1.2) and women (1.5) in the general population. Comparing the risk ratios of taking four or more prescribed medicines across minority ethnic groups, most groups were around the same level as men and women in the general population. The exceptions were Pakistani and Bangladeshi women and, to a lesser extent, Indian men. These groups were more likely to be taking four or more prescribed medications than the general population: 2.35 for Pakistani women, 2.50 for Bangladeshi women, and 1.78 for Indian men. Table 2.18

References and notes

Copyright © 2006, The Information Centre. All rights reserved

1 World Health Organization (1992). International statistical classification of diseases and related health problems. Tenth revision. Geneva: WHO. Please note that for example where the medical name of the condition is not known to informants the survey classification may differ from that obtained through medical diagnosis.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

33

Tables

2.1 Self-reported general health, by minority ethnic group and sex 2.2 Self-reported general health, by age within minority ethnic group and sex 2.3 Comparison of bad or very bad self-reported general health in 2004 and 1999, by age within minority ethnic group and sex 2.4 Self-reported general health, by equivalised household income within minority ethnic group and sex

2.16 Comparison of perceived social support in 2004 and 1999, by minority ethnic group and sex 2.17 Perceived social support, by equivalised household income within minority ethnic group and sex 2.18 Number of prescribed medicines, by minority ethnic group and sex

2.5 Self-reported longstanding illness and limiting longstanding illness, by minority ethnic group and sex 2.6 Comparison of self-reported longstanding illness and limiting longstanding illness in 2004 and 1999, by age within minority ethnic group and sex 2.7 Rate per thousand reporting longstanding illness conditions, by minority ethnic group and sex 2.8 Self-reported longstanding illness, by equivalised household income within minority ethnic group and sex 2.9 Self-reported acute sickness in the last two weeks, by minority ethnic group and sex 2.10 Self-reported acute sickness in the last two weeks, by age within minority ethnic group and sex

2.12 GHQ12 score, by minority ethnic group and sex 2.13 Comparison of GHQ12 score in 2004 and 1999, by minority ethnic group and sex 2.14 GHQ12 score, by equivalised household income within minority ethnic group and sex 2.15 Perceived social support, by minority ethnic group and sex

34

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2.11 Self-reported acute sickness in the last two weeks, by equivalised household income within minority ethnic group and sex

Table 2.1 Self-reported general health, by minority ethnic group and sex Aged 16 and over

2004

Self-reported general health

Minority ethnic group

General population

Black Caribbean

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Men Observed % Very good Good Good/very good Fair Bad Very bad Bad/very bad Standardised risk ratios Good/very good

27 46 73 17 7 2 9

43 42 85 11 3 1 4

32 37 69 22 7 2 9

35 38 72 17 7 3 10

24 43 68 17 11 4 15

38 43 81 15 3 0 4

37 34 71 19 7 2 10

36 41 77 17 5 2 6

0.97

1.04

0.88

0.86

0.76

1.00

0.94

1

Standard error of the ratio

0.04

0.04

0.03

0.04

0.04

0.03

0.04

Bad/very bad

1.37

0.81

1.45

2.33

3.77

0.75

1.41

Standard error of the ratio

0.37

0.25

0.27

0.42

0.55

0.20

0.33

1

Women Observed % Very good Good Good/very good Fair Bad Very bad Bad/very bad Standardised risk ratios Good/very good

23 39 62 27 9 2 11

37 41 78 15 6 0 7

29 42 71 22 6 2 8

27 38 65 20 9 6 15

20 44 64 21 10 4 14

28 51 78 19 2 0 3

40 39 79 16 4 1 5

34 41 74 19 5 1 7

0.81

0.91

0.90

0.73

0.67

0.98

1.07

1

Standard error of the ratio

0.03

0.04

0.03

0.04

0.04

0.04

0.03

Bad/very bad

1.90

1.68

1.39

3.54

4.02

0.55

0.74

Standard error of the ratio

0.31

0.36

0.24

0.49

0.57

0.20

0.19

478 675

377 475

903 1067

421 497

178 208

151 163

1776 2369

46188 48679

412 652

390 468

550 634

432 507

409 478

348 375

497 656

2879 3822

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Bases (weighted) Men Women Bases (unweighted) Men Women

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

1

35

Table 2.2 Self-reported general health, by age within minority ethnic group and sex Aged 16 and over

Black Caribbean Very good Good Good/very good Fair Bad Very bad Bad/very bad Black African Very good Good Good/very good Fair Bad Very bad Bad/very bad Indian Very good Good Good/very good Fair Bad Very bad Bad/very bad Pakistani Very good Good Good/very good Fair Bad Very bad Bad/very bad Bangladeshi Very good Good Good/very good Fair Bad Very bad Bad/very bad Chinese Very good Good Good/very good Fair Bad Very bad Bad/very bad

2004 Age group

Men

Women

16-34

35-54

55+

All men

16-34

35-54

55+

All women

%

%

%

%

%

%

%

%

27 58 85 11 3 1 4

37 46 83 12 4 1 5

14 34 48 31 16 5 21

27 46 73 17 7 2 9

29 50 79 17 4 1 5

26 40 66 28 6 1 6

12 23 34 40 20 6 26

23 39 62 27 9 2 11

50 40 91 6 2 1

39 45 83 13 3 1

[31] [35] [66] [27] [6] [-]

43 42 85 11 3 1

48 41 89 9 1 -

28 44 72 18 10 -

[14] [24] [38] [40] [16] [6]

37 41 78 15 6 0

3

3

[6]

4

1

10

[22]

7

50 33 83 15 2 2

27 45 71 22 6 1 7

13 27 40 36 19 5 24

32 37 69 22 7 2 9

38 47 85 13 1 1 2

26 43 69 24 5 1 6

14 31 45 33 16 7 22

29 42 71 22 6 2 8

49 40 89 10 1 0 1

28 39 67 20 11 2 13

6 28 34 33 18 16 34

35 38 72 17 7 3 10

40 43 83 12 4 1 5

16 36 52 29 12 7 19

4 15 19 36 25 20 45

27 38 65 20 9 6 15

37 51 88 10 1 1 2

12 42 54 25 18 3 21

[8] [15] [23] [23] [33] [20] [53]

24 43 68 17 11 4 15

28 52 80 15 4 1 5

7 30 38 35 20 7 27

27 27 29 24 20 44

20 44 64 21 10 4 14

49 43 91 9 -

34 47 81 16 3 3

19 35 54 33 11 2 13

38 43 81 15 3 0 4

36 55 90 10 -

27 48 75 22 3 1 3

8 49 57 36 7 0 7

28 51 78 19 2 0 3

Continued…

36

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

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Self-reported general health

Table 2.2 continued Aged 16 and over Self-reported general health

Irish Very good Good Good/very good Fair Bad Very bad Bad/very bad General population Very good Good Good/very good Fair Bad Very bad Bad/very bad

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Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

2004 Age group

Men

Women

16-34

35-54

55+

All men

16-34

35-54

55+

All women

%

%

%

%

%

%

%

%

43 38 81 15 4 4

46 34 80 12 5 3 8

25 31 56 30 12 3 14

37 34 71 19 7 2 10

49 41 90 8 2 2

41 44 86 9 4 1 5

32 32 64 29 6 2 8

40 39 79 16 4 1 5

45 42 88 11 1 0

38 42 80 14 4 1

24 38 62 26 8 4

36 41 77 17 5 2

42 45 87 11 2 0

37 41 78 16 5 1

23 37 60 28 9 2

34 41 74 19 5 1

2

6

12

6

2

6

12

7

141 179 327 205 91 74 412 14800

196 159 384 152 65 50 678 16676

142 40 192 64 21 27 686 14713

478 377 903 421 178 151 1776 46188

219 239 408 274 135 63 497 14649

291 198 466 161 51 78 1038 16897

165 37 193 62 21 22 833 17133

675 475 1067 497 208 163 2369 48679

122 179 201 222 210 172 114 740

166 172 231 145 150 118 194 975

124 39 118 65 49 58 189 1164

412 390 550 432 409 348 497 2879

200 234 240 278 310 148 149 914

290 190 275 164 118 176 275 1372

162 44 119 65 50 51 232 1536

652 468 634 507 478 375 656 3822

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

37

Table 2.3 Comparison of bad or very bad self-reported general health in 2004 and 1999, by age within minority ethnic groupa and sex Aged 16 and over

Black Caribbean 2004 1999 Indian 2004 1999 Pakistani 2004 1999 Bangladeshi 2004 1999 Chinese 2004 1999 Irish 2004 1999 General population 2004 1999

Age group

Men 16-34

35-54

55+

%

%

%

%

%

%

%

%

4 1

5 4

21 20

9 8

5 3

6 7

26 24

11 10

2 1

7 10

24 23

9 9

2 3

6 9

22 40

8 12

1 2

13 17

34 33

10 11

5 4

19 19

45 42

15 12

2 5

21 21

[53] 44

15 18

5 4

27 23

44 28

14 11

2

3 3

13 15

4 5

1

3 4

7 11

3 4

4 3

8 4

14 17

10 7

2 0

5 7

8 10

5 6

2 2

6 6

12 10

6 6

2 3

6 6

12 11

7 7

196 92 384 252 152 120 65 37 50 42 678 714 16676 15772

142 129 192 125 64 47 21 29 27 19 686 448 14713 15186

478 366 903 595 421 358 178 137 151 96 1776 1546 46188 43301

219 189 408 252 274 223 135 91 63 35 497 566 14649 14776

291 190 466 255 161 117 51 33 78 62 1038 879 16897 19215

165 122 193 108 62 31 21 14 22 17 833 543 17133 17809

675 501 1067 614 497 370 208 139 163 113 2369 1988 48679 51800

166 141 231 267 145 217 150 143 118 127 194 240 975 1303

124 192 118 127 65 77 49 116 58 65 189 162 1164 1221

412 545 550 626 432 620 409 533 348 301 497 537 2879 3558

200 282 240 267 278 384 310 361 148 109 149 203 914 1242

290 285 275 276 164 203 118 144 176 194 275 301 1372 1587

162 179 119 112 65 56 50 58 51 58 232 204 1536 1410

652 746 634 655 507 643 478 563 375 361 656 708 3822 4239

Bases (weighted) Black Caribbean 2004 141 Black Caribbean 1999 145 Indian 2004 327 Indian 1999 218 Pakistani 2004 205 Pakistani 1999 191 Bangladeshi 2004 91 Bangladeshi 1999 70 Chinese 2004 74 Chinese 1999 34 Irish 2004 412 Irish 1999 385 General population 2004 14800 General population 1999 12343 Bases (unweighted) Black Caribbean 2004 122 Black Caribbean 1999 212 Indian 2004 201 Indian 1999 232 Pakistani 2004 222 Pakistani 1999 326 Bangladeshi 2004 210 Bangladeshi 1999 274 Chinese 2004 172 Chinese 1999 109 Irish 2004 114 Irish 1999 135 General population 2004 740 General population 1999 1034

38

Women All men

16-34

35-54

55+

All women

a Black Africans were include in the

2004 survey but not in the 1999 survey, so therefore are excluded from this comparative table.

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Bad or very bad self-reported general health

2004, 1999

Table 2.4 Self-reported general health, by equivalised household income within minority ethnic group and sex Aged 16 and over Self-reported general health

2004 Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

41 46 88 11 1 1

40 42 82 13 5 5

35 42 77 16 5 2 7

49 36 85 14 1 1

28 47 75 19 5 1 6

25 39 64 24 10 2 12

47 47 94 6 -

46 47 93 6 1 1

49 36 86 10 3 1 4

53 38 92 7 1 1

41 44 85 11 3 3

40 42 82 12 5 1 5

49 36 85 13 2 0 2

37 46 82 14 3 1 4

35 35 70 21 9 0 9

47 35 82 16 2 2

34 46 80 14 4 2 6

27 40 67 23 7 2 10

61 35 96 4 -

51 41 92 3 3 2 5

37 42 79 13 5 2 8

[64] [29] [93] [7] [ -] [ -] [ -]

39 35 74 15 7 5 11

34 41 74 16 7 4 10

a a a a a a a

35 44 80 11 6 3 10

29 47 76 13 8 3 11

a a a a a a a

29 58 87 8 5 5

26 49 75 15 7 3 10

46 47 93 7 -

35 51 86 10 2 1 4

42 31 73 21 6 6

38 54 92 8 -

31 52 83 15 2 2

33 43 76 20 3 1 4

Copyright © 2006, The Information Centre. All rights reserved

Observed % Black Caribbean Very good Good Good/very good Fair Bad Very bad Bad/very bad Black African Very good Good Good/very good Fair Bad Very bad Bad/very bad Indian Very good Good Good/very good Fair Bad Very bad Bad/very bad Pakistani Very good Good Good/very good Fair Bad Very bad Bad/very bad Bangladeshi Very good Good Good/very good Fair Bad Very bad Bad/very bad Chinese Very good Good Good/very good Fair Bad Very bad Bad/very bad

a Results are not shown because of small bases.

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

39

Table 2.4 continued

Aged 16 and over Self-reported general health

2004 Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

62 28 90 9 1 1 1

47 37 84 11 4 1 4

31 33 64 22 10 3 13

62 34 96 3 0 0

51 36 87 9 4 0 4

34 30 64 28 7 2 9

52 39 91 7 1 1

38 43 81 16 3 1

31 39 71 19 8 3

52 38 90 8 2 0

37 43 80 15 3 1

29 38 67 23 8 2

2

4

11

2

5

10

Good/very good Black Caribbean

0.26

1.91

2.49

0.63

1.42

3.50

Standard error of the ratio

0.16

0.93

0.82

0.27

0.39

0.72

Black African

0.00

0.53

1.44

0.93

1.48

2.75

Observed % Irish Very good Good Good/very good Fair Bad Very bad Bad/very bad General population Very good Good Good/very good Fair Bad Very bad Bad/very bad

Standard error of the ratio

0.00

0.33

0.61

0.75

0.63

0.89

Indian

0.46

1.22

2.76

0.61

2.07

2.16

Standard error of the ratio

0.25

0.40

0.82

0.28

0.56

0.61

Pakistani

0.40

2.18

3.29

[0.75]

3.33

4.57

Standard error of the ratio

0.41

0.75

0.69

[0.56]

0.65

0.83

a

4.81

4.18

a

3.93

4.66

Bangladeshi Standard error of the ratio

Chinese

a

0.98

0.80

a

0.95

0.92

0.47

0.42

2.41

0.09

0.43

1.06

Standard error of the ratio

0.34

0.29

0.94

0.09

0.30

0.52

Irish

0.38

2.35

3.03

0.11

1.69

1.61

Standard error of the ratio

0.17

0.71

1.07

0.07

0.74

0.49

General population

0.37

1.31

2.83

0.37

1.20

2.44

Standard error of the ratio

0.08

0.22

0.54

0.07

0.17

0.36

Bad /very bad Black Caribbean

1.10

0.95

0.82

0.98

0.81

0.69

Standard error of the ratio

0.04

0.07

0.09

0.06

0.06

0.05

Black African

0.93

1.48

2.75

0.93

1.48

2.75

Standard error of the ratio

0.75

0.63

0.89

0.75

0.63

0.89

Indian

0.61

2.07

2.16

0.61

2.07

2.16

Standard error of the ratio

0.28

0.56

0.61

0.28

0.56

0.61

Pakistani

0.75

3.33

4.57

[0.75]

3.33

4.57

Standard error of the ratio

0.56

0.65

0.83

[0.56]

0.65

0.83

a

3.93

4.66

a

3.93

4.66

Bangladeshi Standard error of the ratio

Chinese

a

0.95

0.92

a

0.95

0.92

0.09

0.43

1.06

0.09

0.43

1.06

Standard error of the ratio

0.09

0.30

0.52

0.09

0.30

0.52

Irish

0.11

1.69

1.61

0.11

1.69

1.61

Standard error of the ratio

0.07

0.74

0.49

0.07

0.74

0.49

General population

0.37

1.20

2.44

0.37

1.20

2.44

Standard error of the ratio

0.07

0.17

0.36

0.07

0.17

0.36

a Results are not shown because of small

bases.

Continued…

40

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

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Standardised risk ratios

Table 2.4 continued

Aged 16 and over

2004 Equivalised household income tertile

Men

Copyright © 2006, The Information Centre. All rights reserved

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

157 115 278 66 4 45 885 17672

163 132 292 70 24 34 658 17274

323 286 403 443 190 62 819 14848

145 128 275 42 7 50 1130 15920

189 148 299 87 25 42 823 16871

418 366 464 465 205 60 886 17714

129 93 158 54 10 107 213 1115

129 147 184 65 56 79 183 1122

265 284 262 433 423 140 227 975

129 96 151 33 17 113 266 1193

164 143 181 83 58 89 213 1302

382 371 288 450 445 137 279 1412

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

41

Table 2.5 Self-reported longstanding illness and limiting longstanding illness, by minority ethnic group and sex Aged 16 and over Longstanding illness and limiting longstanding illness

2004 Minority ethnic group

General population

Black Caribbean

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Men Observed % Longstanding illness Limiting longstanding illness Number of longstanding illnesses 1 illness 2 or more illnesses Mean number of illnesses

39 24

24 10

37 23

35 20

30 24

22 9

47 26

43 23

25 14 1.36

17 6 1.37

21 16 1.53

21 14 1.54

15 15 1.60

13 9 1.47

30 17 1.38

27 17 1.39

Standard error of the mean

0.10

0.08

0.10

0.13

0.13

0.08

0.09

Standardised risk ratios Longstanding illness

0.86

0.67

0.91

0.96

0.95

0.61

1.07

Standard error of the ratio

0.08

0.08

0.07

0.08

0.08

0.07

0.08

Limiting longstanding illness

1.00

0.63

1.12

1.17

1.52

0.57

1.11

Standard error of the ratio

0.14

0.12

0.12

0.14

0.15

0.10

0.13

1 1

Women Observed % Longstanding illness Limiting longstanding illness Number of longstanding illnesses 1 illness 2 or more illnesses Mean number of illnesses

44 28

24 15

30 19

41 30

31 21

24 10

44 23

47 27

25 19 1.49

16 8 1.49

18 13 1.47

23 18 1.70

19 12 1.60

17 7 1.38

28 16 1.40

28 19 1.44

Standard error of the mean

0.08

0.09

0.06

0.12

0.11

0.08

0.07

Standardised risk ratios Longstanding illness

1.02

0.66

0.73

1.17

1.00

0.61

0.91

Standard error of the ratio

0.06

0.07

0.06

0.08

0.07

0.07

0.07

Limiting longstanding illness

1.20

0.83

0.86

1.60

1.22

0.46

0.80

Standard error of the ratio

0.11

0.11

0.09

0.14

0.11

0.08

0.09

479 676

374 473

903 1067

423 499

178 208

151 163

1776 2366

46188 48706

413 653

390 468

550 634

433 508

410 478

348 375

497 655

2879 3824

42

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

1

Copyright © 2006, The Information Centre. All rights reserved

Bases (weighted) Men Women Bases (unweighted) Men Women

1

Table 2.6 Comparison of self-reported longstanding illness and limiting longstanding illness in 2004 and 1999, by age within minority ethnic groupa and sex Aged 16 and over Longstanding illness and limiting longstanding illness

2004, 1999 Age group

Men 16-34

35-54

55+

%

%

%

%

%

%

%

%

17 33

31 39

70 60

39 44

24 30

43 41

73 74

44 45

8 11

19 22

46 39

24 24

17 16

24 21

49 53

28 27

19 14

37 34

69 62

37 32

16 17

31 41

60 76

30 37

9 7

22 21

50 42

23 21

10 8

17 26

46 62

19 25

19 15

40 39

72 69

35 30

23 21

56 41

86 76

41 32

8 10

23 30

54 49

20 22

14 14

40 30

70 57

30 23

12 21

42 45

[73] 70

30 38

18 18

53 48

69 64

31 30

8 15

34 36

[62] 61

24 30

10 12

38 39

45 53

21 22

8 15

23 23

59 50

22 25

17 16

24 25

42 42

24 25

2 8

12 13

22 28

9 14

5 6

11 12

17 24

10 12

28 36

41 41

65 66

47 47

27 31

41 43

59 64

44 46

9 21

25 22

37 47

26 29

15 14

18 27

34 42

23 27

23 26

40 41

67 64

43 44

28 27

43 40

67 64

47 45

9 10

21 23

40 39

23 25

15 12

22 22

43 42

27 26

Black Caribbean Longstanding illness 2004 1999 Limiting longstanding illness 2004 1999 Indian Longstanding illness 2004 1999 Limiting longstanding illness 2004 1999

Copyright © 2006, The Information Centre. All rights reserved

Women All men

Pakistani Longstanding illness 2004 1999 Limiting longstanding illness 2004 1999 Bangladeshi Longstanding illness 2004 1999 Limiting longstanding illness 2004 1999 Chinese Longstanding illness 2004 1999 Limiting longstanding illness 2004 1999 Irish Longstanding illness 2004 1999 Limiting longstanding illness 2004 1999 General population Longstanding illness 2004 1999 Limiting longstanding illness 2004 1999

16-34

35-54

55+

All women

a Black Africans were include in the

2004 survey but not in the 1999 survey, so therefore are excluded from this comparative table.

Continued … HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

43

Table 2.6 continued

Aged 16 and over

2004, 1999 Age group

16-34

Bases (weighted) Black Caribbean 2004 144 Black Caribbean 1999 144 Indian 2004 327 Indian 1999 218 Pakistani 2004 205 Pakistani 1999 191 Bangladeshi 2004 91 Bangladeshi 1999 70 Chinese 2004 74 Chinese 1999 34 Irish 2004 412 Irish 1999 385 General population 2004 14800 General population 1999 12343 Bases (unweighted) Black Caribbean 2004 122 Black Caribbean 1999 211 Indian 2004 201 Indian 1999 232 Pakistani 2004 222 Pakistani 1999 326 Bangladeshi 2004 210 Bangladeshi 1999 274 Chinese 2004 172 Chinese 1999 109 Irish 2004 114 Irish 1999 135 General population 2004 740 General population 1999 1034

44

Women 35-54

55+

All men

16-34

35-54

55+

All women

196 93 384 251 152 120 65 37 50 42 678 714 16676 15772

142 130 192 125 64 47 21 29 27 19 686 448 14713 15186

479 366 903 595 423 358 178 136 151 96 1776 1546 46188 43301

219 190 408 252 274 223 135 91 63 35 497 566 14649 14776

291 190 466 256 161 117 51 33 78 62 1038 879 16897 19215

165 123 193 108 62 31 21 14 22 17 833 543 17133 17809

675 503 1067 616 497 370 208 139 163 113 2369 1988 48679 51800

166 142 231 266 145 217 150 142 118 127 194 240 975 1303

124 193 118 127 65 77 49 116 58 65 189 162 1164 1221

413 546 550 625 433 620 410 532 348 301 497 537 2879 3558

200 283 240 267 278 384 310 361 148 109 149 203 914 1242

290 285 277 277 164 203 118 144 176 194 275 301 1372 1587

162 180 119 113 65 56 50 58 51 58 232 204 1536 1410

653 748 634 657 508 643 478 563 375 361 655 708 3824 4239

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

Copyright © 2006, The Information Centre. All rights reserved

Men

Table 2.7 Rate per thousand reporting longstanding illness conditions, by minority ethnic group and sex Aged 16 and over

2004

Condition group (ICD chapters)a

Minority ethnic group Black Caribbean

General population

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Copyright © 2006, The Information Centre. All rights reserved

Men Observed % Infectious disease Neoplasms & benign growths Endocrine & metabolic Blood & related organs Mental disorders Nervous system Eye complaints Ear complaints Heart & circulatory system Respiratory system Digestive system Genito-urinary system Skin complaints Musculoskeletal system Other complaints

8 6 86 14 27 14 22 24 126 58 17 17 7 149 10

2 0 45 9 35 12 7 0 54 38 17 16 2 61 9

2 7 95 0 33 15 24 19 133 64 43 16 12 132 19

0 1 94 5 29 23 17 15 110 85 19 25 15 127 6

2 8 106 2 21 15 10 6 107 64 43 17 7 108 4

0 5 36 0 10 8 6 6 74 69 29 19 18 60 0

2 23 69 10 53 43 23 32 134 85 51 16 12 194 4

2 19 72 5 28 34 18 29 123 96 43 17 17 173 5

Standardised risk ratios Infectious disease

2.63

0.93

0.58

0.00

0.82

0.00

0.90

1

Standard error of the ratio

2.24

1.01

0.64

0.00

0.90

0.00

0.98

Neoplasms & benign growths

0.32

0.00

0.52

0.07

0.53

0.29

1.23

Standard error of the ratio

0.20

0.00

0.29

0.06

0.28

0.22

0.57

Endocrine & metabolic

0.97

1.09

1.53

2.01

2.63

0.66

0.92

Standard error of the ratio

0.22

0.34

0.23

0.38

0.49

0.19

0.24

Blood & related organs

4.75

2.11

0.00

3.17

2.71

0.00

2.17

Standard error of the ratio

3.17

1.74

0.00

3.34

2.79

0.00

1.36

Mental disorders

0.93

1.10

1.19

1.10

0.89

0.38

1.80

Standard error of the ratio

0.35

0.35

0.40

0.40

0.41

0.21

0.45

Nervous system

0.30

0.33

0.60

0.83

0.69

0.28

1.27

Standard error of the ratio

0.14

0.16

0.23

0.32

0.36

0.16

0.39

Eye complaints

1.25

1.10

2.03

2.06

0.70

0.43

1.45

Standard error of the ratio

0.51

0.65

0.71

1.07

0.35

0.31

0.61

Ear complaints

1.10

0.00

0.90

0.95

0.22

0.30

1.18

Standard error of the ratio

0.51

0.00

0.33

0.56

0.13

0.21

0.61

Heart & circulatory system

1.12

0.84

1.30

1.47

1.66

0.90

0.99

Standard error of the ratio

0.20

0.22

0.18

0.24

0.28

0.18

0.17

Respiratory system

0.66

0.36

0.70

0.90

0.80

0.85

0.83

Standard error of the ratio

0.17

0.12

0.15

0.18

0.20

0.17

0.19

Digestive system

0.42

0.39

0.96

0.48

1.51

0.85

1.03

Standard error of the ratio

0.21

0.18

0.36

0.18

0.47

0.32

0.33

Genito-urinary system

0.88

1.62

1.03

2.11

1.26

1.62

0.70

Standard error of the ratio

0.34

1.00

0.51

0.78

0.47

0.79

0.30

Skin complaints

0.20

0.11

0.79

0.83

0.45

0.91

0.75

Standard error of the ratio

0.11

0.11

0.39

0.42

0.27

0.39

0.44

Musculoskeletal system

0.85

0.46

0.83

0.95

0.80

0.48

1.13

Standard error of the ratio

0.15

0.11

0.10

0.16

0.14

0.10

0.17

Other complaints

1.31

1.45

2.92

1.06

2.24

0.00

0.82

Standard error of the ratio

0.79

0.89

2.12

0.81

2.08

0.00

0.66

a ICD Chapters refer to the tenth revision (1992).

1 1 1 1 1 1 1 1 1 1 1 1 1 1

Continued …

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

45

Table 2.7 continued Aged 16 and over Condition group (ICD chapters)a

2004 Minority ethnic group Black Caribbean

General population

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Women Observed % Infectious disease Neoplasms & benign growths Endocrine & metabolic Blood & related organs Mental disorders Nervous system Eye complaints Ear complaints Heart & circulatory system Respiratory system Digestive system Genito-urinary system Skin complaints Musculoskeletal system Other complaints

1 10 109 16 29 35 32 7 124 89 30 27 10 185 6

5 8 33 10 17 25 8 3 66 45 16 9 7 95 -

0 8 60 17 17 30 11 8 100 54 33 12 8 123 6

1 3 111 20 49 44 16 2 93 84 52 37 13 182 5

3 5 74 17 30 26 16 4 91 55 55 13 10 107 4

5 5 41 14 20 19 8 3 56 35 25 13 18 69 0

10 26 54 12 37 33 28 13 78 99 69 28 20 174 -

1 19 75 9 34 44 24 21 118 93 56 25 18 208 4

Standardised risk ratios Infectious disease

0.41

3.41

0.00

1.12

3.05

2.59

8.03

1

Standard error of the ratio

0.45

2.62

0.00

1.23

3.37

2.85

6.53

Neoplasms & benign growths

0.77

0.68

0.73

0.53

0.67

0.51

1.47

Standard error of the ratio

0.33

0.37

0.41

0.42

0.45

0.39

0.55

Endocrine & metabolic

1.59

0.90

0.98

2.51

1.79

0.82

0.79

Standard error of the ratio

0.23

0.27

0.17

0.36

0.34

0.21

0.18

Blood & related organs

2.47

1.08

2.36

3.10

2.96

1.73

0.70

Standard error of the ratio

0.95

0.69

0.91

1.44

1.50

0.79

0.42

Mental disorders

0.93

1.10

1.19

1.10

0.89

0.38

1.80

Standard error of the ratio

0.35

0.35

0.40

0.40

0.41

0.21

0.45

Nervous system

0.79

0.54

0.64

0.96

0.70

0.51

0.76

Standard error of the ratio

0.22

0.23

0.20

0.27

0.23

0.23

0.21

Eye complaints

1.84

1.16

0.52

0.60

1.37

0.70

1.36

Standard error of the ratio

0.59

0.60

0.24

0.60

0.56

0.43

0.60

Ear complaints

0.36

0.22

0.49

0.23

0.28

0.11

0.69

Standard error of the ratio

0.15

0.17

0.26

0.23

0.21

0.11

0.31

Heart & circulatory system

1.48

1.23

1.30

1.69

2.00

0.93

0.62

Standard error of the ratio

0.20

0.26

0.18

0.27

0.27

0.29

0.21

Respiratory system

0.93

0.60

0.57

1.14

0.74

0.40

0.98

Standard error of the ratio

0.16

0.17

0.10

0.22

0.15

0.13

0.17

Digestive system

0.64

0.47

0.65

1.30

1.44

0.53

1.22

Standard error of the ratio

0.19

0.21

0.17

0.40

0.37

0.18

0.28

Genito-urinary system

1.05

0.42

0.45

1.62

0.58

0.64

1.36

Standard error of the ratio

0.41

0.22

0.18

0.50

0.23

0.34

0.44

Skin complaints

0.61

0.39

0.49

0.64

0.36

1.19

0.77

Standard error of the ratio

0.29

0.25

0.25

0.29

0.16

0.47

0.33

Musculoskeletal system

1.07

0.77

0.78

1.41

0.99

0.45

0.79

Standard error of the ratio

0.14

0.13

0.10

0.15

0.14

0.09

0.10

Other complaints

1.95

0.09

1.64

0.86

1.50

0.00

0.03

Standard error of the ratio

1.46

0.09

0.87

0.64

1.14

0.00

0.04

46

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

1 1 1 1 1 1 1 1 1 1 1 1 1

Continued …

Copyright © 2006, The Information Centre. All rights reserved

a ICD Chapters refer to the tenth revision (1992).

1

Table 2.7 continued Aged 16 and over

2004 Minority ethnic group

Copyright © 2006, The Information Centre. All rights reserved

Bases (weighted) Men Women Bases (unweighted) Men Women

General population

Black Caribbean

Black African

Indian

479 676

377 473

903 1067

423 499

413 651

390 469

550 634

433 508

Pakistani Bangladeshi

Chinese

Irish

178 208

151 163

1776 2366

46188 48706

408 478

348 375

496 655

2878 3821

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

47

Table 2.8 Self-reported longstanding illness, by equivalised household income within minority ethnic group and sex Aged 16 and over Longstanding illness

2004 Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

27 23 23 [19] a 21 39 38

43 29 38 30 24 23 55 51

51 24 55 45 36 [42] 65 52

34 22 26 [24] a 26 37 39

48 22 29 44 31 20 54 56

50 27 38 44 30 30 55 54

0.667

0.849

1.109

0.812

1.013

1.173

0.116

0.15

0.172

0.125

0.117

0.106

0.489

0.751

0.651

0.673

0.559

0.72

0.118

0.167

0.146

0.144

0.111

0.129

0.604

0.958

1.223

0.69

0.717

0.805

0.102

0.123

0.167

0.093

0.104

0.094

0.379

0.8

1.133

0.939

1.241

1.19

0.148

0.128

0.117

0.243

0.126

0.117

0.353

0.813

1.037

1.410

0.917

0.978

0.18

0.124

0.099

0.313

0.122

0.092

0.565

0.678

1.014

0.637

0.488

0.645

0.12

0.135

0.212

0.130

0.128

0.135

0.892

1.069

1.341

0.800

1.088

1.040

0.104

0.161

0.213

0.104

0.135

0.138

0.934

1.062

1.13

0.888

1.109

1.097

0.044

0.059

0.102

0.038

0.049

0.064

152 113 264 55 8 44 833 21894

115 89 241 119 39 36 398 11527

106 90 150 137 74 21 270 5635

156 123 305 56 9 52 1040 19500

188 115 287 134 44 34 568 14304

179 150 203 168 84 24 347 6537

124 104 159 47 19 105 207 1343

90 105 155 114 89 77 122 754

96 94 97 155 170 49 89 353

149 102 179 46 23 120 257 1472

163 123 173 135 101 74 163 1180

179 149 126 176 191 58 123 537

Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Standardised risk ratios Black Caribbean Longstanding illness Standard error of the ratio

Black African Longstanding illness Standard error of the ratio

Indian Longstanding illness Standard error of the ratio

Pakistani Longstanding illness Standard error of the ratio

Bangladeshi Longstanding illness Standard error of the ratio

Chinese Longstanding illness Standard error of the ratio

Irish Longstanding illness Standard error of the ratio

General population Longstanding illness Standard error of the ratio

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

48

a Results are not shown because of small

bases.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

Copyright © 2006, The Information Centre. All rights reserved

Observed %

Table 2.9 Self-reported acute sickness in the last two weeks, by minority ethnic group and sex Aged 16 and over

2004

Acute sickness in last two weeksa

Minority ethnic group

General population

Black Caribbean

Black African

Indian

13 2 3 2 6 87 9.4

10 5 2 3 1 90 5.4

13 3 2 3 4 87 8.0

15 4 3 3 6 85 8.1

Standard error of the mean

0.78

0.77

0.60

Standardised risk ratios Had acute sickness

0.86

0.80

Standard error of the ratio

0.15

0.16

21 7 4 4 6 79 7.3

Standard error of the mean

Standardised risk ratios Had acute sickness Standard error of the ratio

Pakistani Bangladeshi

Chinese

Irish

14 3 4 3 5 86 8.4

8 3 2 1 2 92 6.1

15 5 3 3 5 85 7.6

14 4 2 2 6 86 8.1

0.68

0.60

1.05

0.72

0.30

0.90

1.42

1.27

0.64

0.97

1

0.14

0.21

0.19

0.13

0.15

14 6 3 1 5 86 7.0

15 5 1 4 5 85 8.0

21 5 4 4 8 79 8.1

15 4 3 3 5 85 8.0

9 4 0 1 3 91 7.8

17 5 3 4 5 83 7.3

19 5 3 3 7 81 7.9

0.51

0.71

0.53

0.59

0.71

0.87

0.63

0.22

1.17

0.82

0.85

1.39

1.10

0.56

0.89

1

0.13

0.12

0.10

0.15

0.14

0.11

0.12

479 672

377 476

903 1067

423 499

177 208

151 163

1775 2363

46178 48674

413 651

390 469

550 634

433 508

408 478

348 375

496 656

2878 3821

Men Observed % Had acute sickness 1-3 days 4-6 days 7-13 days a full 2 weeks No acute sickness Mean number of days

Women Observed % Had acute sickness 1-3 days 4-6 days 7-13 days a full 2 weeks No acute sickness Mean number of days

Bases (weighted) Men Women Bases (unweighted) Men Women

Copyright © 2006, The Information Centre. All rights reserved

a Mean number of days are based on those with acute sickness.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

49

Table 2.10 Self-reported acute sickness in the last two weeks, by age within minority ethnic group and sex Aged 16 and over

Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

50

2004 Age group

Men

Women

16-34

35-54

55+

All men

16-34

35-54

55+

All women

%

%

%

%

%

%

%

%

9 8 8 6 6 5 4 11

12 10 10 18 19 8 21 13

18 [15] 26 39 [38] 16 15 17

13 10 13 15 14 8 15 14

13 9 12 13 8 8 14 13

23 18 15 28 26 9 19 20

29 [23] 22 39 30 15 17 22

21 14 15 21 15 9 17 19

141 179 327 205 91 74 412 14800

196 159 384 154 65 50 678 16665

143 40 192 64 21 27 685 14713

479 377 903 423 177 151 1775 46178

219 240 408 276 135 63 497 14649

292 198 466 161 51 78 1033 16924

162 37 193 62 21 22 833 17101

672 476 1067 499 208 163 2363 48674

122 179 201 222 209 172 114 740

166 172 231 146 150 118 194 974

125 39 118 65 49 58 188 1164

413 390 550 433 408 348 496 2878

200 235 240 279 310 148 149 914

290 190 275 164 118 176 274 1374

161 44 119 65 50 51 232 1533

651 469 634 508 478 375 655 3821

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

Copyright © 2006, The Information Centre. All rights reserved

Acute sickness in in last two weeks

Table 2.11 Self-reported acute sickness in the last two weeks, by equivalised household income within minority ethnic group and sex Aged 16 and over Acute sickness in last two weeks

2004 Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

Black Caribbean Had acute sickness No acute sickness Mean number of daysa

6 94 7.6

13 87 10.6

15 85 10.0

17 83 6.7

24 76 7.3

25 75 7.1

Standard error of the mean

1.51

1.20

1.24

1.32

0.93

0.88

Black African Had acute sickness No acute sickness Mean number of daysa

8 92 2.6

3 97 8.9

17 83 5.0

11 89 5.8

14 86 9.8

17 83 6.5

Standard error of the mean

1.02

2.27

1.03

1.55

1.50

1.01

10 90

6 94

20 80

12 88

16 84

24 76

Copyright © 2006, The Information Centre. All rights reserved

Observed %

Indian Had acute sickness No acute sickness Mean number of daysa

7.5

6.3

8.2

7.4

7.9

8.8

Standard error of the mean

1.43

1.26

0.85

1.24

1.06

0.71

Pakistani Had acute sickness No acute sickness Mean number of daysa

[13] [87] [2.3]

19 81 7.0

19 81 9.5

[13] [87] [3.7]

19 81 8.9

24 76 8.0

Standard error of the mean

[0.86]

1.18

0.90

[0.40]

0.98

0.92

Bangladeshi Had acute sickness No acute sickness Mean number of daysa

b b b

14 86 8.0

14 86 8.3

b b b

14 86 6.1

17 83 8.3

Standard error of the mean

b

1.46

1.02

b

1.68

0.89

Chinese Had acute sickness No acute sickness Mean number of daysa

7 93 6.0

11 89 6.3

[7] [93] [8.2]

12 88 11.2

11 89 6.6

8 92 5.9

Standard error of the mean

1.94

1.70

[3.23]

1.17

1.48

2.13

Irish Had acute sickness No acute sickness Mean number of daysa

11 89 5.6

19 81 8.4

24 76 9.4

17 83 5.8

20 80 8.8

21 79 8.4

Standard error of the mean

1.29

1.01

1.41

0.98

1.09

0.95

General population Had acute sickness No acute sickness Mean number of daysa

13 87 6.9

15 85 9.6

17 83 8.9

15 85 6.3

21 79 8.7

26 74 9.3

Standard error of the mean

0.37

0.51

0.67

0.36

0.36

0.40

a Means of all those with an illness. b Results are not shown because of small bases.

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

51

Table 2.11 continued

Aged 16 and over Acute sickness in last two weeks

2004 Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

Had acute sickness Black Caribbean

0.51

0.71

1.12

0.82

1.25

1.34

Standard error of the ratio

0.18

0.22

0.32

0.19

0.22

0.21

Black African

0.43

0.20

1.70

0.54

0.84

1.31

Standardised risk ratios

Standard error of the ratio

0.19

0.10

0.49

0.16

0.24

0.31

Indian

0.83

0.43

1.36

0.64

0.93

1.33

Standard error of the ratio

Pakistani Standard error of the ratio

Bangladeshi Standard error of the ratio

Chinese

0.24

0.14

0.35

0.14

0.18

0.25

[0.78]

1.54

1.41

[1.15]

1.34

1.43

[0.30]

0.33

0.25

[0.56]

0.28

0.24

b

1.52

1.21

b

0.97

1.35

b

0.30

0.23

b

0.30

0.25

0.57

0.80

[0.71]

0.84

0.66

0.44

Standard error of the ratio

0.24

0.29

[0.45]

0.24

0.29

0.19

Irish

0.68

1.06

1.86

0.88

1.12

1.19

Standard error of the ratio

0.18

0.29

0.50

0.20

0.30

0.28

General population

0.97

0.96

1.21

0.83

1.03

1.43

Standard error of the ratio

0.10

0.12

0.20

0.07

0.09

0.14

152 113 264 55 8 44 833 21894

115 89 241 119 38 36 398 11527

106 90 150 137 74 21 269 5635

156 123 305 56 9 52 1040 19500

186 115 287 134 44 34 568 14283

179 153 203 168 84 24 347 6537

124 104 159 47 19 105 207 1343

90 105 155 114 88 77 122 754

96 94 97 155 169 49 88 353

149 102 179 46 23 120 257 1472

162 123 173 135 101 74 163 1178

178 150 126 176 191 58 123 537

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

52

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

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b Results are not shown because of small bases.

Table 2.12 GHQ12 score, by minority ethnic group and sex Aged 16 and over

2004

GHQ12 score

Minority ethnic group

General population

Black Caribbean

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Men Observed % 0 1-3 4 or more Standardised risk ratios 4 or more

62 25 13

71 18 11

64 21 16

63 22 15

63 19 18

70 21 9

67 21 12

68 21 11

1.21

0.88

1.32

1.56

1.83

0.76

1.08

1

Standard error of the ratio

0.22

0.17

0.19

0.28

0.35

0.15

0.21

54 28 18

52 29 19

61 24 14

57 23 20

60 25 15

61 26 13

61 24 15

61 24 15

4 or more

1.27

1.19

0.99

1.73

1.37

0.83

0.95

1

Standard error of the ratio

0.17

0.19

0.13

0.24

0.23

0.15

0.13

372 556

295 364

769 890

315 328

104 122

135 139

1614 2182

41950 44845

315 514

293 350

464 534

322 334

246 283

310 318

427 587

2621 3523

Women Observed % 0 1-3 4 or more Standardised risk ratios

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Bases (weighted) Men Women Bases (unweighted) Men Women

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

53

Table 2.13 Comparison of GHQ12 score in 2004 and 1999, by minority ethnic groupa and sex Aged 16 and over GHQ12 score

2004, 1999 Minority ethnic group

General population

Black Caribbean

Indian

%

%

%

62 25 13

64 21 16

51 33 16

2004 0 1-3 4 or more 1999 0 1-3 4 or more

Pakistani Bangladeshi

Chinese

Irish

%

%

%

%

63 22 15

63 19 18

70 21 9

67 21 12

68 21 11

54 31 16

55 27 18

48 26 26

69 28 3

51 31 18

55 30 15

54 28 18

61 24 14

57 23 20

60 25 15

61 26 13

61 24 15

61 24 15

44 34 23

47 30 23

49 28 22

46 31 23

61 31 8

51 29 20

50 31 19

372 331 556 464

769 540 890 504

315 284 328 269

104 104 122 104

135 85 139 104

1614 1497 2182 1929

41950 41374 44845 49806

315 492 514 686

464 565 534 546

322 488 334 464

246 402 283 424

310 264 318 328

427 515 587 684

2621 3389 3523 4052

Men 2004 0 1-3 4 or more 1999 0 1-3 4 or more

Women

Bases (weighted) Men 2004 Men 1999 Women 2004 Women 1999 Bases (unweighted) Men 2004 Men 1999 Women 2004 Women 1999

a Black Africans were include in the 2004 survey but not in the 1999 survey, so therefore are excluded from

54

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

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this comparative table.

Table 2.14 GHQ12 score, by equivalised household income within minority ethnic group and sex Aged 16 and over

2004

GHQ12 score

Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

57 32 11

66 24 11

66 13 21

64 23 13

51 30 19

47 30 23

81 10 9

76 13 12

56 29 15

57 31 12

53 29 17

43 31 26

74 18 8

67 21 13

49 24 26

64 23 12

65 24 11

51 24 25

[64] [30] [6]

61 20 20

58 26 16

[78] [19] [3]

52 23 26

59 21 19

a a a

[69] [18] [13]

58 18 23

a a a

[52] [29] [19]

62 21 16

71 22 7

66 19 15

[66] [23] [11]

62 27 11

56 24 20

[65] [22] [13]

73 20 7

70 16 14

43 30 27

67 20 13

57 29 14

50 24 25

70 21 9

66 21 14

59 21 19

65 22 12

59 25 16

54 24 22

GHQ12 score of 4 or more Black Caribbean

1.11

0.83

1.92

0.83

1.30

1.55

Standard error of the ratio

0.41

0.33

0.53

0.21

0.32

0.30

Black African

0.76

0.92

1.29

0.89

0.89

2.14

Observed % Black Caribbean 0 1-3 4 or more Black African 0 1-3 4 or more Indian 0 1-3 4 or more Pakistani 0 1-3 4 or more Bangladeshi 0 1-3 4 or more Chinese 0 1-3 4 or more Irish 0 1-3 4 or more General population 0 1-3 4 or more

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Standardised risk ratios

Standard error of the ratio

0.30

0.35

0.43

0.33

0.29

0.49

Indian

0.58

1.20

2.22

0.79

0.74

1.60

Standard error of the ratio

Pakistani Standard error of the ratio

Bangladeshi Standard error of the ratio

Chinese

0.20

0.29

0.55

0.20

0.18

0.27

[0.47]

1.87

1.39

[0.15]

2.14

1.81

[0.32]

0.48

0.35

[0.15]

0.49

0.39

a

[1.37]

1.52

a

[1.88]

1.45

a

[0.57]

0.39

a

[0.66]

0.32

0.66

1.17

[0.98]

0.56

1.23

[0.91]

Standard error of the ratio

0.27

0.35

[0.57]

0.18

0.36

[0.35]

Irish

0.62

0.97

2.52

0.69

1.04

1.43

Standard error of the ratio

0.25

0.33

0.67

0.16

0.29

0.35

General Population

0.75

1.17

1.72

0.80

1.06

1.51

Standard error of the ratio

0.09

0.16

0.28

0.08

0.11

0.18

a Results are not shown because of small bases.

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

55

Table 2.14 continued

Aged 16 and over

2004 Equivalised household income tertile

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

56

Women Middle

Lowest

Highest

Middle

Lowest

130 104 242 46 8 43 811 20773

83 67 210 87 18 32 347 10336

87 67 124 106 42 16 232 4828

141 116 286 38 8 48 1013 18709

161 75 236 78 20 30 514 13255

148 116 168 117 52 19 316 5693

106 92 147 40 18 103 197 1277

69 76 135 84 44 69 103 679

75 69 77 117 99 36 73 302

130 94 169 32 19 108 249 1418

134 84 144 82 48 65 140 1093

144 114 104 120 117 47 109 468

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

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Men Highest

Table 2.15 Perceived social support, by minority ethnic group and sex Aged 16 and over

2004

Perceived social support

Minority ethnic group

General population

Black Caribbean

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Men Observed % No lack Some lack Severe lack Standardised risk ratios Severe lack

46 29 25

47 29 23

44 27 29

38 25 38

40 25 35

40 30 30

56 26 17

57 27 16

1.52

1.37

1.76

2.36

2.34

1.89

0.96

1

Standard error of the ratio

0.21

0.18

0.18

0.27

0.30

0.22

0.15

52 28 20

51 27 23

51 28 22

45 25 30

50 17 33

44 30 26

68 22 11

67 23 11

Severe lack

1.97

2.07

1.99

2.47

3.07

2.32

0.84

1

Standard error of the ratio

0.27

0.30

0.24

0.33

0.45

0.28

0.15

390 567

296 377

771 907

315 341

104 126

135 143

1624 2195

42128 45113

327 521

296 362

467 541

321 346

246 292

312 328

433 597

2636 3548

Women Observed % No lack Some lack Severe lack Standardised risk ratios

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Bases (weighted) Men Women Bases (unweighted) Men Women

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

57

Table 2.16 Comparison of perceived social support in 2004 and 1999, by minority ethnic groupa and sex Aged 16 and over Perceived social support

2004, 1999 Minority ethnic group

General population

Black Caribbean

Indian

%

%

%

46 29 25

44 27 29

48 33 19

Pakistani Bangladeshi

Chinese

Irish

%

%

%

%

38 25 38

40 25 35

40 30 30

56 26 17

57 27 16

39 29 32

38 33 29

34 30 36

30 32 38

55 33 12

54 30 16

52 28 20

51 28 22

45 25 30

50 17 33

44 30 26

68 22 11

67 23 11

55 29 15

39 27 33

40 33 27

41 30 30

33 33 34

66 25 10

63 26 11

390 336 567 470

771 542 907 520

315 290 341 273

104 109 126 112

135 90 143 108

1624 1486 2195 1942

42128 41573 45113 50247

327 500 521 695

467 569 541 561

321 500 346 472

246 418 292 456

312 281 328 341

433 512 597 688

2636 3404 3548 4088

Men 2004 No lack Some lack Severe lack 1999 No lack Some lack Severe lack

Women 2004 No lack Some lack Severe lack 1999 No lack Some lack Severe lack Bases (weighted) Men 2004 Men 1999 Women 2004 Women 1999 Bases (unweighted) Men 2004 Men 1999 Women 2004 Women 1999

c Black Africans were include in the 2004 survey but not in the 1999 survey, so therefore are excluded from

58

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

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this comparative table.

Table 2.17 Perceived social support, by equivalised household income within minority ethnic group and sex Aged 16 and over

2004

Perceived social support

Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

46 32 22

37 30 33

58 17 25

56 29 16

52 28 20

53 28 19

54 32 15

46 31 23

44 25 31

61 26 13

49 29 22

38 26 36

52 24 24

39 31 29

32 25 43

59 29 12

44 30 26

40 26 34

[46] [22] [32]

39 18 43

31 28 41

[51] [30] [19]

41 23 36

41 28 31

a a a

[56] [5] [39]

32 30 37

a a a

[66] [8] [27]

47 16 37

58 25 18

32 33 35

[36] [23] [41]

60 28 12

38 22 40

[27] [36] [37]

70 21 9

47 29 24

30 33 37

80 17 3

60 29 11

42 33 26

64 25 10

52 28 20

44 28 29

74 19 6

63 25 12

50 31 19

Severe lack of social support Black Caribbean

1.39

1.78

1.44

1.49

1.84

1.74

Standard error of the ratio

0.34

0.42

0.40

0.40

0.43

0.37

Black African

0.74

1.28

1.99

1.30

2.21

2.62

Observed % Black Caribbean No lack Some lack Severe lack Black African No lack Some lack Severe lack Indian No lack Some lack Severe lack Pakistani No lack Some lack Severe lack Bangladeshi No lack Some lack Severe lack Chinese No lack Some lack Severe lack Irish No lack Some lack Severe lack General population No lack Some lack Severe lack

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Standardised risk ratios

Standard error of the ratio

0.25

0.34

0.50

0.48

0.50

0.53

Indian

1.43

1.84

2.67

1.18

2.21

3.18

Standard error of the ratio

Pakistani Standard error of the ratio

Bangladeshi Standard error of the ratio

Chinese

0.27

0.28

0.43

0.30

0.41

0.55

[2.20]

2.64

2.66

[3.23]

2.58

2.56

[0.65]

0.49

0.38

[1.50]

0.55

0.41

a

[2.65]

2.08

a

[2.32]

2.88

a

[0.61]

0.47

a

[0.75]

0.75

1.05

2.11

[2.92]

1.02

3.64

[3.18]

Standard error of the ratio

0.25

0.36

[0.69]

0.38

0.70

[0.74]

Irish

0.44

1.36

2.52

0.24

1.05

1.74

Standard error of the ratio

0.14

0.35

0.58

0.08

0.43

0.42

General population

0.64

1.30

1.89

0.59

1.19

1.89

Standard error of the ratio

0.07

0.15

0.23

0.07

0.15

0.24

a Results are not shown because of small bases.

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

59

Table 2.17 continued

Aged 16 and over

2004 Equivalised household income tertile

Men

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

131 101 241 46 8 43 799 20899

96 67 210 87 18 33 357 10436

86 70 124 106 42 16 243 4834

139 116 287 38 8 49 1023 18771

167 79 242 82 21 31 515 13354

150 123 170 126 54 20 327 5757

108 90 147 40 18 103 196 1285

74 76 136 84 43 72 104 687

74 72 77 117 100 36 77 304

129 94 169 33 19 112 251 1423

138 88 147 86 49 67 145 1103

144 120 104 127 123 48 112 475

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HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

Copyright © 2006, The Information Centre. All rights reserved

a Results are not shown because of small bases.

Table 2.18 Number of prescribed medicines, by minority ethnic group and sex Aged 16 and over

2004

Number of prescribed medicinesa

Minority ethnic group Black Caribbean

General population (2003)b

Black African

Indian

12 8 7 12 1.2

8 11 5 4 0.6

11 8 6 17 1.5

8 10 3 10 1.0

0.17

0.11

0.16

3.1

2.2

3.6

Standard error of the mean

0.28

0.20

Standardised risk ratios 4 or more

1.07

Standard error of the ratio

0.30

Pakistani Bangladeshi

Chinese

Irish

11 11 3 12 1.3

7 3 1 9 0.7

10 8 4 15 1.3

13 9 6 12 1.2

0.15

0.22

0.17

0.17

0.03

3.3

3.7

3.5

3.5

3.0

0.27

0.35

0.43

0.52

0.31

0.05

0.81

1.78

1.50

1.59

1.36

1.33

1

0.49

0.29

0.33

0.36

0.38

0.27

12 15 8 12 1.4

11 5 4 7 0.7

15 9 5 10 1.0

16 8 6 14 1.4

11 11 7 14 1.4

12 9 2 5 0.7

17 15 6 13 1.4

16 11 8 14 1.5

0.12

0.12

0.10

0.15

0.16

0.12

0.12

0.03

2.9

2.7

2.7

3.1

3.4

2.5

2.8

3.0

Standard error of the mean

0.20

0.34

0.19

0.27

0.27

0.34

0.17

0.04

Standardised risk ratios 4 or more

1.26

1.08

1.22

2.35

2.50

0.68

0.74

1

Standard error of the ratio

0.22

0.34

0.20

0.38

0.44

0.23

0.13

243 337

179 248

444 538

202 251

77 107

75 80

890 1143

5531 5877

218 327

165 216

316 382

208 260

143 185

183 199

320 418

5086 6322

Men Observed % 1 2 3 4 or more Mean number of medicines per person Standard error of the mean

Mean number of medicines per taker

Women Observed % 1 2 3 4 or more Mean number of medicines per person Standard error of the mean

Mean number of medicines per taker

Bases (weighted) Men Women Bases (unweighted) Men Women

a The bases are all those who answered the question on medicines.

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b Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING

61

Cardiovascular disease and diabetes

3

Jennifer Mindell & Paola Zaninotto

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Summary ●

14.5% of Irish men and 13.0% of women from the general population reported ever having a cardiovascular disorder diagnosed by a doctor. Black African men were onequarter as likely, and Bangladeshi women over half as likely, to have any CVD condition, compared with the general population. The prevalence of any CVD condition increased markedly with age.

●

In all minority ethnic groups the overall prevalence of ischaemic heart disease (IHD), and of IHD or stroke, was higher in men than in women. Black African informants reported the lowest prevalence of IHD and of IHD or stroke.

●

Within most minority ethnic groups, the prevalence of CVD, IHD and IHD or stroke showed small non-significant differences by equivalised household income. Informants from the Irish group, and from the general population, showed significantly higher prevalence (and higher risk ratio) of CVD, IHD and IHD or stroke in the lowest income category than the highest income category. IHD, and IHD or stroke, were also more common in Black Caribbean women in the lowest income tertile.

●

Black Caribbean women showed the highest rates of angina symptoms (3.9% Grades 1 and 2 angina combined), and Black Caribbean men showed the highest rates of symptoms of possible myocardial infarction (8.2%), based on the Rose Angina Questionnaire.

●

There was a general increase in the prevalence of CVD between 1999 and 2004. This increase was non-significant in all minority ethnic groups, except for Pakistani men where the prevalence of CVD doubled significantly between the two surveys.

●

After adjusting for age, doctor-diagnosed diabetes was almost four times as prevalent in Bangladeshi men, and almost three times as prevalent in Pakistani and Indian men compared with men in the general population. Among women, doctor-diagnosed diabetes was more than five times as likely among Pakistani women, at least three times as likely in Bangladeshi and Black Caribbean women, and two-and-a-half times as likely in Indian women, compared with women in the general population.

●

The prevalence of doctor-diagnosed diabetes increased markedly with age, in both men and women. It was more common in men than women for most minority ethnic groups and age-groups.

●

Type 2 diabetes accounted for the majority of cases. Black African, Black Caribbean, Indian, Pakistani and Bangladeshi men aged 35-54 and (except Black African men) aged 55+ had higher prevalence of type 2 diabetes than the general population. Among women, type 2 diabetes was more common in participants from Indian, Pakistani and Bangladeshi groups aged 35+, and among Black Caribbean, Black African, Indian and Pakistani women aged 55+.

●

The prevalence of undiagnosed diabetes did not differ between different minority ethnic groups in men.

●

The pattern for age-standardised prevalence of doctor-diagnosed diabetes among

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 3: CARDIOVASCULAR DISEASE AND DIABETES

63

64

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 3: CARDIOVASCULAR DISEASE AND DIABETES

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minority ethnic groups relative to the general population was the same in 2004 as in 1999, among both men and women. Observed prevalence did not rise significantly between 1999 and 2004 in any minority ethnic group.

3.1 Cardiovascular disease 3.1.1

Introduction Cardiovascular disease (CVD) is one of the leading contributors to the global disease burden. Its main components are ischaemic heart disease (IHD, also called coronary heart disease (CHD) or coronary artery disease (CAD)) and stroke. Although death rates are falling, CVD remains the main cause of death in England, causing over 190,000 deaths (over 92,500 IHD and over 40,000 stroke deaths) in England and Wales in 2004, of which just under 52,000 were before the age of 75.1 Each year in England there are 110,000 strokes,2 of which about 40% are recurrent strokes.3 In 2003/04, there were almost 308,000 admissions to hospital in England due to IHD and 98,500 for stroke (3% and 1% of all admissions respectively),4 with stroke patients occupying 20% of acute and 25% of long term hospital beds.2 The Health Survey for England (HSE) 20035 summarised trends in mortality and morbidity of CVD and geographical inequalities across Britain; the Healthcare Commission has recently summarised the impact of CHD on individuals and the NHS.6 Risks of CVD are greatly increased in people who smoke, are physically inactive, have a low-fibre and/or high-fat diet, are obese, have raised blood pressure or cholesterol, or have diabetes. Psychosocial factors, such as depression and anxiety, psychosocial work characteristics, and social support, also contribute to the development of and mortality from IHD.7 These factors explain much, but not all, of the marked social class gradient and geographical inequalities in CHD morbidity and mortality. Cultural factors play a part, but poverty severely constrains the ability to make and act upon choices, such as lifestyle and healthcare choices. CVD is a particular problem in many minority ethnic groups; many of the statistics that are available on prevalence of CVD and its risk factors among minority ethnic groups in England originate from the HSE series.8 Mortality from IHD is particularly high among Irish and Scottish people and those from South Asian groups, particularly Pakistanis and Bangladeshis.9,10,11 Mortality from IHD is 50% higher in people born in Bangladesh, India and Pakistan than among the general population.6 The extent to which deprivation, adverse lifestyle factors, poorer access to healthcare, or other factors contribute to this high risk is not completely understood.12,13,14 For Indian, Bangladeshi and Pakistani groups, their varied but substantially raised prevalence of diabetes contributes to the raised risk of IHD.6,15 Elevated risks of premature death and poor health have also been reported in second-11 and third-generation15 Irish, as well as in Irish migrants. Black Caribbean and Black African people have lower premature death rates of IHD than the general population but this is predicted to change as their smoking prevalence has been rising.17 IHD is also less common in Chinese people.

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Research findings on ethnic inequalities in access to diagnosis and treatment of IHD are mixed, often depending on how and whether ‘South Asians’ are subdivided into ethnic categories:18 Bangladeshi patients appear to be most disadvantaged, and Pakistani patients also disadvantaged, relative to Indian patients and the general population.18,19,20 Adjustment for education and income attenuates but does not abolish these differences.19 Risk factors for stroke are similar to those for IHD3, though raised blood pressure is more, and smoking and raised cholesterol less, closely associated with stroke. The proportion of strokes caused by infarction or haemorrhage depends on the ethnic composition of the population studied. Black Africans and Black Caribbeans have above average prevalence of hypertension and of ischaemic stroke2,21,22 (between 69%23,24 and 89%25 of strokes in the UK), although atrial fibrillation (another important risk factor for stroke3) is less important among Black and South Asian groups.22 Intracerebral haemorrhage, which is less common (7%25 – 13%23,24 of strokes) but more frequently fatal, has different risk factors, although hypertension is again important. Chinese26 and Black24 people are at particular risk of both types of stroke, with hypertension as a predominant risk factor.24,26 Survival after a first stroke has recently been shown to be greater in Black patients than the general population, allowing for age, type and severity of stroke.27 Mortality from ischaemic stroke is higher in

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Bangladeshi people, attributable to double the age-adjusted incidence, compared with White Europeans.28 The first part of this chapter reports the prevalence of self-reported CVD conditions, IHD, and stroke. It investigates differences in specific conditions between ethnic groups, and examines CVD by household income. The second part covers the prevalence of diabetes among minority ethnic groups by age, sex and household income. 3.1.2

Methods and definitions Some of the definitions used in this volume differ from those used in 1999. When changes over time are examined, the current definition is used and the 1999 data have been recoded accordingly. ●

‘Any CVD condition’: this differs from the definition used in 1999. Informants are classified as having any CVD condition if they reported having any of the following conditions confirmed by a doctor: angina, heart attack, stroke, heart murmur, irregular heart rhythm, ‘other heart trouble’. High blood pressure and diabetes are not included in this definition, since they are risk factors for CVD and are dealt with separately.

●

‘Ischaemic heart disease’ (IHD) (also called ‘coronary heart disease’ (CHD)): informants are classified as having IHD if they reported having angina or a heart attack confirmed by a doctor.

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IHD or stroke: informants are classified as having IHD or stroke if they reported having angina, or a heart attack or a stroke, confirmed by a doctor.

●

Rose Angina Questionnaire: this aims to collect information on symptoms of angina or heart attack irrespective of medical diagnosis. Informants are classified as having angina symptoms based on answers to questions on whether they have experienced chest pain.29 Informants are classified as having had a possible myocardial infarction (heart attack) if they reported having ever had an attack of severe pain across the front of the chest, lasting for half an hour or more. This is referred to in this chapter as ‘possible myocardial infarction’ (again irrespective of medical diagnosis).

All tables refer to ever having the condition. General population comparisons are made with HSE 2003, as these questions were not asked of the general population sample in the 2004 survey. Prevalence of cardiovascular conditions, by minority ethnic group This section presents the prevalence by sex, age and minority ethnic group separately for any cardiovascular condition and for a number of specific cardiovascular diseases. For clarity, the text comments on the broader disease groupings before commenting on more specific conditions. This differs from the order of the tables. Age is the strongest risk factor for both ischaemic heart disease (IHD) and stroke in the general population.25 Results from HSE 2004 confirm that this is also the case in almost every minority ethnic group for stroke, angina, heart attack, and abnormal heart rhythm (except Black Caribbean and Chinese women), although numbers of older Black African people and Bangladeshi men are too small to draw firm conclusions. Age-standardised risk ratios are used to take account of differences in the age profile of different minority ethnic groups (see chapter 1). Any CVD condition Irish men had the highest prevalence of any CVD (14.5%) while Black African men had the lowest (2.3%). Women from the general population had the highest prevalence of any CVD (13.0%) and Bangladeshi women had the lowest (4.8%). Black African men were onequarter as likely, and Bangladeshi women over half as likely, to have any CVD condition, compared with the general population. The age-standardised risk ratios for men and women in other minority ethnic groups were not significantly different from 1. Table 3.3

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3.1.3

Figure 3A Prevalence of CVD, by minority ethnic group and age

16 to 34 35 to 54 55+

Men 45 40 35

Percent

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The proportion with any CVD condition increased with age in both sexes, and was markedly higher in the oldest age group (55 and over). Table 3.4, Figure 3A Ischaemic heart disease or stroke

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The lowest prevalence of ischaemic heart disease (IHD, defined as doctor-diagnosed angina or heart attack) or stroke was seen among Black African informants (0.7% for men and 1.0% for women), while the highest was for Pakistani men (9.1%), Irish women (5.4%) and women from the general population (5.8%). As with the observed prevalences, agestandardised risk ratios were significantly low for Black African informants (0.22 for men and 0.37 for women), and high for Pakistani men (2.12). Table 3.3 The prevalence of IHD or stroke increased with age in both sexes. Among those aged 55 and over, the prevalence was highest in Indian women (18.9%) and Pakistani men (41.1%) and lowest in the Chinese group (8.7% for men and 9.0% for women). Black African informants, aged 55 and over, had also low prevalence of IHD (5.2% for men and 1.5% for women, but note small bases). Table 3.4 Ischaemic heart disease The observed prevalence of ischaemic heart disease (angina or heart attack) was higher in men than in women. Black African informants had the lowest prevalence of IHD (0.7% for men and 0.5% for women). Among women, the age-standardised risk ratios of IHD were generally not significantly different from 1; the only exception was for Black African women (0.15). Among men, Black African informants also had the lowest risk ratio (0.27), while the highest risk ratio was 2.43 in Pakistani men. Table 3.3

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Among men aged 55 and over, Pakistanis had the highest prevalence of IHD (35.1%) and Chinese males had the lowest (7.2%). Black African males also had low prevalence of IHD (5.2%, but note the small base). For women aged 55 and over, prevalence of IHD was highest in the Indian group (14.7%) and lowest in the Black Caribbean (6.3%) and Irish (6.6%) groups. Table 3.4 In men, the observed prevalence of angina and of heart attack was lowest among Black African men (0.7% angina, none with heart attack) and highest among Pakistani men (6.9% angina, 4.1% heart attack). The age-standardised risk ratios followed the same pattern as the observed percentages. Relative to men in the general population, risk ratios for angina were low for Black African men (0.36) and high for Pakistani men (2.85) - the only risk ratio to be significantly greater than the general population (set at 1.0). In women from minority ethnic groups, the observed prevalence of angina was lowest among Black African women (0.5%) and highest among Indian women (3.2%). After adjusting for age, rates of angina among Black African women were significantly lower than in the general population (risk ratio 0.19). The observed prevalence of angina was lower among Bangladeshi women than women from the general population. However, after standardising for age, the risk ratio among Bangladeshi women was twice as high (2.22) as for women in the general population (set at 1). This was the only risk ratio to be significantly higher than the general population. Table 3.1, Figure 3B Figure 3B Prevalence of angina, by minority ethnic group Women

Risk ratio, logarithmic scale

Men 10.0

10.0

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2.0

1.0

1.0

0.5

0.5

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0.1 sh

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i

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Bl

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General population = 1.0. Error bars indicate 95% confidence limits.

The highest prevalence of angina and of heart attack was observed in those aged 55 and over: the prevalence of angina was highest in Pakistani men (30.9%) and Indian women (14.7%), while the prevalence of heart attack was highest in the Pakistani group (19.0% men, 6.9% women). Table 3.2 Stroke The prevalence of stroke was highest among Irish informants (4.5% for men and 2.7% for women). Age-standardised risk of stroke for men and women in each minority ethnic group did not differ significantly from the general population, except for Chinese women (risk ratio 0.22) and Black African men (risk ratio 0.00). Results from other studies suggest that the incidence of stroke is higher among Chinese and Black African populations.21,26 Explanations for the low prevalence found in HSE 2004 include small numbers surveyed (only 39 Black African men aged 55 and over, the age group in whom most strokes occur); 68

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The age-standardised risk ratios of heart attack for men and women from minority ethnic groups did not differ significantly from those of men and women in the general population. The only exceptions were Black African (risk ratio 0.00 for men and women) and Chinese informants (risk ratio 0.12 for men and 0.00 for women). Table 3.1

an increased case fatality rate, so raised incidence is not matched by raised prevalence; differences between those populations surveyed in HSE and those previously studied; and chance. Table 3.1 The prevalence of stroke was highest among informants aged 55 and over. Black Caribbean and Pakistani men had the highest prevalence (11.5% and 9.6% respectively). Among women aged 55 and over, the highest prevalence was among Bangladeshi (11.9%) and Pakistani (10.1%) informants. The difference in prevalence of stroke between Black African men aged 55 and over (0%) and similarly aged men in the general population (6.4%) is not statistically significant. Table 3.2 Heart murmur, abnormal heart murmur and ‘other’ heart trouble The observed prevalence of heart murmur was significantly lower among Black African men (0.4%) and Chinese women (0.8%) compared with the general population (3.1% for men and 3.4% for women). After adjusting for age, the rates of heart murmur were still lowest for Black African men (risk ratio 0.15) and Chinese women (0.30). The observed prevalence of abnormal heart rhythm was significantly lower among Black African men (0.4%) and Bangladeshi women (2.3%) compared with the general population (5.1% for men and 5.6% for women). After age standardisation, the risk ratio of abnormal heart rhythm was lowest for Black African men (0.08) and for Black Caribbean women (0.53). The observed prevalence of ‘other’ heart trouble was significantly lower than the general population (2.8% for men and 1.8% for women) among Bangladeshi men (none) and Chinese men (0.6%). After adjusting for age, Bangladeshi and Chinese men had the lowest rates (risk ratio 0.00 and 0.25 respectively) of ‘other’ heart trouble. Table 3.1 Heart murmur, abnormal heart murmur and ‘other’ heart trouble were more common among people below the age of 35 than the other conditions. People from minority ethnic groups reported lower rates of heart murmur, abnormal heart rhythm (except for Irish women) and ‘other’ heart trouble (except for Black Caribbean women) than the general population. The prevalence of self-reported heart murmur rose with age in most groups, except Indian and Irish men. Table 3.2 3.1.4

CVD by equivalised household income

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This section presents the prevalence of CVD, IHD and IHD or stroke by equivalised household income tertile within minority ethnic group. Equivalised household income is a measure of household income that takes account of the number of persons in the household. The sample was divided into equivalised household income tertiles which were applied to all minority ethnic groups: they are not group-specific, and do not divide each group into equal thirds; the income levels that form the boundaries of the tertiles are the same for each group. Among men, the observed prevalence of any CVD tended to be highest in the lowest income. Irish informants in the lowest income tertile had the highest prevalence of CVD (30.3% for men and 25.2% for women) compared with 8.4% for men and 7.8% for women in the highest income tertile. Similarly, after adjusting for age, higher rates of CVD were found among those with the lowest income for Irish men (risk ratio 2.45) and women (risk ratio 2.21), than those in the highest income tertile (0.79 for men and 0.69 for women). This was similar to but more exaggerated than the pattern seen among the general population (prevalence 21.2% in the lowest and 8.9% in the highest tertile of income, risk ratios 1.43 and 0.78 respectively in men; 16.5% in the lowest and 9.0% in the highest income tertile, risk ratios 1.20 and 0.83 respectively for women). Numbers of Pakistani and Bangladeshi informants in the highest tertile of income were too low to confirm this pattern. However, the pattern in Chinese women was different, as the prevalence of CVD in Chinese women in the highest income tertile was greater, but not significantly so, than the prevalence in the lowest tertile of income. In other minority ethnic groups, there was no clear relationship between income and prevalence of CVD.

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For both IHD and IHD or stroke, the observed prevalence was also generally higher among informants with the lowest income. The largest differences in prevalence were found in informants in the general population (prevalence of IHD in the lowest income tertile 11.9% of men and 6.1% of women, and of IHD or stroke 15.2% of men and 8.8% of women for IHD) and for Irish informants (prevalence of IHD in the lowest income tertile13.2% of men and 13.6% of women, and IHD or stroke 20.1% of men and 18.4% of women). After adjusting for age, the same pattern was found for IHD and for IHD or stroke as for all CVD. The rates were generally higher for informants in the lowest income tertile (except for Chinese women, where the reverse pattern was again not significant). Among Irish informants, the risk ratio for IHD or stroke among women in the lowest income category was 3.49 compared with 0.28 for Irish women in the highest income tertile; the equivalent risk ratios for men were 2.37, compared with 0.09 in the highest income tertile. Higher risk ratios were also found among informants with the lowest income for the general population (1.84 for men and for 1.49 women, compared with 0.57 and 0.51 respectively in the highest income tertile). The pattern was similar but closer to 1 for IHD. The other group for whom risk ratios differed significantly by income was Black Caribbean women (risk ratio for IHD 1.92 for women in the lowest and 0.14 for the highest income tertile, and for IHD or stroke 1.75 and 0.42 respectively). Table 3.5 3.1.5

Prevalence of symptoms of angina and possible myocardial infarction, using the Rose Angina Questionnaire Angina The prevalence of angina symptoms based on the Rose Angina Questionnaire (grades 1 and 2 combined) was highest among Bangladeshi men (2.4%) and Black Caribbean women (3.9%). Women from each minority ethnic group and from the general population were more likely to report milder symptoms (grade 1) than more severe symptoms (grade 2). This was not always the case for men. Comparing the figures for symptoms of chest pain with those for self-reported doctordiagnosed angina, clear discrepancies emerged. For men, the reported rates of chest pain (Table 3.6) were lower than the reported rates of doctor-diagnosed angina (Table 3.2). In contrast, angina symptoms among Black African women were much higher than the prevalence of doctor-diagnosed angina reported (2.2% and 0.5% respectively). Higher rates for symptoms compared with diagnoses of angina were also reported in Pakistani women. Age-standardised risk ratios of Grade 1 angina were significantly low for Black Caribbean men (0.02), Black African men (0.09) and Chinese women (0.15). The Grade 2 angina risk ratios of the minority ethnic groups (in both sexes) were not significantly different from those in the general population; the only exception was for Black African men and Chinese women who both had a risk ratio of 0.00. Tables 3.6, 3.7

The prevalence of possible symptoms of myocardial infarction based on the Rose Angina Questionnaire (Table 3.7) increased with age. Generally the rates were much higher than those for self-reported heart attack (ever diagnosed) shown in Table 3.2. This confirms previous findings.3,30 Table 3.7 3.1.6

Comparison between 1999 and 2004 The prevalence of CVD, IHD, and IHD or stroke, by age, sex and minority ethnic group were compared using results from the 1999 HSE. The definition of CVD used in 1999 included high blood pressure and diabetes. Therefore data from 1999 (and 1998 for the general population) were re-analysed using the new definition to enable comparisons to be made.

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The age-standardised risks of symptoms of possible MI were significantly low for Black African and Chinese men (0.42 and 0.33 respectively). Among women, Bangladeshis, Pakistanis and Black Caribbeans had significantly high risk ratios (2.03, 1.85 and 1.80 respectively). Table 3.6

There was a general but (in the majority of cases) not significant increase in the prevalence of CVD between 1999 and 2004 in most minority ethnic groups and in the general population. The only significant increase was among Pakistani men, where the prevalence of CVD almost doubled between the two survey years (12.0% in 2004 and 6.3% in 1999). Similarly, among men and women, the differences between 1999 and 2004 in the prevalence of IHD were generally not statistically significant. The only exceptions were for Black Caribbean and Pakistani men, where the prevalence of IHD doubled between the two survey years. The prevalence of IHD or stroke increased significantly for Pakistani men to 9.1% in 2004 from 4.8% in 1999; the increase among Indian women (to 4.2% in 2004 from 2.3% in 1999) was not quite statistically significant. In all other groups, the differences in the prevalence of IHD or stroke between the survey years were not statistically significant. Table 3.8 The general patterns of disease between different minority ethnic groups seen in 2004 were similar to those reported in 1999. A few differences were noted, however. For example, in the 2004 survey, the risk ratios for angina and for IHD for Black Caribbean, and the risk ratio of angina for Chinese men, were not significantly different from those for men in the general population. For Chinese women, the risk ratios for angina and for IHD were no different from women in the general population. However, age-standardised risk ratios for angina and for IHD were significantly lower in Black Caribbean men and Chinese men and women in 1999 than in the general population.8 The relationships found between CVD and income differed between the two surveys. In HSE 2004, the observed prevalence of CVD in men tended to be higher in the lowest income tertile than the highest income tertile. After adjusting for age, higher rates of CVD were found among those with the lowest income for Irish men (risk ratio 2.27) and women (risk ratio 1.96). In contrast, the highest risks in 1999 were found in middle and higherincome Bangladeshi men, higher income Bangladeshi women, and middle and higherincome Black Caribbean women.8 After adjusting for age, the rates of IHD or stroke were higher for informants in the lowest income category in minority ethnic groups (except for Chinese women) and in the general population in 2004. However, in 1999, this was seen only in men and women in the general population and not for any of the minority ethnic groups.8

3.2 Diabetes 3.2.1

Introduction

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Diabetes is characterised by high blood glucose levels (hyperglycaemia). The resulting chronic hyperglycaemia is associated with damage and possible failure of many organs, especially the eyes, kidneys, nerves, heart, and blood vessels. Diabetes is a known risk factor for CVD. It also tends to worsen the effects of other risk factors for CVD, such as dyslipidaemia, hypertension, smoking, and obesity. There are two main types of diabetes: 1 and 2. Type 1 diabetes (also known in the past as insulin-dependent, or juvenile diabetes) is the result of autoimmune destruction of the cells of the pancreas which produce insulin. Type 2 diabetes (formerly known as non insulindependent) is characterised by insulin resistance (i.e. the inability of the body to respond to insulin). Type 2 diabetes is the more common, accounting for over 90% of all diabetes. It is much more common in Black Caribbean and South Asian groups.9 In the past, it was a disease that appeared in middle-age, with increasing prevalence into old age. However, cases are now being diagnosed in children worldwide.31 This is closely linked with the rising epidemic of obesity. The first cases in England were reported in 2000 in overweight girls aged nine to 16 of Pakistani, Indian or Arabic origin32 and in white adolescents in 2002.33 In the UK in 2004, children of South Asian origin were more than 13 times more likely to have type 2 diabetes than white children.34

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3.2.2

Methods and definitions The following definitions are used in this report: ‘Diabetes’ means self-reported doctor-diagnosed diabetes. The HSE interview makes no distinction between type 1 and 2 diabetes. For classification purposes, type 1 diabetes has been defined as being diagnosed before the age of 35 and being on insulin therapy at the time of the survey.

●

‘Undiagnosed diabetes’: For those informants who had a fasting blood sample taken, a fasting blood plasma glucose level ≥ 7mmol/l in the absence of a reported diagnosis of diabetes has been considered indicative of undiagnosed diabetes. The prevalence of undiagnosed diabetes has been reported separately for the subgroup with a valid fasting blood sample and aged over 35.

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‘Controlled diabetes’: This can be assessed by measuring glycated haemoglobin (see chapter 10) but the bases were too small to examine levels in men and women with diabetes by minority ethnic group. These results are, therefore, not reported here.

●

As these questions were not asked of general population informants in the 2004 HSE, comparisons with the general population use data from HSE 2003.

Prevalence of diabetes, by minority ethnic group Doctor-diagnosed diabetes Observed prevalence of doctor-diagnosed diabetes was significantly higher in Black Caribbean, Indian, Pakistani, and Bangladeshi men (ranging from 7.3 to 10.1%) and women (5.2 to 8.6%) than in the general population (4.3% men, 3.4% women). After adjusting for age, doctor-diagnosed diabetes was almost four times as likely in Bangladeshi men, and almost three times as likely in Pakistani and in Indian men compared with men in the general population. Among women, doctor-diagnosed diabetes was more than five times as likely among Pakistani women, at least three times as likely in Bangladeshi and Black Caribbean women, and two-and-a-half times as likely in Indian women compared with women in the general population. Prevalence of type 1 diabetes was below 1% in each minority ethnic group and in the general population. Table 3.9 The prevalence of doctor-diagnosed diabetes increased markedly with age, in both men and women. It was more common in men than women for most minority ethnic groups and age-groups. However, Pakistani women aged 55+ had a significantly higher prevalence of diabetes (44.4%) than Pakistani men (25.3%). Table 3.10, Figure 3C Type 2 diabetes accounted for the majority of cases. Black African, Black Caribbean, Indian, Pakistani and Bangladeshi men aged 35-54 and (except Black African men) aged 55+ had higher prevalence of type 2 diabetes than the general population. Among women, type 2 diabetes was more common in participants from Indian, Pakistani and Bangladeshi groups aged 35+ and among Black Caribbean, Black African, Indian and Pakistani women aged 55+. Doctor-diagnosed diabetes was rare among those aged 16-34, but was highest among Indian men (2.0%), Black African men (1.7%) and Irish women (1.7%). Undiagnosed diabetes

Table 3.10, Figures 3C and 3D

Too few participants provided a fasting blood sample to enable analysis of undiagnosed diabetes (i.e. a fasting blood plasma glucose level ≥ 7mmol/l in the absence of a reported diagnosis of diabetes) by minority ethnic group, except for Indian men and women. We therefore aggregated minority ethnic groups (combining Black Caribbean and Black African to form a group labelled ‘Black’, and Indian, Pakistani and Bangladeshi informants to form a group labelled ‘South Asian’) to enable analyses comparing prevalence of undiagnosed diabetes between different groups, and comparison of these figures with reported prevalence of doctor-diagnosed diabetes. The following figures are limited to those 72

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3.2.3

●

Figure 3C Prevalence of doctor-diagnosed diabetes, by minority ethnic group and age

16 to 34 35 to 54 55+

Men 45 40 35

Percent

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Figure 3D Prevalence of doctor-diagnosed type 2 diabetes, by minority ethnic group Women

Risk ratio, logarithmic scale

10.0

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Men 10.0

General population = 1.0. Error bars indicate 95% confidence limits.

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participants who provided a fasting blood sample, to enable comparisons between prevalence of doctor-diagnosed and of undiagnosed diabetes among the same groups of informants. Prevalence of doctor-diagnosed diabetes therefore differs from that quoted elsewhere in this chapter. Prevalence of undiagnosed diabetes increased with age in men but the differences were not significant. Although the prevalence of diabetes (diagnosed plus undiagnosed) varied markedly between different ethnic groups, the prevalence of undiagnosed diabetes did not differ in men. In women aged 35-54, prevalence of undiagnosed diabetes in South Asian women (4.0%) was significantly higher than in Black women (no cases found) or women in the general population (0.6%). Table 3.11 Almost all cases of diabetes in Black and South Asian men were already diagnosed, whereas at least two-fifths of cases of diabetes in Irish men and in males in the general population were undiagnosed. More than three-quarters of cases of diabetes in South Asian women were diagnosed, with an even higher proportion of cases diagnosed in Black and Irish women and women in the general population. Figure 3E Figure 3E Diagnosed and undiagnosed diabetes

Doctor-diagnosed diabetes Undiagnosed diabetes

Women

Percent

Men 18

18

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14

12

12

10

10

8

8

6

6

4

4

2

2

0

0

ia

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ut n

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So

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Bl

Aggregated ethnic group

Aggregated ethnic group

Diabetes by equivalised household income

3.2.5

Comparison between 1999 and 2004 The pattern for age-standardised prevalence of doctor-diagnosed diabetes among minority ethnic groups relative to the general population in 2004 replicated the results of HSE 1999.8 Although the prevalence of doctor-diagnosed diabetes in 2004 was higher than in 1999 in most minority ethnic groups (for all adults and in age-groups 35-54 and 55 and over), this increase was only significant in the general population (up to 4.3% in men and 3.4% in women in 2003, from 3.3% and 2.5% respectively in 1998). The largest rises appeared in older people (aged 55 and over), particularly among Black Caribbean and Indian men and Indian and Pakistani women. However, rises were not universal: prevalence of doctordiagnosed diabetes appeared to fall in older Bangladeshi women and in older Pakistani 74

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Observed prevalence of doctor-diagnosed diabetes was significantly inversely related to household income in some groups. The age-standardised risk ratios for doctor-diagnosed diabetes were significantly higher in informants in the lowest income tertile compared with the highest tertile for Black Caribbean and Indian men, Pakistani women, and men and women in the general population. However, the opposite pattern was seen in Chinese men (risk ratio 2.40 for the highest and 0.40 for the lowest income tertiles). Other differences seen were not significant. Table 3.12

men. Although the magnitude of some of these changes was large, none were significant as the number of informants was small when analysed by sex, age-group and minority ethnic group. Changes in the age-composition of informants between the two years within the age-groups could affect the observed prevalence. Additionally, these results do not distinguish between changes in prevalence of diabetes, associated with increasing obesity, and increased detection of those with diabetes. Table 3.13

References and notes 1 Death registrations in England and Wales, 2004: causes. Health Statistics Quarterly. 2005; 26:62-69 www.statistics.gov.uk/downloads/theme_health/HSQ26.pdf 2 National Audit Office. Reducing brain damage: Faster access to better stroke care. HC 452. Department of Health, London, 2005. www.nao.org.uk/publications/nao_reports/05-06/0506452.pdf 3 Carroll K, Murad S, Eliahu J, Majeed A. Stroke incidence and risk factors in a population-based cohort study. Office of National Statistics Health Quarterly (12) Winter 2001, 18-26. www.statistics.gov.uk/downloads/theme_health/HSQ12_v2.pdf 4 Department of Health (England), Hospital Episode Statistics - 2003/04 www.hesonline.nhs.uk/Ease/servlet/DynamicPageBuild?siteID=1802&categoryID=192 5 Primatesta P. Chapter 1.Cardiovascular disease and associated risk factors. In Sproston K, Primatesta P (eds). Health Survey for England 2003. Volume 1: Cardiovascular disease. TSO, London, 2004. 6 Healthcare Commission. Getting to the heart of it. Coronary heart disease in England: A review of progress towards the national standards. London: Commission for Healthcare Audit and Inspection, 2005. 7 Hemingway H, Marmot M. Psychosocial factors in the aetiology and prognosis of coronary heart disease: systematic review of prospective cohort studies. BMJ. 1999; 318:1460-1467. 8 Erens B, Primatesta P, Prior G (eds). Health Survey for England. The health of minority ethnic groups 1999. TSO, London, 2001. 9 Aspinall P, Jacobson B. Ethnic disparities in health and health care: A focused review of the evidence and selected examples of good practice. London Health Observatory, London 2004. 10 Harding S, Maxwell R. Differences in mortality of migrants. In Drever F, Whitehead M(eds). Health inequalities: Decennial supplement Series DS No 15, pp 95-121. TSO, London, 1997. 11 Harding S, Balarajan R. Patterns of mortality in second generation Irish living in England and Wales: longitudinal study. BMJ. 1996; 312:1389-1392. 11 Britton A, Shipley M, Marmot M, Hemingway H. Does access to cardiac investigation and treatment contribute to social and ethnic differences in coronary heart disease? Whitehall II prospective cohort study. BMJ. 2004; 329:318-323. 11 Bardsley M, Hamm J, Lowdell C, Morgan D, Storkey M. Developing health needs assessment for black and minority ethnic groups. Health of Londoners Project, London, 2000. 12 Nazroo JY. South Asian people and heart disease: an assessment of the importance of socioeconomic position. Ethn Dis. 2001; 11:401-411. 13 Bhopal R. Epidemic of cardiovascular disease in South Asians (editorial). BMJ. 2002; 324:625-626. 14 Gill PS, Kai J, Bhopal RS, Wild S. Health care needs assessment: black and minority ethnic groups. In Stevens A, Raftery J, Mant JM (eds). Health care needs assessment. The epidemiologically based needs assessment reviews. Radcliffe Press, Oxford, 2003. 15 Bhopal R, Unwin N, White M, Yallop J, Walker L, Alberti KG et al. Heterogeneity of coronary heart disease risk factors in Indian, Pakistani, Bangladeshi, and European origin populations: cross sectional study. BMJ. 1999; 319:215-220.

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16 Wild S, McKeigue P. Cross sectional analysis of mortality by country of birth in England & Wales 19701992. BMJ. 1997; 314: 705-10. 17 Abbotts J, Harding S, Cruickshank K. Cardiovascular risk profiles in UK-born Caribbeans and Irish living in England and Wales. Atherosclerosis. 2004; 175:295-303. 18 Mindell J, Klodawski E, Fitzpatrick J. Using routine data to measure ethnic inequalities in revascularisation in London. A technical report. London Health Observatory, London, 2005. www.lho.org.uk/ViewResource.aspx?id=9732 19 Feder G, Crook AM, Magee P, Banerjee S, Timmis AD, Hemingway H. Ethnic differences in invasive management of coronary disease: prospective cohort study of patients undergoing angiography. BMJ. 2002; 324:511-516. 20 Kuppuswamy VC, Gupta S. Excess coronary heart disease in South Asians in the United Kingdom. BMJ. 2005; 330: 1223-1224.

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75

21 Hajat C, Tilling K, Stewart JA, Lemic-Stojcevic N, Wolfe CDA. Ethnic Differences in Risk Factors for Ischemic Stroke: A European Case-Control Study. Stroke. 2004; 35:1562-1567. 22 Conway DSG, Lip GYH. Ethnicity in relation to atrial fibrillation and stroke (the West Birmingham Stroke Project). Am J Cardiol. 2003; 92:1476-1479. 23 Intercollegiate Stroke Working Party. National clinical guidelines for stroke. 2nd edition. Royal College of Physicians, London, 2004. www.rcplondon.ac.uk/pubs/books/stroke/stroke_guidelines_2ed.pdf 24 Wolfe C, Rudd AG, Howard R et al. Incidence and case fatality rates of stroke subtypes in a multiethnic population: the South London Stroke Register. J Neurology, Neurosurgery, Psychiatry. 2002; 72:211-6. 25 Rothwell PM, Coull AJ, Silver LE et al for the Oxford Vascular Study. Population-based study of eventrate, incidence, case fatality, and mortality for all acute vascular events in all arterial territories (Oxford Vascular Study). Lancet. 2005; 366:1773-83. 26 Zhang XF, Attia J, D'Este C, Yu XH. Prevalence and Magnitude of Classical Risk Factors for Stroke in a Cohort of 5092 Chinese Steelworkers Over 13.5 Years of Follow-up. Stroke. 2004; 35:1052-1056. 27 Wolfe CDA, Smeeton NC, Coshall C, Tilling K, Rudd AG. Survival differences after stroke in a multiethnic population: follow-up study with the south London stroke register. BMJ 2005; 331:431-433. 28 Bhopal R, Rahemtulla T, Sheikh A. Persistent high stroke mortality in Bangladeshi populations. BMJ. 2005; 331:1096-1097. 29 Rose defined angina as a chest pain or discomfort with the following characteristics: 1. The site must include either the sternum (any level) or the left arm and left anterior chest (defined as the anterior chest wall between the levels of clavicle and lower end sternum); 2. It must be provoked by either hurrying or walking uphill (or by walking on the level, for those who never attempt more); 3. When it occurs on walking it must make the subject either stop or slacken pace, unless nitroglycerin is taken; 4. It must disappear on a majority of occasions in 10 minutes or less from the time when the subject stands still. Grade 1 angina occurs when the subject only experiences the chest pain when walking uphill or hurrying. Grade 2 angina occurs when the subject experiences the chest pain even when walking at an ordinary pace on the level. 30 Lampe F, Colhoun H, Dong W. Cardiovascular Disease and respiratory conditions, in Colhoun H, Prescott-Clarke P (eds). Health Survey for England 1994. London: HMSO, 1996. 31 Pinhas-Hamiel O, Zeitler P. The global spread of type 2 diabetes mellitus in children and adolescents. J Pediatrics. 2005; 146:693-700. 32 Ehtisham S, Barrett TG, Shaw NJ. Type 2 diabetes mellitus in UK children - an emerging problem. Diabetic Med. 2000; 17:867-871. 33 Drake AJ, Smith A, Betts PR, Crowne EC, Shield JPH. Type 2 diabetes in obese white children. Arch Dis Child. 2002; 86:207-208.

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34 Ehtisham S, Hattersley AT, Dunger DB, Barrett TG. First UK survey of paediatric type 2 diabetes and MODY. Arch Dis Child. 2004; 89:526-529.

Tables

3.1 Prevalence of CVD conditions, by minority ethnic group and sex 3.2 Prevalence of CVD conditions, by age within minority ethnic group and sex 3.3 Prevalence of CVD/IHD/IHD or stroke, by minority ethnic group and sex 3.4 Prevalence of CVD/IHD/IHD or stroke, by age within minority ethnic group and sex 3.5 Prevalence of CVD, IHD, IHD or stroke, by equivalised household income tertile within minority ethnic group and sex 3.6 Prevalence of angina and MI symptoms (using the Rose Angina Questionnaire), by minority ethnic group and sex 3.7 Prevalence of angina and MI symptoms (using the Rose Angina Questionnaire), by age within minority ethnic group and sex 3.8 Comparison of CVD/IHD/IHD or stroke in 2004 and 1999, by age within minority ethnic group and sex 3.9 Prevalence of doctor-diagnosed diabetes, by minority ethnic group and sex 3.10 Prevalence of doctor-diagnosed diabetes, by age within minority ethnic group and sex 3.11 Prevalence of undiagnosed and doctordiagnosed diabetes, by age within aggregated minority ethnic group and sex

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3.12 Prevalence of doctor-diagnosed diabetes, by equivalised household income tertile within minority ethnic group and sex 3.13 Comparison of doctor-diagnosed diabetes in 2004 and 1999, by age within minority ethnic group and sex

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 3: CARDIOVASCULAR DISEASE AND DIABETES

77

Table 3.1 Prevalence of CVD conditions, by minority ethnic group and sex Aged 16 and over CVD conditionsa

2004 Minority ethnic group

General population (2003)b

Black Caribbean

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Men Observed % Angina Heart attack Heart murmur Abnormal heart rhythm ‘Other’ heart trouble Stroke Standardised risk ratios Angina

3.4 3.2 1.6 3.8 1.0 3.4

0.7 0.4 0.4 0.8 -

4.9 3.9 1.8 1.9 2.6 1.1

6.9 4.1 2.6 3.0 2.9 1.8

3.1 2.9 0.7 1.6 1.8

1.6 0.3 1.6 3.1 0.6 0.7

4.0 3.0 2.6 4.5 1.7 4.5

4.8 3.8 3.1 5.1 2.8 2.4

0.73

0.36

1.26

2.85

1.24

0.60

0.73

1

Standard error of the ratio

0.22

0.25

0.31

0.75

0.37

0.23

0.22

Heart attack

0.79

0.00

1.33

1.71

1.75

0.12

0.85

Standard error of the ratio

0.25

0.00

0.33

0.51

0.61

0.12

0.29

Heart murmur

0.49

0.15

0.67

0.90

0.22

0.57

1.36

Standard error of the ratio

0.26

0.15

0.23

0.30

0.13

0.30

0.60

Abnormal heart rhythm

1.01

0.08

0.46

0.75

0.59

0.84

0.83

Standard error of the ratio

0.33

0.06

0.16

0.23

0.32

0.29

0.23

‘Other’ heart trouble

0.34

0.37

1.01

1.83

0.00

0.25

0.74

Standard error of the ratio

0.14

0.25

0.50

0.68

0.00

0.19

0.32

Stroke

1.26

0.00

0.59

1.06

2.05

0.71

1.98

Standard error of the ratio

0.55

0.00

0.25

0.46

1.02

0.43

0.70

1 1 1 1 1

Women Observed % Angina Heart attack Heart murmur Abnormal heart rhythm ‘Other’ heart trouble Stroke Standardised risk ratios Angina

1.5 1.4 2.7 2.8 2.3 1.8

0.5 1.7 2.5 1.3 0.5

3.2 1.0 1.5 3.0 1.6 1.2

2.5 1.1 1.4 2.9 1.6 1.7

2.0 0.6 1.0 2.3 1.0 1.8

1.2 0.8 3.1 1.0 0.4

2.5 0.8 2.1 6.3 1.4 2.7

3.4 1.7 3.4 5.6 1.8 2.2

0.61

0.19

1.79

2.19

2.22

1.00

0.87

1

Standard error of the ratio

0.23

0.13

0.46

0.65

0.61

0.67

0.28

Heart attack

1.49

0.00

1.15

1.95

1.47

0.00

0.55

Standard error of the ratio

0.50

0.00

0.56

0.82

0.79

0.00

0.28

Heart murmur

0.90

0.77

0.52

0.59

0.72

0.30

0.51

Standard error of the ratio

0.30

0.37

0.21

0.22

0.29

0.18

0.15

Abnormal heart rhythm

0.53

0.89

0.64

0.75

0.90

0.62

0.91

Standard error of the ratio

0.14

0.41

0.19

0.22

0.25

0.20

0.20

‘Other’ heart trouble

1.69

1.37

1.19

1.98

1.08

0.57

0.90

Standard error of the ratio

0.51

0.71

0.44

0.73

0.53

0.29

0.55

Stroke

1.31

0.69

0.72

2.25

2.73

0.22

1.20

Standard error of the ratio

0.42

0.43

0.27

0.86

1.02

0.17

0.44

480 676

377 476

903 1067

423 499

178 208

151 163

1776 2369

7202 7634

414 653

390 469

550 634

433 508

411 478

348 375

497 656

6602 8234

1 1 1 1

a Ever had condition diagnosed by a doctor. b Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which

was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response.

78

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Bases (weighted) Men Women Bases (unweighted) Men Women

1

Table 3.2 Prevalence of CVD conditions, by age within minority ethnic group and sex Aged 16 and over CVD conditiona

2004 Age group

Men

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Black Caribbean Angina Heart attack Heart murmur Abnormal heart rhythm ‘Other’ heart trouble Stroke Black African Angina Heart attack Heart murmur Abnormal heart rhythm ‘Other’ heart trouble Stroke Indian Angina Heart attack Heart murmur Abnormal heart rhythm ‘Other’ heart trouble Stroke Pakistani Angina Heart attack Heart murmur Abnormal heart rhythm ‘Other’ heart trouble Stroke Bangladeshi Angina Heart attack Heart murmur Abnormal heart rhythm ‘Other’ heart trouble Stroke Chinese Angina Heart attack Heart murmur Abnormal heart rhythm ‘Other’ heart trouble Stroke Irish Angina Heart attack Heart murmur Abnormal heart rhythm ‘Other’ heart trouble Stroke

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

3.1 -

0.4 1.1 2.2 2.5 0.3 -

10.7 9.3 2.5 6.2 3.0 11.5

3.4 3.2 1.6 3.8 1.0 3.4

0.4 1.3 1.7 0.4 -

0.9 0.8 2.5 3.7 3.3 1.1

4.6 3.7 4.6 2.5 3.1 5.6

1.5 1.4 2.7 2.8 2.3 1.8

0.3 0.8 1.3 -

0.9 0.5 -

[5.2] [-] [-] [-] [-] [-]

0.7 0.4 0.4 0.8 -

0.1 1.2 0.6 1.1 0.4

1.0 1.2 3.1 1.4 0.4

[-] [-] [8.1] [11.0] [2.3] [1.5]

0.5 1.7 2.5 1.3 0.5

0.4 1.4 1.9 -

2.8 0.8 2.9 0.7 0.5 -

17.3 16.5 2.2 5.4 8.1 5.2

4.9 3.9 1.8 1.9 2.6 1.1

0.7 1.8 0.4 -

1.2 0.8 1.4 2.6 2.5 1.0

14.7 3.5 3.7 6.6 2.0 4.2

3.2 1.0 1.5 3.0 1.6 1.2

2.1 1.8 0.6 -

6.2 3.4 2.3 2.6 1.5 1.1

30.9 19.0 4.7 7.8 14.0 9.6

6.9 4.1 2.6 3.0 2.9 1.8

0.6 0.5 1.9 0.4 0.2

1.5 0.7 2.4 2.9 1.3 0.9

13.7 6.9 2.8 7.6 7.9 10.1

2.5 1.1 1.4 2.9 1.6 1.7

-

4.8 2.9 1.0 2.0 1.9

[11.4] [15.1] [2.4] [7.5] [-] [9.2]

3.1 2.9 0.7 1.6 1.8

0.4 0.2 0.3

2.7 2.7 2.5 1.6

12.7 5.6 9.7 14.1 2.2 11.9

2.0 0.6 1.0 2.3 1.0 1.8

0.6 1.1 0.6 -

1.1 1.1 1.7 0.8

7.2 7.5 11.3 1.8 2.2

1.6 0.3 1.6 3.1 0.6 0.7

1.8 -

0.1 1.2 3.8 1.1 0.5

8.2 1.9 3.8 3.7 0.8

1.2 0.8 3.1 1.0 0.4

0.4 6.4 2.1 1.0 -

0.6 2.5 2.0 1.5 1.9 2.2

9.7 5.1 1.0 8.9 2.0 9.4

4.0 3.0 2.6 4.5 1.7 4.5

1.8 0.5 2.0 0.9

1.1 0.4 0.9 6.3 1.3 0.6

5.7 1.8 3.9 9.9 1.2 6.3

2.5 0.8 2.1 6.3 1.4 2.7

a Ever had condition diagnosed by a doctor.

16-34

35-54

55+

All women

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 3: CARDIOVASCULAR DISEASE AND DIABETES

79

Table 3.2 continued

Aged 16 and over CVD conditiona

2004 Age group

Men

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

2.4 2.0 0.6 0.3

1.5 1.5 2.6 3.7 1.6 0.7

13.4 10.4 4.6 9.8 6.5 6.4

4.8 3.8 3.1 5.1 2.8 2.4

0.1 2.4 2.6 0.4 0.3

0.8 0.5 2.9 5.7 1.2 0.7

8.7 4.5 4.7 8.1 3.6 5.2

3.4 1.7 3.4 5.6 1.8 2.2

196 159 384 154 65 50 678 2601

143 40 192 64 21 27 686 2281

480 377 903 423 178 151 1776 7202

219 240 408 276 135 63 497 2319

292 198 466 161 51 78 1038 2640

165 37 193 62 21 22 833 2675

676 476 1067 499 208 163 2369 7634

167 172 231 146 150 118 194 2364

125 39 118 65 49 58 189 2467

414 390 550 433 411 348 497 6602

200 235 240 279 310 148 149 2175

291 190 275 164 118 176 275 2897

162 44 119 65 50 51 232 3162

653 469 634 508 478 375 656 8234

General population (2003)b Angina Heart attack Heart murmur Abnormal heart rhythm ‘Other’ heart trouble Stroke

Bases (weighted) Black Caribbean 141 Black African 179 Indian 327 Pakistani 205 Bangladeshi 92 Chinese 74 Irish 412 General population (2003) 2320 Bases (unweighted) Black Caribbean 122 Black African 179 Indian 201 Pakistani 222 Bangladeshi 212 Chinese 172 Irish 114 General population (2003) 1771

16-34

35-54

55+

All women

a Ever had condition diagnosed by a doctor. b Comparative data for the general population are not available on this topic from the 2004 survey, so data have

80

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been taken from the 2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response.

Table 3.3 Prevalence of CVD/IHD/IHD or stroke, by minority ethnic group and sex Aged 16 and over

2004

Any CVD/IHD/IHD or stroke

Minority ethnic group

General population (2003)a

Black Caribbean

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Men Observed % Any CVD IHD IHD or stroke Standardised risk ratios Any CVD

9.4 4.4 6.6

2.3 0.7 0.7

10.7 6.4 7.1

12.0 8.2 9.1

5.6 4.2 5.1

5.3 1.6 2.2

14.5 5.5 7.9

13.6 6.4 7.9

0.73

0.25

0.91

1.28

0.69

0.58

1.16

1

Standard error of the ratio

0.17

0.10

0.15

0.24

0.16

0.14

0.22

IHD

0.77

0.27

1.34

2.43

1.40

0.44

0.86

Standard error of the ratio

0.20

0.19

0.27

0.58

0.39

0.17

0.23

IHD or stroke

0.85

0.22

1.18

2.12

1.34

0.52

0.98

Standard error of the ratio

0.22

0.15

0.24

0.48

0.33

0.20

0.24

1 1

Women Observed % Any CVD IHD IHD or stroke Standardised risk ratios Any CVD

9.2 2.4 3.9

5.5 0.5 1.0

7.3 3.3 4.2

7.0 2.7 3.6

4.8 2.0 3.1

5.3 1.2 1.5

11.4 2.9 5.4

13.0 4.1 5.8

0.89

0.83

0.72

0.93

0.83

0.56

0.83

1

Standard error of the ratio

0.13

0.24

0.12

0.16

0.18

0.15

0.14

IHD

0.91

0.15

1.51

1.90

1.80

0.81

0.80

Standard error of the ratio

0.25

0.11

0.37

0.56

0.50

0.54

0.24

IHD or stroke

1.10

0.37

1.24

1.77

1.82

0.64

0.97

Standard error of the ratio

0.23

0.18

0.27

0.44

0.45

0.38

0.24

480 676

377 476

903 1067

423 499

178 208

151 163

1776 2369

7202 7634

414 653

390 469

550 634

433 508

411 478

348 375

497 656

6602 8234

Bases (weighted) Men Women Bases (unweighted) Men Women

1 1

a Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which

Copyright © 2006, The Information Centre. All rights reserved

was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 3: CARDIOVASCULAR DISEASE AND DIABETES

81

Table 3.4 Prevalence of CVD/IHD/IHD or stroke, by age within minority ethnic group and sex Aged 16 and over

2004 Age group

Men 16-34

35-54

55+

%

%

%

%

%

%

%

%

3.1 -

3.9 1.5 1.5

23.1 12.8 20.1

9.4 4.4 6.6

3.8 0.4 0.4

8.9 1.6 2.7

16.8 6.3 10.8

9.2 2.4 3.9

2.4 0.3 0.3

1.4 -

[5.2] [5.2] [5.2]

2.3 0.7 0.7

2.6 0.1 0.4

6.0 1.0 1.5

[20.6] [-] [1.5]

5.5 0.5 1.0

3.6 -

6.8 3.2 3.2

30.6 23.9 26.9

10.7 6.4 7.1

2.2 -

4.9 1.5 1.8

23.7 14.7 18.9

7.3 3.3 4.2

3.4 -

11.1 7.9 8.0

42.0 35.1 41.1

12.0 8.2 9.1

3.2 0.6 0.8

7.7 2.2 3.1

22.2 13.7 17.6

7.0 2.7 3.6

-

7.5 5.5 6.1

[24.2] [18.0] [24.2]

5.6 4.2 5.1

0.8 0.3

8.4 2.7 4.2

21.4 12.7 18.2

4.8 2.0 3.1

1.1 -

3.6 1.1 1.9

20.1 7.2 8.7

5.3 1.6 2.2

1.8 -

5.5 0.1 0.6

14.7 8.2 9.0

5.3 1.2 1.5

8.8 0.4 0.4

8.3 2.5 4.3

24.1 11.5 16.0

14.5 5.5 7.9

5.2 0.9

7.7 1.4 1.9

19.7 6.6 12.4

11.4 2.9 5.4

4.6 0.3

8.0 2.1 2.6

29.4 17.9 21.6

13.6 6.4 7.9

5.2 0.1 0.4

9.4 1.1 1.7

23.5 10.6 14.5

13.0 4.1 5.8

196 159 384 154 65 50 678 2601

143 40 192 64 21 27 686 2281

480 377 903 423 178 151 1776 7202

219 240 408 276 135 63 497 2319

292 198 466 161 51 78 1038 2640

165 37 193 62 21 22 833 2675

676 476 1067 499 208 163 2369 7634

167 172 231 146 150 118 194 2364

125 39 118 65 49 58 189 2467

414 390 550 433 411 348 497 6602

200 235 240 279 310 148 149 2175

291 190 275 164 118 176 275 2897

162 44 119 65 50 51 232 3162

653 469 634 508 478 375 656 8234

Black Caribbean Any CVD IHD IHD or stroke Black African Any CVD IHD IHD or stroke Indian Any CVD IHD IHD or stroke Pakistani Any CVD IHD IHD or stroke Bangladeshi Any CVD IHD IHD or stroke Chinese Any CVD IHD IHD or stroke Irish Any CVD IHD IHD or stroke General population (2003)a Any CVD IHD IHD or stroke

Bases (weighted) Black Caribbean 141 Black African 179 Indian 327 Pakistani 205 Bangladeshi 92 Chinese 74 Irish 412 General population (2003) 2320 Bases (unweighted) Black Caribbean 122 Black African 179 Indian 201 Pakistani 222 Bangladeshi 212 Chinese 172 Irish 114 General population (2003) 1771

82

Women All men

16-34

35-54

55+

All women

a Comparative data for the general

population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which was weighted for nonresponse. The 2004 survey is weighted for differential selection probabilities and non-response.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 3: CARDIOVASCULAR DISEASE AND DIABETES

Copyright © 2006, The Information Centre. All rights reserved

Any CVD/IHD/IHD or stoke

Table 3.5 Prevalence of CVD, IHD, IHD or stroke, by equivalised household income tertile within minority ethnic group and sex Aged 16 and over

2004

Any CVD/IHD/IHD or stroke

Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

7.8 2.3 2.3

7.7 2.7 6.2

6.9 4.7 6.4

6.0 0.5 1.2

9.9 2.8 3.7

10.4 4.5 5.9

1.8 -

1.5 -

3.5 0.6 0.6

9.2 1.2 1.2

4.8 0.7

4.4 0.5 1.4

8.9 3.1 3.1

3.8 1.8 2.4

15.4 10.4 12.3

7.9 0.9 0.9

6.7 4.7 5.1

7.5 4.0 6.8

[8.5] [-] [-]

11.5 10.7 10.7

14.7 10.5 11.8

[2.3] [-] [-]

7.0 0.8 2.6

7.8 3.8 5.1

a a a

2.9 2.9 2.9

7.9 6.1 6.7

a a a

2.4 1.8 1.8

6.7 2.1 4.2

4.2 -

7.2 2.6 3.8

[6.2] [4.2] [4.2]

9.6 1.9 2.7

2.7 1.5 1.5

3.5 1.8 1.8

8.4 0.6 0.6

21.4 8.9 15.0

30.3 13.2 20.1

7.8 1.1

12.8 2.7 7.2

25.2 13.6 18.4

8.9 2.7 3.3

17.0 9.2 10.9

21.2 11.9 15.2

9.0 1.3 1.9

16.1 6.3 8.6

16.5 6.1 8.8

Any CVD Black Caribbean

0.91

0.48

0.45

0.56

0.86

0.97

Standard error of the ratio

0.35

0.19

0.16

0.17

0.24

0.21

Black African

0.17

0.12

0.37

1.04

0.56

0.89

Observed % Black Caribbean Any CVD IHD IHD or stroke Black African Any CVD IHD IHD or stroke Indian CVD IHD IHD or stroke Pakistani Any CVD IHD IHD or stroke Bangladeshi Any CVD IHD IHD or stroke Chinese Any CVD IHD IHD or stroke Irish Any CVD IHD IHD or stroke General population (2003)b Any CVD IHD IHD or stroke

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Standardised risk ratios

Standard error of the ratio

0.13

0.09

0.22

0.45

0.26

0.42

Indian

0.83

0.38

1.07

0.95

0.72

0.57

Standard error of the ratio

Pakistani Standard error of the ratio

Bangladeshi Standard error of the ratio

0.22

0.15

0.34

0.38

0.23

0.15

[0.64]

1.23

1.39

[0.23]

0.92

1.03

[0.34]

0.38

0.39

[0.24]

0.28

0.28

a

0.49

0.86

a

0.39

1.16

a

0.28

0.26

a

0.22

0.36

Chinese

0.49

0.83

[0.38]

1.09

0.31

0.30

Standard error of the ratio

0.30

0.39

[0.23]

0.50

0.20

0.21

Irish

0.79

1.25

2.45

0.69

0.88

2.21

Standard error of the ratio

0.26

0.36

0.77

0.20

0.28

0.64

General population (2003)b

0.78

1.15

1.43

0.83

1.12

1.20

Standard error of the ratio

0.06

0.09

0.14

0.06

0.07

0.10

a Results are not shown because of small

bases. b Comparative data for the general population

are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response.

Continued… HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 3: CARDIOVASCULAR DISEASE AND DIABETES

83

Table 3.5 continued

Aged 16 and over

2004

Any CVD/IHD/IHD or stroke

Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

IHD Black Caribbean

0.93

0.51

0.71

0.14

0.88

1.92

Standard error of the ratio

0.44

0.35

0.33

0.14

0.46

0.67

Black African

0.00

0.00

0.36

0.42

0.00

0.16

Standard error of the ratio

0.00

0.00

0.36

0.41

0.00

0.13

Indian

0.79

0.44

1.74

0.69

2.10

1.28

Standard error of the ratio

Pakistani Standard error of the ratio

Bangladeshi Standard error of the ratio

Chinese

0.36

0.24

0.64

0.48

0.91

0.43

[0.00]

2.85

2.47

[0.00]

0.62

2.61

[0.00]

0.95

0.91

[0.00]

0.59

1.01

a

1.23

1.65

a

1.48

2.02

a

0.70

0.60

a

0.90

0.91

0.00

0.76

[0.64]

2.31

0.84

0.63

Standard error of the ratio

0.00

0.53

[0.47]

2.12

0.75

0.64

Irish

0.12

1.35

1.52

0.00

0.75

2.95

Standard error of the ratio

0.08

0.65

0.67

0.00

0.46

1.08

General population (2003)b

0.60

1.33

1.71

0.51

1.44

1.40

Standard error of the ratio

0.07

0.13

0.22

0.09

0.16

0.19

IHD or stroke Black Caribbean

0.76

0.75

0.78

0.42

0.79

1.75

Standard error of the ratio

0.36

0.36

0.30

0.25

0.37

0.51

Black African

0.00

0.00

0.29

0.29

0.19

0.95

Standard error of the ratio

0.00

0.00

0.29

0.28

0.19

0.70

Indian

0.64

0.49

1.63

0.47

1.56

1.49

Standard error of the ratio

Pakistani Standard error of the ratio

Bangladeshi Standard error of the ratio

Chinese

0.29

0.23

0.58

0.33

0.63

0.43

[0.00]

2.30

2.27

[0.00]

1.33

2.09

[0.00]

0.76

0.75

[0.00]

0.68

0.74

a

0.99

1.55

a

1.01

2.48

a

0.57

0.52

a

0.62

0.98

0.00

0.82

[0.52]

1.72

0.58

0.43

Standard error of the ratio

0.00

0.46

[0.38]

1.45

0.52

0.44

Irish

0.09

1.65

2.37

0.28

1.14

3.49

Standard error of the ratio

0.07

0.61

1.04

0.26

0.49

1.09

General population (2003)b

0.57

1.31

1.84

0.51

1.39

1.49

Standard error of the ratio

0.07

0.12

0.22

0.07

0.14

0.17

151 113 264 55 8 44 833 3244

115 89 241 119 39 36 398 1887

106 90 150 137 75 21 270 959

156 123 305 56 9 52 1040 2956

188 115 287 134 44 34 568 2218

179 153 203 168 84 24 347 1199

123 104 159 47 19 105 207 2959

90 105 155 114 89 77 122 1759

96 94 97 155 171 49 89 902

149 102 179 46 23 120 257 3108

163 123 173 135 101 74 163 2462

179 150 126 176 191 58 123 1332

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003)b Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003)b

84

a Results are not shown because of small

bases. b Comparative data for the general population

are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 3: CARDIOVASCULAR DISEASE AND DIABETES

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Standardised risk ratios

Table 3.6 Prevalence of angina and MI symptoms (using the Rose Angina Questionnaire), by minority ethnic group and sex Aged 16 and over

2004

Angina or myocardial infarction symptoms

Minority ethnic group

General population (2003)a

Black Caribbean

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Men Observed % Grade 1 angina Grade 2 angina Symptoms of possible MI Standardised risk ratios Grade 1 angina

0.1 0.3 8.2

0.1 3.0

1.2 0.6 5.6

0.8 1.1 6.2

1.0 1.4 6.8

1.1 0.3 2.2

0.9 1.4 7.7

1.5 0.7 7.5

0.02

0.09

0.93

0.61

0.76

0.82

0.34

1

Standard error of the ratio

0.02

0.09

0.67

0.35

0.38

0.54

0.17

Grade 2 angina

0.56

0.00

1.66

2.28

5.02

0.61

1.92

Standard error of the ratio

0.36

0.00

0.88

1.21

2.66

0.60

1.06

Symptoms of possible MI

1.29

0.42

0.76

1.12

1.44

0.33

1.18

Standard error of the ratio

0.30

0.14

0.17

0.27

0.32

0.11

0.26

1 1

Women Observed % Grade 1 angina Grade 2 angina Symptoms of possible MI Standardised risk ratios Grade 1 angina

2.7 1.2 7.1

1.6 0.6 4.9

1.0 0.5 2.8

2.4 0.5 6.8

0.6 0.3 6.1

0.3 1.0

1.5 0.9 5.3

1.7 0.6 5.0

1.94

1.22

0.80

1.77

0.81

0.15

1.03

1

Standard error of the ratio

0.61

0.53

0.35

0.67

0.47

0.14

0.41

Grade 2 angina

2.75

1.80

1.24

1.25

0.55

0.00

1.47

Standard error of the ratio

1.39

1.21

0.69

0.87

0.40

0.00

0.83

Symptoms of possible MI

1.80

1.17

0.61

1.85

2.03

0.17

1.05

Standard error of the ratio

0.32

0.30

0.16

0.33

0.43

0.08

0.24

480 676

377 476

903 1067

423 499

178 208

151 163

1776 2369

7202 7634

414 653

390 469

550 634

433 508

411 478

348 375

497 656

6602 8234

Bases (weighted) Men Women Bases (unweighted) Men Women

1 1

a Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which

Copyright © 2006, The Information Centre. All rights reserved

was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 3: CARDIOVASCULAR DISEASE AND DIABETES

85

Table 3.7 Prevalence of angina and MI symptoms (using the Rose Angina Questionnaire), by age within minority ethnic group and sex Aged 16 and over

2004 Age group

Men 16-34

35-54

55+

%

%

%

%

%

%

%

%

5.9

0.2 7.1

0.4 0.8 12.2

0.1 0.3 8.2

2.0 0.4 7.2

2.8 0.9 5.8

3.3 3.0 9.4

2.7 1.2 7.1

0.3 1.9

4.5

[-] [-] [1.9]

0.1 3.0

1.0 2.9

2.4 0.1 6.4

[1.4] [6.8] [9.0]

1.6 0.6 4.9

1.9 0.9

0.4 5.0

1.5 3.0 14.6

1.2 0.6 5.6

0.7 0.3

0.8 3.6

2.0 3.0 5.7

1.0 0.5 2.8

0.6 0.1 1.8

0.1 2.2 5.8

2.9 1.8 21.4

0.8 1.1 6.2

1.4 0.6 3.0

4.3 11.6

1.4 1.8 11.7

2.4 0.5 6.8

0.5 1.2

2.6 0.8 10.8

[-] [7.6] [18.6]

1.0 1.4 6.8

0.3 2.4

1.7 0.4 12.5

1.9 14.6

0.6 0.3 6.1

0.7

0.8 3.6

2.9 1.6 4.0

1.1 0.3 2.2

-

0.5 1.6

1.9

0.3 1.0

7.2

0.5 0.7 8.5

1.8 3.0 7.1

0.9 1.4 7.7

1.5 2.3

1.3 0.8 7.2

1.7 1.5 4.6

1.5 0.9 5.3

0.5 3.2

1.0 0.5 6.8

3.0 1.5 12.6

1.5 0.7 7.5

0.9 0.1 3.2

1.1 0.5 4.2

2.9 1.3 7.3

1.7 0.6 5.0

196 159 384 154 65 50 678 2601

143 40 192 64 21 27 686 2281

480 377 903 423 178 151 1776 7202

219 240 408 276 135 63 497 2319

292 198 466 161 51 78 1038 2640

165 37 193 62 21 22 833 2675

676 476 1067 499 208 163 2369 7634

167 172 231 146 150 118 194 2364

125 39 118 65 49 58 189 2467

414 390 550 433 411 348 497 6602

200 235 240 279 310 148 149 2175

291 190 275 164 118 176 275 2897

162 44 119 65 50 51 232 3162

653 469 634 508 478 375 656 8234

Black Caribbean Grade 1 angina Grade 2 angina Symptoms of possible MI Black African Grade 1 angina Grade 2 angina Symptoms of possible MI Indian Grade 1 angina Grade 2 angina Symptoms of possible MI Pakistani Grade 1 angina Grade 2 angina Symptoms of possible MI Bangladeshi Grade 1 angina Grade 2 angina Symptoms of possible MI Chinese Grade 1 angina Grade 2 angina Symptoms of possible MI Irish Grade 1 angina Grade 2 angina Symptoms of possible MI General population (2003)a Grade 1 angina Grade 2 angina Symptoms of possible MI

Bases (weighted) Black Caribbean 141 Black African 179 Indian 327 Pakistani 205 Bangladeshi 92 Chinese 74 Irish 412 General population (2003) 2320 Bases (unweighted) Black Caribbean 122 Black African 179 Indian 201 Pakistani 222 Bangladeshi 212 Chinese 172 Irish 114 General population (2003) 1771

86

Women All men

16-34

35-54

55+

All women

a Comparative data for the general

population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which was weighted for nonresponse. The 2004 survey is weighted for differential selection probabilities and non-response.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 3: CARDIOVASCULAR DISEASE AND DIABETES

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Angina or myocardial infarction symptoms

Table 3.8 Comparison of CVD/IHD/IHD or stroke in 2004 and1999, by age within minority ethnic groupa and sex Aged 16 and over Any CVD/IHD/IHD or stroke

Copyright © 2006, The Information Centre. All rights reserved

Black Caribbean 2004 Any CVD IHD IHD or stroke 1999 Any CVD IHD IHD or stroke Indian 2004 Any CVD IHD IHD or stroke 1999 Any CVD IHD IHD or stroke Pakistani 2004 Any CVD IHD IHD or stroke 1999 Any CVD IHD IHD or stroke Bangladeshi 2004 Any CVD IHD IHD or stroke 1999 Any CVD IHD IHD or stroke Chinese 2004 Any CVD IHD IHD or stroke 1999 Any CVD IHD IHD or stroke

2004, 1999 Age group

Men

Women

16-34

35-54

55+

All men

16-34

35-54

55+

All women

%

%

%

%

%

%

%

%

3.1 -

3.9 1.5 1.5

23.1 12.8 20.1

9.4 4.4 6.6

3.8 0.4 0.4

8.9 1.6 2.7

16.8 6.3 10.8

9.2 2.4 3.9

4.3 -

5.2 1.6

14.6 5.6 12.4

8.2 2.0 4.8

2.9 -

6.7 1.6 1.6

15.2 7.1 8.9

7.3 2.3 2.8

3.6 -

6.8 3.2 3.2

30.6 23.9 26.9

10.7 6.4 7.1

2.2 -

4.9 1.5 1.8

23.7 14.7 18.9

7.3 3.3 4.2

1.3 -

7.5 4.0 4.8

32.7 24.5 29.2

10.5 6.8 8.2

1.7 -

3.7 0.5 1.3

18.5 8.2 10.1

5.5 1.7 2.3

3.4 -

11.1 7.9 8.0

42.0 35.1 41.1

12.0 8.2 9.1

3.2 0.6 0.8

7.7 2.2 3.1

22.2 13.7 17.6

7.0 2.7 3.6

0.7 -

7.9 5.0 6.0

24.8 19.9 21.3

6.3 4.3 4.8

1.3 0.3 0.5

6.5 2.7 2.7

19.0 11.6 16.8

4.4 2.0 2.6

-

7.5 5.5 6.1

[24.2] [18.0] [24.2]

5.6 4.2 5.1

0.8 0.3

8.4 2.7 4.2

21.4 12.7 18.2

4.8 2.0 3.1

0.5 0.5 0.5

8.4 4.0 4.0

21.3 15.4 17.8

7.0 4.6 5.1

2.2 0.2

6.9 4.0 4.6

11.2 4.6 6.3

4.3 1.4 1.9 a Black Africans were included in the

1.1 1.0 -

3.6 1.1 1.9 4.8 2.1 2.1

20.1 7.2 8.7 11.6 5.8 9.7

5.3 1.6 2.2 4.8 2.1 2.9

1.8 1.6 -

5.5 0.1 0.6 4.5 0.3 0.3

14.7 8.2 9.0 9.3 1.3 2.5

5.3 1.2 1.5 4.3 0.4 0.6

Continued…

2004 survey but not in the 1999 survey, so are therefore excluded from this comparative table. b Comparative data for the general

population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which was weighted for nonresponse. The 2004 survey is weighted for differential selection probabilities and non-response. c Comparative data for the general

population are not available on this topic from the 1999 survey itself, and for this table comparative data have therefore been taken from the 1998 survey, in which no weighting was involved.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 3: CARDIOVASCULAR DISEASE AND DIABETES

87

Table 3.8 continued

Aged 16 and over

Irish 2004 Any CVD IHD IHD or stroke 1999 Any CVD IHD IHD or stroke General population 2003b Any CVD IHD IHD or stroke 1998c Any CVD IHD IHD or stroke Bases (weighted) Black Caribbean 2004 Black Caribbean 1999 Indian 2004 Indian 1999 Pakistani 2004 Pakistani 1999 Bangladeshi 2004 Bangladeshi 1999 Chinese 2004 Chinese 1999 Irish 2004 Irish 1999 General population 2003 General population 1998 Bases (unweighted) Black Caribbean 2004 Black Caribbean 1999 Indian 2004 Indian 1999 Pakistani 2004 Pakistani 1999 Bangladeshi 2004 Bangladeshi 1999 Chinese 2004 Chinese 1999 Irish 2004 Irish 1999 General population 2003 General population 1998

88

Age group

Men

Women

16-34

35-54

55+

All men

16-34

35-54

55+

All women

%

%

%

%

%

%

%

%

8.8 0.4 0.4

8.3 2.5 4.3

24.1 11.5 16.0

14.5 5.5 7.9

5.2 0.9

7.7 1.4 1.9

19.7 6.6 12.4

11.4 2.9 5.4

5.0 -

8.2 2.6 2.6

29.3 16.3 21.5

13.5 5.9 7.4

6.5 0.3

8.3 1.8 1.8

22.8 9.9 14.9

11.8 3.5 5.0

4.6 0.3

8.0 2.1 2.6

29.4 17.9 21.6

13.6 6.4 7.9

5.2 0.1 0.4

9.4 1.1 1.7

23.5 10.6 14.5

13.0 4.1 5.8

4.2 0.3 0.3

8.2 2.6 3.2

28.3 18.2 21.9

13.7 7.1 8.5

5.1 0.2 0.6

8.3 1.2 1.9

23.0 11.9 15.5

12.4 4.6 6.2

141 216 327 229 92 331 74 275 74 107 412 134 2321 b

196 138 384 265 65 207 50 146 50 133 678 248 2601 b

143 193 192 132 21 81 27 112 27 61 686 155 2281 b

480 547 903 626 178 620 151 533 151 301 1776 537 7202 b

219 282 408 268 135 387 63 370 63 110 497 202 2319 b

292 282 466 273 51 203 78 135 78 197 1038 313 2640 b

165 183 193 115 21 53 22 58 22 54 833 193 2675 b

676 748 1067 657 208 643 163 563 163 361 2369 708 7634 b

122 212 201 232 222 326 212 274 172 109 114 135 1771 2213

167 142 231 267 146 217 150 143 118 127 194 240 2364 2594

125 193 118 127 65 77 49 116 58 65 189 162 2467 2386

414 547 550 626 433 620 411 533 348 301 497 537 6602 7193

200 283 240 267 279 384 310 361 148 109 149 203 2175 2636

291 285 275 277 164 203 118 144 176 194 275 301 2897 3057

162 180 119 113 65 56 50 58 51 58 232 204 3162 3022

653 748 634 657 508 643 478 563 375 361 656 708 8234 8715

a Black Africans were included in the

2004 survey but not in the 1999 survey, so are therefore excluded from this comparative table. b Comparative data for the general

population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which was weighted for nonresponse. The 2004 survey is weighted for differential selection probabilities and non-response. c Comparative data for the general

population are not available on this topic from the 1999 survey itself, and for this table comparative data have therefore been taken from the 1998 survey, in which no weighting was involved.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 3: CARDIOVASCULAR DISEASE AND DIABETES

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Any CVD/IHD/IHD or stroke

2004, 1999

Table 3.9 Prevalence of doctor-diagnosed diabetes, by minority ethnic group and sex Aged 16 and over

2004

Doctor-diagnosed diabetes

Minority ethnic group

General population (2003)a

Black Caribbean

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Men Observed % Type 1b Type 2 Type 1 or type 2 Standardised risk ratios Type 1b

0.5 9.5 10.0

0.7 4.3 5.0

0.9 9.2 10.1

7.3 7.3

0.2 8.0 8.2

0.3 3.4 3.8

3.6 3.6

0.6 3.8 4.3

0.48

1.05

1.31

0.00

0.37

0.53

0.00

1

Standard error of the ratio

0.37

0.70

0.64

0.00

0.38

0.53

0.00

Type 2

2.37

2.17

3.17

3.27

4.59

1.44

0.80

Standard error of the ratio

0.65

0.71

0.52

0.66

0.94

0.44

0.26

Type 1 or type 2

2.05

1.98

2.86

2.72

3.87

1.29

0.67

Standard error of the ratio

0.54

0.60

0.43

0.54

0.78

0.36

0.22

1 1

Women Observed % Type 1b Type 2 Type 1 or type 2 Standardised risk ratios Type 1b

0.8 7.6 8.4

0.1 2.0 2.1

5.9 5.9

0.2 8.4 8.6

0.6 4.5 5.2

3.3 3.3

0.3 2.0 2.3

0.3 3.1 3.4

2.35

0.11

0.00

0.65

1.00

0.00

0.58

1

Standard error of the ratio

1.04

0.11

0.00

0.66

0.60

0.00

0.40

Type 2

3.16

2.14

2.95

6.25

3.64

2.06

0.90

Standard error of the ratio

0.53

0.73

0.55

1.05

0.90

0.58

0.27

Type 1 or type 2

3.03

1.80

2.46

5.32

3.20

1.72

0.84

Standard error of the ratio

0.49

0.61

0.46

0.87

0.77

0.48

0.24

480 676

377 476

903 1067

423 499

178 208

151 163

1776 2369

7202 7634

414 653

390 469

550 634

433 508

411 478

348 375

497 656

6602 8234

Bases (weighted) Men Women Bases (unweighted) Men Women

1 1

a Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which

was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response.

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b Type 1 diabetes defined as doctor-diagnosed diabetes, with diagnosis age<35 and currently on insulin.

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Table 3.10 Prevalence of doctor-diagnosed diabetes, by age within minority group and sex Aged 16 and over

Black Caribbean Type 1a Type 2 Types 1 and 2 combinedb Black African Type 1a Type 2 Types 1 and 2 combinedb Indian Type 1a Type 2 Types 1 and 2 combinedb

2004 Age group

Men 16-34

35-54

55+

%

%

%

%

%

%

%

%

-

5.3 5.3

1.8 24.8 26.5

0.5 9.5 10.0

1.3 1.3

0.7 3.1 3.7

0.5 25.7 26.2

0.8 7.6 8.4

1.4 0.3 1.7

5.6 5.6

[17.3] [17.3]

0.7 4.3 5.0

0.1 0.1

0.7 0.7

[22.2] [22.2]

0.1 2.0 2.1

0.4 1.5 2.0

1.7 8.1 9.8

24.3 24.3

0.9 9.2 10.1

0.7 0.7

4.3 4.3

20.5 20.5

5.9 5.9

9.7 9.7

25.3 25.3

7.3 7.3

-

0.7 9.0 9.7

44.4 44.4

0.2 8.4 8.6

0.7 12.0 12.7

[29.9] [29.9]

0.2 8.0 8.2

0.9 0.7 1.6

10.9 10.9

13.5 13.5

0.6 4.5 5.2

1.1 1.7 2.7

16.1 16.1

0.3 3.4 3.8

0.7 0.7

2.5 2.5

13.1 13.1

3.3 3.3

1.0 1.0

8.3 8.3

3.6 3.6

1.7 1.7

0.6 1.2 1.9

3.2 3.2

0.3 2.0 2.3

1.0 2.2 3.1

0.4 9.7 10.1

0.6 3.8 4.3

0.5 0.4 0.9

0.3 1.7 2.0

0.2 6.9 7.0

0.3 3.1 3.4

196 159 384 154 65 50 678 2601

143 40 192 64 21 27 686 2281

480 377 903 423 178 151 1776 7202

219 240 408 276 135 63 497 2319

292 198 466 161 51 78 1038 2640

165 37 193 62 21 22 833 2675

676 476 1067 499 208 163 2369 7634

Pakistani Type 1a Type 2 Types 1 and 2 combinedb Bangladeshi Type 1a Type 2 Types 1 and 2 combinedb Chinese Type 1a Type 2 Types 1 and 2 combinedb Irish Type 1a Type 2 Types 1 and 2 combinedb General population (2003)c Type 1a 0.2 Type 2 0.2 Types 1 and 2 combinedb 0.3 Bases (weighted) Black Caribbean 141 Black African 179 Indian 327 Pakistani 205 Bangladeshi 92 Chinese 74 Irish 412 General population (2003)c 2320 Bases (unweighted) Black Caribbean 122 Black African 179 Indian 201 Pakistani 222 Bangladeshi 212 Chinese 172 Irish 114 General population (2003)c 1771

90

Women All men

16-34

35-54

55+

All women

a Type 1 diabetes defined as doctor-

diagnosed diabetes, with diagnosis age<35 and currently on insulin.

167 172 231 146 150 118 194 2364

125 39 118 65 49 58 189 2467

414 390 550 433 411 348 497 6602

200 235 240 279 310 148 149 2175

291 190 275 164 118 176 275 2897

162 44 119 65 50 51 232 3162

653 469 634 508 478 375 656 8234

b Numbers may not add exactly, due to

rounding c Comparative data for the general

population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which was weighted for nonresponse. The 2004 survey is weighted for differential selection probabilities and non-response.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 3: CARDIOVASCULAR DISEASE AND DIABETES

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Doctor-diagnosed diabetes

Table 3.11 Prevalence of undiagnosed and doctor-diagnosed diabetes, by age within aggregated minority ethnic group and sex Aged 35 and over with a fasting blood glucose measurement Undiagnosed and doctordiagnosed diabetesa

2004

Age group

Men

Women

35-54

55+

Men aged 35+

%

%

%

%

%

%

0.9 12.3

[3.2] [21.2]

1.6 15.3

0.9

[-] [19.2]

5.8

1.6 11.5

[4.7] [16.7]

2.5 13.0

4.0 2.5

[ -] [36.8]

3.1 10.2

0.4

5.6 6.8

2.7 3.5

1.1

0.9 3.1

0.5 2.1

1.4 3.8

4.5 4.6

2.9 4.2

0.6 1.5

1.1 7.1

0.8 4.2

68 107 126 190

33 42 121 167

101 149 248 358

95 119 182 208

35 35 185 196

130 154 367 404

74 123 69 200

34 42 60 200

108 165 129 400

100 119 83 250

34 35 79 237

134 154 162 487

35-54

Women aged 55+ 35+

Blackb Undiagnosed diabetes Doctor-diagnosed diabetesc South Asiand Undiagnosed diabetes Doctor-diagnosed diabetes Irish Undiagnosed diabetes Doctor-diagnosed diabetes General population (2003)e Undiagnosed diabetes Doctor-diagnosed diabetes Bases (weighted) Black South Asian Irish General population (2003) Bases (unweighted) Black South Asian Irish General population (2003)

a Undiagnosed diabetes defined as fasting blood glucose ≥7.0mmol/l without doctor-diagnosed

diabetes. b Black: the aggregated responses from Black Caribbean and Black African participants. c The prevalence of doctor-diagnosed diabetes may differ from those shown in Tables 3.10 and

3.11 as this table is restricted to those who provided a fasting blood sample. d South Asian: the aggregated responses from Indian, Pakistani and Bangladeshi participants. e Comparative data for the general population are not available on this topic from the 2004 survey,

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so data have been taken from the 2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response.

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Table 3.12 Prevalence of doctor-diagnosed diabetes, by equivalised household income tertile within minority ethnic group and sex Aged 16 and over

2004

Doctor-diagnosed diabetes

Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

1.7 4.9 3.4 [2.3] a 6.8 2.2 2.9

15.5 7.1 12.8 4.9 6.2 1.5 5.4 5.2

17.3 5.2 16.9 12.4 8.9 [2.0] 7.5 6.4

4.0 3.1 2.2 [2.6] a 0.8 0.7 1.7

9.0 2.2 7.0 7.9 2.6 3.0 2.1 4.4

7.7 1.2 7.0 9.2 5.5 6.5 8.0 4.9

Black Caribbean

0.52

2.45

4.25

1.82

2.89

3.61

Standard error of the ratio

0.30

0.78

1.76

0.92

0.78

1.08

Black African

1.77

2.76

2.63

4.43

1.54

1.36

Observed % Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003)b

Standard error of the ratio

0.94

1.59

1.49

2.43

1.13

1.05

Indian

1.49

3.55

4.03

1.34

3.13

2.36

Standard error of the ratio

Pakistani Standard error of the ratio

Bangladeshi Standard error of the ratio

Chinese

0.58

0.97

1.04

0.63

1.05

0.76

[3.35]

1.72

3.76

[1.18]

5.49

6.71

[3.08]

0.76

1.04

[1.16]

1.46

1.81

a

3.31

3.36

a

1.76

3.72

a

1.16

1.02

a

1.09

1.31

2.40

0.43

[0.40]

1.01

1.57

2.20

Standard error of the ratio

0.85

0.43

[0.41]

1.00

0.94

1.00

Irish

0.54

0.81

1.26

0.46

0.44

2.75

Standard error of the ratio

0.30

0.43

0.62

0.42

0.21

1.11

General population (2003)b

0.80

1.14

1.40

0.68

1.23

1.37

Standard error of the ratio

0.10

0.14

0.23

0.11

0.17

0.22

152 113 264 55 8 44 833 3247

115 89 241 119 39 36 398 1889

106 90 150 137 75 21 270 962

156 123 305 56 9 52 1040 2957

188 115 287 134 44 34 568 2223

179 153 203 168 84 24 347 1201

124 104 159 47 19 105 207 2962

90 105 155 114 89 77 122 1761

96 94 97 155 171 49 89 905

148 102 179 46 23 120 257 3109

163 123 173 135 101 74 163 2467

179 150 126 176 191 58 123 1334

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003)b Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003)b

a Results not shown because of small bases. b Comparative data for the general population are not available on this topic from the 2004 survey, so data

have been taken from the 2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response.

92

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Standardised risk ratios

Table 3.13 Comparison of doctor-diagnosed diabetesa in 2004 and 1999, by age within minority ethnic group and sex Aged 16 and over Doctor-diagnosed diabetes

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Black Caribbean 2004 1999 Indian 2004 1999 Pakistani 2004 1999 Bangladeshi 2004 1999 Chinese 2004 1999 Irish 2004 1999 General population 2003b 1998c

2004, 1999 Age group

Men

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

1.9

5.3 3.2

26.5 17.6

10.0 7.8

1.3 0.4

3.7 3.9

26.2 25.7

8.4 7.9

2.0 0.7

9.8 8.0

24.3 19.2

10.1 7.7

0.7 0.6

4.3 4.4

20.5 15.3

5.9 4.7

0.8

9.7 9.6

25.3 39.0

7.3 8.7

1.1

9.7 7.4

44.4 28.3

8.6 5.3

2.4

12.7 10.6

[29.9] 30.6

8.2 10.6

1.6 0.4

10.9 12.1

13.5 26.0

5.2 5.9

-

2.7 2.2

16.1 16.1

3.8 4.2

0.7 1.6

2.5 0.7

13.1 11.8

3.3 2.6

1.6

1.0 0.8

8.3 11.8

3.6 4.2

1.7 -

1.9 1.9

3.2 5.9

2.3 2.4

0.3 0.5

3.1 2.2

9.7 6.9

4.3 3.3

0.9 0.8

2.0 1.2

7.1 5.3

3.4 2.5

196 138 384 265 154 207 65 146 50 133 678 248 2601 c

143 193 192 132 64 81 21 112 27 61 686 155 2281 c

480 547 903 626 423 620 178 533 151 301 1776 537 7202 c

219 282 408 268 276 387 135 370 63 110 497 202 2319 c

292 282 466 273 161 203 51 135 78 197 1038 313 2640 c

165 183 193 115 62 53 21 58 22 54 833 193 2675 c

676 748 1067 657 499 643 208 563 163 361 2369 708 7634 c

Bases (weighted) Black Caribbean 2004 141 Black Caribbean 1999 216 Indian 2004 327 Indian 1999 229 Pakistani 2004 205 Pakistani 1999 331 Bangladeshi 2004 92 Bangladeshi 1999 275 Chinese 2004 74 Chinese 1999 107 Irish 2004 412 Irish 1999 134 General population (2003)b 2320 General population (1998) c Bases (unweighted) Black Caribbean 2004 122 Black Caribbean 1999 212 Indian 2004 201 Indian 1999 232 Pakistani 2004 222 Pakistani 1999 326 Bangladeshi 2004 212 Bangladeshi 1999 274 Chinese 2004 172 Chinese 1999 109 Irish 2004 114 Irish 1999 135 General population (2003)b 1771 General population (1998) 2213

16-34

35-54

55+

All women

a Black Africans were included in the

167 142 231 267 146 217 150 143 118 127 194 240 2364 2594

125 193 118 127 65 77 49 116 58 65 189 162 2467 2386

414 547 550 626 433 620 411 533 348 301 497 537 6602 7193

200 283 240 267 279 384 310 361 148 109 149 203 2175 2636

291 285 275 277 164 203 118 144 176 194 275 301 2897 3057

162 180 119 113 65 56 50 58 51 58 232 204 3162 3022

653 748 634 657 508 643 478 563 375 361 656 708 8234 8715

2004 survey but not in the 1999 survey, so are therefore excluded from this comparative table. b Comparative data for the general

population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which was weighted for nonresponse. The 2004 survey is weighted for differential selection probabilities and non-response. c Comparative data for the general

population are not available on this topic from the 1999 survey itself, and for this table comparative data have therefore been taken from the 1998 survey, in which no weighting was involved.

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Use of tobacco products

4

Heather Wardle

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Summary ●

Self-reported cigarette smoking prevalence was 24% among men within the general population. Equivalent estimates among each ethnic group were 25% Black Caribbean, 21% Black African, 20% Indian, 29% Pakistani, 40% Bangladeshi, 21% Chinese and 30% among Irish men. After adjustments for age, Bangladeshi and Irish men were more likely to report smoking cigarettes than men in the general population (Bangladeshi risk ratio 1.43, Irish risk ratio 1.30) whilst Indian men were less likely to report smoking cigarettes than men in the general population (Indian risk ratio 0.78).

●

Self-reported cigarette smoking prevalence among women was 24% among Black Caribbean women, 10% for Black African, 5% Indian, 5% Pakistani, 2% Bangladeshi, 8% Chinese and 26% among Irish women, compared with 23% for women in the general population. Black African, South Asian and Chinese women were less likely to report currently smoking cigarettes than women within the general population (standardised risk ratio of 0.34 or less). There were no significant differences in the prevalence of smoking between Black Caribbean or Irish women and women in the general population.

●

Among men in the general population, cigarette smoking prevalence was greatest among those aged 16-34, and decreased with age. The same pattern was evident among Chinese and Irish men. However, for Black Caribbean and South Asian men, cigarette smoking was most prevalent among those aged 35-54.

●

Among women from the general population, as well as Black Caribbean, Black African, Indian, Chinese and Irish groups, cigarette smoking prevalence decreased with age. This was most notable among Black Caribbean women, with smoking prevalence falling from 44% among those aged 16-34 to 5% among those aged 55 and over.

●

The proportion of male cigarette smokers in the general population fell to 24% in 2004, from 27% in 1999. Among Irish and Black Caribbean men, cigarette smoking was also less prevalent in 2004 than in 1999, for example among Black Caribbean men prevalence fell to 25% in 2004 from 35% in 1999.

●

For women in the general population and Irish women, cigarette smoking prevalence was lower in 2004 than in 1999. Among the general population estimates were 23% in 2004 compared with 27% in 1999. Equivalent estimates for Irish women were 26% in 2004 and 33% in 1999. For all other ethnic groups no differences were observed.

●

Questions about use of chewing tobacco were asked of South Asian (Pakistani, Indian, Bangladeshi) informants. Use of chewing tobacco was most prevalent among Bangladeshi groups, with 9% of men and 16% of women reporting using chewing tobacco. Among Bangladeshi women, use of chewing tobacco was greatest among those aged 35 and over (26%). Among men, there was no difference in use of chewing tobacco by age.

●

Significantly fewer Bangladeshi men and women reported using chewing tobacco in 2004 than in 1999. For men, prevalence fell to 9% in 2004 from 19% in 1999.

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95

●

Self-reported use of any tobacco product (which included smoking cigarettes and/or cigars and/or pipes and/or use of chewing tobacco) was 28% for men and 23% for women within the general population. The biggest difference between cigarette smoking prevalence alone and overall use of any tobacco product was observed among Irish men, (30% compared with 36% respectively) and among Bangladeshi women (2% compared with 17%).

●

There is evidence, from saliva cotinine samples, that prevalence of tobacco use is greater than self-reported estimates. For example, among Bangladeshi men and women, self-reported use of tobacco products was 44% and 17% respectively. However, if those who also had a cotinine level indicative of tobacco use (15 ng/ml or more) are included, this estimate rises to 60% for men and 35% for women.

96

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Equivalent estimates for women were 16% in 2004 compared with 26% in 1999. For Indian and Pakistani groups, the estimates were similar between the two survey years.

4.1 Introduction 4.1.1

Introduction In 1998, the government White Paper, Smoking Kills identified smoking as the single biggest cause of preventable illness and death.1 The White Paper set the target to reduce levels of smoking within the general population to 24% by 2010. In 2004, this was revised with the publication of the Public Service Agreement targets which set the target to reduce adult smoking rates to 21% or less by 2010, with a reduction in prevalence among routine and manual groups to 26% or less.2 The White Paper recognised that levels of smoking varied between different socioeconomic groups and stated that reductions in levels of smoking should occur equitably among manual and non-manual groups. Evidence from the 1999 Health Survey for England (HSE 1999) showed that use of tobacco products also varied within and between minority ethnic groups.3 This chapter focuses on use of different types of tobacco product among minority ethnic groups and the general population. Where appropriate, differences by socio-economic status within minority ethnic groups are presented, and comparisons with results from HSE 1999 are made.

4.1.2

Methods Informants aged 25 and over were asked about their use of tobacco products within the face to face interview. The interview collected information about use of various tobacco products including cigarettes, cigars and, for men, pipes. Informants who stated that they currently smoked were asked to estimate their daily cigarette consumption. For those aged 16-17, information about use of tobacco products was collected through a self-completion questionnaire. This offered informants privacy, allowing them to reply without disclosing their smoking behaviour to other household members. At the interviewer’s discretion, those aged 18-24 could answer the questions either through the face to face interview or through the self-completion questionnaire. 12% of adults aged 18-24 answered the smoking questions through the self-completion questionnaire. Both the self-completion questionnaire and the interview questions focused on current smoking status, estimated daily consumption of cigarettes among current smokers and use of cigars and pipes. For those from South Asian groups (Indian, Pakistani and Bangladeshi), further information about use of chewing tobacco was collected as part of the interview (and is, therefore, only available for those aged 18 and over).

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Questions about use of chewing tobacco were introduced in HSE 1999 and repeated in 2004. They were asked of South Asian informants, who were believed to be the only groups in which use of chewing tobacco was likely to be significant. These questions were included because of the related health risks of using chewing tobacco. Chewing tobacco is a major risk factor for oral cancer, which is prevalent on the Indian subcontinent. Chewing tobacco comes in three forms: plain chewing tobacco, tobacco paste (zarda) and paan masala (tobacco mixed with betel nut). Use of any of these was defined as use of chewing tobacco. Informants were also asked whether they used a Hukka (tobacco smoked through water using a pipe), bidi (rolled tobacco leaf) and paan without tobacco (plain betel leaf). Use of a hukka and bidi were included in the definition of use of any tobacco product but were not included within the definition of use of chewing tobacco. Use of paan without tobacco was not included within the definition of use of any tobacco products. 4.1.3

Cotinine Cotinine is a metabolite of nicotine. It is generally considered to be the most useful of various biological markers that are indicators of tobacco use. It can be measured in serum or saliva. For this survey cotinine levels were measured using saliva. A saliva sample was taken during the nurse visit from all co-operating informants aged four and over. Cotinine

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97

has a half-life in the body of 16-20 hours, which means that it will detect regular tobacco use, but not occasional tobacco use if the last occasion was several days ago. A level of 15 nanograms per millilitre (ng/ml) is regarded as indicative of smoking; it is unlikely to be due to anything other than personal use of tobacco. In 2004, nurse visits were confined to those from minority ethnic groups. As such, cotinine data for the general population are not available and comparative general population data have been taken from HSE 2003.

4.2 Cigarette smoking 4.2.1

Introduction All informants were asked if they had ever smoked a cigarette and, if so, whether they still smoked nowadays. Former cigarette smokers were asked whether they had smoked regularly or just occasionally. This information was used to classify informants into the following categories: current cigarette smoker, ex-regular cigarette smoker, and never regular cigarette smoker. Informants who reported smoking cigars or pipes only were not included in this classification. However, this information is included within the classification for use of any type of tobacco product (see section 4.6.2). Cigarette smoking by minority ethnic group Cigarette smoking status among men Among the general population, 24% of men currently smoked cigarettes. Within minority ethnic groups, the proportion ranged from 20% of Indian men to 40% of Bangladeshi men. Age-standardised risk ratios were used to take into account differences in the age profile of different minority ethnic groups (see chapter 1). Both Bangladeshi and Irish men were more likely to report current smoking than the general population (Bangladeshi men risk ratio 1.43, Irish men risk ratio 1.30). Indian men were less likely to report currently smoking cigarettes than men in the general population (Indian men risk ratio 0.78). Figure 4A Self-reported cigarette smoking, by minority ethnic group 10.0

10.0

2.0

2.0

1.0

1.0

0.5

0.5

0.1

0.1

0.01

0.01

an ric n a be

ib ar

Af

C

an ric n a be

ib ar

Af

C

sh Iri se i ne hi sh C de la ng Ba ni a st ki Pa an

k

k

ac

di

In

Bl

ac

Bl

k

ac

k

sh Iri se i ne hi sh C de la ng Ba ni a st ki Pa an di

In

Bl

ac

Bl

General population = 1.0. Error bars indicate 95% confidence limits.

98

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Women

Men

Risk ratio, logarithmic scale

4.2.2

47% of men within the general population reported that they had never smoked regularly. With the exception of Bangladeshi and Irish men, men in minority ethnic groups were more likely than those in the general population to report that they had never smoked regularly. 59% of Black Caribbean men, 71% of Black African men and 68% of Chinese men reported that they had never smoked regularly. Within the general population, the proportion of current smokers decreased with age. A similar pattern was observed among Irish and Chinese men. However, for South Asian and Black Caribbean men cigarette smoking was most prevalent among those aged 34-55. Among Black African men, smoking levels changed little with age. Tables 4.1, 4.2, Figure 4A Cigarette smoking status among women The pattern of cigarette smoking among minority ethnic groups was very different in women than among men. Around one quarter of Black Caribbean women (24%), Irish women (26%) and women in the general population (23%) were current cigarette smokers. Among all other minority ethnic groups, prevalence of cigarette smoking was low, ranging from 2% among Bangladeshi women to 10% among Black African women. Correspondingly, women from South Asian, Chinese and Black African groups were significantly more likely than those in the general population to report never regularly smoking cigarettes, with Bangladeshi women being most likely to report this (risk ratio, 1.72). A more consistent association between age and cigarette smoking prevalence was observed among women than among men. With the exception of Pakistani and Bangladeshi women, cigarette smoking became less prevalent as age increased. This was most notable among Black Caribbean women: 44% of those aged 16-34 smoked cigarettes, falling to 21% for those aged 35-54 and to 5% for those aged 55 and over. Tables 4.1, 4.2, Figure 4A

4.2.3

Comparison of cigarette smoking in 1999 and 2004 Cigarette smoking prevalence among Black Caribbean men, Irish men and men in the general population decreased between 2004 and 1999. Among Black Caribbean men, estimates in 2004 were 10 percentage points (p.p.) lower than in 1999: 25% compared with 35%. Equivalent figures for Irish men were 30% in 2004 and 39% in 1999. For men in the general population they were 24% in 2004 and 27% in 1999. For all other minority ethnic groups, there were no significant differences between the two years. Among Irish women and those in the general population, smoking prevalence was also lower in 2004 than in 1999. In 2004, 26% of Irish women were current cigarette smokers compared with 33% in 1999. Among women in the general population, the proportion fell to 23% in 2004 from 27% in 1999. There were no significant differences among any of the other ethnic groups. Table 4.3, Figure 4B Figure 4B Self-reported cigarette smoking, 1999 and 2004, by minority ethnic group Women

Percent

Men 45

45

40

40

35

35

30

30

25

25

20

20

15

15

10

10

5

5

0

0 al er on en ti G ula p po sh Iri se i ne hi sh C de la ng Ba ni a st ki Pa an di In k n ac ea Bl ibb ar C

al er on en ti G ula p po sh Iri se i ne hi sh C de la ng Ba ni a st ki Pa an di In k n ac ea Bl ibb ar C

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1999 2004

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99

4.2.4

Cigarette smoking by sociodemographic factors Cigarette smoking prevalence by equivalised household income Equivalised household income is a measure of household income that takes account of the number of persons in the household. Among men from Black African, Indian and Irish groups, and men within the general population, smoking prevalence was higher among those from the lowest income households than those in the highest income households. However, after these estimates had been standardised for differences in the age profile of men within each income group, this pattern only remained among men in the general population. Among Black Caribbean women, Irish women, and women in the general population, cigarette smoking was highest among those in the lowest income tertile: 33%, 40% and 34% respectively. The equivalent figures among women in the highest income tertile were 18% (Black Caribbean women) and 19% (Irish women and women in the general population). For the remaining minority ethnic groups there was no clear pattern. Table 4.4 Cigarette smoking prevalence by NS-SEC of household reference person NS-SEC is a classification of social position that was introduced in the 2001 census. It has similarities to the Registrar General’s Social Class. Informants are assigned to an NS-SEC category based on the current or former occupation of the household reference person. The three categories presented here are managerial and professional, intermediate, and routine and manual occupations. For men in the general population, cigarette smoking was most prevalent within routine and manual households. The same was true among men from Black African, Chinese and Irish groups. Among Black African men, estimates increased from 14% among those from managerial and professional households, to 29% among those from routine and manual households. Equivalent estimates for Chinese men were 15% and 28%, and for Irish men were 19% and 37%. Among Indian men, no pattern was observed. After these estimates had been standardised for differences in the age profile of men within each NS-SEC group, the difference by NS-SEC for the Chinese group was no longer apparent, but it remained among Black African and Irish groups. For women in the general population, Irish women and Chinese women, cigarette smoking prevalence was greatest among those from routine and manual households (30%, 32% and 14% respectively). In contrast, among Pakistani women, cigarette smoking prevalence was 5 p.p. higher among women from managerial and professional households (10%) than those from routine and manual households (5%), although the low number of observations meant that this difference was not significant. Results for the other minority ethnic groups varied and no clear pattern emerged. Table 4.5

4.3 Number of cigarettes smoked Introduction Informants who reported that they smoked cigarettes were asked how many cigarettes they smoke on weekdays and how many cigarettes they smoke on weekends. These responses were used to produce an estimate of the average number of cigarettes smoked per day. From this, the following categories were used to describe estimated daily consumption of cigarettes among current smokers: fewer than 10 cigarettes per day, 10 to fewer than 20 cigarettes per day, and 20 or more cigarettes per day. 4.3.2

Number of cigarettes smoked by current smokers within minority ethnic group The proportion of male smokers who smoked fewer than 10 cigarettes per day, 10 to fewer than 20 cigarettes per day, and 20 or more cigarettes per day within the general population was 29%, 39% and 31% respectively. Men from each minority ethnic group (except Irish men) were less likely to report smoking 20 or more cigarettes per day than men in the 100

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4.3.1

general population, ranging from one in twenty Black African male smokers to one in six Pakistani male smokers. Among female smokers, Black Caribbean and Black African women were also less likely than women in the general population to smoke 20 or more cigarettes a day (Black Caribbean women risk ratio 0.23, Black African women risk ratio 0.08). Among South Asian and Chinese groups, the number of women who reported smoking cigarettes was too small for reliable estimates to be produced. Table 4.6 4.3.3

Comparison of the number of cigarettes smoked in 1999 and 2004 Within the general population, fewer male smokers reported smoking 20 or more cigarettes per day in 2004 (31%) than in 1999 (37%). Among men in minority ethnic groups there were no significant differences in levels of daily cigarette consumption between 2004 and 1999. Similarly, among women, estimates of daily cigarette consumption were very similar in 2004 and 1999, and no significant differences between the two years were observed. Table 4.7

4.4 Self-reported use of chewing tobacco and other tobacco products 4.4.1

Use of chewing tobacco among South Asian groups South Asian (Indian, Pakistani and Bangladeshi) informants were asked about their use of other tobacco products, namely chewing tobacco and use of tobacco in conjunction with other products such as paan, as well as use of paan without tobacco. (See section 4.1.2 for a full description of the different types of tobacco product). Only observed percentages are presented in this section as there are no general population figures to use for comparative purposes. Informants were classified as using chewing tobacco if they reported using paan with tobacco, paan with masala, or chewing tobacco. Among Indian and Pakistani groups, use of chewing tobacco was low. Estimates ranged between 1% of Pakistani women to 4% of Indian men. Use of chewing tobacco was most prevalent among Bangladeshi informants: significantly more Bangladeshi women (16%) used chewing tobacco than Bangladeshi men (9%). Use of chewing tobacco, by South Asian ethnic group South Asian group Indian

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Men Uses chewing tobacco Does not use chewing tobacco Women Uses chewing tobacco Does not use chewing tobacco

Pakistani Bangladeshi

%

%

%

4 96

2 98

9 91

1 99

1 99

16 84

Among men, the proportion reporting that they used chewing tobacco as well as smoking cigarettes, and those who reported using chewing tobacco only, were roughly similar. For example, 4% of Indian men reported using chewing tobacco. Of these, half stated they also smoked cigarettes, whilst half used chewing tobacco only. There was no clear pattern in use of chewing tobacco by age. Among South Asian women, those who used chewing tobacco did not do so in conjunction with cigarette smoking (prevalence of cigarette smoking was particularly low among these groups). Among Bangladeshi women, use of chewing tobacco was most prevalent among those aged 35 and over; 26% of Bangladeshi women aged 35-54 used chewing tobacco compared with 9% for those aged 18-34. Tables 4.8, 4.9

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101

4.4.2

Comparison of use of chewing tobacco in 1999 and 2004 For Indian and Pakistani groups, the proportion using chewing tobacco in 2004 was similar to 1999. Figures for Indian men in 2004 and 1999 were 4% and 6% respectively, and for Pakistani men the prevalence was 2% in both years. For both Bangladeshi men and women, chewing tobacco use was significantly lower in 2004 than in 1999. For men, prevalence fell to 9% in 2004 from 19% in 1999. Equivalent estimates for women were 16% in 2004 and 26% in 1999. Table 4.10

4.5 Cotinine 4.5.1

Introduction Cotinine is a derivative of nicotine, and a high cotinine level is an indicator of recent tobacco use. A cotinine level of 15 ng/ml is indicative of tobacco use within the past 24 hours, whether personal smoking, use of other tobacco products, or use of nicotine replacement products as an adjunct to smoking cessation. Only 16 informants reported using nicotine replacement products within the last seven days. Therefore, a cotinine measurement of 15 ng/ml or over is likely to be the result of personal tobacco use or use of other tobacco products. As such, cotinine measurements can provide an objective check of self-reported use of tobacco products. Saliva cotinine samples were taken from informants as part of the nurse visit. To correct for biases within the sub-sample providing a valid cotinine sample, an additional weight was applied to the cotinine data. Table 4.11 shows the distribution of the sample for whom we have a valid cotinine measurement (before the additional weight was applied) compared with the distribution of the total sample across a number of different categories, such as age group and self-reported smoking status. Table 4.11

4.5.2

Cotinine levels by minority ethnic group Within the general population, 30% of men had a cotinine level of 15 ng/ml or more. Within minority ethnic groups, estimates ranged from 23% for Chinese men to 35% for Pakistani and 57% for Bangladeshi men. The proportion of men with a cotinine level of 15 ng/ml or more was significantly higher among Bangladeshi men than any other group. Within the general population, 25% of women had a cotinine level of 15 ng/ml or more. Among Black African, Indian, Pakistani and Chinese women, prevalence was lower than the general population ranging from 7% for Indian women to 14% for Black African women. For women from Black Caribbean, Irish and Bangladeshi groups, prevalence was similar to the general population and was highest among Bangladeshi women (29%). The high cotinine levels among Bangladeshi women contrasts with their low rate of self-reported smoking and is probably due to use of chewing tobacco. Table 4.12 Comparisons of cotinine levels in 1999 and 2004 Prevalence of cotinine levels of 15 ng/ml or more was significantly lower among Black Caribbean and Irish men in 2004 than in 1999. In 2004, 26% of Black Caribbean men and 32% of Irish men had a cotinine level of 15 ng/ml or more. The equivalent figures in 1999 were 40% for both groups. Similarly, cotinine prevalence was significantly lower among Irish women in 2004 (26%) than in 1999 (33%). Among all other minority ethnic groups and the general population, there were no other significant differences between the two years. Table 4.14

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4.5.3

4.6 Prevalence and cotinine-adjusted prevalence of use of tobacco products 4.6.1

Introduction This section presents information about overall use of any tobacco product including selfreported use of cigarettes, cigars, pipes (among men) and chewing tobacco. This information has been combined to produce an overall estimate of use of any tobacco products. In section 4.6.4, self-reported estimates of any tobacco are analysed in relation to cotinine levels. An ‘adjusted’ measure of tobacco use was created by including within the measure informants who either reported using any tobacco product or had a cotinine level of 15 ng/ml or more. This enables the level of under-reporting of prevalence of tobacco use to be assessed.

4.6.2

Self-reported use of all tobacco products, by minority ethnic group Use of any tobacco products varied between minority ethnic group, ranging between 22% of Black African men and 44% of Bangladeshi men. The extent to which overall tobacco use exceeded cigarette smoking prevalence varied from being one percentage point (p.p.) higher among Black African men (22% compared with 21%) to 6 p.p. higher among Irish men (36% compared with 30%). Overall, cigarette smoking accounted for the majority of tobacco use among men. Among most minority ethnic groups, cigar smoking prevalence was the next most popular form of tobacco use, with the exception of Bangladeshi men, where chewing tobacco was more common (9%) than smoking cigars (4%). Similarly, with the exception of Bangladeshi women, cigarette consumption accounted for nearly all tobacco use among women. Among Bangladeshi women, virtually all tobacco use was derived from use of chewing tobacco (16%) rather than smoking cigarettes (2%). Table 4.15

4.6.3

Prevalence of use of all tobacco products, by NS-SEC of household reference person With the exception of Irish men and Black African men, and men within the general population, there were no significant differences between NS SEC groups in the use of any tobacco products. For Irish men, Black African men and men in the general population, use of tobacco products was higher among those from routine and manual households than those from managerial and professional households. Among Irish women, and women in the general population, use of any tobacco product was more prevalent among women from routine and manual households than those from managerial and professional households, the difference ranging between 21% and 32% for Irish women, and 16% and 30% for women in the general population. For Pakistani women, use of any tobacco products was higher among women from managerial and professional households (16%), than those from intermediate (5%) and routine and manual groups (6%). Table 4.16

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4.6.4

Cotinine-adjusted prevalence of tobacco use by minority ethnic group Table 4.17 shows estimates for adjusted tobacco use derived by including informants who report using any type of tobacco product or have a cotinine level of 15 ng/ml or more (in the absence of self-reported tobacco use). For both men and women, adjusted tobacco use estimates were higher than self-reported estimates within all minority ethnic groups. The greatest difference between self-reported estimates of tobacco use and adjusted tobacco use was observed among Bangladeshi men and women. For Bangladeshi men, adjusted tobacco use prevalence (60%) was 16 percentage points (p.p.) higher than self-reported use of tobacco alone (44%); among Bangladeshi women, the difference was 18 p.p. (35% compared with 17%). For both Pakistani and Bangladeshi women, the adjusted tobacco use estimates were double the self-reported estimates for use of any tobacco product.

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103

Figure 4C Adjusted use of tobacco products, by minority ethnic group Women

Risk ratio, logarithmic scale

Men 10.0

10.0

2.0

2.0

1.0

1.0

0.5

0.5

0.1

0.1 sh

Iri

ni

se i sh de

ne

hi C

la

ar C

a st

ng

Ba

ki

an an di ric n Af a be ib k

k

ac

Pa

In

Bl

ac

Bl

sh

Iri

se i sh de

la

ne

hi C

ni

ar C

a st

ng

Ba

ki

an an di ric n Af a be ib k

k

ac

Pa

In

Bl

ac

Bl

General population = 1.0. Error bars indicate 95% confidence limits.

Figures 4C shows the age-standardised relative risk ratios of adjusted use of tobacco products for men and women within each minority ethnic group, compared with the general population. Among men, Bangladeshis were the only group more likely than the general population to report using any type of tobacco product, or have a cotinine level suggesting they had recently used a tobacco product (risk ratio 1.66). Chinese men were the only group who had a significantly lower adjusted use of tobacco than the general population (risk ratio 0.66). Black African, Indian, Pakistani and Chinese women had a significantly lower adjusted use of tobacco than women in the general population (Black African risk ratio 0.60, Indian women risk ratio 0.37, Pakistani women 0.47, Chinese women 0.41). No group had a significantly higher adjusted use of tobacco than the general population. Table 4.17, Figure 4C

References and notes 1 Smoking Kills: A White Paper on Tobacco, p 83. The Stationery Office, London, 1998. 2 PSA targets for the Department of Health and smoking are outlined at the following address: http://www.hm-treasury.gov.uk/media//70320/sr04_psa_ch3.pdf.

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3 Erens B, Primatesta P, Prior G (eds) Health Survey for England: The health of minority and ethnic groups. Volume 1: Findings. The Stationary Office, London 2001.

Tables

4.1 Self-reported cigarette smoking status, by minority ethnic group and sex 4.2 Self-reported cigarette smoking status, by age within minority ethnic group and sex

4.17 Prevalence of self-reported tobacco use, of saliva cotinine of 15 ng/ml or over, and of adjusted tobacco use, by minority ethnic group and sex

4.3 Comparison of self-reported cigarette smoking status in 2004 and 1999, by age within minority ethnic group and sex 4.4 Self-reported cigarette smoking status, by equivalised household income tertile within minority ethnic group and sex 4.5 Self-reported cigarette smoking status, by NSSEC of household reference person (HRP) within minority ethnic group and sex 4.6 Number of cigarettes smoked by current smokers, by minority ethnic group and sex 4.7 Comparison of number of cigarettes smoked in 2004 and 1999, by minority ethnic group and sex 4.8 Use of chewing tobacco, by South Asian minority ethnic group and sex 4.9 Use of chewing tobacco, by age within South Asian minority ethnic group and sex 4.10 Comparison of use of chewing tobacco in 2004 and 1999, by age within South Asian minority ethnic group and sex 4.11 Comparison of saliva cotinine sample with total sample, by minority ethnic group and sex

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4.12 Saliva cotinine levels, by minority ethnic group and sex 4.13 Saliva cotinine, by age within minority ethnic group and sex 4.14 Comparison of saliva cotinine prevalence in 2004 and 1999, by age within minority ethnic group and sex 4.15 Self-reported use of tobacco products, by minority ethnic group and sex 4.16 Self-reported use of tobacco products, by NSSEC of household reference person (HRP) within minority ethnic group and sex HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 4: USE OF TOBACCO PRODUCTS

105

Table 4.1 Self-reported cigarette smoking status, by minority ethnic group and sex Aged 16 and over Cigarette smoking status

2004 Minority ethnic group

General population

Black Caribbean

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Men Observed % Current cigarette smoker Ex-regular cigarette smoker Never regular cigarette smoker Standardised risk ratios Current cigarette smoker

25 16 59

21 8 71

20 13 66

29 8 63

40 13 47

21 11 68

30 30 40

24 29 47

1.02

0.80

0.78

1.08

1.43

0.81

1.30

1

Standard error of the ratio

0.12

0.11

0.09

0.11

0.11

0.13

0.13

Ex-regular cigarette smoker

0.60

0.35

0.52

0.35

0.67

0.54

1.01

Standard error of the ratio

0.10

0.07

0.07

0.07

0.10

0.08

0.12

Never regular cigarette smoker

1.18

1.42

1.35

1.28

0.93

1.33

0.84

Standard error of the ratio

0.07

0.07

0.06

0.07

0.06

0.07

0.06

1 1

Women Observed % Current cigarette smoker Ex-regular cigarette smoker Never regular cigarette smoker Standardised risk ratios Current cigarette smoker

24 13 63

10 3 87

5 2 92

5 2 93

2 1 97

8 3 89

26 27 47

23 22 56

1.08

0.34

0.23

0.19

0.11

0.32

1.11

1

Standard error of the ratio

0.11

0.07

0.04

0.04

0.04

0.07

0.11

Ex-regular cigarette smoker

0.62

0.15

0.11

0.07

0.05

0.15

1.12

Standard error of the ratio

0.09

0.05

0.04

0.03

0.03

0.05

0.13

Never regular cigarette smoker

1.10

1.58

1.65

1.68

1.72

1.59

0.91

Standard error of the ratio

0.05

0.05

0.04

0.04

0.04

0.05

0.06

472 658

366 464

899 1061

412 490

172 197

150 162

1773 2362

45652 48357

403 637

379 457

547 630

423 497

396 453

345 372

496 653

2855 3805

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1

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Bases (weighted) Men Women Bases (unweighted) Men Women

1

Table 4.2 Self-reported cigarette smoking status, by age within minority ethnic group and sex Aged 16 and over

2004

Cigarette smoking status

Age group

Men

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Black Caribbean Current cigarette smoker Ex-regular cigarette smoker Never regular cigarette smoker Black African Current cigarette smoker Ex-regular cigarette smoker Never regular cigarette smoker Indian Current cigarette smoker Ex-regular cigarette smoker Never regular cigarette smoker Pakistani Current cigarette smoker Ex-regular cigarette smoker Never regular cigarette smoker Bangladeshi Current cigarette smoker Ex-regular cigarette smoker Never regular cigarette smoker Chinese Current cigarette smoker Ex-regular cigarette smoker Never regular cigarette smoker Irish Current cigarette smoker Ex-regular cigarette smoker Never regular cigarette smoker General population Current cigarette smoker Ex-regular cigarette smoker Never regular cigarette smoker Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

27 11 62

34 9 58

12 31 57

25 16 59

44 8 48

21 18 62

5 10 85

24 13 63

21 5 75

20 13 67

[25] [6] [69]

21 8 71

15 3 82

6 3 91

[2] [1] [96]

10 3 87

18 8 74

22 11 67

19 27 54

20 13 66

8 3 89

4 2 94

3 1 97

5 2 92

28 4 68

34 8 58

18 21 60

29 8 63

5 2 92

7 0 93

2 98

5 2 93

35 3 62

49 18 33

[29] [41] [30]

40 13 47

1 1 98

4 96

[3] [2] [95]

2 1 97

25 6 69

21 11 68

9 26 64

21 11 68

12 3 85

5 2 93

4 5 91

8 3 89

46 10 45

26 29 45

25 43 32

30 30 40

35 15 50

26 24 50

21 38 41

26 27 47

32 10 58

26 25 49

14 52 35

24 29 47

28 12 60

26 20 53

15 31 54

23 22 56

135 170 324 195 86 73 412 14338

195 156 383 153 65 50 678 16633

142 40 192 64 21 27 683 14681

472 366 899 412 172 150 1773 45652

202 230 404 267 125 62 493 14299

291 197 464 161 51 78 1038 16924

165 37 193 62 21 22 831 17135

658 464 1061 490 197 162 2362 48357

114 172 199 213 198 170 114 721

165 169 230 145 149 117 194 973

124 38 118 65 49 58 188 1161

403 379 547 423 396 345 496 2855

186 224 237 268 287 145 147 895

289 189 274 164 117 176 275 1374

162 44 119 65 49 51 231 1536

637 457 630 497 453 372 653 3805

16-34

35-54

All 55+ women

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107

Table 4.3 Comparison of self-reported cigarette smoking status in 2004 and 1999, by age within minority ethnic groupa and sex Aged 16 and over

2004, 1999 Age group

Men

Black Caribbean 2004 Current cigarette smoker Ex-regular cigarette smoker Never regular cigarette smoker 1999 Current cigarette smoker Ex-regular cigarette smoker Never regular cigarette smoker Indian 2004 Current cigarette smoker Ex-regular cigarette smoker Never regular cigarette smoker 1999 Current cigarette smoker Ex-regular cigarette smoker Never regular cigarette smoker Pakistani 2004 Current cigarette smoker Ex-regular cigarette smoker Never regular cigarette smoker 1999 Current cigarette smoker Ex-regular cigarette smoker Never regular cigarette smoker Bangladeshi 2004 Current cigarette smoker Ex-regular cigarette smoker Never regular cigarette smoker 1999 Current cigarette smoker Ex-regular cigarette smoker Never regular cigarette smoker Chinese 2004 Current cigarette smoker Ex-regular cigarette smoker Never regular cigarette smoker 1999 Current cigarette smoker Ex-regular cigarette smoker Never regular cigarette smoker

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

27 11 62

34 9 58

12 31 57

25 16 59

44 8 48

21 18 62

5 10 85

24 13 63

32 9 59

48 18 34

29 28 43

35 18 47

35 11 54

27 13 60

8 7 86

25 11 64

18 8 74

22 11 67

19 27 54

20 13 66

8 3 89

4 2 94

3 1 97

5 2 92

25 8 68

23 10 67

19 24 57

23 12 65

10 2 88

3 0 96

2 3 95

6 1 93

28 4 68

34 8 58

18 21 60

29 8 63

5 2 92

7 0 93

2 98

5 2 93

24 5 71

31 9 60

23 11 65

26 7 67

5 2 93

4 0 95

4 96

5 1 94

35 3 62

49 18 33

[29] [41] [30]

40 13 47

1 1 98

4 96

[3] [2] [95]

2 1 97

37 4 60

50 11 39

54 25 20

44 10 46

0 0 99

2 1 97

4 4 92

1 1 98

25 6 69

21 11 68

9 26 64

21 11 68

12 3 85

5 2 93

4 5 91

8 3 89

17 7 77

21 16 63

10 39 51

17 18 65

15 2 83

8 3 89

3 4 93

9 3 88

16-34

35-54

All 55+ women

Continued…

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Cigarette smoking status

Table 4.3 continued Aged 16 and over

2004, 1999

Cigarette smoking status

Age group

Men

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Irish 2004 Current cigarette smoker Ex-regular cigarette smoker Never regular cigarette smoker 1999 Current cigarette smoker Ex-regular cigarette smoker Never regular cigarette smoker General population 2004 Current cigarette smoker Ex-regular cigarette smoker Never regular cigarette smoker 1999 Current cigarette smoker Ex-regular cigarette smoker Never regular cigarette smoker Bases (weighted) 2004 Black Caribbean Indian Pakistani Bangladeshi Chinese Irish General population 1999 Black Caribbean Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) 2004 Black Caribbean Indian Pakistani Bangladeshi Chinese Irish General population 1999 Black Caribbean Indian Pakistani Bangladeshi Chinese Irish General population

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

46 10 45

26 29 45

25 43 32

30 30 40

35 15 50

26 24 50

21 38 41

26 27 47

50 13 37

42 24 34

25 49 26

39 29 32

36 17 47

36 24 40

25 35 40

33 25 42

32 10 58

26 25 49

14 52 35

24 29 47

28 12 60

26 20 53

15 31 54

23 22 56

35 11 54

30 28 42

17 51 32

27 31 42

36 12 52

30 22 49

15 30 55

27 22 52

135 324 195 86 73 412 14338

195 383 153 65 50 678 16633

142 192 64 21 27 683 14681

472 899 412 172 150 1773 45652

202 404 267 125 62 493 14299

291 464 161 51 78 1038 16924

165 193 62 21 22 831 17135

658 1061 490 197 162 2362 48357

141 215 184 68 33 385 12237

92 251 119 37 42 711 15705

129 124 47 29 19 448 15171

362 591 349 134 95 1544 43113

186 249 218 89 34 566 14681

190 255 117 33 62 876 19174

122 108 31 14 17 543 17782

498 612 365 136 112 1985 51637

114 199 213 198 170 114 721

165 230 145 149 117 194 973

124 118 65 49 58 188 1161

403 547 423 396 345 496 2855

186 237 268 287 145 147 895

289 274 164 117 176 275 1374

162 119 65 49 51 231 1536

637 630 497 453 372 653 3805

207 229 312 261 105 135 1026

141 266 216 143 127 239 1298

192 125 77 116 65 162 1219

540 620 605 520 297 536 3543

278 263 375 347 107 203 1233

285 275 203 144 194 300 1583

178 113 56 58 58 204 1408

741 651 634 549 359 707 4224

16-34

35-54

All 55+ women

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 4: USE OF TOBACCO PRODUCTS

a Black Africans were

included in the 2004 survey but not in the 1999 survey, so therefore are excluded from this comparative table.

109

Table 4.4 Self-reported cigarette smoking status, by equivalised household income tertile within minority ethnic group and sex Aged 16 and over Cigarette smoking status

2004 Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

26

28

24

18

23

33

16

20

31

9

7

11

17

18

31

6

3

10

[30]

21

40

[5]

5

7

a

42

43

a

-

3

18

22

[23]

9

12

4

25

37

43

19

29

40

21

26

31

19

25

34

Black Caribbean Current cigarette smoker

1.01

1.23

0.94

0.70

1.05

1.30

Standard error of the ratio

0.20

0.25

0.22

0.16

0.19

0.19

Black African Current cigarette smoker

0.74

0.73

1.16

0.28

0.28

0.34

Standard error of the ratio

0.27

0.19

0.25

0.11

0.11

0.09

Indian Current cigarette smoker

0.69

0.71

1.20

0.23

0.12

0.41

Standard error of the ratio

0.15

0.13

0.21

0.07

0.07

0.13

[0.92]

0.80

1.49

[0.20]

0.16

0.25

[0.23]

0.17

0.19

[0.15]

0.07

0.08

Bangladeshi Current cigarette smoker

a

1.49

1.66

a

-

0.13

Standard error of the ratio

a

0.20

0.19

a

-

0.05

Chinese Current cigarette smoker

0.65

0.74

[1.07]

0.31

0.50

0.23

Standard error of the ratio

0.14

0.24

[0.29]

0.10

0.16

0.15

Irish Current cigarette smoker

1.14

1.80

1.68

0.87

1.20

1.88

Standard error of the ratio

0.17

0.28

0.33

0.15

0.19

0.32

General population Current cigarette smoker

0.85

1.12

1.34

0.74

1.10

1.54

Standard error of the ratio

0.07

0.10

0.14

0.06

0.08

0.13

Observed % Black Caribbean Current cigarette smoker Black African Current cigarette smoker Indian Current cigarette smoker Pakistani Current cigarette smoker Bangladeshi Current cigarette smoker Chinese Current cigarette smoker Irish Current cigarette smoker General population Current cigarette smoker

Pakistani Current cigarette smoker Standard error of the ratio

a Results are not shown because of small base sizes.

Continued…

110

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 4: USE OF TOBACCO PRODUCTS

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Standardised risk ratios

Table 4.4 continued

Aged 16 and over

2004 Equivalised household income tertile

Men Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

151 112 263 55 8 44 833 21714

115 84 239 117 38 35 396 11371

101 86 149 131 70 21 270 5568

154 123 302 56 9 52 1037 19362

181 113 285 131 42 34 565 14250

177 146 203 165 80 23 345 6420

122 103 158 47 19 105 207 1335

90 101 154 112 87 76 121 746

90 90 96 151 160 47 89 350

147 102 177 46 23 120 256 1465

157 121 172 132 97 74 162 1176

176 145 126 171 182 56 122 531

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a Results are not shown because of small base sizes.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 4: USE OF TOBACCO PRODUCTS

111

Table 4.5 Self-reported cigarette smoking status, by NS-SEC of household reference person (HRP) within minority ethnic group and sex Aged 16 and over Cigarette smoking status

2004 NS-SEC of household reference person

Men

Women

Managerial & professional

Intermediate

Routine & manual

Managerial & professional

Intermediate

Routine & manual

28

18

24

16

32

24

14

18

29

7

17

11

20

19

21

5

5

5

18

35

28

10

4

5

35

34

42

[-]

2

2

15

21

28

8

4

14

19

36

37

21

27

32

17

24

32

15

23

30

Black Caribbean Current cigarette smoker

1.03

0.65

1.12

0.72

1.30

1.21

Standard error of the ratio

0.20

0.17

0.18

0.15

0.23

0.17

Black African Current cigarette smoker

0.55

0.82

1.08

0.22

0.56

0.38

Standard error of the ratio

0.16

0.30

0.18

0.08

0.18

0.11

Indian Current cigarette smoker

0.78

0.68

0.82

0.19

0.24

0.21

Standard error of the ratio

0.14

0.16

0.11

0.06

0.11

0.07

Pakistani Current cigarette smoker

0.67

1.28

1.07

0.35

0.10

0.18

Standard error of the ratio

0.18

0.24

0.15

0.15

0.05

0.07

Bangladeshi Current cigarette smoker

1.29

1.11

1.58

[-]

0.04

0.11

Standard error of the ratio

0.25

0.23

0.14

[-]

0.04

0.05

Chinese Current cigarette smoker

0.63

0.77

0.95

0.32

0.17

0.60

Standard error of the ratio

0.18

0.16

0.23

0.09

0.09

0.17

Irish Current cigarette smoker

0.83

1.67

1.64

0.95

1.20

1.44

Standard error of the ratio

0.16

0.33

0.20

0.17

0.30

0.19

General population Current cigarette smoker

0.71

0.97

1.36

0.64

1.03

1.36

Standard error of the ratio

0.06

0.09

0.09

0.06

0.08

0.09

Observed % Black Caribbean Current cigarette smoker Black African Current cigarette smoker Indian Current cigarette smoker Pakistani Current cigarette smoker Bangladeshi Current cigarette smoker Chinese Current cigarette smoker Irish Current cigarette smoker General population Current cigarette smoker

112

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 4: USE OF TOBACCO PRODUCTS

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Standardised risk ratios

Table 4.5 continued

Aged 16 and over

2004 NS-SEC of household reference person

Men

Copyright © 2006, The Information Centre. All rights reserved

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

Women

Managerial & professional

Intermediate

Routine & manual

Managerial & professional

Intermediate

Routine & manual

150 128 330 76 25 55 673 19796

72 61 191 120 23 38 312 8540

239 146 356 176 101 43 780 16737

216 154 382 75 21 69 1028 18992

122 70 211 139 25 45 436 9653

282 167 408 198 106 38 812 18486

123 128 189 68 55 130 171 1235

65 55 107 116 52 88 88 523

202 161 236 188 232 100 232 1066

201 134 214 74 49 154 256 1470

121 67 125 133 56 101 123 753

278 178 257 201 237 88 247 1482

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113

Table 4.6 Number of cigarettes smoked by current smokers, by minority ethnic group and sex Current smokers aged 16 and over Number of cigarettes smoked per day

2004 Minority ethnic group Black Caribbean

General population

Black African

Indian

63 32 5

55 32 13

44 40 16

Pakistani Bangladeshi

Chinese

Irish

51 41 8

22 45 33

29 39 31

Men Observed % Under 10 cigarettes per day 10 to under 20 per day 20 or more per day Mean number of cigarettes smoked per day by current smokers

59 31 10

49 41 11

8.2

8.1

9.7

10.0

9.6

8.8

14.8

14.6

Standard error of the mean

0.66

1.03

0.90

0.69

0.41

0.60

0.83

0.38

Standardised risk ratios 20 or more per day

0.35

0.13

0.42

0.51

0.26

0.35

1.04

1

Standard error of the ratio

0.17

0.08

0.13

0.11

0.07

0.15

0.16

56 37 7

[63] [35] [2]

a a a

a a a

a a a

a a a

39 37 24

30 43 27

Women Observed % Under 10 cigarettes per day 10 to under 20 per day 20 or more per day Mean number of cigarettes smoked per day by current smokers

8.3

[7.5]

a

a

a

a

12.2

13.1

Standard error of the mean

0.61

[0.83]

a

a

a

a

0.78

0.27

Standardised risk ratios 20 or more per day

0.23

[0.08]

a

a

a

a

0.85

1

Standard error of the ratio

0.09

[0.07]

a

a

a

a

0.16

116 156

74 46

180 57

118 25

68 4

31 13

544 622

10861 10873

111 144

70 39

107 29

123 25

159 10

69 29

162 199

640 851

Bases (weighted) Men Women Bases (unweighted)b Men Women

114

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 4: USE OF TOBACCO PRODUCTS

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a Results are not shown because of small base sizes. b Base sizes differ from table 4.1 as some informants were unable or unwilling to estimate daily consumption of cigarettes.

Table 4.7 Comparison of number of cigarettes smoked in 2004 and 1999, by minority ethnic groupa and sex Current smokers aged 16 and over Number of cigarettes smoked per day

2004

Minority ethnic group

General population

Black Caribbean

Indian

%

%

%

59 31 10

55 32 13

54 32 13

Pakistani Bangladeshi

Chinese

Irish

%

%

%

%

44 40 16

49 41 11

51 41 8

22 45 33

29 39 31

47 38 14

34 42 21

50 36 14

40 40 19

23 36 40

27 35 37

56 37 7

b b b

b b b

b b b

b b b

39 37 24

30 43 27

53 38 9

[66] [20] [14]

b b b

b b b

[54] [34] [9]

28 41 31

29 44 27

116 156

180 57

118 25

68 4

31 13

544 622

10861 10873

126 125

134 36

92 17

59 2

16 10

602 651

11581 13725

111 144

107 29

123 25

159 10

69 29

162 199

640 851

190 181

134 40

161 29

236 7

53 32

215 241

960 1113

Men 2004 Under 10 cigarettes per day 10 to under 20 per day 20 or more per day 1999 Under 10 cigarettes per day 10 to under 20 per day 20 or more per day

Women 2004 Under 10 cigarettes per day 10 to under 20 per day 20 or more per day 1999 Under 10 cigarettes per day 10 to under 20 per day 20 or more per day Bases (weighted) 2004 Men Women 1999 Men Women Bases (unweighted) 2004 Men Women 1999 Men Women

Copyright © 2006, The Information Centre. All rights reserved

a Black Africans were included in the 2004 survey but not in the 1999 survey, so therefore are excluded from this comparative table. b Results are not shown because of small base sizes.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 4: USE OF TOBACCO PRODUCTS

115

Table 4.8 Use of chewing tobacco, by South Asian minority ethnic group and sex South Asians aged 18 and over Types of chewing tobacco useda

2004

Minority ethnic group Men Indian

Paan with tobacco (zarda) Paan masala Chewing tobacco Any chewing tobacco Paan without tobacco Hukka/Hookah Bidi Other tobacco substances Does not use any of these substances Bases (weighted) Bases (unweighted)

Women Pakistani Bangladeshi

Indian

Pakistani Bangladeshi

%

%

%

%

%

%

1 3 1 4 2 1 0 0

1 1 0 2 1 1 0

8 1 9 16 0 0 -

1 1 2 0 0 -

0 1 0 1 0 0 0 0

13 5 16 13 0 -

93

96

75

97

97

71

845 514

386 395

166 380

1009 597

458 465

184 423

116

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 4: USE OF TOBACCO PRODUCTS

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a These categories are not mutually exclusive as an informant may use more than one product.

Table 4.9 Use of chewing tobacco, by age within South Asian minority ethnic group and sex South Asians aged 18 and over Use of chewing tobacco

2004 Age group

Men 18-34

35-54

55+

%

%

%

%

%

%

%

%

3

5

4

4

1

1

1

1

-

3

1

2

-

-

-

-

3 97

2 95

3 96

2 96

1 99

1 99

1 99

1 99

2

2

1

2

1

0

6

1

1

1

-

1

-

-

-

-

1 98

0 98

1 99

1 98

1 99

0 100

6 94

1 99

8

10

[14]

9

9

28

[29]

16

5

7

[5]

5

-

2

[3]

1

3 92

3 90

[10] [86]

4 91

9 91

26 72

[27] [71]

16 84

272 169 80

382 153 65

192 64 21

845 386 166

355 235 113

461 161 50

193 62 21

1009 458 184

167 185 182

229 145 149

118 65 49

514 395 380

205 236 258

273 164 116

119 65 49

597 465 423

Indian Uses chewing tobacco Uses chewing tobacco and smokes cigarettes Uses chewing tobacco and does not smoke cigarettes Does not use chewing tobacco Pakistani Uses chewing tobacco Uses chewing tobacco and smokes cigarettes Uses chewing tobacco and does not smoke cigarettes Does not use chewing tobacco Bangladeshi Uses chewing tobacco Uses chewing tobacco and smokes cigarettes Uses chewing tobacco and does not smoke cigarettes Does not use chewing tobacco

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Bases (weighted) Indian Pakistani Bangladeshi Bases (unweighted) Indian Pakistani Bangladeshi

Women All men

18-34

35-54

All 55+ women

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 4: USE OF TOBACCO PRODUCTS

117

Table 4.10 Comparison of use of chewing tobacco in 2004 and 1999, by age within South Asian minority ethnic group and sex South Asians aged 18 and over

2004, 1999 Age group

Men

Women

18-34a

35-54

55+

All men

%

%

%

%

%

%

%

%

3

5

4

4

1

1

1

1

-

3

1

2

-

-

-

-

3 97

2 95

3 96

2 96

1 99

1 99

1 99

1 99

7

6

6

6

1

2

4

2

5

2

1

3

-

-

-

-

2 93

4 94

5 94

4 94

1 99

2 98

4 96

2 98

2

2

1

2

1

0

6

1

1

1

-

1

-

-

-

-

1 98

0 98

1 99

1 98

1 99

0 100

6 94

1 99

2

1

5

2

2

2

-

2

1

-

1

1

-

1

-

0

1 98

1 99

4 95

2 98

2 98

2 98

100

2 98

8

10

[14]

9

9

28

[29]

16

5

7

[5]

5

-

2

[3]

1

3 92

3 90

[10] [86]

4 91

9 91

26 72

[27] [71]

16 84

14

23

28

19

15

43

56

26

10

11

17

12

0

-

2

0

4 86

12 77

11 72

8 81

14 85

43 57

53 44

26 74

Indian 2004 Uses chewing tobacco Uses chewing tobacco and smokes cigarettes Uses chewing tobacco and does not smoke cigarettes Does not use chewing tobacco 1999 Uses chewing tobacco Uses chewing tobacco and smokes cigarettes Uses chewing tobacco and does not smoke cigarettes Does not use chewing tobacco Pakistani 2004 Uses chewing tobacco Uses chewing tobacco and smokes cigarettes Uses chewing tobacco and does not smoke cigarettes Does not use chewing tobacco 1999 Uses chewing tobacco Uses chewing tobacco and smokes cigarettes Uses chewing tobacco and does not smoke cigarettes Does not use chewing tobacco Bangladeshi 2004 Uses chewing tobacco Uses chewing tobacco and smokes cigarettes Uses chewing tobacco and does not smoke cigarettes Does not use chewing tobacco 1999 Uses chewing tobacco Uses chewing tobacco and smokes cigarettes Uses chewing tobacco and does not smoke cigarettes Does not use chewing tobacco

18-34a

35-54

All 55+ women

a In 2004, questions about chewing tobacco were asked of those aged 18 and over whereas in 1999 these questions were

asked of everyone aged 16 and over.

Continued…

118

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 4: USE OF TOBACCO PRODUCTS

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Use of chewing tobacco

Table 4.10 continued

South Asians aged 18 and over

2004, 1999 Age group

Men

Women

18-34a

35-54

55+

All men

%

%

%

%

%

%

%

%

272 169 80

382 153 65

192 64 21

845 386 166

355 235 113

461 161 50

193 62 21

1009 458 184

213 179 65

251 119 37

124 47 29

588 345 132

248 213 87

255 117 33

108 31 14

611 360 135

167 185 182

229 145 149

118 65 49

514 395 380

205 236 258

273 164 116

119 65 49

597 465 423

224 304 253

266 216 143

125 77 116

615 597 512

261 364 340

275 203 144

113 56 58

649 623 542

Bases (weighted) 2004 Indian Pakistani Bangladeshi 1999 Indian Pakistani Bangladeshi Bases Men (unweighted) 2004 Indian Pakistani Bangladeshi 1999 Indian Pakistani Bangladeshi

18-34a

35-54

All 55+ women

a In 2004, questions about chewing tobacco were asked of those aged 18 and over whereas in 1999 these questions were

Copyright © 2006, The Information Centre. All rights reserved

asked to everyone aged 16 and over.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 4: USE OF TOBACCO PRODUCTS

119

Table 4.11 Comparison of saliva cotinine sample with total sample, by minority ethnic group and sex Aged 16 and over

Black Caribbean Age 16-34 35-54 55 and over Tobacco status Self-reported user of tobacco Black African Age 16-34 35-54 55 and over Tobacco status Self-reported user of tobacco Indian Age 16-34 35-54 55 and over Tobacco status Self-reported user of tobacco Pakistani Age 16-34 35-54 55 and over Tobacco status Self-reported user of tobacco Bangladeshi Age 16-34 35-54 55 and over Tobacco status Self-reported user of tobacco Chinese Age 16-34 35-54 55 and over Tobacco status Self-reported user of tobacco Irish Age 16-34 35-54 55 and over Tobacco status Self-reported user of tobacco

Men

Women

Total sample

Sample with cotinine assay

Total sample

Sample with cotinine assay

%

%

%

%

29 41 30

29 39 32

32 43 24

33 44 23

28

31

24

29

47 42 11

46 45 9

50 42 8

54 41 5

22

27

10

5

36 43 21

32 45 23

38 44 18

36 49 16

24

21

6

5

49 36 15

47 37 17

55 32 12

51 35 14

30

32

7

8

51 37 12

45 42 13

65 25 10

57 33 10

44

37

17

22

49 33 18

49 37 15

39 48 14

36 55 9

23

22

8

9

23 38 39

24 39 37

21 44 35

22 44 34

36

30

26

25

Continued…

120

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 4: USE OF TOBACCO PRODUCTS

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Age and tobacco status

2004

Table 4.11 continued

Aged 16 and over

2004

Age and tobacco status

General population (2003) Age 16-34 35-54 55 and over Tobacco status Self-reported user of tobacco

Copyright © 2006, The Information Centre. All rights reserved

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003) Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003)

Men

Women

Total sample

Sample with cotinine assay

Total sample

Sample with cotinine assay

32 36 32

28 39 33

30 35 35

30 39 32

31

30

24

26

480 377 903 423 178 151 1776 7202

195 149 462 170 48 64 1053 779

676 476 1067 499 208 163 2369 7634

282 193 497 174 61 62 1305 803

414 390 550 433 411 348 497 6602

162 137 274 165 110 144 272 736

653 469 634 508 478 375 656 8234

256 173 302 173 136 141 340 882

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 4: USE OF TOBACCO PRODUCTS

121

Table 4.12 Saliva cotinine levels, by minority ethnic group and sexa Aged 16 and over with a valid cotinine assay Saliva cotinine (ng/ml)

2004

Minority ethnic group

General population (2003)

Black Caribbean

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Men Observed % % with 15 ng/ml and over Standardised risk ratios 15 ng/ml and over

26

27

27

35

57

23

32

30

0.93

0.79

0.86

1.07

1.79

0.72

1.13

1

Standard error of the ratio

0.16

0.15

0.10

0.15

0.20

0.14

0.15

Women Observed % % with 15 ng/ml and over Standardised risk ratios 15 ng/ml and over

26

14

7

13

29

10

26

25

1.00

0.63

0.26

0.48

1.18

0.40

1.02

1

Standard error of the ratio

0.15

0.21

0.07

0.11

0.20

0.11

0.14

195 282

149 193

462 497

170 174

48 61

64 62

1053 1305

779 803

162 256

137 173

274 302

165 173

110 136

144 141

272 340

736 882

Bases (weighted) Men Women Bases (unweighted) Men Women

122

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 4: USE OF TOBACCO PRODUCTS

Copyright © 2006, The Information Centre. All rights reserved

a An additional weight has been added to correct for response bias in the sub-sample providing a valid saliva sample (see section 4.5).

Table 4.13 Saliva cotinine, by age within minority ethnic group and sexa Aged 16 and over with a valid cotinine assay Saliva cotinine (ng/ml)

2004

Age group

Men

Black Caribbean % with 15 ng/ml and over Black African % with 15 ng/ml and over Indian % with 15 ng/ml and over Pakistani % with 15 ng/ml and over Bangladeshi % with 15 ng/ml and over Chinese % with 15 ng/ml and over Irish % with 15 ng/ml and over General population (2003) % with 15 ng/ml and over Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003) Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003)

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

[33]

34

10

26

38

25

12

26

30

25

b

27

19

5

b

14

26

29

25

27

10

4

9

7

38

34

29

35

14

11

b

13

[59]

[52]

b

57

21

[37]

b

29

26

28

b

23

19

5

b

10

54

23

26

32

39

21

23

26

36

32

23

30

32

29

15

25

56 69 147 79 22 31 262 218

75 67 210 63 20 23 404 305

65 13 105 28 6 9 387 256

195 149 462 170 48 64 1053 779

89 105 180 88 35 22 289 237

125 78 239 61 19 34 568 308

69 9 77 25 6 5 447 258

282 193 497 174 61 62 1305 803

46 60 84 79 49 70 59 175

64 64 124 56 46 54 111 281

52 13 66 30 15 20 102 280

162 137 274 165 110 144 272 736

77 90 104 89 77 52 72 231

118 72 145 60 46 76 146 346

61 11 53 24 13 13 122 305

256 173 302 173 136 141 340 882

16-34

35-54

All 55+ women

a An additional weight has been added to correct for response bias in the sub-sample providing a valid saliva sample

(see section 4.5).

Copyright © 2006, The Information Centre. All rights reserved

b Results are not shown because of small base sizes.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 4: USE OF TOBACCO PRODUCTS

123

Table 4.14 Comparison of saliva cotinine prevalence in 2004 and 1999, by age within minority ethnic groupa and sexb Aged 16 and over with a valid cotinine assay Saliva cotinine (ng/ml)

2004, 1999

Age group

Men

Black Caribbean 2004 % with 15 ng/ml and over 1999 % with 15 ng/ml and over Indian 2004 % with 15 ng/ml and over 1999 % with 15 ng/ml and over Pakistani 2004 % with 15 ng/ml and over 1999 % with 15 ng/ml and over Bangladeshi 2004 % with 15 ng/ml and over 1999 % with 15 ng/ml and over Chinese 2004 % with 15 ng/ml and over 1999 % with 15 ng/ml and over Irish 2004 % with 15 ng/ml and over 1999 % with 15 ng/ml and over General population 2003 % with 15 ng/ml and over 1998 % with 15 ng/ml and over

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

[33]

34

10

26

38

25

12

26

35

46

41

40

37

24

6

26

26

29

25

27

10

4

9

7

35

26

24

29

11

9

[12]

10

38

34

29

35

14

11

c

13

39

33

[24]

35

11

8

c

10

[59]

[52]

c

57

21

[37]

c

29

49

50

[77]

55

18

[68]

c

34

26

28

c

23

19

5

c

10

[12]

24

c

18

[4]

11

c

9

54

23

26

32

39

21

23

26

49

40

34

40

32

39

22

33

36

32

23

30

32

29

15

25

40

33

24

32

36

28

18

27

16-34

35-54

All 55+ women

a Black Africans were included in the 2004 survey but not the 1999 survey, so are therefore excluded from this

comparative table. b An additional weight has been added to correct for response bias in the sub-sample providing a valid saliva sample

Continued…

124

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 4: USE OF TOBACCO PRODUCTS

Copyright © 2006, The Information Centre. All rights reserved

(see section 4.5). c Results are not shown because of small base sizes.

Table 4.14 continued

Aged 16 and over with a valid cotinine assay

2004, 1999

Age group

Men

Bases (weighted) 2004 Black Caribbean Indian Pakistani Bangladeshi Chinese Irish General population (2003) 1999 Black Caribbean Indian Pakistani Bangladeshi Chinese Irish General population (1998) Bases(unweighted) 2004 Black Caribbean Indian Pakistani Bangladeshi Chinese Irish General population (2003) 1999 Black Caribbean Indian Pakistani Bangladeshi Chinese Irish General population (1998)

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

56 147 79 22 31 262 218

75 210 63 20 23 404 305

65 105 28 6 9 387 256

195 462 170 48 64 1053 779

89 180 88 35 22 289 237

125 239 61 19 34 568 308

69 77 25 6 5 447 258

282 497 174 61 62 1305 803

77 127 82 22 14 199 d

48 146 62 14 23 424 d

62 57 22 11 6 261 d

188 329 167 46 43 883 d

101 127 98 31 16 318 d

102 134 51 8 32 444 d

47 37 13 4 5 206 d

251 298 162 43 53 968 d

46 84 79 49 70 59 175

64 124 56 46 54 111 281

52 66 30 15 20 102 280

162 274 165 110 144 272 736

77 104 89 77 52 72 231

118 145 60 46 76 146 346

61 53 24 13 13 122 305

256 302 173 136 141 340 882

109 127 136 88 45 65 1520

71 158 107 54 71 139 1902

90 63 36 37 20 98 1620

270 348 279 179 136 302 5042

148 134 167 126 49 115 1676

148 143 88 36 99 147 2051

68 44 23 12 17 89 1741

364 321 278 174 165 351 5468

16-34

35-54

All 55+ women

a Black Africans were included in the 2004 survey but not the 1999 survey, so are therefore excluded from this

comparative table. b An additional weight has been added to correct for response bias in the sub-sample providing a valid saliva sample

Copyright © 2006, The Information Centre. All rights reserved

(see section 4.5). c Results are not shown because of small base sizes. d In 1999, comparative general population data were not available for saliva cotinine. Comparative data was therefore

taken from the 1998 survey, in which no weighting was involved.

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Table 4.15 Self-reported use of tobacco products, by minority ethnic group and sex Aged 16 and over Use of tobacco products

2004 Minority ethnic group

General population

Black Caribbean

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Men Observed % Cigarettes Cigarsa Pipesb Chewing tobaccoc Any tobacco product Standardised risk ratios Any tobacco product

25 7 0 c 28

21 11 1 c 22

20 7 4 24

29 5 1 2 30

40 4 0 9 44

21 10 2 c 23

30 11 2 c 36

24 12 2 c 28

0.98

0.74

0.83

1.00

1.40

0.77

1.28

1

Standard error of the ratio

0.11

0.10

0.09

0.10

0.10

0.11

0.10

24 0

10 1

5 -

5 -

2 -

8 1

26 0

23 1

Women Observed % Cigarettes Cigarsa Chewing tobaccoc Any tobacco product Standardised risk ratios Any tobacco product

c 24

c 10

1 6

1 7

16 17

c 8

c 26

c 23

1.07

0.34

0.27

0.29

0.84

0.33

1.10

1

Standard error of the ratio

0.11

0.06

0.05

0.05

0.11

0.07

0.11

472 658

366 464

897 1055

412 490

172 196

150 162

1773 2362

45621 48331

403 637

379 457

546 628

423 497

396 451

345 372

496 653

2853 3803

Bases (weighted) Men Women Bases (unweighted) Men Women

a Use of cigars was only asked of men and women who answered the questions about smoking in the main questionnaire rather than as part

the self completion booklet. b Use of pipes was only asked of men who answered the questions about smoking in the main questionnaire rather than as part of the self

completion booklet.

126

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c Use of chewing tobacco products was only asked of South Asian informants.

Table 4.16 Self-reported use of tobacco products, by NS-SEC of household reference person (HRP) within minority ethnic group and sex Aged 16 and over Use of tobacco products

2004 NS-SEC of household reference person

Men

Women

Managerial & professional

Intermediate

Routine & manual

Managerial & professional

Intermediate

Routine & manual

28 11 1 c 32

18 11 c 21

24 4 c 25

16 1 b c 16

32 b c 32

24 b c 24

14 13 3 c 14

18 3 c 20

29 11 c 29

7 2 b c 7

17 b c 17

11 b c 11

20 7 5 24

19 4 2 22

21 10 4 26

5 b 3 7

5 b 1 6

5 b

18 5 1 18

35 6 2 2 37

28 5 2 2 30

10 b 4 16

4 b 0 5

5 b 2 6

35 17 2 39

34 5 9 38

42 1 0 11 47

[-] [-] [b] [12] [11]

2 b 15 17

2 b 15 16

15 16 2 c 19

21 12 5 c 22

28 1 c 28

8 3 b c 9

4 b c 4

14 b c 14

19 16 2 c 28

36 11 c 38

37 8 2 c 41

21 0 b c 21

27 b c 27

32 1 b c 32

17 14 2 c 22

24 12 2 c 28

32 9 1 c 35

15 1 b c 16

23 1 b c 23

30 1 b c 30

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Observed % Black Caribbean Cigarettes Cigarsa Pipesb Chewing tobaccoc Any tobacco product Black African Cigarettes Cigarsa Pipesb Chewing tobaccoc Any tobacco product Indian Cigarettes Cigarsa Pipesb Chewing tobaccoc Any tobacco product Pakistani Cigarettes Cigarsa Pipesb Chewing tobaccoc Any tobacco product Bangladeshi Cigarettes Cigarsa Pipesb Chewing tobaccoc Any tobacco product Chinese Cigarettes Cigarsa Pipesb Chewing tobaccoc Any tobacco product Irish Cigarettes Cigarsa Pipesb Chewing tobaccoc Any tobacco product General population Cigarettes Cigarsa Pipesb Chewing tobaccoc Any tobacco product

5

a Use of cigars was

only asked of men and women who answered the questions about smoking in the main questionnaire rather than as part the self completion booklet. b Use of pipes was

only asked of men who answered the questions about smoking in the main questionnaire rather than as part of the self completion booklet. c Use of chewing

tobacco products was only asked of South Asian groups who answered the questions about smoking in the main questionnaire rather than as part of the self completion booklet.

Continued…

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Table 4.16 continued

Aged 16 and over Use of tobacco products

2004 NS-SEC of household reference person

Men

Women

Managerial & professional

Intermediate

Routine & manual

Managerial & professional

Intermediate

Routine & manual

Black Caribbean Any tobacco product

1.06

0.69

1.01

0.71

1.29

1.20

Standard error of the ratio

0.19

0.17

0.16

0.15

0.23

0.17

Black African Any tobacco product

0.49

0.76

0.96

0.22

0.55

0.38

Standard error of the ratio

0.14

0.26

0.15

0.08

0.18

0.11

Indian Any tobacco product

0.85

0.73

0.87

0.29

0.25

0.21

Standard error of the ratio

0.13

0.18

0.11

0.07

0.11

0.07

Pakistani Any tobacco product

0.61

1.16

1.01

0.74

0.27

0.23

Standard error of the ratio

0.16

0.20

0.13

0.22

0.16

0.08

Bangladeshi Any tobacco product

1.26

1.13

1.58

[0.47]

0.82

0.81

Standard error of the ratio

0.21

0.21

0.11

[0.16]

0.32

0.14

Chinese Any tobacco product

0.68

0.73

0.83

0.33

0.17

0.59

Standard error of the ratio

0.16

0.16

0.20

0.09

0.09

0.17

Irish Any tobacco product

0.95

1.51

1.56

0.95

1.19

1.43

Standard error of the ratio

0.13

0.28

0.18

0.16

0.30

0.18

General population Any tobacco product

0.79

0.96

1.27

0.65

1.02

1.35

Standard error of the ratio

0.06

0.08

0.08

0.06

0.08

0.09

150 128 329 76 25 55 673 19779

72 61 191 120 23 38 312 8540

239 146 356 176 101 43 780 16723

216 154 382 75 21 69 1028 18992

122 70 211 139 25 45 436 9653

282 167 408 198 106 38 812 18486

123 128 188 68 55 130 171 1234

65 55 107 116 52 88 88 523

202 161 236 188 232 100 232 1065

201 134 214 74 49 154 256 1470

121 67 125 133 56 101 123 753

278 178 257 201 237 88 247 1482

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

a Use of cigars was only asked of men and women who answered the questions about smoking in the main questionnaire rather than

as part the self completion booklet. b Use of pipes was only asked of men who answered the questions about smoking in the main questionnaire rather than as part of

the self completion booklet. c Use of chewing tobacco products was only asked of South Asian groups who answered the questions about smoking in the main

questionnaire rather than as part of the self completion booklet.

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Standardised risk ratios

Table 4.17 Prevalence of self-reported tobacco use, of saliva cotinine of 15 ng/ml or over, and of adjusted tobacco use, by minority ethnic group and sexa Aged 16 and over with a valid cotinine assay Use of tobacco products, saliva cotinine (ng/ml), adjusted tobacco use

2004

Minority ethnic group Black Caribbean

General population (2003)b

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Men Observed % Self-reported use of any tobacco products Saliva cotinine level 15 ng/ml or over Adjusted tobacco use prevalence Extent of under reporting Standardised risk ratios Adjusted tobacco use

28 26 30 3

22 27 30 8

24 27 32 8

30 35 37 7

44 57 60 16

23 23 25 2

36 32 38 2

31 30 34 2

0.98

0.79

0.95

1.02

1.66

0.66

1.15

1

Standard error of the ratio

0.15

0.14

0.11

0.13

0.17

0.12

0.13

24 26 28 4

10 14 14 4

6 7 10 4

7 13 14 6

17 29 35 18

8 10 11 3

26 26 28 2

24 25 27 3

Standardised risk ratios Adjusted tobacco use

1.03

0.60

0.37

0.47

1.26

0.41

1.02

1

Standard error of the ratio

0.15

0.20

0.08

0.11

0.19

0.11

0.14

195 277

148 187

460 497

168 173

48 57

64 62

1053 1303

775 800

162 253

136 169

273 302

163 171

109 129

144 141

272 339

733 880

Women Observed % Self-reported use of any tobacco products Saliva cotinine level 15 ng/ml or over Adjusted tobacco use prevalence Extent of under reporting

Bases (weighted) Men Women Bases (unweighted) Men Women

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a An additional weight has been added to correct for response bias in the sub-sample providing a valid saliva sample (see section 4.5). b In 2004 comparative general population data were not available for saliva cotinine. Comparative data were therefore taken from the 2003 survey.

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Alcohol consumption

5

Elizabeth Becker, Amy Hills and Bob Erens

Copyright © 2006, The Information Centre. All rights reserved

Summary ●

Men and women from all minority ethnic groups reported drinking alcohol less frequently than the general population, except the Irish who drank as frequently.

●

In the general population, 8% of men and 14% of women were non-drinkers. All other minority ethnic groups were more likely than the general population to be nondrinkers, apart from the Irish who were as likely. The highest percentage of nondrinkers were found among Pakistani adults (89% of men and 95% of women), and Bangladeshi adults (97% of men and 98% of women).

●

Among the general population, 76% of men and 61% of women said they had drunk alcohol on at least one day in the week before the interview. Except for the Irish, the proportion of men and women who said they drank on at least one day in the past week was lower for all minority ethnic groups; the proportion was lowest among Bangladeshi informants (1% of men and women) and Pakistani informants (7% of men and 3% of women).

●

In the general population, the mean number of days in the past week when alcohol was consumed was 2.7 for men and 1.8 for women. Estimates for Irish men and women were slightly higher than the general population (3.0 for men and 2.1 for women), but were much lower for the other minority ethnic groups: for example, the highest mean number of days among the other groups was 1.8 days for Black Caribbean men and 1.0 days for Black Caribbean women.

●

45% of men in the general population drank more than 4 units of alcohol on their heaviest drinking day in the last week. The proportion exceeding 4 units was higher among Irish men (at 56%), but lower for all other minority ethnic groups: 28% for Black Caribbean men, 22% for Indian men, 19% for Chinese men, 17% for Black African men, 4% for Pakistani men and 1% for Bangladeshi men. 25% of men in the general population were binge drinking (i.e. consuming 8 or more units) in the past week; except for the Irish, the proportion of men who were binge drinking was lower for all the other minority ethnic groups.

●

In the general population, the proportion of women consuming 3 or more units on their heaviest drinking day was 30%. It was higher among Irish women (36%), but lower for all other minority ethnic groups: 18% for Black Caribbean women, 12% for Chinese women, 8% for Indian women, 7% for Black African women, and only 1% or less for Pakistani and Bangladeshi women. The pattern was similar for binge drinking among women (i.e. 6 or more units): 14% of women in the general population drank this much, as did 16% of Irish women, 6% of Black Caribbean women, 4% of Indian and Chinese women, 2% of Black African women, and 1% or less Pakistani and Bangladeshi women.

●

There was very little statistically significant change in the amount of alcohol consumed on the heaviest drinking day between 1999 and 2004. In the general population, the only change was an increase in the proportion of women in the general population who were binge drinking, from 12% to 14%. For the minority ethnic groups, the only differences over this five year period were: an increase in the percentage of Indian women exceeding 3 units (from 5% to 8%); and an increase in Chinese men exceeding both 4 units (from 8% to 19%) and 8 units (from 2% to 10%).

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5.1 Introduction The misuse of alcohol has been shown to contribute to a number of health problems, ranging from high blood pressure to liver cirrhosis, cancer, cardiovascular disease and suicide. Many social problems have also been linked to the misuse of alcohol, such as antisocial behaviour, crime and domestic violence. However, there is also evidence that low levels of alcohol consumption can have positive effects. For example, low levels of consumption can have a protective effect against coronary heart disease and stroke for men over 40, and post-menopausal women.1 The advice currently given on sensible drinking states that: ●

There is no significant health risk for men (of all ages) who regularly consume between 3 and 4 units a day and for women (of all ages) who regularly consume between 2 and 3 units a day.

●

Regular drinking of 4 or more units a day for men, or 3 or more a day for women, is likely to result in increasing health risk and is not advised.

●

Drinking up to 2 units a day can have a moderate protective effect against heart disease for men over 40 and post-menopausal women.2

In Britain alcohol is consumed by the majority of people. However, there are major differences in the frequency and levels of consumption when looking at minority ethnic groups, largely due to cultural differences and religious beliefs (which may also affect people’s willingness to report their consumption). Results from HSE 1999 confirmed that many minority ethnic groups were drinking significantly less than the general population.3 Where possible, this chapter will make comparisons with HSE 1999. However, since 1999, the questions asked about alcohol consumption have been modified in line with government drinking guidelines, which are now given in daily rather than weekly levels. So, instead of focusing on average weekly consumption, questions now look at drinking in the past week, although a question on usual frequency of drinking is still included. Age standardisation has been carried out on a number of key measures in this section. This is because minority ethnic groups differ from the general population in their age distribution, so in order to compare them effectively the effects of age need to be factored out. Agestandardised risk ratios are used to take account of differences in the age profile of different minority ethnic groups (see Chapter 1). This chapter contains sections on usual frequency of drinking (Section 5.3), frequency of drinking in the past week (Section 5.4) and the amount consumed on the heaviest drinking day in the past week (Section 5.5).

5.2 Measures

Informants were asked for the details of the amounts drunk for six different types of alcohol (normal strength beer/lager/stout/cider/shandy; strong beer/lager/cider; wine/sherry and martini; spirits and liqueurs; and alcoholic soft drinks), which were then converted to units of alcohol consumed.4 By combining these estimates, it is possible to derive an estimate for the heaviest day's consumption out of the last seven. For informants aged 16-17, the module of questions on drinking was administered using a special smoking and drinking self-completion questionnaire. For those aged 18 and over, information on alcohol consumption was collected as part of the face-to-face interview, except in a minority of cases for informants aged 18-24 where the interviewer felt that responses might be unduly affected by the presence of other household members. In these

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Preliminary questions established whether informants drank alcohol at all and how often they had usually drunk it in the past year. Informants were then asked whether they had drunk alcohol in the last seven days. Informants who had drunk in the past week were asked about alcohol consumption on the heaviest drinking day in that week.

cases, the 16-17 self-completion questionnaire was given to informants (and it was completed by 12% of those aged 18-24). As yet, there is no consensus on a formal definition of the term ‘binge drinking.’ However, it is often defined as consuming 8 units or more for men and 6 units or more for women on at least one drinking day in the week, and it is this definition that is used in this report (as in previous HSE reports). These amounts are double the daily recommended amounts used in current guidelines (see above).

5.3 Usual drinking frequency 5.3.1

Usual drinking frequency by minority ethnic group Informants were asked how often they usually had an alcoholic drink in the last 12 months. The results showed a similar pattern to that found in 1999. Within the general population, 8% of men were non-drinkers or ex-drinkers, and a further 5% drank only once or twice a year. The proportions of women in the general population falling in these two categories were higher at 14% and 10% respectively. About one in five men (18%) and one in ten women (10%) in the general population said they drank almost every day, while about twofifths of men (41%) and one-quarter (26%) of women, drank on three or more days a week. As in 1999, the Irish were the only minority ethnic group more likely to drink on three or more days a week than the general population: 51% of Irish men and 30% of Irish women. Informants in the other minority ethnic groups were much less likely to report drinking at this level. 28% of Black Caribbean men, 18% of Indian and Chinese men, 17% of Black African men, 2% of Pakistani men and 1% of Bangladeshi men reported drinking on three or more days a week. For women, the equivalent figures were: 11% Black Caribbean, 9% Chinese, 6% Black African, 5% Indian and less than 0.5% Pakistani (with no Bangladeshi women in the sample drinking on three or more days a week). The vast majority of Pakistani and Bangladeshi adults were non-drinkers (89% Pakistani men, 95% Pakistani women, 97% Bangladeshi men and 98% Bangladeshi women). These differences between minority ethnic groups and the general population remained significant for all groups after standardisation for age, apart from Irish women. Table 5.1, Figure 5A Figure 5A Usually drank on 3 or more days a week

Men Women

60 50

Percent

40 30 20

0

i sh

al er on en ti G ula p po

se

ne

sh

hi

Iri

C de

la

i

an

st

ng

ki

Ba

Pa

an

di In

k ac Bl can ri

Af

k n ac ea Bl ibb ar

C

Copyright © 2006, The Information Centre. All rights reserved

10

Usual frequency of drinking varied by age, as Table 5.2 shows. Among men in the general population, the likelihood of drinking almost every day increased with age from 9% at age 16-34, to 27% at age 55 and over. This pattern was also found for men from the Irish, Chinese and Indian minority ethnic groups, and to a lesser extent among Black Caribbean and Black African men. Given the low prevalence of drinking among Pakistani and Bangladeshi men, it was not observable in these groups. HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 5: ALCOHOL CONSUMPTION

133

At the other extreme, the likelihood of being a non-drinker, or only a very occasional drinker (i.e. drinks less than once every two months) was also highest among the oldest age group of men in the general population (16%). This was also found among men from the Irish, Chinese, Indian and Black Caribbean minority ethnic groups. In the general population, the pattern for women was similar to that for men: i.e. women in the oldest age group of 55 and over were the most likely to drink almost every day (14% compared with 2% of women aged 16-34), and were also the most likely to be non-drinkers or only very occasional drinkers (33% compared with 18% of women aged 16-34). A similar relationship between age and drinking almost every day was found only among Irish women. However, the proportion who were non-drinkers or only occasional drinkers increased with age among Irish, Chinese, Indian and Black Caribbean women. Table 5.2 5.3.2

Comparison of usual drinking frequency in 1999 and 2004 For most minority ethnic groups, the pattern of self-reported usual drinking frequency was very similar in 2004 to that found in 1999. The biggest difference was found among Chinese men, with an apparent decrease in the proportion of non-drinkers or very occasional drinkers, from 43% in 1999 to 31% in 2004. The biggest change was found among the oldest group of Chinese men, with the proportion decreasing from 69% to 48%. Table 5.3

5.3.3

Usual drinking frequency by equivalised household income Equivalised household income is a measure of household income that takes account of the number persons in the household. Table 5.4 shows usual self-reported drinking frequency by equivalised household income tertiles. In the general population, men and women in the highest income tertile were the least likely to be non-drinkers or only very occasional drinkers (7% men, 13% women). This was also found to be the case among Indian men and women, Pakistani men, Chinese men and women, and Irish men and women. In the general population, men and women in the highest income tertile were also the most likely to drink on three or more days a week (48% men, 36% women). This was also found to be statistically significant among Irish women. Table 5.4

5.4 Frequency of drinking in the past week Frequency of drinking in the past week by minority ethnic group Informants aged 16 and over were asked if they had drunk alcohol in the past seven days. Those who had were asked how much they drank on their heaviest drinking day in the last week (on the most recent occasion if the same amount was drunk on more than one day). They were asked to detail the amount drunk for each type of drink, which was then converted to the number of units of alcohol consumed. Among the general population, the proportion who said they had drunk alcohol on at least one day in the past week was 76% for men and 61% for women. It was slightly higher among Irish men and women (80% and 67% respectively), but after standardisation for age the difference was not significant for men. In all minority ethnic groups (except Bangladeshi), women were less likely than men to report drinking alcohol on at least one day in the past seven. Table 5.5, Figure 5B As in 1999, the proportion of men and women who said they drank on at least one day in the past week was lower for all minority ethnic groups (except Irish) than it was for the general population. The proportion was lowest among Bangladeshi (1% men, 1% women) and Pakistani informants (7% men, 3% women). For the other groups, the proportion of men who reported drinking on at least one day was 38% Black African, 48% Chinese, 47% Indian and 60% Black Caribbean. For women, the equivalent proportions were 26%, 32%, 21% and 47% respectively. Men and women in Black African, Black Caribbean, Indian and Chinese minority ethnic groups were more likely to have drunk on at least one day than Pakistani and Bangladeshi men and women, but were less likely than the general 134

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5.4.1

Figure 5B Number of days drank in past week

Drank on 0 days Drank on 1 or 2 days Drank on 3 or 4 days Drank on 5 or 6 days Drank on all 7 days

Men 100 90 80

Percent

70 60 50 40 30 20 10 0 al er on en ti G ula p po

Iri

al er on en ti G ula p po

sh

ne

i sh de

se

la

ni

Iri

hi C

ng

Ba

a st

ki

n

a di

Pa

In

k ac Bl can ri Af

k n ac ea Bl ibb ar C

Women 100 90 80

Percent

70 60 50 40 30 20 10 0 C ne

sh

hi i

sh

de

se

la

i

an

st

ng

ki

Ba

Pa

an

di

In

k ac Bl can ri

Af

k n ac ea Bl ibb ar

C

population to have done so. These differences remained after standardising for age, and the standardised risk ratios were considerably lower than 1 for all groups except the Irish.

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In the general population, the mean number of days in the past week when alcohol was consumed was 2.7 for men and 1.8 for women. (The base for this mean includes those who had not drunk alcohol in the past week, giving them a value of zero.) The means were slightly higher for Irish men and women (3.0 and 2.1 respectively), but were much lower for the other minority ethnic groups. The next highest means were for Black Caribbean men and women (1.8 and 1.0 respectively) and Chinese men and women (1.4 and 0.7 respectively). The mean number of days on which alcohol was drunk was 0.2 or less for Bangladeshi and Pakistani men and women. Table 5.6 shows the number of days on which alcohol was consumed in the past week by age within minority ethnic group. Among both sexes, but especially among men, the pattern of drinking frequency in the past week was similar to the pattern of usual drinking frequency in the past year (as described in Section 5.3.1). For example, in the general population, it was men in the oldest group (55 and over) who were the most likely to say they drank almost every day, and they were also the most likely to report drinking on all seven days in the past week (23%). This same pattern was found among men in all minority ethnic groups (except for Bangladeshi and Pakistani men where there were very few drinkers in any of the age groups). Table 5.6

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135

5.4.2

Comparison of frequency of drinking in the past week in 1999 and 2004 Table 5.7 compares the 1999 and 2004 surveys with respect to the number of days on which informants had drunk alcohol in the past week. The results are similar in both years, showing very few statistically significant changes between the two surveys. The only changes were an increase in drinking on at least one day in the last week among Indian women (from 15% to 21%) and among Chinese men (from 39% to 48%). Table 5.7

5.4.3

Frequency of drinking in the past week by equivalised household income Table 5.8 shows the frequency of drinking in the past week by equivalised household income tertiles. Although there were some minor differences in detail, the pattern found for drinking in the past week was similar to that described in Section 5.3.3 for usual frequency of drinking by equivalised household income tertiles. In the general population, men and women in the highest income tertile had the highest mean number of days on which they drank in the past week (3.1 for men, 2.4 for women). Irish women in the highest income tertile also drank on the most days in the last week (2.8). Table 5.8

5.5 Amount consumed on the heaviest drinking day in the past week Amount consumed on the heaviest drinking day in the past week by minority ethnic group Table 5.9 shows the amount of alcohol consumed on the heaviest drinking day in the past week, based on all informants (regardless of whether or not they drank in the past week). The module of questions in 2004 was the same as that used to look at daily drinking in HSE 1999; the method of calculating alcohol consumption on the heaviest day is described in Section 5.2. The proportion of men in the general population who exceeded government guidelines (i.e. 4 or more units of alcohol) on their heaviest drinking day was 45%. It was higher (56%) among Irish men, but lower for all other groups: 28% for Black Caribbean men, 22% for Indian men, 19% for Chinese men, 17% for Black African men, 4% for Pakistani men and only 1% for Bangladeshi men. One in four (25%) men in the general population were binge drinking (defined as consuming 8 or more units) on their heaviest drinking day in the past week. The proportion binge drinking was higher among Irish men (32%), but much lower for all other groups: 12% for Black Caribbean men, 10% for Chinese men, 9% for Indian men, 7% for Black African men, 3% for Pakistani men, and less than 0.5% for Bangladeshi men. All the differences described above between the minority ethnic groups and the general population were significant after standardisation for age. The proportion of women drinking more than government guidelines (i.e. 3 or more units) on their heaviest drinking day was 30% among the general population, rising to 36% among Irish women. It was lower among all other minority ethnic groups: 18% for Black Caribbean women, 12% for Chinese women, 8% for Indian women, 7% for Black African women, and only 1% or less for both Pakistani and Bangladeshi women. The pattern was similar for binge drinking (6 or more units) among women: 14% of women in the general population drank this much, as did a similar proportion of Irish women (16%). The other groups were less likely to consume this amount: 6% of Black Caribbean women, 4% of Indian and Chinese women, 2% of Black African women, and 1% or less of both Pakistani and Bangladeshi women. Except for Irish women, the differences between minority ethnic groups and the general population in the proportions drinking 3 or more, and 6 or more, units were still significant after controlling for age. Table 5.9, Figure 5C

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5.5.1

Figure 5C Alcohol consumption on heaviest drinking day in the past week

Drank 4 or more units Drank 8 or more units

Men 60 50

Percent

40 30 20 10 0 al er on en ti G ula p po

ni

i sh de

se

la

ne

sh

Iri

hi C

ng

Ba

a st

ki

n

a di

Pa

In

k ac Bl can ri Af

k n ac ea Bl ibb ar C

Drank 3 or more units Drank 6 or more units

Women 60 50

Percent

40 30 20 10 0 se i

sh

de

al er on en ti G ula p po

ne

sh

hi

Iri

C la

i

an

st

ng

ki

Ba

Pa

an

di

In

k ac Bl can ri

Af

k n ac ea Bl ibb ar

C

Table 5.10 shows the same variable broken down by age within minority ethnic group. In the general population, alcohol consumption on the heaviest drinking day decreased with age in terms of the proportion exceeding government guidelines (4 units for men, 3 for women), the proportion binge drinking (8 units for men, 6 for women) and the mean number of units consumed. Mean consumption in the oldest group (55 and over) was less than half that for the youngest group (16-34), and the proportion binge drinking was also much lower among both sexes. A similar trend was found for all the minority ethnic groups (except for Black African men and women, who did not show a clear pattern). Table 5.10

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5.5.2

Comparison of the amount consumed on the heaviest drinking day in the past week in 1999 and 2004 Table 5.11 compares the 1999 and 2004 surveys in respect of the amount drunk on the heaviest drinking day in the past week. Among men in the general population there was virtually no change since 1999, either in the proportion drinking 4 or more, or 8 or more, units per week, or in mean units drunk. The same applies to women, except for an increase in binge drinking from 12% to 14% over the five year period. These results are in line with longer-term drinking trends shown by HSE. Trends for minority ethnic groups are difficult to interpret, given there are only two data points (1999 and 2004). The only statistically significant differences between the 1999 and 2004 surveys are: firstly, an increase in the proportion of Indian women drinking 3 or more units on their heaviest drinking day from 5% to 8%; secondly, an increase in Chinese men

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 5: ALCOHOL CONSUMPTION

137

drinking both 4 or more units (from 8% to 19%) and 8 or more units (from 2% to 10%) on their heaviest drinking day. While the differences for Chinese men appear quite large, given the small sample size and the variations in sampling methods for this group between 1999 and 2004, it is not possible to determine the extent to which this is a real increase or an artefact of the changes in sampling methodology (see Chapter 1). Table 5.11, Figure 5D Figure 5D Percentage binge drinking on heaviest drinking day in past week in 1999 and 2004 Women

Percent

Men 40

40

35

35

30

30

25

25

20

20

15

15

10

10

5

5

0

0 al er on en ti G ula p po sh Iri se i ne hi sh C de la ng Ba ni a st ki Pa an di In k n ac ea Bl ibb ar C

al er on en ti G ula p po sh Iri se i ne hi sh C de la ng Ba ni a st ki Pa an di In k n ac ea Bl ibb ar C

Amount consumed on the heaviest drinking day in the past week by equivalised household income Table 5.12 shows the amount drunk on the heaviest drinking day by equivalised household income tertiles. Among the general population, informants of both sexes in the highest income tertile were the most likely to exceed government recommendations (4 units men, 3 units women) and to binge drink (8 units men, 6 units women). Because of small sample sizes, there are few statistically significant differences between income tertiles for the minority ethnic groups. The only differences that were significant were: Irish men in the highest income tertile were the most likely to drink 8 or more units; and, Irish and Indian women in the highest tertile were the most likely to drink 3 or more units. Compared with past week drinkers in the general population, after controlling for age (see the standardised risk ratios in Table 5.12), it appears that most minority ethnic income tertile groups are less likely to binge drink than the general population. In about four-fifths of these groups, the proportion binge drinking was lower than the general population after controlling for age; only Irish men in the highest income tertile were more likely to binge drink, while the other income tertile sub-groups were not significantly different from the general population. Table 5.12

References and notes 1 Bondy S et al. Low-risk drinking guidelines: the scientific evidence. Canadian J Publ Hlth 1999; 90:264270. Rimm EG et al. Prospective study of alcohol consumption and risk of coronary heart disease in men. Lancet 1991; 338:464-68. 2 Sensible drinking: the report of an inter-department working group. Department of Health, December 1995. 3 Erens B and Laiho J. Chapter 5: Alcohol consumption in Erens B, Primatesta P, Prior G (eds) Health Survey for England 1999: The health of minority ethnic groups. Volume 1: Findings. The Stationery Office, London 2001.

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5.5.3

1999 2004

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4 The method for calculating level of alcohol consumption on the heaviest drinking day in the past week follows that used in previous Health Surveys. For six types of alcoholic drink (normal strength beer/lager/stout/cider/shandy, strong beer/lager/cider, spirits/liqueurs, fortified wines, wine, and alcoholic soft drinks), informants were asked how much they drank on their heaviest drinking day in the past week. The amount given was converted into units of alcohol, with a unit equal to half a pint of normal beer/lager/cider/shandy, a single measure of spirits, one glass of wine, one small glass of fortified wine, and one glass of alcoholic soft drink. A half pint of strong beer/lager/cider counted as 1.5 units, as does a large can of ordinary strength beer/lager/cider. The units for each type of drink were added together to give a total for the heaviest drinking day.

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139

Tables

5.1 Self-reported usual frequency of drinking alcohol in the past year, by minority ethnic group and sex 5.2 Self-reported usual frequency of drinking alcohol in the past year, by age within minority ethnic group and sex 5.3 Comparison of self-reported usual frequency of drinking alcohol in the past year, 2004 and 1999, by minority ethnic group and sex 5.4 Usual drinking frequency, by equivalised household income tertile within minority ethnic group and sex 5.5 Number of days on which alcohol was consumed in the past week, by minority ethnic group and sex 5.6 Number of days on which alcohol was consumed in the past week, by age within minority ethnic group and sex 5.7 Comparison of frequency of drinking in the last week, 2004 and 1999, by minority ethnic group and sex 5.8 Frequency of drinking in the past week, by equivalised household income tertile within minority ethnic group and sex 5.9 Amount consumed on the heaviest drinking day in the past week, by minority ethnic group and sex

5.11 Comparison of amount consumed on heaviest drinking day in the past week, 2004 and 1999, by minority ethnic group and sex 5.12 Amount consumed on the heaviest drinking day in the past week, by equivalised household income tertile within minority ethnic group and sex

140

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5.10 Amount consumed on heaviest drinking day in the past week, by age within minority ethnic group and sex

Table 5.1 Self-reported usual frequency of drinking alcohol in the past year, by minority ethnic group and sex Aged 16 and over

2004

Usual drinking frequency

Minority ethnic group Black Caribbean

General population

Black African

Indian

10 5 13 29 13 8 7

7 1 9 19 13 10 9

7 3 7 24 12 7 5

1 0 1 3 2 1 1

Pakistani Bangladeshi

Chinese

Irish

1 0 1 1 0

7 2 9 26 17 9 12

20 7 23 28 5 3 3

18 6 18 29 11 4 5

Men Observed % Almost every day Five or six days a week Three or four days a week Once or twice a week Once or twice a month Once every couple of months Once or twice a year Not at all in the last 12 months/ non-drinker Sub-total: three or more days a week Standardised risk ratios Three or more days a week

15 28

32 17

33 18

89 2

97 1

19 18

10 51

8 41

0.75

0.47

0.44

0.05

0.01

0.49

1.23

1

Standard error of the ratio

0.08

0.08

0.05

0.02

0.01

0.07

0.10

4 1 6 20 21 13 14

2 0 3 15 15 9 11

2 1 2 9 10 8 9

0 0 1 1 1 2

1 1 0

4 1 4 16 13 10 18

11 3 16 30 14 9 7

10 4 12 26 15 9 10

Women Observed % Almost every day Five or six days a week Three or four days a week Once or twice a week Once or twice a month Once every couple of months Once or twice a year Not at all in the last 12 months/ non-drinker Sub-total: three or more days a week Standardised risk ratios Three or more days a week

21 11

45 6

59 5

95 0

98 -

33 9

11 30

14 26

0.42

0.28

0.21

0.01

0.00

0.37

1.06

1

Standard error of the ratio

0.06

0.08

0.04

0.01

0.00

0.08

0.11

472 656

366 464

899 1058

411 489

172 196

150 162

1763 2352

45610 48284

403 634

378 457

547 628

422 496

396 452

345 372

495 652

2852 3799

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Bases (weighted) Men Women Bases (unweighted) Men Women

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141

Table 5.2 Self-reported usual frequency of drinking alcohol in the past year, by age within minority ethnic group and sex Aged 16 and over

2004 Age group

Men

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

17 83 31 7

21 79 26 11

26 74 27 12

21 79 28 10

24 76 10 2

29 71 13 5

60 40 7 4

35 65 11 4

45 55 14 4

41 59 18 10

[22] [78] [26] [13]

41 59 17 7

60 40 3 1

54 46 7 3

[42] [58] [13] [2]

56 44 6 2

38 62 10 3

33 67 21 8

50 50 23 12

39 61 18 7

60 40 5 1

65 35 6 2

88 12 4 3

67 33 5 2

91 9 2 -

88 12 4 2

95 5 0 -

91 9 2 1

96 4 1 -

96 4 0 -

99 1 0 -

97 3 0 -

97 3 0 -

97 3 1 -

[100] [0] [0] [-]

97 3 1 -

99 1 0 -

98 2 0 -

[100] [0] [0] [-]

99 1 0 -

25 75 12 0

30 70 22 10

48 52 27 18

31 69 18 7

43 57 9 3

54 46 9 4

67 33 8 6

52 48 9 4

10 90 45 14

10 90 53 19

19 81 51 26

13 87 51 20

11 89 21 2

13 87 35 12

27 73 27 15

17 83 30 11

General population Non- or very occasional drinker 12 Drinks at least once every 2 months 88 Drinks on 3 or more days a week 32 Drinks almost every day 9

12 88 45 17

16 84 47 27

13 87 41 18

18 82 18 2

21 79 32 12

33 67 26 14

24 76 26 10

Black Caribbean Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day Black African Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day Indian Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day Pakistani Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day Bangladeshi Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day Chinese Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day Irish Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day

142

16-34

35-54

All 55+ women

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 5: ALCOHOL CONSUMPTION

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Usual drinking frequency

Table 5.2 continued

Aged 16 and over

2004 Age group

Men

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Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

Women

16-34

35-54

55+

All men

135 169 324 195 86 73 412 14338

195 156 383 152 65 50 678 16622

142 40 192 64 21 27 673 14650

472 366 899 411 172 150 1763 45610

201 230 401 266 124 62 493 14273

291 197 464 161 51 78 1038 16910

165 37 193 62 21 22 820 17101

656 464 1058 489 196 162 2352 48284

114 171 199 213 198 170 114 721

165 169 230 144 149 117 194 972

124 38 118 65 49 58 187 1159

403 378 547 422 396 345 495 2852

184 224 235 267 286 145 147 893

288 189 274 164 117 176 275 1373

162 44 119 65 49 51 230 1533

634 457 628 496 452 372 652 3799

16-34

35-54

All 55+ women

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143

Table 5.3 Comparison of self-reported usual frequency of drinking alcohol in the past year, 2004 and 1999, by minority ethnic groupa and sex Aged 16 and over

2004, 1999 Age group

Men

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

17 83 31 7

21 79 26 11

26 74 27 12

21 79 28 10

24 76 10 2

29 71 13 5

60 40 7 4

35 65 11 4

19 81 22 6

10 90 35 13

22 78 28 16

18 82 28 11

21 79 10 2

22 78 19 7

48 52 6 2

28 72 12 4

38 62 10 3

33 67 21 8

50 50 23 12

39 61 18 7

60 40 5 1

65 35 6 2

88 12 4 3

67 33 5 2

36 64 22 4

40 60 27 13

44 56 26 15

39 61 25 10

64 36 7 2

74 26 4 0

93 7 1 1

73 27 5 1

91 9 2 -

88 12 4 2

95 5 0 -

91 9 2 1

96 4 1 -

96 4 0 -

99 1 0 -

97 3 0 -

93 7 2 1

92 8 3 2

91 9 3 -

92 8 2 1

98 2 1 1

97 3 2 2

100 -

98 2 1 1

97 3 1 -

[100] [0] [0] [-]

97 3 1 -

99 1 0 -

98 2 0 -

[100] [0] [0] [-]

99 1 0 -

96 4 1 1

100 -

97 3 1 1

100 0 -

98 2 -

100 -

99 1 -

Black Caribbean 2004 Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day 1999 Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day Indian 2004 Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day 1999 Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day Pakistani 2004 Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day 1999 Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day Bangladeshi

2004 Non- or very occasional drinker 97 Drinks at least once every 2 months 3 Drinks on 3 or more days a week 0 Drinks almost every day 1999 Non- or very occasional drinker 95 Drinks at least once every 2 months 5 Drinks on 3 or more days a week 2 Drinks almost every day 1

16-34

35-54

All 55+ women

a Black Africans were included in the 2004 survey but not in 1999, and are therefore excluded from this comparative table.

Continued…

144

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Usual drinking frequency

Table 5.3 continued

Aged 16 and over

2004, 1999

Usual drinking frequency

Age group

Men

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

25 75 12 0

30 70 22 10

48 52 27 18

31 69 18 7

43 57 9 3

54 46 9 4

67 33 8 6

52 48 9 4

37 63 18 9

35 65 17 7

69 31 11 7

43 57 16 8

46 54 9 1

61 39 9 3

67 33 4 2

57 43 8 2

10 90 45 14

10 90 53 19

19 81 51 26

13 87 51 20

11 89 21 2

13 87 35 12

27 73 27 15

17 83 30 11

1 99 49 13

7 93 46 15

16 84 41 26

8 92 45 18

10 90 27 6

12 88 32 10

33 67 26 15

17 83 29 10

12 88 32 9

12 88 45 17

16 84 47 27

13 87 41 18

18 82 18 2

21 79 32 12

33 67 26 14

24 76 26 10

8 92 41 11

8 92 46 18

17 83 41 24

11 89 43 18

14 86 23 4

17 83 31 12

32 68 27 16

21 79 27 11

Chinese 2004 Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day 1999 Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day Irish 2004 Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day 1999 Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day General population 2004 Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day 1999 Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day

16-34

35-54

All 55+ women

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Continued…

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145

Table 5.3 continued

Aged 16 and over

2004, 1999 Age group

Bases (weighted) Black Caribbean 2004 Black Caribbean 1999 Indian 2004 Indian 1999 Pakistani 2004 Pakistani 1999 Bangladeshi 2004 Bangladeshi 1999 Chinese 2004 Chinese 1999 Irish 2004 Irish 1999 General population 2004 General population 1999 Bases (unweighted) Black Caribbean 2004 Black Caribbean 1999 Indian 2004 Indian 1999 Pakistani 2004 Pakistani 1999 Bangladeshi 2004 Bangladeshi 1999 Chinese 2004 Chinese 1999 Irish 2004 Irish 1999 General population 2004 General population 1999

146

Women

16-34

35-54

55+

All men

135 141 324 215 195 183 86 66 73 33 412 385 14338 12249

195 92 383 251 152 119 65 37 50 42 678 709 16622 15704

142 129 192 124 64 47 21 29 27 19 673 446 14650 15171

472 362 899 589 411 348 172 132 150 95 1763 1540 45610 43125

201 187 401 248 266 217 124 87 62 34 493 566 14273 14708

291 189 464 255 161 117 51 33 78 62 1038 876 16910 19161

165 122 193 108 62 31 21 14 22 17 820 543 17101 17782

656 497 1058 611 489 364 196 134 162 112 2352 1985 48284 51651

114 206 199 228 213 310 198 256 170 105 114 135 721 1026

165 141 230 265 144 216 149 142 117 127 194 238 972 1297

124 192 118 125 65 77 49 116 58 65 187 161 1159 1219

403 539 547 618 422 603 396 514 345 297 495 534 2852 3542

184 277 235 262 267 373 286 340 145 107 147 203 893 1235

288 283 274 275 164 203 117 144 176 194 275 300 1373 1582

162 178 119 113 65 56 49 58 51 58 230 204 1533 1408

634 738 628 650 496 632 452 542 372 359 652 707 3799 4225

16-34

35-54

All 55+ women

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 5: ALCOHOL CONSUMPTION

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Men

Table 5.4 Usual drinking frequency, by equivalised household income tertile within minority ethnic group and sex Aged 16 and over

2004

Usual drinking frequency

Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

14 86 33 12

28 72 26 9

18 82 27 10

23 77 13 7

32 68 14 5

42 58 5 1

37 63 17 5

46 54 18 4

51 49 19 13

51 49 6 3

54 46 5 1

65 35 4 1

23 77 21 6

45 55 17 5

50 50 21 12

48 52 8 2

74 26 3 1

69 21 4 1

[76] [24] [5] [4]

94 6 1 -

92 8 1 1

[91] [9] [0] [-]

96 4 0 -

98 2 1 -

a a a a

96 4 0 -

99 1 1 -

a a a a

99 1 0 -

99 1 0 -

19 81 23 4

37 63 16 7

[45] [55] [15] [9]

40 60 14 5

58 42 7 2

70 30 3 3

8 92 54 18

15 85 59 32

31 69 35 14

8 92 41 12

21 79 25 12

27 73 16 6

7 93 48 19

17 83 37 18

27 73 26 12

13 87 36 12

30 70 19 9

40 60 14 6

Black Caribbean Drinks on 3 or more days a week

0.91

0.70

0.67

0.47

0.60

0.20

Standard error of the ratio

0.14

0.17

0.17

0.13

0.14

0.07

Drinks almost every day

0.89

0.67

0.52

0.61

0.59

0.15

Standard error of the ratio

0.28

0.24

0.21

0.21

0.25

0.12

Black African Drinks on 3 or more days a week

0.56

0.47

0.40

0.20

0.20

0.12

Standard error of the ratio

0.19

0.16

0.12

0.09

0.09

0.06

Drinks almost every day

0.57

0.21

0.71

0.31

0.22

0.11

Standard error of the ratio

0.42

0.13

0.27

0.22

0.16

0.08

Observed % Black Caribbean Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day Black African Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day Indian Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day

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Pakistani Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day Bangladeshi Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day Chinese Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day Irish Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day General population Non- or very occasional drinker Drinks at least once every 2 months Drinks on 3 or more days a week Drinks almost every day

Standardised risk ratios

a Results are not shown because of small

bases.

Continued… HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 5: ALCOHOL CONSUMPTION

147

Table 5.4 continued

Aged 16 and over Usual drinking frequency

2004 Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

Indian Drinks on 3 or more days a week

0.57

0.38

0.47

0.35

0.13

0.14

Standard error of the ratio

0.11

0.07

0.11

0.11

0.06

0.08

Drinks almost every day

0.38

0.36

0.70

0.36

0.07

0.06

Standard error of the ratio

0.15

0.12

0.24

0.24

0.07

0.06

[0.10]

0.03

0.02

[0.00]

0.00

0.03

[0.08]

0.03

0.02

[0.00]

0.00

0.03

[0.20]

0.00

0.05

[0.00]

0.00

0.00

Pakistani Drinks on 3 or more days a week Standard error of the ratio

Drinks almost every day Standard error of the ratio

[0.19]

0.00

0.05

[0.00]

0.00

0.00

Bangladeshi Drinks on 3 or more days a week

a

0.00

0.01

a

0.00

0.00

Standard error of the ratio

a

0.00

0.01

a

0.00

0.00

Drinks almost every day

a

0.00

0.00

a

0.00

0.00

Standard error of the ratio

a

0.00

0.00

a

0.00

0.00

Chinese Drinks on 3 or more days a week

0.59

0.45

[0.39]

0.51

0.27

0.12

Standard error of the ratio

0.12

0.13

[0.17]

0.14

0.14

0.12

Drinks almost every day

0.23

0.62

[0.58]

0.58

0.35

0.34

Standard error of the ratio

0.11

0.28

[0.28]

0.29

0.26

0.34

Irish Drinks on 3 or more days a week

1.34

1.27

0.90

1.49

0.90

0.57

Standard error of the ratio

0.12

0.17

0.21

0.18

0.19

0.16

Drinks almost every day

1.10

1.32

0.81

1.14

1.04

0.73

Standard error of the ratio

0.21

0.33

0.36

0.27

0.38

0.32

General population Drinks on 3 or more days a week

1.17

0.87

0.61

1.36

0.73

0.51

Standard error of the ratio

0.05

0.06

0.08

0.08

0.06

0.07

Drinks almost every day

1.13

0.95

0.61

1.27

0.79

0.66

Standard error of the ratio

0.09

0.10

0.12

0.12

0.10

0.13

151 112 263 55 8 44 833 21714

115 84 239 117 38 35 396 11359

101 86 149 130 70 21 260 5557

154 123 302 56 9 52 1037 19349

181 113 284 131 42 34 565 14228

176 146 203 163 80 23 335 6407

122 103 158 47 19 105 207 1335

90 101 154 112 87 76 121 745

90 89 96 150 160 47 88 349

147 102 177 46 23 120 256 1464

157 121 171 132 97 74 162 1174

175 145 126 170 181 56 121 530

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

a Results are not shown because of small bases.

148

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Standardised risk ratios

Table 5.5 Number of days on which alcohol was consumed in the past week, by minority ethnic group and sex Aged 16 and over

2004

Number of days

Minority ethnic group

General population

Black Caribbean

Black African

Indian

Observed % 0 1 2 3 4 5 6 7 Sub-total: drank on at least 1 day Mean number of days

40 20 14 7 5 5 2 7 60 1.78

62 13 9 4 2 3 1 5 38 1.12

53 18 11 6 3 2 3 6 47 1.31

93 3 2 1 0 0 1 7 0.16

Standard error of the mean

0.14

0.13

0.10

Standardised risk ratios Drank on at least 1 day

0.80

0.51

Standard error of the ratio

0.04

0.04

Drank on all 7 days

0.51

Standard error of the ratio

0.13

Mean number of days Standard error of the ratio

Pakistani Bangladeshi

Chinese

Irish

99 0 0 0 0 1 0.03

52 19 9 4 6 1 1 8 48 1.39

20 11 19 14 11 6 1 18 80 2.98

24 17 15 11 8 5 4 15 76 2.70

0.05

0.01

0.14

0.15

0.06

0.62

0.09

0.01

0.64

1.07

1.00

0.04

0.02

0.01

0.05

0.04

0.43

0.42

0.04

-

0.65

1.10

0.13

0.08

0.04

-

0.14

0.17

0.69

0.43

0.50

0.06

0.01

0.56

1.07

0.06

0.05

0.04

0.02

0.01

0.06

0.06

Observed % 0 1 2 3 4 5 6 7 Sub-total: drank on at least 1 day Mean number of days

53 24 11 4 2 1 0 3 47 0.97

74 15 5 2 1 1 0 2 26 0.51

79 11 5 3 0 0 0 2 21 0.46

97 1 1 0 0 3 0.05

99 0 0 1 0.01

68 14 9 3 2 0 1 3 32 0.74

33 20 12 11 6 6 3 9 67 2.10

39 20 13 9 5 4 2 9 61 1.84

Standard error of the mean

0.08

0.07

0.06

0.02

0.00

0.09

0.11

0.04

Standardised risk ratios Drank on at least 1 day

0.75

0.43

0.33

0.04

0.01

0.49

1.10

1.00

Standard error of the ratio

0.04

0.05

0.04

0.01

0.01

0.05

0.05

Drank on all 7 days

0.41

0.23

0.23

0.01

-

0.40

0.97

Standard error of the ratio

0.13

0.10

0.09

0.01

-

0.16

0.18

Mean number of days

0.55

0.31

0.26

0.02

0.01

0.41

1.09

Standard error of the ratio

0.05

0.05

0.03

0.01

0.00

0.06

0.07

465 640

357 454

874 1044

406 488

172 194

147 157

1754 2329

45399 47791

397 617

369 447

532 619

416 495

395 448

338 363

491 642

2837 3755

Men

1.00 1.00

Copyright © 2006, The Information Centre. All rights reserved

Women

Bases (weighted) Men Women Bases (unweighted) Men Women

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 5: ALCOHOL CONSUMPTION

1.00 1.00

149

Table 5.6 Number of days on which alcohol was consumed in the past week, by age within minority ethnic group and sex Aged 16 and over

2004 Age group

Men

Black Caribbean Drank on at least 1 day Drank on all 7 days Mean number of days Black African Drank on at least 1 day Drank on all 7 days Mean number of days Indian Drank on at least 1 day Drank on all 7 days Mean number of days Pakistani Drank on at least 1 day Drank on all 7 days Mean number of days Bangladeshi Drank on at least 1 day Drank on all 7 days Mean number of days Chinese Drank on at least 1 day Drank on all 7 days Mean number of days Irish Drank on at least 1 day Drank on all 7 days Mean number of days General population Drank on at least 1 day Drank on all 7 days Mean number of days Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

150

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

59 1 1.6

63 9 2.0

58 12 1.7

60 7 1.8

52 2 1.0

53 3 1.1

27 4 0.7

47 3 1.0

33 3 1.0

43 7 1.3

[42] [9] [1.1]

38 5 1.1

22 1 0.4

30 3 0.6

[27] [2] [0.6]

26 2 0.5

43 2 1.0

52 6 1.5

42 11 1.4

47 6 1.3

24 1 0.4

24 3 0.5

9 1 0.3

21 2 0.5

7 0.1

8 1 0.2

3 0.0

7 1 0.2

3 0 0.1

2 0.0

0 0.0

3 0 0.0

0 0 0.0

2 0 0.1

[0] [0] [0.0]

1 0 0.0

0 0 0.0

2 0 0.0

[0] [0] [0.0]

1 0 0.0

46 3 1.1

54 9 1.7

41 19 1.8

48 8 1.4

35 1 0.7

35 3 0.8

[13] [7] [0.6]

32 3 0.7

84 8 2.5

82 17 3.0

75 25 3.3

80 18 3.0

75 2 1.8

71 11 2.4

57 10 1.9

67 9 2.1

74 7 2.3

77 15 2.8

75 23 3.1

76 15 2.7

62 3 1.5

67 9 2.1

54 13 1.9

61 9 1.8

134 167 316 194 85 73 410 14294

192 151 375 150 65 49 675 16582

140 39 183 61 21 25 670 14523

465 357 874 406 172 147 1754 45399

201 229 400 265 124 60 486 14226

288 189 456 161 50 76 1027 16835

152 37 189 62 21 21 816 16730

640 454 1044 488 194 157 2329 47791

113 169 194 211 197 169 112 719

163 164 226 142 149 114 193 970

121 36 112 63 49 55 186 1148

397 369 532 416 395 338 491 2837

184 223 234 266 284 142 144 890

284 181 268 164 116 173 269 1366

149 43 117 65 48 48 229 1499

617 447 619 495 448 363 642 3755

16-34

35-54

All 55+ women

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 5: ALCOHOL CONSUMPTION

Copyright © 2006, The Information Centre. All rights reserved

Number of days

Table 5.7 Comparison of frequency of drinking in the last week, 2004 and 1999, by minority ethnic groupa and sex Aged 16 and over Number of days

2004, 1999 Age group

Copyright © 2006, The Information Centre. All rights reserved

Men

Black Caribbean 2004 Drank on at least 1 day Drank on all 7 days Mean number of days 1999 Drank on at least 1 day Drank on all 7 days Mean number of days Indian 2004 Drank on at least 1 day Drank on all 7 days Mean number of days 1999 Drank on at least 1 day Drank on all 7 days Mean number of days Pakistani 2004 Drank on at least 1 day Drank on all 7 days Mean number of days 1999 Drank on at least 1 day Drank on all 7 days Mean number of days Bangladeshi 2004 Drank on at least 1 day Drank on all 7 days Mean number of days 1999 Drank on at least 1 day Drank on all 7 days Mean number of days Chinese 2004 Drank on at least 1 day Drank on all 7 days Mean number of days 1999 Drank on at least 1 day Drank on all 7 days Mean number of days

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

59 1 1.6

63 9 2.0

58 12 1.7

60 7 1.8

52 2 1.0

53 3 1.1

27 4 0.7

47 3 1.0

62 4 1.6

75 10 2.4

57 11 1.8

63 8 1.9

57 1 1.1

55 5 1.4

32 1 0.6

50 2 1.1

43 2 1.0

52 6 1.5

42 11 1.4

47 6 1.3

24 1 0.4

24 3 0.5

9 1 0.3

21 2 0.5

47 2 1.3

45 9 1.5

43 13 1.5

46 7 1.4

20 0 0.5

14 0.2

6 0.1

15 0 0.3

7 0.1

8 1 0.2

3 0.0

7 1 0.2

3 0 0.1

2 0.0

0 0.0

3 0 0.0

5 0 0.1

5 2 0.2

9 0.2

5 1 0.1

1 0 0.0

3 0.1

0.0

2 0 0.1

0 0 0.0

2 0 0.1

[0] [0] [0.0]

1 0 0.0

0 0 0.0

2 0 0.0

[0] [0] [0.0]

1 0 0.0

4 1 0.2

2 1 0.1

0.0

2 1 0.1

0 0.0

2 0.0

0.0

1 0.0

46 3 1.1

54 9 1.7

41 19 1.8

48 8 1.4

35 1 0.7

35 3 0.8

[13] [7] [0.6]

32 3 0.7

45 4 1.1

41 5 1.1

22 8 0.8

39 5 1.1

32 1 0.6

28 2 0.6

25 2 0.6

29 2 0.6

16-34

35-54

All 55+ women

a Black Africans were included in the 2004 survey but not in 1999, and are therefore excluded from this

comparative table.

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 5: ALCOHOL CONSUMPTION

151

Table 5.7 continued

Aged 16 and over

2004, 1999 Age group

Men

Irish 2004 Drank on at least 1 day Drank on all 7 days Mean number of days 1999 Drank on at least 1 day Drank on all 7 days Mean number of days General population 2004 Drank on at least 1 day Drank on all 7 days Mean number of days 1999 Drank on at least 1 day Drank on all 7 days Mean number of days Bases (weighted) Black Caribbean 2004 Black Caribbean 1999 Indian 2004 Indian 1999 Pakistani 2004 Pakistani 1999 Bangladeshi 2004 Bangladeshi 1999 Chinese 2004 Chinese 1999 Irish 2004 Irish 1999 General population 2004 General population 1999 Bases (unweighted) Black Caribbean 2004 Black Caribbean 1999 Indian 2004 Indian 1999 Pakistani 2004 Pakistani 1999 Bangladeshi 2004 Bangladeshi 1999 Chinese 2004 Chinese 1999 Irish 2004 Irish 1999 General population 2004 General population 1999

152

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

84 8 2.5

82 17 3.0

75 25 3.3

80 18 3.0

75 2 1.8

71 11 2.4

57 10 1.9

67 9 2.1

88 10 3.1

79 12 2.8

72 20 2.8

79 14 2.9

71 5 1.9

74 9 2.1

48 10 1.4

66 8 1.9

74 7 2.3

77 15 2.8

75 23 3.1

76 15 2.7

62 3 1.5

67 9 2.1

54 13 1.9

61 9 1.8

80 9 2.5

81 13 2.8

72 21 2.7

77 15 2.7

69 3 1.7

67 8 2.0

52 14 1.8

62 9 1.8

134 141 316 215 194 181 85 66 73 33 410 385 14294 12223

192 91 375 250 150 118 65 37 49 42 675 710 16582 15679

140 127 183 120 61 46 21 29 25 18 670 444 14523 15092

465 360 874 585 406 346 172 132 147 92 1754 1539 45399 42993

201 186 400 244 265 216 124 87 60 34 486 553 14226 14680

288 189 456 250 161 117 50 33 76 59 1027 874 16835 19067

152 118 189 108 62 31 21 14 21 16 816 539 16730 17661

640 493 1044 601 488 364 194 134 157 109 2329 1966 47791 51408

113 206 194 228 211 308 197 256 169 104 112 135 719 1024

163 140 226 265 142 215 149 140 114 126 193 238 970 1296

121 189 112 121 63 76 49 116 55 60 186 160 1148 1213

397 535 532 614 416 599 395 512 338 290 491 533 2837 3533

184 276 234 259 266 372 284 340 142 107 144 199 890 1232

284 283 268 271 164 203 116 143 173 187 269 299 1366 1574

149 172 117 112 65 56 48 58 48 54 229 201 1499 1398

617 731 619 642 495 631 448 541 363 348 642 699 3755 4204

16-34

35-54

All 55+ women

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 5: ALCOHOL CONSUMPTION

Copyright © 2006, The Information Centre. All rights reserved

Number of days

Table 5.8 Frequency of drinking in the past week, by equivalised household income tertile within minority ethnic group and sex Aged 16 and over Number of days

2004 Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

72 8 2.2

55 4 1.5

58 9 1.8

56 5 1.3

52 5 1.1

40 0.7

39 3 1.1

34 3 0.9

33 9 1.2

29 2 0.5

26 1 0.5

17 2 0.4

55 5 1.5

42 5 1.2

39 6 1.2

34 2 0.7

15 0.2

14 1 0.3

[21] [4] [0.5]

6 0.1

4 0.0

[8] [-] [0.1]

2 0.0

2 0 0.1

a a a

-

1 0.0

a a a

1 0.0

1 0.0

62 6 1.7

45 9 1.4

[41] [12] [1.4]

42 2 1.0

24 4 0.5

27 5 0.7

83 17 3.1

82 27 3.4

60 19 2.3

81 11 2.8

59 10 1.8

52 6 1.3

84 16 3.1

71 16 2.5

56 9 1.7

74 11 2.4

53 8 1.5

43 6 1.1

Observed % Black Caribbean Drank on at least 1 day Drank on all 7 days Mean number of days Black African Drank on at least 1 day Drank on all 7 days Mean number of days Indian Drank on at least 1 day Drank on all 7 days Mean number of days Pakistani Drank on at least 1 day Drank on all 7 days Mean number of days Bangladeshi Drank on at least 1 day Drank on all 7 days Mean number of days Chinese Drank on at least 1 day Drank on all 7 days Mean number of days Irish Drank on at least 1 day Drank on all 7 days Mean number of days General population Drank on at least 1 day Drank on all 7 days Mean number of days

a Results are not shown because of small bases.

Copyright © 2006, The Information Centre. All rights reserved

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 5: ALCOHOL CONSUMPTION

153

Table 5.8 continued

Aged 16 and over Number of days

2004 Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

Black Caribbean Drank on at least 1 day

0.94

0.76

0.75

0.85

0.90

0.63

Standard error of the ratio

0.07

0.08

0.08

0.09

0.08

0.07

Black African Drank on at least 1 day

0.57

0.44

0.42

0.44

0.39

0.24

Standard error of the ratio

0.10

0.09

0.09

0.10

0.08

0.05

Indian Drank on at least 1 day

0.74

0.53

0.50

0.53

0.24

0.21

Standard error of the ratio

0.06

0.06

0.07

0.07

0.07

0.06

Pakistani Drank on at least 1 day

[0.34]

0.08

0.06

[0.14]

0.02

0.03

Standard error of the ratio

[0.14]

0.03

0.03

[0.07]

0.02

0.02

Bangladeshi Drank on at least 1 day

a

-

0.01

a

0.03

0.02

Standard error of the ratio

a

-

0.01

a

0.02

0.01

Chinese Drank on at least 1 day

0.80

0.61

0.56

0.56

0.37

0.45

Standard error of the ratio

0.07

0.09

0.09

0.07

0.10

0.10

Irish Drank on at least 1 day

1.13

1.03

0.82

1.29

1.06

0.91

Standard error of the ratio

0.04

0.09

0.10

0.06

0.09

0.11

General population Drank on at least 1 day

1.10

0.94

0.73

1.17

0.90

0.71

Standard error of the ratio

0.03

0.04

0.04

0.03

0.04

0.04

148 111 260 55 8 43 833 21681

115 84 233 112 38 35 390 11283

100 81 139 130 69 19 260 5545

153 121 297 56 9 52 1031 19263

178 113 281 130 42 34 560 14074

171 141 198 163 79 22 326 6234

121 101 156 47 19 104 207 1333

90 100 151 108 87 75 118 740

89 85 89 149 159 43 88 348

146 100 175 46 23 119 254 1457

152 121 169 131 97 73 161 1160

171 140 122 170 179 54 116 515

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

a Results are not shown because of small bases.

154

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 5: ALCOHOL CONSUMPTION

Copyright © 2006, The Information Centre. All rights reserved

Standardised risk ratios

Table 5.9 Amount consumed on the heaviest drinking day in the past week, by minority ethnic group and sex Aged 16 and over

2004

Alcohol consumption (units per day)

Minority ethnic group

General population

Black Caribbean

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Men Observed % None Under 2 units 2, under 3 units 3, under 4 units 4, under 5 units 5, under 6 units 6, under 8 units 8 or more units Sub total: 4 or more unitsa Sub total: 8 or more unitsa Standardised risk ratios Consumed 4 or more units

40 12 14 6 5 4 7 12 28 12

62 8 7 6 6 1 3 7 17 7

53 11 9 4 8 2 3 9 22 9

93 1 1 1 1 0 3 4 3

99 0 0 0 0 1 0

52 14 12 3 4 1 4 10 19 10

20 10 9 5 13 3 9 32 56 32

24 13 12 6 8 3 9 25 45 25

0.64

0.35

0.48

0.08

0.01

0.38

1.27

1

Standard error of the ratio

0.07

0.05

0.05

0.02

0.01

0.05

0.07

Consumed 8 or more units

0.48

0.23

0.34

0.10

0.01

0.29

1.35

Standard error of the ratio

0.08

0.06

0.06

0.04

0.01

0.06

0.15

1

Copyright © 2006, The Information Centre. All rights reserved

Women Observed % None Under 2 units 2, under 3 units 3, under 4 units 4, under 5 units 5, under 6 units 6, under 8 units 8 or more units Sub total: 3 or more unitsa Sub total: 6 or more unitsa Standardised risk ratios Consumed 3 or more units

53 17 11 7 4 1 3 3 18 6

74 11 7 2 2 1 1 1 7 2

79 8 5 3 0 1 1 2 8 4

97 1 0 0 0 0 0 0 1 1

99 0 0 1 0

68 15 5 4 2 2 2 2 12 4

33 18 13 10 5 5 8 8 36 16

39 18 13 8 5 3 7 7 30 14

0.60

0.24

0.23

0.03

0.02

0.35

1.21

1

Standard error of the ratio

0.07

0.05

0.04

0.01

0.01

0.06

0.10

Consumed 6 or more units

0.43

0.24

0.23

0.03

0.02

0.35

1.21

Standard error of the ratio

0.07

0.05

0.04

0.01

0.01

0.06

0.10

465 641

357 454

873 1043

406 488

172 194

147 158

1751 2329

45229 47623

397 618

369 446

531 618

416 495

395 448

337 364

490 642

2829 3745

Bases (weighted) Men Women Bases (unweighted) Men Women

1

a These figures are cumulative.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 5: ALCOHOL CONSUMPTION

155

Table 5.10 Amount consumed on heaviest drinking day in the past week, by age within minority ethnic group and sex Aged 16 and over

2004 Age group

Men

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

36 17 3.7

32 16 3.5

15 3 1.7

28 12 3.0

31 12 2.2

17 5 1.3

5 1 0.5

18 6 1.4

0.54

0.50

0.27

0.27

0.30

0.13

0.09

0.12

15 9 2.2

17 6 1.8

20 2 1.5

17 7 1.9

7 3 0.6

8 0 0.6

7 5 0.8

7 2 0.6

0.58

0.31

0.45

0.30

0.16

0.09

0.36

0.10

25 13 2.6 0.46

25 9 2.2 0.21

11 2 1.1 0.20

22 9 2.1 0.21

13 7 0.9 0.17

6 3 0.7 0.14

0 0 0.1 0.03

8 4 0.7 0.09

4 3 0.4

5 4 0.5

1 1 0.1

4 3 0.4

2 1 0.1

0 0 0.0

0 0 0.0

1 1 0.1

0.14

0.23

0.06

0.12

0.09

0.01

0.00

0.05

0 0.0

1 1 0.1

0 0.0

1 0 0.1

0 0 0.0

2 1 0.1

0 0 0.0

1 0 0.0

0.03

0.10

0.00

0.04

0.03

0.09

0.00

0.03

24 17 2.7

15 3 1.6

13 3 1.3

19 10 2.1

21 10 1.5

8 2 0.7

2 0 0.2

12 4 0.9

Standard error of the mean

0.48

0.23

0.30

0.24

0.28

0.12

0.10

0.13

Irish 4/3 or more units 8/6 or more units Mean units

72 51 10.6

57 34 6.3

46 17 3.9

56 32 6.4

51 27 3.7

41 18 2.9

20 6 1.5

36 16 2.6

Standard error of the mean

1.55

0.63

0.35

0.52

0.44

0.32

0.18

0.19

54 37 7.7

49 27 5.0

32 12 3.1

45 25 5.2

39 23 3.1

35 15 2.5

16 5 1.2

30 14 2.2

0.45

0.20

0.11

0.18

0.16

0.10

0.05

0.06

Black Caribbean 4/3 or more units 8/6 or more units Mean units Standard error of the mean

Black African 4/3 or more units 8/6 or more units Mean units Standard error of the mean

Indian 4/3 or more units 8/6 or more units Mean units Standard error of the mean Pakistani 4/3 or more units 8/6 or more units Mean units Standard error of the mean

Bangladeshi 4/3 or more units 8/6 or more units Mean units Standard error of the mean

Chinese 4/3 or more units 8/6 or more units Mean units

General population 4/3 or more units 8/6 or more units Mean units Standard error of the mean

16-34

35-54

All 55+ women

Continued…

156

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 5: ALCOHOL CONSUMPTION

Copyright © 2006, The Information Centre. All rights reserved

Number of units

Table 5.10 continued

Aged 16 and over

2004 Age group

Men

Copyright © 2006, The Information Centre. All rights reserved

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

Women

16-34

35-54

55+

All men

134 165 314 194 85 73 410 14147

192 152 375 150 65 48 675 16571

140 39 183 61 21 25 667 14511

465 357 873 406 172 147 1751 45229

199 228 400 265 124 60 486 14072

288 189 455 161 50 76 1027 16823

153 37 189 62 21 21 816 16728

641 454 1043 488 194 158 2329 47623

113 168 193 211 197 169 112 713

163 165 226 142 149 113 193 969

121 36 112 63 49 55 185 1147

397 369 531 416 395 337 490 2829

183 222 234 266 284 142 144 881

285 181 267 164 116 173 269 1365

150 43 117 65 48 49 229 1499

618 446 618 495 448 364 642 3745

16-34

35-54

All 55+ women

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 5: ALCOHOL CONSUMPTION

157

Table 5.11 Comparison of amount consumed on heaviest drinking day in the past week, 2004 and 1999, by minority ethnic groupa and sex Aged 16 and over

2004, 1999 Age group

Men

Black Caribbean 2004 4/3 or more units 8/6 or more units units Mean units 1999 4/3 or more units 8/6 or more units units Mean units Indian 2004 4/3 or more units 8/6 or more units units Mean units 1999 4/3 or more units 8/6 or more units units Mean units Pakistani 2004 4/3 or more units 8/6 or more units units Mean units 1999 4/3 or more units 8/6 or more units units Mean units Bangladeshi 2004 4/3 or more units 8/6 or more units units Mean units 1999 4/3 or more units 8/6 or more units units Mean units Chinese 2004 4/3 or more units 8/6 or more units units Mean units 1999 4/3 or more units 8/6 or more units units Mean units

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

36 17 3.7

32 16 3.5

15 3 1.7

28 12 3.0

31 12 2.2

17 5 1.3

5 1 0.5

18 6 1.4

29 11 4.5

32 10 3.3

21 9 2.3

27 10 3.4

22 9 3.5

21 6 1.5

5 1 0.5

17 6 2.0

25 13 2.6

25 9 2.2

11 2 1.1

22 9 2.1

13 7 0.9

6 3 0.7

0 0 0.1

8 4 0.7

28 14 6.2

22 9 2.0

13 5 1.5

22 10 3.4

9 5 0.7

3 1 0.3

1 0 0.1

5 2 0.5

4 3 0.4

5 4 0.5

1 1 0.1

4 3 0.4

2 1 0.1

0.0

0 0 0.0

1 1 0.1

3 0 0.3

3 1 0.3

4 1 0.4

3 1 0.3

1 1 0.1

0 0 0.0

-

1 1 0.1

0 0.0

1 1 0.1

[-] [-] [-]

1 0 0.1

0 0 0.0

2 1 0.1

[-] [-] [-]

1 0 0.0

3 3 0.7

0.0

-

2 2 0.4

-

2 0.1

-

0 0.0

24 17 2.7

15 3 1.6

13 3 1.3

19 10 2.1

21 10 1.5

8 2 0.7

[2] [0] [0.2]

12 4 0.9

13 4 1.4

6 1 0.9

4 0.5

8 2 1.0

16 4 1.1

5 2 0.6

6 0.4

9 3 0.7

16-34

35-54

All 55+ women

a Black Africans were included in the 2004 survey but not in 1999, and are therefore excluded from this

comparative table.

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Number of units

Table 5.11 continued

Aged 16 and over

2004, 1999

Number of units

Age group

Men

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Irish 2004 4/3 or more units 8/6 or more units units Mean units 1999 4/3 or more units 8/6 or more units units Mean units General population 2004 4/3 or more units 8/6 or more units units Mean units 1999 4/3 or more units 8/6 or more units units Mean units Bases (weighted) Black Caribbean 2004 Black Caribbean 1999 Indian 2004 Indian 1999 Pakistani 2004 Pakistani 1999 Bangladeshi 2004 Bangladeshi 1999 Chinese 2004 Chinese 1999 Irish 2004 Irish 1999 General population 2004 General population 1999 Bases (unweighted) Black Caribbean 2004 Black Caribbean 1999 Indian 2004 Indian 1999 Pakistani 2004 Pakistani 1999 Bangladeshi 2004 Bangladeshi 1999 Chinese 2004 Chinese 1999 Irish 2004 Irish 1999 General population 2004 General population 1999

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

72 51 10.6

57 34 6.3

46 17 3.9

56 32 6.4

51 27 3.7

41 18 2.9

20 6 1.5

36 16 2.6

78 53 18.4

55 34 5.7

46 22 4.5

58 35 8.4

48 24 3.6

43 13 2.7

16 6 1.2

37 14 2.5

54 37 7.7

49 27 5.0

32 12 3.1

45 25 5.2

39 23 3.1

35 15 2.5

16 5 1.2

30 14 2.2

57 41 8.0

52 27 5.3

31 12 2.9

46 25 5.2

42 24 4.9

34 12 2.2

13 2 1.1

29 12 2.6

134 133 314 200 194 181 85 66 73 30 410 370 14147 10956

192 90 375 250 150 118 65 37 48 42 675 707 16571 15652

140 126 183 118 61 46 21 29 25 18 667 444 14511 15037

465 348 873 568 406 346 172 132 147 90 1751 1520 45229 41645

199 179 400 241 265 216 124 87 60 33 486 526 14072 13916

288 189 455 250 161 117 50 33 76 59 1027 874 16823 19067

153 118 189 108 62 31 21 14 21 16 816 539 16728 17635

641 486 1043 598 488 364 194 134 158 108 2329 1939 47623 50617

113 195 193 212 211 307 197 256 169 97 112 131 713 925

163 138 226 265 142 215 149 140 113 125 193 236 969 1294

121 187 112 120 63 76 49 116 55 60 185 160 1147 1208

397 520 531 597 416 598 395 512 337 282 490 527 2829 3427

183 266 234 255 266 372 284 339 142 103 144 193 881 1168

285 283 267 271 164 203 116 143 173 187 269 299 1365 1574

150 172 117 112 65 56 48 58 49 54 229 201 1499 1396

618 721 618 638 495 631 448 540 364 344 642 693 3745 4138

16-34

35-54

All 55+ women

a Black Africans were included in the 2004 survey but not in 1999, and are therefore excluded from this

comparative table. HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 5: ALCOHOL CONSUMPTION

159

Table 5.12 Amount consumed on the heaviest drinking day in the past week, by equivalised household income tertile within minority ethnic group and sex Aged 16 and over Number of units

2004 Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

40 19 4.1

28 11 3.0

22 8 2.2

24 5 1.5

24 10 1.8

16 8 1.4

0.50

0.51

0.46

0.21

0.29

0.26

15 3 1.5

20 8 1.9

13 10 1.8

6 1 0.6

10 3 0.7

4 1 0.4

0.34

0.58

0.55

0.11

0.17

0.13

22 11 2.2

26 8 2.0

17 8 2.0

14 7 1.2

5 2 0.3

3 5 0.3

Standard error of the mean

0.25

0.33

0.61

0.23

0.10

0.09

Pakistani 4/3 or more units 8/6 or more units Mean units

[8] [4] [0.7]

5 4 0.5

2 2 0.4

[1] [0] [0.1]

2 2 0.2

2 0 0.1

Standard error of the mean

Black Caribbean 4/3 or more units 8/6 or more units Mean units Standard error of the mean

Black African 4/3 or more units 8/6 or more units Mean units Standard error of the mean

Indian 4/3 or more units 8/6 or more units Mean units

[0.39]

0.21

0.21

[0.06]

0.16

0.06

Bangladeshi 4/3 or more units 8/6 or more units Mean units

a a a

-

1 1 0.1

a a a

1 0 0.0

1 1 0.1

Standard error of the mean

a

-

0.09

a

0.04

0.07

28 12 2.8

25 18 2.9

[7] [-] [0.8]

14 4 1.2

9 4 0.7

6 2 0.6

0.44

0.65

[0.19]

0.21

0.23

0.17

62 41 7.3

44 21 4.6

50 23 5.3

47 19 3.1

24 14 2.0

32 19 2.7

0.74

0.60

1.08

0.27

0.31

0.58

52 29 6.1

40 21 4.4

32 19 3.9

38 17 2.7

23 10 1.8

19 13 1.8

0.21

0.27

0.48

0.09

0.10

0.18

Chinese 4/3 or more units 8/6 or more units Mean units Standard error of the mean

Irish 4/3 or more units 8/6 or more units Mean units Standard error of the mean

General population 4/3 or more units 8/6 or more units Mean units Standard error of the mean

a Results are not shown because of small bases.

160

Continued…

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Observed %

Table 5.12 continued

Aged 16 and over

2004

Number of units

Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

Black Caribbean 8/6 or more units (risk ratio)

0.78

0.50

0.25

0.35

0.77

0.51

Standard error of the ratio

0.17

0.16

0.13

0.14

0.25

0.17

Black African 8/6 or more units (risk ratio)

0.12

0.29

0.33

0.04

0.25

0.05

Standard error of the ratio

0.06

0.12

0.14

0.04

0.14

0.05

Indian 8/6 or more units (risk ratio)

0.40

0.28

0.34

0.34

0.05

0.07

Standard error of the ratio

0.10

0.11

0.13

0.11

0.04

0.07

[0.11]

0.13

0.07

[0.00]

0.07

0.02

[0.11]

0.07

0.04

[0.00]

0.07

0.02

Bangladeshi 8/6 or more units (risk ratio)

a

-

0.02

0.00

0.00

0.07

Standard error of the ratio

a

-

0.02

0.00

0.00

0.05

Chinese 8/6 or more units (risk ratio)

0.44

0.63

[0.00]

0.28

0.24

0.16

Standard error of the ratio

0.13

0.16

[0.00]

0.12

0.14

0.15

Irish 8/6 or more units (risk ratio)

1.77

0.84

0.81

1.28

1.19

1.63

Standard error of the ratio

0.22

0.19

0.21

0.25

0.42

0.49

General population 8/6 or more units (risk ratio)

1.09

0.92

0.80

1.10

0.84

1.05

Standard error of the ratio

0.07

0.09

0.12

0.10

0.10

0.14

148 111 260 55 8 43 833 11225

115 84 233 112 38 35 390 5506

101 80 139 130 69 19 260 45229

153 121 297 56 9 52 1031 19171

178 113 278 130 42 34 560 14066

170 140 198 163 79 22 326 6180

121 101 156 47 19 104 207 1329

90 100 151 108 87 75 118 738

90 84 89 149 159 42 88 346

146 100 175 46 23 119 254 1451

152 121 167 131 97 73 161 1160

171 139 122 170 179 54 116 512

Standardised risk ratios

Pakistani 8/6 or more units (risk ratio)

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Standard error of the ratio

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

a Results are not shown because of small bases.

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161

Anthropometric measures, overweight, and obesity

6

Vasant Hirani and Emmanuel Stamatakis

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Summary ●

After adjusting for age, Bangladeshi, Chinese, Indian, Pakistani and Black African men were, on average, shorter than men in the general population, whereas Black Caribbean and Irish men were a similar height to men in the general population. Women in minority ethnic groups were on average shorter than women in the general population, apart from Irish, Black Caribbean and Black African women, who were a similar height to women in the general population.

●

Mean BMI of Chinese (24.1kg/m2), Bangladeshi (24.7kg/m2), Indian (25.8kg/m2) and Pakistani (25.9kg/m2) men was lower than in the general population (27.1kg/m2). Mean BMI in Chinese women was markedly lower (23.2kg/m2), in Indian (26.2kg/m2) and Irish (26.7kg/m2) women was similar to, and in Black Caribbean (28.0kg/m2) and Black African (28.8kg/m2) women was higher than in women in the general population (26.8kg/m2).

●

There are no widely accepted ethnicity-specific BMI cut-off points available. There is a lack of evidence of the validity of the thresholds for defining overweight and obesity used in this report for different ethnic groups.

●

After adjusting for age, Chinese and Bangladeshi men were least likely to be overweight or obese (BMI>25kg/m2), with standardised risk ratios of 0.62 and 0.75, compared with 1.0 for the general population. Indian and Pakistani men were also less likely to be overweight or obese (risk ratios 0.82 and 0.89 respectively). The likelihood of Black African, Black Caribbean and Irish men being overweight or obese was the same as for men in the general population. Among women, levels of overweight including obesity tended to be higher in Black African women (risk ratio 1.37), Pakistani women (risk ratio 1.24) and Black Caribbean women (risk ratio 1.16). Chinese women were half as likely to be overweight or obese (risk ratio 0.46) as women in the general population (set at 1.0).

●

Black Caribbean and Irish (25%) men had the highest prevalence of obesity (BMI>30kg/m2). Bangladeshi men were almost five times, and Chinese men almost four times, less likely to be obese than men in the general population. For women, risk ratios were higher for Black African women (prevalence 38%, risk ratio 2.00), Black Caribbean women (32%, risk ratio 1.43) and Pakistani women (28%, risk ratio 1.48) and lower for Chinese women (8%, risk ratio 0.32) than women in the general population.

●

After age-standardisation, the risk of raised waist hip ratio (WHR) was higher than in the general population for Pakistani (1.46) and Bangladeshi men (1.34), and lower for Chinese (0.66) and Black Caribbean men (0.73). Black Caribbean, Indian, Bangladeshi and Chinese men had a lower risk of raised waist circumference than the general population.

●

The risks of raised WHR and raised waist circumference were generally higher than the general population for women in most minority ethnic groups, except among Indian and Irish women, who had about the same risk as women in the general population, and Chinese women, who had a lower risk.

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After adjusting for age, overweight including obesity tended to increase with income (from the lowest income tertiles to highest income tertiles) among Black African men and Irish men.

●

The prevalence of obesity (BMI>30kg/m2) among women increased from the highest to lowest income tertile for almost all minority ethnic groups, except for Black African, Bangladeshi and Chinese women. The prevalence of morbid obesity (BMI>40kg/m2) increased from 1% in the highest income tertile to 6% in the lowest income tertile in Irish women, from 2% to 9% in Black Caribbean women, and from 3% to 10% in Black African women.

●

The prevalence of raised WHR among Black Caribbean and Indian men was higher in the lowest income tertile (44% and 51%, respectively) than in the highest income tertile (13% and 31%). For Black African and Black Caribbean men this was also true for raised waist circumference.

●

Among Black Caribbean, Indian and Irish women and women in the general population, raised WHR was inversely related to income. Raised waist circumference showed a similar relationship in Irish women (61% in lowest income tertile, 36% in the highest) and women in the general population.

●

Overall, the patterns for BMI, overweight and obesity, WHR and raised waist circumference in HSE 2004 were similar to those in 1999, although for most groups the absolute levels of overweight and obesity, raised WHR and raised waist circumference have increased between the years.

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●

6.1 Introduction 6.1.1

Context The prevalence of obesity is increasing rapidly worldwide.1 In England more than half of all adults are currently classified as overweight or obese.2 Obesity can reduce overall quality of life and lead to premature death due to its association with serious chronic conditions such as type 2 diabetes, hypertension, and cancer.4,5 In particular, it is generally recognised that the central deposition of fat (abdominal or visceral obesity) is more closely associated with these chronic diseases.6 The International Obesity Task Force (IOTF)7 has emphasised that the health burden of obesity would be more easily predicted if the hazards of accumulating intra-abdominal fat were also monitored, in addition to body mass index (BMI), by simple measures such as waist circumference. The public health White Paper Choosing Health: Making healthy choices easier8 set out the Government’s commitments for action on obesity and on reducing ethnic inequalities in health in general. Delivering choosing health,9 Food and Health Action Plan10 and Physical Activity Plan11 specified the action that needs to be taken at national, regional and local level to combat obesity and improve people’s health through better diet and nutrition and increasing physical activity. It is widely acknowledged that both treatment and prevention are important to combat obesity. The Health Development Agency has reviewed the evidence on the best approaches to prevent and treat obesity in individuals.12 A wide range of evidence-based approaches exist, including low-calorie diets, increased physical activity, combinations of physical activity and dieting, and a combination of behavioural therapy with other practices. The National Institute for Clinical Excellence (NICE) is preparing definitive guidance on prevention, identification and management of treatment of obesity, to be published in 2007. This chapter focuses on anthropometric measurements and prevalence of overweight and obesity among minority ethnic groups living in England. In recent years, there has been much discussion of the appropriate obesity and overweight standards for certain minority ethnic groups.13 The relationship between BMI and body fat varies between ethnic groups. For example, people in the South Asian (Indian, Bangladeshi and Pakistani) ethnic groups tend to carry a higher body fat content for a given BMI than the white population, while the opposite is true for Black people.13 However, widely accepted ethnicity-specific BMI cut-off points have not yet been devised. Proposals by the World Health Organisation/International Obesity Task Force14 to set a cut-off of 23kg/m2 for overweight in Asian populations is limited to specific populations and cannot be applied to all Asians.15

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Ethnic subgroup-specific standards have been proposed for waist circumference and waist-hip ratio (WHR)16 but their applicability is limited for the same reason. However, a recent study across 52 countries found a consistent association between quintile of WHR and risk of a heart attack within each ethnic group examined.17 This chapter uses the general population BMI standards used in HSE 1999 and previous HSE reports to define overweight and obesity. The chapter presents anthropometric measures for adults aged 16 and over, focusing on obesity. First, the methods used are described and the measurements defined. The relationships of BMI, overweight and obesity prevalence, waist-hip ratio and waist circumference with ethnicity, age-group within ethnicity, and equivalised household income within ethnicity are examined. Finally, data on BMI, waist circumference and WHR are compared with those obtained five years before (HSE 1999). 6.1.2

Methods and definitions of measurement Full details of the protocols for carrying out the measurements are contained in Volume 2; they are briefly summarised here. Height and weight were measured during the interviewer visit while waist and hip circumferences were measured during the nurse visit.

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Height Height was measured using a portable stadiometer with a sliding head plate, a base plate and three connecting rods marked with a metric measuring scale. Informants were asked to remove their shoes. One measurement was taken, with the informant stretching to the maximum height and the head positioned in the Frankfort plane. The reading was recorded to the nearest millimetre. Weight Weight was measured using Soehnle, Seca and Tanita electronic scales with a digital display. Informants were asked to remove their shoes and any bulky clothing. A single measurement was recorded to the nearest 100g. Informants who were pregnant, chairbound, or unsteady on their feet were not weighed. Informants who weighed more than 130 kg were asked for their estimated weights because the scales are inaccurate above this level. These estimated weights were included in the analysis, as omitting them would have given more misleading population results than including estimated weights. In the analysis of height and weight, data from those who were considered by the interviewer to have unreliable measurements, for example those wearing excessive clothing such as coats and jackets, were excluded from the analysis. Body mass index (BMI) In order to define overweight or obesity, a measurement is required that allows for differences in weight due to height. A widely accepted measure of weight for height, the Body Mass Index (BMI, defined as weight (kg) / height (m2)), has been used for this purpose in the Health Survey series. However BMI does not distinguish between mass due to body fat and mass due to muscular physique. It also does not take account of the distribution of fat. BMI was calculated for all those informants for whom both a valid height and weight measurement were recorded. Adult informants were classified into the following BMI groups: BMI (kg/m2) 18.5 or less Over 18.5 to 25 Over 25 to 30 Over 30

Description Underweight Desirable Overweight Obese

In earlier HSE reports, the healthy (‘desirable’) weight range for BMI was taken as over 20 to 25kg/m2, but medical opinion7 now regards it as more appropriate to define it as over 18.5 to 25kg/m2, and the present report therefore uses this revised definition. BMI greater than 25.0kg/m2 but no greater than 30.0kg/m2 is defined as overweight and BMI exceeding 30.0kg/m2 is defined as obesity. These two categories have frequently been combined in this report to show the proportion who are either overweight or obese. As in the HSE 1998 report and subsequent reports, a sub-set of the obese category has also been defined, namely those with morbid obesity (BMI greater than 40.0kg/m2), who are at particularly high risk of morbidity and mortality.18

Waist was defined as the midpoint between the lower rib and the upper margin of the iliac crest (the top of the hip bone). It was measured using a tape with an insertion buckle at one end. Hip was defined as the widest circumference around the buttocks below the iliac crest. Both measurements were taken twice, using the same tape, and were recorded to the nearest millimetre. Those whose two waist or hip measurements differed by more than 3cm had a third measurement taken. The mean of the two valid measurements was used in the analysis. For waist and hip measurements, all those who reported that they had a colostomy or ileostomy, or were chairbound or pregnant were excluded from the measurement. All those

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Waist and hip

with measurements considered unreliable by the nurse, for example due to excessive clothing or movement, were excluded from the analysis. In the 2004 survey, only informants from minority ethnic groups were offered a nurse visit. Therefore, data on waist and hip measurements are not available for the general population group. In this chapter, waist and waist-hip ratio comparisons between minority ethnic groups and the general population were performed using HSE 2003 general population data for the latter. Waist-hip ratio Waist-hip ratio (WHR) of an individual was defined as mean waist circumference divided by mean hip circumference, i.e. waist girth (m) / hip girth (m). WHR is a measure of deposition of abdominal fat, i.e. central obesity. Unlike BMI, there is no consensus about appropriate WHR levels and what thresholds should be used to define raised WHR.19 For consistency, the same cut-off values as in the 1994, 1998 and subsequent reports have been used: a raised WHR has been taken to be 0.95 or more in men and 0.85 or more in women. WHR was calculated for all informants who agreed to a nurse visit and for whom both a valid waist and hip circumference measurement were recorded. The mean WHR for groups of informants was calculated as the mean of their individual waist-hip ratios. Raised waist circumference It has been postulated that waist circumference may be a better measure than BMI or WHR to identify those with a health risk from being overweight. The definition of raised waist circumference used is the definition of abdominal obesity used by the National Institutes of Health (USA) ATP (Adult Treatment Panel) III.20 A raised waist circumference has been taken to be 102cm or more in men and 88cm or more in women. These levels identify people at risk of the metabolic syndrome, a disorder characterised by increased risk of developing diabetes and cardiovascular disease. Abdominal obesity is more highly correlated with metabolic risk factors (high levels of triglycerides, low HDL-cholesterol) than is elevated BMI.20 6.1.3

Response to anthropometric measures The response rates for these measurements are presented in Table 6.1. ●

Valid height and/or weight measurements were obtained from 79% to 91% of men and 77% to 90% of women from different minority ethnic groups, compared with 85% and 87% in the general population.

●

Fewer informants agreed to a nurse visit, but a very high proportion of those who did had valid waist and hip measurements taken (94% - 100%).

Section 6.3 in Volume 2 gives more details of response rates to the different stages of the survey. Table 6.1

6.2 Anthropometric measures, by minority ethnic groups Copyright © 2006, The Information Centre. All rights reserved

6.2.1

Height The mean observed height of men aged 16 and over ranged from 167.8cm (Bangladeshi men) to 175.2cm (Black Caribbean men). The mean height of men in the general population was 175.0cm. After adjusting for age, Bangladeshi, Chinese, Indian, Pakistani and Black African men were on average shorter than their counterparts in the general population, whereas Black Caribbean and Irish men were a similar height to men in the general population. Mean observed height in women varied from 154.7cm in Bangladeshi women to 163.0cm in Black African women. This latter group was taller than women in the general population, where the mean height was 161.4cm. With age-standardisation, women in minority ethnic

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167

groups were on average shorter than their counterparts in the general population, apart from Irish, Black Caribbean and Black African women, who were a similar height to women in the general population. Table 6.2 Mean height was generally greater among men than women in each minority ethnic group and in the general population. In men and women in each minority ethnic group and in the general population, mean height was greatest in those aged 16-34 and was lowest in those aged 55 and over. The cross-sectional survey could not distinguish the extent to which this represents loss of height with increasing age or younger people being taller than earlier generations. Table 6.3 6.2.2

Weight The observed mean weight in men of most minority ethnic groups was lower than in the general population (82.9 kg); the exception was among Black Caribbean and Irish men where mean weight was about the same as the general population. Among other minority ethnic groups it varied from 69.8kg among Bangladeshi men to 79.6 kg among Black African men. After age standardisation, men from each minority ethnic group, except those of Black Caribbean and Irish origin, were significantly lighter than the general population. Bangladeshi and Chinese men were the lightest. Women in the general population had a mean weight of 69.7 kg, while those of Chinese origin were the lightest (57.8kg) and those of Black African origin were the heaviest (75.9kg). These differences remained after age standardisation. Women of Indian, Bangladeshi and Chinese origin were significantly lighter than those in the general population; Black Caribbean and Black African women were heavier than the general population; and Pakistani and Irish women were about the same weight as women in the general population. Table 6.4 In both sexes, mean weight increased from age 16-34 to age 35-54, and then decreased in those aged 55 and over, in most minority ethnic groups and in the general population. The only exceptions were Irish men, where mean weight remained the same aged 55 and over, and among Black Caribbean women, where weight continued to increase in the oldest group. Table 6.5 BMI, overweight and obesity When reading this section, it needs to be taken into account (as mentioned in section 6.1.1) that there are no agreed ethnicity-specific BMI cut-off points, and therefore the definition for overweight (>25kg/m2 )and obesity (>30.0kg/m2 ) used may not be entirely appropriate for all minority ethnic groups. Mean BMI Among minority ethnic groups, the mean BMI of Chinese (24.1kg/m2), Bangladeshi (24.7kg/m2), Indian (25.8kg/m2) and Pakistani (25.9kg/m2) men was significantly lower than in the general population (27.1kg/m2). Among women, those of Chinese origin had a markedly lower mean BMI (23.2kg/m2) than those in the general population (26.8kg/m2 ). Indian and Irish women had a similar mean BMI to those in the general population. In contrast, mean BMI was higher among Black Caribbean (28.0kg/m2) and Black African (28.8kg/m2) women. Table 6.6 Men’s overweight and obesity prevalence Bangladeshi and Chinese men had the lowest prevalence of overweight including obesity (44% and 37%) and of obesity (6% in each). These findings were confirmed after age standardisation. Age-standardised risk ratios are used to take account of differences in the age profile of different minority ethnic groups (see chapter 1). Chinese and Bangladeshi men were least likely to be overweight or obese (standardised risk ratios, compared with the general population, of 0.62 and 0.75). Indian and Pakistani men were also less likely to be overweight or obese (risk ratios 0.82 and 0.89 respectively). The likelihood of Black

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6.2.3

African, Black Caribbean and Irish men being overweight or obese was the same as for men in the general population. Black Caribbean and Irish men had the highest prevalence of obesity: a quarter of them (25%) were obese. Age-standardised risk ratios showed the likelihood of obesity, compared with the general population, to be lower for Pakistani men (0.76) and Indian men (0.60) and markedly lower for Chinese men (0.26) and Bangladeshi men (0.22): after adjusting for age, Bangladeshi men were almost five times, and Chinese men almost four times, less likely to be obese than men in the general population. Table 6.6, Figure 6A Figure 6A Prevalence of obesity (BMI>30 kg/m2), by minority ethnic group Women

Risk ratio, logarithmic scale

Men 10.0

10.0

2.0

2.0

1.0

1.0

0.5

0.5

0.1

0.1 sh

se i

sh

de

i an

la

ne

hi

Iri

C

ng

an

an

be

an

ric

ib

i

sh

ar

Af

st

ki

Ba

Pa

k

C

an

di

In

ac

k

ac

Bl

Bl

sh

se

de

i an

la

ne

hi

Iri

C

ng

st

ki

Ba

Pa

an

be

ib

ric

Af

ar

C

an

di

In k

k

ac

ac

Bl

Bl

General population = 1.0. Error bars indicate 95% confidence limits.

The observed prevalence of morbid obesity was around 1% or less in men in each minority ethnic group, with the exception of Irish men (2%). Table 6.6 Women’s overweight and obesity prevalence Among women, the prevalence of overweight including obesity was higher among Black Caribbean (65%), Black African (70%) and Pakistani (62%) groups than in the general population (57%). Bangladeshi (51%) women and, particularly, Chinese women (25%) had lower prevalence of overweight including obesity than the general population.

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This pattern was confirmed by age standardisation. Compared with the general population, the risk ratio for overweight including obesity was higher in Black African women (risk ratio 1.37), Pakistani women (1.24) and Black Caribbean women (1.16). Chinese women were half as likely to be overweight or obese (risk ratio 0.46) as women in the general population. Obesity prevalence was higher for Black African women (38%, risk ratio 2.00), Black Caribbean women (32%, risk ratio 1.43) and Pakistani women (28%, risk ratio 1.48) and lower for Chinese women (8%, risk ratio 0.32) than for women in the general population. Compared with women in the general population, Black African women were twice as likely, and Pakistani women about 50% more likely, to be obese, while Chinese women were about three times less likely to be obese than women in the general population. Table 6.6, Figure 6A

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169

2

Prevalence of obesity (BMI>30kg/m ) Black Caribbean

Black African

Indian

25

17

14

15

1.03

0.79

0.60

32

38

1.43

2.00

Men Observed % Standardised risk ratio Women Observed % Standardised risk ratio

Chinese

Irish

General population

6

6

25

23

0.76

0.22

0.26

1.07

1

20

28

17

8

21

23

0.89

1.48

0.89

0.32

0.88

1

Pakistani Bangladeshi

Among Black Caribbean and Black African women (4% and 5%, respectively), observed morbid obesity (BMI>40kg/m2) prevalence was about twice that for women in the general population (2%), but no difference was observed for Irish and Pakistani women (2%). Chinese women had the lowest prevalence (0.3%). Underweight As noted above, the revised definition of underweight, BMI≤ 18.5kg/m2, has been used in this report. A higher proportion of South Asian (Indian, Pakistani and Bangladeshi), and Chinese men and women, than of other minority ethnic groups were underweight; this was more apparent in the 16-34 age group. Bangladeshi informants had the highest prevalence of underweight (4% of men and 5% of women, compared with 1% for men and 2% for women in the general population). Table 6.6 Comparison of BMI measures between the sexes In the general population, men had a higher mean BMI than women (27.1kg/m2 and 26.8kg/m2 respectively) and a higher proportion of men than women were overweight or obese (BMI>25kg/m2). The proportion morbidly obese (BMI>40kg/m2) was 2% among women, 1% among men. Women had a higher mean BMI than men in each minority ethnic group except the Chinese and Irish. The largest difference in prevalence of obesity between men and women was observed in Black Africans, where women’s obesity prevalence was more than double that in men (38% vs 17%), and among the Bangladeshi group, where obesity prevalence was almost three times higher among women than men (17% vs 6%). Table 6.6 Variations in BMI measures by age group Mean BMI was lowest in age group 16-34 for both men and women in all minority ethnic groups, and in the general population, except among the Irish where there was no significant difference in mean BMI by age. It declined at age 55 and over among Indian men.

In women, the prevalence of overweight including obesity generally increased with age in all minority ethnic groups and the general population. The increase in obesity prevalence with age was particularly marked among Black Caribbean, Black African and Indian women: among Black Caribbean women, from 13% in the 16-34 age group to 48% in those aged 55 and over, and among Indian women, from 11% to 27%. Obesity prevalence increased in Black African women from 23% (16-34 age group) to 54% in those aged 35-54 years and 66% in those aged 55+ (but this last percentage is based on a small sample). Table 6.7

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In men, the prevalence of overweight including obesity increased between age 16-34 and age 35-54 in the general population and in all minority groups. Thereafter it levelled off in the general population and among Irish men, but increased at age 55+ among Black Caribbean men, while tending to decrease among Asian groups. (The sample of Black African men aged 55+ was too small for analysis.)

6.2.4

Waist-hip ratio and waist circumference Men’s WHR Among men in the general population, the mean waist-hip ratio (WHR) was 0.92. Among minority ethnic groups, mean WHR varied from 0.87 (both Black African and Chinese men) to 0.93 (Irish men). The prevalence of raised WHR (defined as 0.95 or above for men) varied considerably between minority ethnic groups. Indian, Pakistani and Irish and Bangladeshi men had a higher prevalence of raised WHR than men in the general population. The lowest rate in men was found among Black African (16%) and Chinese men (17%); the highest prevalence was among Indian men (38%). With age standardisation, risk ratios for raised WHR were significantly higher than the general population among Pakistani men (1.46) and Bangladeshi men (1.34), and lower among Chinese men (0.66) and Black Caribbean men (0.73). Black African, Indian and Irish men did not show a significant difference from men in the general population. Table 6.8, Figure 6B Figure 6B Prevalence of raised WHR (0.95+), by minority ethnic group Women

Risk ratio, logarithmic scale

Men 10.0

10.0

2.0

2.0

1.0

1.0

0.5

0.5

0.1

0.1 sh

sh

de

se

ne

hi

Iri

C

i

an

la

ng

i

i

be

an

ric

ib

sh

ar

Af

C

st

ki

Ba

Pa

k

an

di

In

ac

k

ac

Bl

Bl

sh

se

de

i an

la

ne

hi

Iri

C

ng

an

an

be

an

ric

ib

ar

Af

st

ki

Ba

Pa

k

C

an

di

In

ac

k

ac

Bl

Bl

General population = 1.0. Error bars indicate 95% confidence limits.

Men’s waist circumference The prevalence of raised waist circumference (102 cm or more in men) was 31% in men in the general population. As with raised WHR, there was considerable variation between minority ethnic groups. In men, the lowest rates were recorded among Chinese men (8%) and the highest among Irish men (33%). As shown in the table below, with standardisation, Black Caribbean, Indian, Bangladeshi and Chinese men had a significantly lower risk of raised waist circumference than the general population. The other groups had risk levels not significantly different from the general population.

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Prevalence of raised waist circumference

Men Observed % Standardised risk ratio Women Observed % Standardised risk ratio

Black Caribbean

Black African

Indian

Chinese

Irish

General population

%

%

%

%

%

%

%

%

22

19

20

30

12

8

33

31

0.66

0.81

0.70

1.23

0.51

0.28

0.96

1

47

53

38

48

43

16

43

41

1.23

1.51

0.97

1.49

1.39

0.50

1.00

1

Pakistani Bangladeshi

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Women’s WHR Among the general population, the mean waist-hip ratio (WHR) was 0.82 in women. Among women in minority ethnic groups, means ranged from 0.81 (Black African and Chinese) to 0.85 (Bangladeshi). Women in most minority ethnic groups (except Black African women and Chinese women) had a higher prevalence of raised WHR (0.85 or more) than the general population. The lowest rates in women were found among Chinese informants (22%), and the highest (50%) among Bangladeshi women. After adjusting for age, risk ratios for raised WHR were significantly higher than the general population for women in each minority ethnic group, except among Indian women and Chinese women where risk ratios were not significantly different from that of the general population. Table 6.8, Figure 6B Women’s waist circumference Mean waist circumference ranged from 77.6cm in Chinese women to 90.1cm in Black African women and was 86.4cm for women in the general population. Women of Black Caribbean, Black African and Pakistani origin had a significantly higher prevalence of raised waist circumference (88cm or higher) than the general population and Chinese women had a lower prevalence of raised waist circumference than the general population. Prevalence ranged from 16% of Chinese women to 53% of Black African women. With age standardisation, risk ratios for raised waist circumference were higher than the general population among all ethnic groups except among Chinese women (0.50) and were about the same for Irish and Indian women. Tables 6.8, 6.9 Comparison between the sexes In general, mean waist-hip ratio and mean waist circumference was higher in men than in women in all minority ethnic groups and the general population, although the reverse was true for prevalence of raised waist circumference. Women had an increased prevalence of raised WHR compared with men in the Black Caribbean, Black African and Bangladeshi groups, but Indian men had higher prevalence of raised WHR than women (38% and 30%, respectively), and there was no difference between men and women of Irish, Pakistani and Chinese origin. Tables 6.8, 6.9 Variations in WHR by age group Mean WHR and mean waist circumference (with very few exceptions, such as Indian men and women) increased with age in each minority ethnic group and in the general population for both men and women. Table 6.9

Equivalised household income is a measure of household income that takes account of the number of persons in the household. Age-standardised risk ratios compare the results for men (or women) in each tertile of equivalised household income in each minority ethnic group with men (or women) in the general population, all tertiles of equivalised income combined. Overweight (including obesity) and obesity prevalence, by equivalised household income In men, mean observed BMI increased with income in Black African men (mean BMI 25.7kg/m2 in the lowest income tertile, 27.3kg/m2 in the highest income tertile), Irish men (25.6 and 27.5kg/m2 respectively) and Chinese men (23.1 and 25.1kg/m2). It was not related to equivalised household income in any other minority ethnic group, nor in the general population. Age-standardised results showed the same patterns. The prevalence of overweight including obesity among men did not show any clear pattern

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6.3 Overweight, obesity, waist-hip ratio and waist circumference, by equivalised household income tertile

by income in most minority ethnic groups, except for those of Black African, Irish and Chinese origin. Black African men in the highest income tertile had a greater prevalence of overweight including obesity (75%) than those in both the middle and lowest income tertiles (54%); for Irish men, the percentages were 71% in the highest income tertile compared with 43% in the lowest, and were 46% and 21% respectively in Chinese men. Standardised risk ratios confirmed the tendency for overweight or obesity to increase with income among Black African and Irish men. Among men in the other minority ethnic groups the differences were much smaller. Among men, the proportion who were obese (BMI >30kg/m2) was not related to equivalised household income for any minority ethnic group. Mean BMI in women varied far more with income, though with no consistent pattern. Among minority ethnic groups other than Black African women, Bangladeshi women and Chinese women, mean BMI was higher among those in the lowest income tertile than those in the highest income tertile. There was also no clear pattern in the prevalence of overweight including obesity by income for all minority ethnic groups, although in the general population the prevalence of overweight including obesity increased with higher income (38% in the lowest to 49% in the highest income tertile). The prevalence of obesity (BMI >30kg/m2) among women increased from the highest to lowest income tertile for almost all minority ethnic groups, except for women of Black African, Bangladeshi and Chinese origin. For women of Indian and Irish origin, the increase in the prevalence of obesity from the highest to lowest income tertile was greater than other groups: for Indian women it doubled from 14% in the highest income tertile to 29% in the lowest income tertile, and for Irish women it increased from 16% to 31%. This increase from the highest to the lowest tertile was also apparent for women in the general population (from 19% to 29%). With age standardisation, most minority ethnic groups showed little difference by income tertiles for overweight including obesity, but age standardisation confirmed the pattern for obesity. Table 6.10 The observed prevalence of morbid obesity among women by equivalised household income tertiles is shown in the table below. Prevalence of morbid obesity 2 (BMI>40kg/m ) in women, by equivalised household income tertile and minority ethnic group Highest

Middle

Lowest

%

%

%

2 3 0 1 1 1

3 4 1 1 4 4

9 10 2 3 1 6 5

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Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

The observed prevalence of morbid obesity (BMI >40kg/m2 ) was higher among women in the lowest than highest income tertile, in almost all minority ethnic groups except among Chinese, Pakistani and Bangladeshi women, where the differences were not significant. The prevalence of morbid obesity for Irish women increased from 1% in the highest income tertile to 6% in the lowest income tertile; for Black Caribbean women from 2% to 9%, and Black African women from 3% to 10%. Prevalence of raised WHR and raised waist circumference, by equivalised household income In men and women, in all minority ethnic groups, there was no clear pattern in mean observed WHR and waist circumference by income. HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY

173

The prevalence of raised WHR among Black Caribbean and Indian men was higher in the lowest income tertile (44% and 51%, respectively) than in the highest income tertile (13% and 31%); this was also apparent for men in the general population (38% in the lowest and 29% in the highest income tertile). For Black African and Black Caribbean men this was also true for raised waist circumference. After age standardisation, the observed findings were generally confirmed. Among Black Caribbean and Indian women there was an inverse association with income for raised WHR but not for raised waist circumference: the prevalence of raised WHR was higher in the lowest income tertile (33% among Black Caribbean women, 39% in Indian women) than in the highest income tertile (19% and 21%, respectively). This income pattern was also true for women of Irish origin and those in the general population, but for both raised WHR and waist circumference. Age standardisation generally confirmed the observed pattern for raised WHR and waist circumference. Table 6.11

6.4 Comparisons between 1999 and 2004 BMI, overweight and obesity There were few significant differences in mean BMI between 1999 and 2004 for men or women in all age groups. Among men in minority ethnic groups and in the general population, the prevalence of overweight including obesity increased between 1999 and 2004. There were marked differences between the years among Black Caribbean men in the 16-34 age group: the proportion either overweight or obese increased substantially to 58% in 2004 from 40% in 1999. Among men and women of Bangladeshi origin, there was also a significant increase in overweight including obesity: from 36% in 1999 to 44% in 2004 in men, and from 37% to 51% in women. There was a significant decline in overweight including obesity among Chinese women to 25% in 2004 from 33% in 1999. Among men and women in almost all minority ethnic groups and in the general population, the prevalence of obesity did not change significantly between 1999 and 2004. The exception was Black Caribbean men, in whom obesity increased from 18% in 1999 to 25% in 2004. The proportion of men and women in the general population who were either overweight or obese increased significantly between 1999 and 2004, from 63% to 67% among men and from 54% to 57% among women. The proportion who were obese increased from 19% of men in 1999 to 23% in 2004, and among women from 21% to 23%. Table 6.12, Figure 6C WHR

The prevalence of raised WHR tended to rise in women in each group (except Chinese women) between 1999 and 2004. The proportion with a raised WHR increased greatly among women of Irish origin (from 25% in 1999 to 37% in 2004, and among Irish women aged 16-34 from 9% to 30%). The prevalence of raised WHR also increased among Black Caribbean women from 63% to 78% in those aged 55 and over (not in other age groups), and among Bangladeshi women from 57% to 77% in the 35-54 age group. There was a 10 percentage point increase (from 20% to 30%) in raised WHR among women in the general population between 1998 and 2003.

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Among men, the prevalence of raised WHR increased significantly between 1999 and 2004 among Pakistani men, particularly in the 16-24 age group (from 9% to 17%) and in Black Caribbean men in the 35-54 age group (10% in 1999 and 25% in 2004). For other minority ethnic groups there was little change in the prevalence of raised WHR between the two years.

Figure 6C Prevalence of overweight, including obesity (BMI>25 kg/m2), 1999 and 2004, by minority ethnic group Women

Men

Percent

1999 2004

70

70

60

60

50

50

40

40

30

30

20

20

10

10

0

0 al er on en ti G ula p po sh Iri se i ne hi sh C de la ng Ba n i a st ki Pa an di In k n ac ea Bl ibb ar C

al er on en ti G ula p po sh Iri se i ne hi sh C de la ng Ba n i a st ki Pa an di In k n ac ea Bl ibb ar C

Waist circumference A similar increase to that for raised WHR was observed for raised waist circumference among Black Caribbean men and Pakistani men between the years. The proportion with a raised waist circumference more than doubled between 1999 and 2004 among Bangladeshi men (5% to 12%). Chinese men aged 35-54 had a marked increase in raised waist circumference between 1999 and 2004 (3% to 10%). There were few differences among men between the years in other ethnic groups and the general population. Raised waist circumference increased among women of Irish and Bangladeshi origin (in both cases from 33% in 1999 to 43% in 2004). There were no significant differences between the two years in other ethnic groups. There was also an increase in raised waist circumference (from 31% to 41%) among women in the general population between 1998 and 2003, an increase of similar magnitude to that in WHR. Overall, the results show that the patterns for BMI, overweight and obesity, WHR and waist circumference in 2004 reflect those in 1999, but for most groups the absolute levels of overweight and obesity and raised WHR and raised waist circumference have increased between the years. Table 6.13 Figure 6D Figure 6D Prevalence of raised waist circumference (102cm+ in men and 88cm+ in women), 1999 and 2004, by minority ethnic group Women

Percent

Men 50

50

40

40

30

30

20

20

10

10

0

0 al er on en ti G ula p po sh Iri se i ne hi sh C de la ng Ba ni a st ki Pa an di In k n ac ea Bl ibb ar C

al er on en ti G ula p po sh Iri se i ne hi sh C de la ng Ba ni a st ki Pa an di In k n ac ea Bl ibb ar C

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1999 2004

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References and notes 1 James PT. Obesity: the worldwide epidemic. Clinical Dermatology 2004; 22:276-80. 2 Hirani V. Chapter 6: Anthropometric measures, overweight and obesity in Sproston K, Primatesta P (eds). Health Survey for England 2003. Volume 2: Risk Factors for Cardiovascular Disease.The Stationery Office, London, 2004. 3 Jonsson S, Hedblad B, Engstrom G et al Influence of obesity on cardiovascular risk. Twenty-three-year follow-up of 22,025 men from an urban Swedish population. International Journal of Obesity 2002; 8:1046-53. 4 Stein CJ, Colditz GA. The Epidemic of Obesity. The Journal of Clinical Endocrinology & Metabolism 2004; 89:2522-2525. 5 Kopelman PG. Obesity as a medical problem. Nature 2000; 404:635-643. 6 Sjostrom L. Obesity and its relationship to other diseases (Chapter 11.4) pp 235-239. in Shetty PS, McPherson K (eds). Diet, nutrition and chronic disease: lessons from contrasting worlds 1996. London School of Hygiene and Tropical Medicine Sixth Annual Public Health Forum, Wiley, London, 1997. 7 International Obesity Task Force [On-line] www.iotf.org/ 8 Department of Health. Choosing Health: Making Healthy Choices Easier. London: The Stationery Office, 2004. www.dh.gov.uk/PublicationsAndStatistics/ 9 Delivering choosing health: making healthier choices easier is published at: www.dh.gov.uk/assetRoot/04/10/57/13/04105713.pdf 10 Choosing a Better Diet: A consultation on priorities for a food and health action plan is published at: www.dh.gov.uk/assetRoot/04/06/58/34/04065834.pdf 11 Choosing Activity: a physical activity action plan is published at: www.dh.gov.uk/assetRoot/04/10/57/10/04105710.pdf 12 Health Development Agency. The management of obesity and overweight. An analysis of reviews of diet, physical activity and behavioural approaches. Health Development Agency, London, 2003. www.publichealth.nice.org.uk/page.aspx?o=502623 13 Prentice A, Jebb S. Beyond body mass index. Obesity Reviews, 2001; 2:141-147. 14 International Diabetes Institute. The Asia-Pacific perspective: redefining obesity and its treatment. International Diabetes Institute, Victoria, Australia, 2000. 15 Bell CA, Adair LS, Popkin BM. Ethnic differences in the association between body mass index and hypertension. American Journal of Epidemiology 2002; 155:346-353. 16 Snehalatha C, Viswanathan V, Ramachandran A. Cutoff values for normal anthropometric variables in Asian Indian adults. Diabetes Care, 2003; 26:1380-1384. 17 Yusuf S, Hawken S, Ôunpuu et al. Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case-control study. Lancet 2005: 366:1640-1649. 18 NHS Consensus Development Conference. Gastrointestinal surgery for severe obesity. Nutrition 1996; 12:397-402. 19 Molarius A, Seidell JC. Selection of anthropometric indicators for classification of abdominal fatness - a critical review. International Journal of Obesity 1998: 22:719-727.

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20 National Institutes of Health. Third report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III): National Institutes of Health, Bethesda, Md ,2001. NIH Publication 01-3670.

Tables

6.1 Response to anthropometric measurements, by minority ethnic group and sex 6.2 Height, by minority ethnic group and sex 6.3 Height, by age within minority ethnic group and sex 6.4 Weight, by minority ethnic group and sex 6.5 Weight, by age within minority ethnic group and sex 6.6 Body mass index (BMI), overweight and obesity, by minority ethnic group and sex 6.7 Body mass index (BMI), overweight and obesity, by age within minority ethnic group and sex 6.8 Waist-hip ratio (WHR) and waist circumference, by minority ethnic group and sex 6.9 Waist-hip ratio (WHR) and waist circumference, by age within minority ethnic group and sex 6.10 Body mass index (BMI), overweight and obesity, by equivalised household income tertile within minority ethnic group and sex 6.11 Waist-hip ratio (WHR) and waist circumference, by equivalised household income tertile within minority ethnic group and sex 6.12 Comparison of body mass index (BMI), overweight and obesity in 2004 with 1999, by age within minority ethnic group and sex

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6.13 Comparison of waist-hip ratio (WHR) and waist circumference in 2004 with 1999, by age within minority ethnic group and sex

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Table 6.1 Response to anthropometric measurements, by minority ethnic group and sex Aged 16 and over who were interviewed/had a nurse visit Proportion providing valid measurement

2004

Minority ethnic group

General populationa

Black Caribbean

Black African

Indian

%

%

%

%

81 81 79 96 95

79 79 77 95 94

89 90 88 98 98

78 80 75 98 98

77 80 75 97 98

480 243

Pakistani Bangladeshi

Chinese

Irish

%

%

%

%

80 81 80 95 95

82 80 80 97 97

91 90 89 99 100

90 90 88 97 98

87 87 84 96 97

90 89 88 94 95

84 84 83 94 95

81 78 77 95 96

86 86 85 97 97

89 87 86 98 98

87 85 83 97 97

377 179

903 444

423 202

178 77

151 75

1776 890

46188 5531

676

476

1067

499

208

163

2369

48719

665 334

456 239

1048 518

465 231

199 104

159 77

2330 1132

47793 5727

414 218

390 165

550 316

433 208

411 143

348 183

497 320

2879 5086

653

469

634

508

478

375

656

3825

643 324

448 207

621 370

476 238

459 180

366 191

648 414

3765 6180

Men Height Weight BMI Waist-hip Waist circumference

Women Height Weight BMI Waist-hip Waist circumference Bases (weighted) Men Height, weight, BMI (interviewed) Waist, hip (saw nurse)a Women Height (interviewed) Weight, BMI (interviewed, not pregnant) Waist, hip (saw nurse)a Bases (unweighted) Men Height, weight, BMI (interviewed) Waist, hip (saw nurse)a Women Height (interviewed) Weight, BMI (interviewed, not pregnant) Waist,hip (saw nurse)a

a Comparative data for the general population are not available for nurse visits from the 2004 survey, so data have been taken from the 2003 survey, which

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was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response.

Table 6.2 Height, by minority ethnic group and sex Aged 16 and over with a valid height measurement Height (cm)

2004

Minority ethnic group

General population

Black Caribbean

Black African

Indian

175.2

173.5

170.2

172.1

0.50

0.49

0.36

0.44

Pakistani Bangladeshi

Chinese

Irish

167.8

170.8

174.2

175.0

0.51

0.52

0.45

0.18

1

Men Observed Mean height Standard error of the mean

Standardised Mean height: ratio of means

1.00

0.98

0.97

0.98

0.95

0.97

1.00

Standard error of the ratio

0.003

0.003

0.002

0.003

0.004

0.003

0.003

162.8

163.0

156.4

157.8

154.7

157.9

161.4

161.4

0.42

0.46

0.36

0.35

0.39

0.48

0.32

0.14

1

Women Observed Mean height Standard error of the mean

Standardised Mean height: ratio of means

1.01

1.00

0.96

0.97

0.95

0.97

1.00

Standard error of the ratio

0.003

0.003

0.002

0.002

0.003

0.003

0.002

391 527

299 365

807 958

339 421

146 168

137 140

1600 2113

40070 42289

328 489

303 351

487 568

348 423

338 387

313 319

427 584

2496 3311

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Bases (weighted) Men Women Bases (unweighted) Men Women

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Table 6.3 Height, by age within minority ethnic group and sex Aged 16 and over with a valid height measurement

2004

Age group

Men

Black Caribbean Mean height Standard error of the mean

5th percentile 10th percentile Median 90th percentile 95th percentile Black African Mean height Standard error of the mean

5th percentile 10th percentile Median 90th percentile 95th percentile Indian Mean height Standard error of the mean

5th percentile 10th percentile Median 90th percentile 95th percentile Pakistani Mean height Standard error of the mean

5th percentile 10th percentile Median 90th percentile 95th percentile Bangladeshi Mean height Standard error of the mean

5th percentile 10th percentile Median 90th percentile 95th percentile Chinese Mean height Standard error of the mean

5th percentile 10th percentile Median 90th percentile 95th percentile

Women

16-34

35-54

55+

All men

16-34

35-54

55+

All women

177.3

176.4

171.2

175.2

164.9

162.6

159.7

0.66

0.77

0.84

0.5

0.62

0.55

0.75

162.8 0.42

167.1 173.0 177.2 181.9 189.6

164.0 169.1 176.9 182.4 188.9

158.7 166.1 170.7 178.0 182.0

163.2 168.2 175.9 181.0 187.6

153.8 158.2 164.4 170.3 177.5

152.4 157.0 162.4 168.1 174.3

148.8 154.7 160.2 164.4 170.1

152.1 157.0 162.7 168.3 174.9

174.8

172.9

a

173.5

163.3

163.2

[160.3]

163.0

0.49

0.49

a

0.49

0.60

0.59

[1.05]

0.46

163.4 170.0 175.3 179.5 184.8

162.4 165.9 172.9 179.0 185.4

a a a a a

162.6 167.5 173.6 179.0 184.8

153.0 156.8 163.3 169.5 175.6

154.4 [151.5] 158.1 [156.2]] 162.8 [160.2 168.0 [164.4] 173.3 [171.8]

153.0 157.1 162.8 168.5 173.6

172.1

170.3

166.5

170.2

157.6

156.5

153.5

156.4

0.54

0.50

0.75

0.36

0.47

0.47

0.73

0.36

162.3 165.5 171.4 178.2 184.0

158.0 165.0 171.1 175.5 179.4

156.3 160.5 166.4 173.2 177.6

158.1 164.1 170.2 176.0 182.5

147.7 152.8 157.1 162.7 168.3

147.0 151.5 156.5 161.6 166.2

142.9 147.8 153.2 158.5 165.2

145.6 151.5 156.3 161.8 167.3

173.0

171.6

[169.8]

172.1

158.9

156.7

[155.9]

157.8

0.77

0.55

[0.99]

0.44

0.42

0.59

[0.96]

0.35

161.5 167.7 173.4 178.4 186.2

160.1 166.5 171.4 176.8 183.0

[161.8] [165.1] [169.0] [174.6] [180.0]

161.4 166.9 172.2 177.5 183.7

150.0 153.4 158.6 163.9 169.1

147.1 151.1 156.9 162.4 167.5

[145.9] [150.8] [155.1] [161.6] [168.7]

148.2 152.1 157.6 163.2 168.4

169.8

166.5

[163.1]

167.8

155.9

152.6

[151.4]

154.7

0.53

0.69

[0.95]

0.51

0.46

0.58

[0.81]

0.39

157.6 163.3 169.8 176.8 180.2

155.1 160.3 166.1 172.5 179.2

[154.8] [157.9] [162.8] [168.8] [-]

156.5 161.6 168.0 174.2 179.5

146.1 150.5 155.2 161.3 167.3

142.4 147.8 153.0 157.7 162.6

[142.3] [146.4] [151.0] [156.7] [-]

144.7 149.4 154.0 160.2 165.7

173.6

169.1

165.8

170.8

159.8

157.2

[154.1]

157.9

0.68

0.69

1.15

0.52

0.67

0.50

[1.23]

0.48

162.3 168.4 173.4 179.0 185.0

159.7 163.0 169.0 173.9 182.9

153.0 158.2 167.2 172.7 184.1

158.5 165.0 171.0 176.7 184.6

149.7 154.8 160.1 164.3 170.2

148.8 152.4 157.8 160.8 166.3

[142.5] [149.3] [154.1] [158.8] [-]

148.0 152.9 158.0 162.9 169.1

a Results are not shown because of small bases.

Continued…

180

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY

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Height (cm)

Table 6.3 continued Aged 16 and over with a valid height measurement Height (cm)

2004

Age group

Men

Irish Mean height Standard error of the mean

5th percentile 10th percentile Median 90th percentile 95th percentile General population Mean height Standard error of the mean

5th percentile 10th percentile Median 90th percentile 95th percentile Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

Women

16-34

35-54

55+

All men

16-34

35-54

55+

All women

176.3

175.3

171.7

174.2

163.3

163.1

158.0

0.88

0.56

0.71

0.45

0.50

0.46

0.63

161.4 0.32

164.4 170.3 177.0 182.1 186.7

164.0 170.2 175.0 180.8 185.4

160.1 165.6 171.4 177.7 183.2

162.2 168.5 174.4 180.0 185.2

152.5 159.1 163.2 168.0 172.4

153.1 158.2 163.6 168.0 171.9

148.4 152.9 156.9 163.5 169.1

150.6 155.8 161.9 166.8 171.5

177.2

175.5

171.9

175.0

162.9

162.5

158.8

161.4

0.33

0.24

0.23

0.18

0.27

0.20

0.20

0.14

166.3 171.8 177.5 183.0 188.9

163.8 169.8 175.2 181.5 187.0

160.3 166.3 171.9 177.8 183.2

162.7 169.1 174.9 181.1 187.2

152.0 157.4 162.9 168.2 174.1

152.2 157.4 162.5 168.0 173.0

148.1 153.4 158.6 164.7 169.6

150.6 155.8 161.4 167.1 172.5

115 144 293 165 76 69 387 13030

164 126 343 130 54 44 631 14871

112 30 170 44 16 23 582 12169

391 299 807 339 146 137 1600 40070

180 195 376 234 112 55 459 13088

235 144 423 139 40 68 958 15207

112 26 159 48 16 18 696 13994

527 365 958 421 168 140 2113 42289

97 142 179 182 174 159 103 659

137 134 205 119 126 104 174 877

94 27 103 47 38 50 150 960

328 303 487 348 338 313 427 2496

160 183 219 236 257 127 137 821

220 138 250 138 93 152 248 1234

109 30 99 49 37 40 199 1256

489 351 568 423 387 319 584 3311

Copyright © 2006, The Information Centre. All rights reserved

a Results are not shown because of small bases.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY

181

Table 6.4 Weight, by minority ethnic group and sex Aged 16 and over with a valid weight measurement Weight (kg)

2004

Minority ethnic group

General population

Black Caribbean

Black African

Indian

Observed Mean weight

83.3

79.6

74.5

77.0

Standard error of the mean

1.04

1.06

0.78

0.83

Pakistani Bangladeshi

Chinese

Irish

69.8

70.4

82.8

82.9

0.58

0.65

1.15

0.34

1

Men

Standardised Mean weight: ratio of means

1.00

0.96

0.90

0.93

0.84

0.85

1.00

Standard error of the ratio

0.014

0.013

0.01

0.01

0.009

0.009

0.016

Observed Mean weight

73.9

75.9

64.4

67.6

61.5

57.8

69.6

69.7

Standard error of the mean

0.86

1.13

0.65

0.84

0.82

0.62

0.77

0.30

1

Standardised Mean weight: ratio of means

1.06

1.11

0.92

0.99

0.90

0.83

1.00

Standard error of the ratio

0.013

0.018

0.011

0.013

0.013

0.010

0.015

391 532

298 365

814 930

341 389

143 155

136 137

1595 2019

39976 40736

326 492

305 352

492 551

351 394

331 357

309 311

430 559

2497 3214

Bases (weighted) Men Women Bases (unweighted) Men Women

182

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY

Copyright © 2006, The Information Centre. All rights reserved

Women

Table 6.5 Weight, by age within minority ethnic group and sex Aged 16 and over with a valid weight measurement Weight (kg)

2004

Age group

Men 16-34

35-54

55+

Black Caribbean Mean weight

81.3

85.2

83.0

83.3

67.1

76.8

78.1

Standard error of the mean

2.04

1.59

1.44

1.03

1.16

1.46

1.38

0.84

56.9 67.5 82.0 93.3 107.2

61.0 70.8 85.0 97.9 115.2

62.6 72.1 81.8 92.3 106.5

59.8 69.8 82.8 94.5 108.4

49.9 56.8 66.1 74.4 97.8

54.3 62.5 72.3 91.3 109.5

59.0 65.4 77.9 88.5 103.8

52.0 60.4 70.6 85.9 104.5 75.9

5th percentile 10th percentile Median 90th percentile 95th percentile Black African Mean weight

16-34

35-54

55+

All women

73.9

77.1

82.7

a

79.6

69.9

82.5

[82.3]

Standard error of the mean

1.34

1.51

a

1.06

1.40

1.42

[2.72]

1.09

5th percentile 10th percentile Median 90th percentile 95th percentile Indian Mean weight

57.6 65.8 75.7 87.1 99.8

61.4 69.9 80.2 93.6 111.9

a a a a a

58.8 68.4 78.4 90.3 104.1

48.3 56.0 68.6 82.2 92.6

59.5 68.9 79.6 98.0 112.7

[64.0] [68.9] [82.0] [95.8] [117.5]

52.1 61.2 74.9 88.0 105.5

73.2

77.9

70.0

74.5

60.0

66.8

66.0

64.1

Standard error of the mean

1.25

1.09

1.01

0.78

0.91

0.89

1.10

0.63

53.7 60.9 72.3 83.4 104.7

58.3 66.1 75.1 89.2 103.9

51.8 62.8 69.7 77.3 86.3

54.5 63.1 72.6 84.1 101.5

42.3 51.0 58.5 67.8 81.9

49.5 55.8 64.9 76.8 90.8

48.8 57.4 64.0 72.1 89.2

46.2 54.0 62.3 73.1 89.9

75.0

78.8

[79.3]

77.0

63.8

71.6

[73.1]

67.6

1.38

1.14

[1.71]

0.82

1.03

1.44

[2.07]

0.84

55.1 61.9 72.6 88.3 105.9

61.3 68.5 78.2 88.2 100.4

[59.2] [65.0] [80.7] [87.7] [97.6]

56.4 65.1 76.1 88.2 102.6

44.6 52.9 61.5 75.0 88.5

50.9 59.6 68.8 84.2 97.3

[50.9] [62.8] [71.8] [82.8] [92.9]

47.1 55.1 65.9 79.3 92.9 61.5

5th percentile 10th percentile Median 90th percentile 95th percentile Pakistani Mean weight Standard error of the mean

5th percentile 10th percentile Median 90th percentile 95th percentile Bangladeshi Mean weight

Copyright © 2006, The Information Centre. All rights reserved

Women All men

69.2

71.7

[66.3]

69.8

59.6

66.1

[62.3]

Standard error of the mean

0.99

0.82

[1.78]

0.58

0.94

1.06

[2.27]

0.82

5th percentile 10th percentile Median 90th percentile 95th percentile Chinese Mean weight

51.0 58.3 69.7 77.1 91.7

56.9 64.3 71.5 79.7 91.3

[47.2] [58.1] [68.5] [74.5] [-]

52.0 60.0 69.7 77.8 90.3

42.3 49.8 58.4 68.7 80.8

51.2 56.9 66.4 74.2 83.3

[46.7] [52.4] [61.5] [70.4] [-]

43.8 51.4 60.4 70.4 81.3

69.5

73.3

67.8

70.4

57.0

58.8

[56.4]

57.8

Standard error of the mean

0.93

1.12

1.61

0.65

0.91

0.87

[1.58]

0.62

5th percentile 10th percentile Median 90th percentile 95th percentile

53.3 60.1 68.6 79.1 92.9

56.2 64.3 72.9 82.2 96.7

50.0 57.9 67.9 76.0 98.6

53.0 60.7 69.8 79.2 92.6

44.0 49.4 56.2 62.5 78.8

46.0 50.1 56.9 67.0 79.7

[44.3] [48.3] [55.4] [66.5] [-]

45.1 49.8 56.3 65.4 78.7

a Results are not shown because of small bases.

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY

183

Table 6.5 continued Aged 16 and over with a valid weight measurement Weight (kg)

2004

Age group

Men

Women

16-34

35-54

55+

All men

Irish Mean weight

79.7

83.6

83.8

82.8

70.2

70.5

68.1

Standard error of the mean

2.58

1.26

1.96

1.05

2.32

1.13

1.06

0.76

52.7 66.3 75.6 92.5 121.3

61.3 71.8 83.3 92.2 109.4

61.3 68.6 81.2 99.0 119.5

58.0 69.8 81.4 94.4 115.1

49.4 58.6 65.8 76.5 129.9

53.7 59.2 68.2 80.0 96.9

49.3 57.5 67.3 78.1 89.9

50.7 58.6 66.8 79.6 98.0

79.0

86.3

82.8

82.9

66.7

71.5

70.3

69.7

0.63

0.47

0.44

0.31

0.51

0.47

0.42

0.30

57.6 64.9 76.4 90.8 107.4

65.0 74.1 84.7 98.0 112.2

61.9 71.6 80.6 93.0 109.1

60.6 70.0 81.4 94.8 109.8

49.7 55.7 64.1 76.5 95.1

51.6 59.5 68.7 82.3 101.1

50.9 58.8 68.2 81.0 96.5

50.8 57.8 67.1 80.2 97.9

118 148 293 166 75 68 369 12879

158 124 346 130 53 43 631 14762

115 26 175 45 16 24 595 12335

391 298 814 341 143 136 1595 39976

175 191 351 208 101 51 445 11972

236 147 412 135 38 68 900 14625

121 27 167 46 16 18 673 14139

532 365 930 389 155 137 2019 40736

97 146 179 183 171 156 99 649

132 134 207 119 122 101 174 873

97 25 106 49 38 52 157 975

326 305 492 351 331 309 430 2497

155 178 203 211 233 118 132 753

222 143 245 136 88 153 232 1189

115 31 103 47 36 40 195 1272

492 352 551 394 357 311 559 3214

5th percentile 10th percentile Median 90th percentile 95th percentile General population Mean weight Standard error of the mean

5th percentile 10th percentile Median 90th percentile 95th percentile Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

16-34

35-54

55+

All women

69.6

184

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY

Copyright © 2006, The Information Centre. All rights reserved

a Results are not shown because of small bases.

Table 6.6 Body mass index (BMI), by minority ethnic group and sex Aged 16 and over with both valid height and weight measurements BMI (kg/m2) and BMI status (%)

2004

Minority ethnic group

General population

Black Caribbean

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Men Observed 18.5 or undera Over 18.5 to 25 Over 25 to 30 Over 30 to 40 Over 40 All over 25 (overweight, including obese) All over 30 (obese) Mean BMI

0 32 42 25 0

1 37 45 17 0

3 44 39 13 0

3 41 40 14 1

4 51 39 6 0

3 60 31 6 0

2 31 42 24 2

1 32 44 22 1

67 25 27.1

62 17 26.4

53 14 25.8

55 15 25.9

44 6 24.7

37 6 24.1

67 25 27.2

67 23 27.1

Standard error of the mean

0.28

0.31

0.23

0.25

0.18

0.23

0.34

0.10

1

Standardised risk ratios Overweight, including obese

1.02

1.00

0.82

0.89

0.75

0.62

0.99

Standard error of the ratio

0.056

0.060

0.046

0.048

0.060

0.050

0.060

Obese

1.03

0.79

0.60

0.76

0.22

0.26

1.07

Standard error of the ratio

0.146

0.143

0.081

0.122

0.053

0.062

0.154

1

Women Observed 18.5 or undera Over 18.5 to 25 Over 25 to 30 Over 30 to 40 Over 40 All over 25 (overweight, including obese) All over 30 (obese) Mean BMI

3 33 32 28 4

2 29 31 34 5

3 42 35 19 1

2 35 34 26 2

5 44 34 17 1

5 70 17 7 0

2 40 37 19 2

2 41 34 21 2

65 32 28.0

70 38 28.8

55 20 26.2

62 28 27.1

51 17 25.7

25 8 23.2

58 21 26.7

57 23 26.8

Standard error of the mean

0.37

0.44

0.22

0.30

0.33

0.28

0.29

0.12

1

Standardised risk ratios Overweight, including obese

1.16

1.37

1.00

1.24

1.06

0.46

0.99

Standard error of the ratio

0.059

0.060

0.046

0.051

0.057

0.055

0.063

Obese

1.43

2.00

0.89

1.48

0.89

0.32

0.88

Standard error of the ratio

0.133

0.170

0.084

0.137

0.124

0.070

0.101

380 500

291 344

798 921

336 387

143 153

135 136

1574 2008

39244 39803

317 459

297 332

482 546

346 391

330 353

307 308

420 555

2444 3135

Copyright © 2006, The Information Centre. All rights reserved

Bases (weighted) Men Women Bases (unweighted) Men Women

1

a Those with BMI of 18.5 kg/m2 or under are referred to as underweight using the revised definition.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY

185

Table 6.7 Body mass index (BMI), overweight and obesity, by age within minority ethnic group and sex Aged 16 and over with both valid height and weight measurements

2004

Age group

Men

Women

16-34

35-54

55+

All men

16-34

35-54

55+

All women

Black Caribbean 18.5 or undera Over 18.5 to 25 Over 25 to 30 Over 30 to 40 Over 40 All over 25 (overweight including obese) All over 30 (obese) Mean BMI

1 41 40 17 1

32 41 27 -

23 46 30 -

0 32 42 25 0

6 55 26 11 2

2 26 32 34 6

9 43 44 4

3 33 32 28 4

58 18 26.2

68 27 27.2

77 30 28.0

67 25 27.1

38 13 24.8

72 39 29.1

91 47 30.5

65 32 28.0

Standard error of the mean

0.59

0.41

0.48

0.28

0.46

0.59

0.55

0.37

2 48 43 7 1

27 46 26 -

b b b b b

1 37 45 17 0

3 43 32 21 1

14 32 46 9

[ -] [7] [27] [54] [12]

2 29 31 34 5

All over 25 (overweight including obese) All over 30 (obese) Mean BMI

51 7 25.3

73 26 27.5

b b b

62 17 26.4

54 23 26.5

86 54 31.2

[93] [66] [32.4]

70 38 28.8

Standard error of the mean

0.37

0.42

b

0.31

0.52

0.58

[1.20]

0.44

Black African 18.5 or undera Over 18.5 to 25 Over 25 to 30 Over 30 to 40 Over 40

Indian 18.5 or undera Over 18.5 to 25 Over 25 to 30 Over 30 to 40 Over 40 All over 25 (overweight including obese) All over 30 (obese) Mean BMI

6 50 34 9 0

1 36 43 21 0

51 43 6 -

3 44 39 13 0

7 58 24 11 0

0 35 39 23 2

24 49 26 2

3 42 35 19 1

44 10 24.7

64 21 26.9

49 6 25.3

53 14 25.8

35 11 24.1

64 25 27.3

76 27 27.8

55 20 26.2

Standard error of the mean

0.38

0.30

0.34

0.23

0.35

0.32

0.37

0.22

Pakistani 18.5 or undera Over 18.5 to 25 Over 25 to 30 Over 30 to 40 Over 40 All over 25 (overweight including obese) All over 30 (obese) Mean BMI

6 50 33 11 1

1 31 51 15 2

[39] [35] [26] [ -]

3 41 40 14 1

4 50 31 14 1

21 38 37 4

[ -] [13] [35] [49] [3]

2 35 34 26 2

45 11 24.9

68 16 26.8

[61] [26] [26.9]

55 15 25.9

46 14 25.2

79 41 29.2

[87] [52] [30.0]

62 28 27.1

Standard error of the mean

0.40

0.37

[0.49]

0.25

0.40

0.53

[0.84]

0.30

a Those with BMI of 18.5 kg/m2 or under are referred to as underweight using the revised definition. b Results are not shown because of small bases.

Continued…

186

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY

Copyright © 2006, The Information Centre. All rights reserved

BMI (kg/m2) and BMI status (%)

Table 6.7 continued

Aged 16 and over with both valid height and weight measurements BMI (kg/m2) and BMI status (%)

Men

Women

16-34

35-54

55+

All men

16-34

35-54

55+

All women

Bangladeshi 18.5 or undera Over 18.5 to 25 Over 25 to 30 Over 30 to 40 Over 40 All over 25 (overweight including obese) All over 30 (obese) Mean BMI

6 60 28 5 1

2 41 49 8 -

[4] [42] [52] [1] [ -]

4 51 39 6 0

8 53 26 12 1

21 51 28 -

[2] [40] [38] [21] [ -]

5 44 34 17 1

33 5 24.0

57 8 25.8

[53] [1] [24.8]

44 6 24.7

39 13 24.5

79 28 28.4

[58] [21] [27.0]

51 17 25.7

Standard error of the mean

0.29

0.25

[0.53]

0.18

0.41

0.40

[0.85]

0.33

4 73 20 3 -

1 45 43 10 1

2 54 38 5 -

3 60 31 6 0

9 74 11 6 -

1 69 20 9 1

[6] [65] [24] [5] [ -]

5 70 17 7 0

All over 25 (overweight including obese) All over 30 (obese) Mean BMI

23 3 23.0

54 11 25.6

44 5 [24.9]

37 6 24.1

18 6 22.3

29 9 23.8

[29] [5] [23.6]

25 8 23.2

Standard error of the mean

0.25

0.33

[0.57]

0.23

0.36

0.37

[0.61]

0.28

Chinese 18.5 or undera Over 18.5 to 25 Over 25 to 30 Over 30 to 40 Over 40

Copyright © 2006, The Information Centre. All rights reserved

2004

Age group

Irish 18.5 or undera Over 18.5 to 25 Over 25 to 30 Over 30 to 40 Over 40 All over 25 (overweight ncluding obese) All over 30 (obese) Mean BMI

4 44 32 19 -

2 27 53 16 2

28 35 35 2

2 31 42 24 2

4 49 30 11 6

0 44 36 17 2

2 30 42 26 0

2 40 37 19 2

51 19 25.6

71 18 27.0

72 37 28.5

67 25 27.2

47 17 26.3

56 19 26.5

68 26 27.3

58 21 26.7

Standard error of the mean

0.73

0.40

0.68

0.34

0.83

0.43

0.42

0.29

General population 18.5 or undera Over 18.5 to 25 Over 25 to 30 Over 30 to 40 Over 40 All over 25 (overweight including obese) All over 30 (obese) Mean BMI

3 51 33 13 1

1 23 49 26 1

0 23 49 26 1

1 32 44 22 1

3 54 28 13 2

1 40 33 23 3

1 31 40 26 2

2 41 34 21 2

46 13 25.2

77 27 28.0

76 27 28.0

67 23 27.1

43 15 25.1

58 25 27.1

68 28 27.8

57 23 26.8

Standard error of the mean

0.20

0.15

0.14

0.10

0.20

0.17

0.17

0.12

a Those with BMI of 18.5 kg/m2 or under are referred to as underweight using the revised definition. b Results are not shown because of small bases.

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY

187

Table 6.7 continued

Aged 16 and over with both valid height and weight measurements BMI (kg/m2) and BMI status (%)

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

2004

Age group

Men

Women

16-34

35-54

55+

All men

16-34

35-54

55+

All women

113 142 290 165 74 68 369 12727

158 123 338 130 53 43 628 14694

109 26 170 42 16 23 578 11823

380 291 798 336 143 135 1574 39244

171 182 350 207 100 51 445 11858

220 136 412 135 38 67 898 14477

109 26 159 46 15 17 665 13468

500 344 921 387 153 136 2008 39803

95 140 177 182 170 156 99 643

131 132 203 119 122 101 173 868

91 25 102 45 38 50 148 933

317 297 482 346 330 307 420 2444

150 170 202 209 231 118 132 747

204 132 245 135 88 151 231 1176

105 30 99 47 34 39 192 1212

459 332 546 391 353 308 555 3135

188

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY

Copyright © 2006, The Information Centre. All rights reserved

a Those with BMI of 18.5 kg/m2 or under are referred to as underweight using the revised definition. b Results are not shown because of small bases.

Table 6.8 Waist-hip ratio (WHR) and waist circumference, by minority ethnic group and sex Aged 16 and over with a valid waist and hip measurement WHR and waist circumference

2004

Minority ethnic group Black Caribbean

Black African

General population (2003)a Indian

Pakistani Bangladeshi

Chinese

Irish

Men Observed Mean WHR

0.90

0.87

0.92

0.92

0.91

0.87

0.93

0.92

Standard error of the mean

0.006

0.006

0.005

0.006

0.007

0.007

0.005

0.001

Mean waist circumference

92.5

90.6

93.0

95.0

88.7

86.8

97.3

96.5

Standard error of the mean

1.01

1.16

0.82

0.87

1.00

1.02

0.93

0.22

25

16

38

36

32

17

36

33

% with waist-hip ratio 0.95 and over % with waist circumference 102 cm and over Standardised risk ratios % with waist-hip ratio 0.95 and over

22

19

20

30

12

8

33

31

0.73

0.77

1.15

1.46

1.34

0.66

0.98

1

Standard error of the ratio

0.13

0.18

0.11

0.13

0.16

0.13

0.12

% with waist circumference 102 cm and over

0.66

0.81

0.70

1.23

0.51

0.28

0.96

Standard error of the ratio

0.13

0.17

0.09

0.15

0.12

0.07

0.13

1

Women Observed Mean WHR

0.83

0.81

0.82

0.84

0.85

0.81

0.83

0.82

Standard error of the mean

0.006

0.008

0.004

0.006

0.005

0.005

0.005

0.001

Mean waist circumference

88.4

90.2

83.9

87.7

85.7

77.6

87.4

86.4

Standard error of the mean

1.10

1.40

0.74

0.93

1.09

0.75

0.83

0.21

37

32

30

39

50

22

37

30

% with waist-hip ratio 0.85 and over % with waist circumference 88 cm and over Standardised risk ratios % with waist-hip ratio 0.85 and over

47

53

38

48

43

16

43

41

1.42

1.64

1.15

1.77

2.29

1.00

1.27

1

Standard error of the ratio

0.14

0.23

0.11

0.16

0.17

0.16

0.13

% with waist circumference 88 cm and over

1.23

1.51

0.97

1.49

1.39

0.50

1.00

Standard error of the ratio

0.10

0.13

0.08

0.10

0.12

0.10

0.09

231 327

169 232

434 485

192 217

75 100

75 75

872 1110

4962 5995

209 314

156 200

310 345

197 224

138 171

182 185

311 405

5397 5554

Bases (weighted)b Men Women Bases (unweighted)b Men Women

1

a Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which

was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response.

Copyright © 2006, The Information Centre. All rights reserved

b Bases vary: those shown are for those aged 16 and over with a valid waist and hip measurement.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY

189

Table 6.9 Waist-hip ratio (WHR) and waist circumference, by age within minority ethnic group and sex Aged 16 and over with a valid waist and hip measurement

2004

Age group

Men 16-34

Women 35-54

55+

All men

16-34

35-54

All 55+ women

Black Caribbean Mean WHR

0.85

0.90

0.95

0.90

0.78

0.83

0.89

0.83

Standard error of the mean

0.006

0.010

0.008

0.006

0.009

0.007

0.008

0.006

Mean waist circumference

86.3

94.2

97.4

92.5

79.5

89.8

99.0

88.4

Standard error of the mean

1.74

1.70

1.43

1.01

1.44

1.43

1.31

1.10

% with raised waist-hip ratioa 1 % with raised waist circumferenceb 9 Black African Mean WHR 0.84

25 24

53 34

25 22

14 19

35 47

77 88

37 47

0.90

c

0.87

0.78

0.83

c

0.81

Standard error of the mean

0.008

0.008

c

0.006

0.01

0.007

c

0.008

Mean waist circumference

85.7

94.3

c

90.6

83.6

95.3

c

90.2

Standard error of the mean

1.65

1.44

c

1.16

1.98

1.34

c

1.40

% with raised waist-hip ratioa 4 % with raised waist circumferenceb 10 Indian Mean WHR 0.86

21 24

c c

16 19

14 30

42 73

c c

32 53

0.94

0.97

0.92

0.78

0.84

0.84

0.82

Standard error of the mean

0.007

0.005

0.006

0.005

0.007

0.005

0.008

0.004

Mean waist circumference

86.5

96.5

96.0

93.0

76.4

88.2

87.8

83.9

Standard error of the mean

1.37

0.92

1.07

0.82

1.14

0.93

1.19

0.74

% with raised waist-hip ratioa 5 % with raised waist circumferenceb 11 Pakistani Mean WHR 0.88

46 28

68 19

36 20

13 14

39 53

45 49

30 38

0.94

[1.01]

0.92

0.81

0.85

[0.92]

0.84

Standard error of the mean

0.008

0.006

[0.011]

0.006

0.007

0.009

[0.011]

0.006

Mean waist circumference

91.0

96.7

[105.4]

95.0

82.0

91.1

[100.3]

87.7

Standard error of the mean

1.37

1.01

[1.48]

0.87

1.31

1.77

[1.20]

0.93

% with raised waist-hip ratioa 17 % with raised waist circumferenceb 21 Bangladeshi Mean WHR 0.87

46 26

[84] [71]

37 30

22 29

47 57

[85] [96]

39 48

0.95

c

0.91

0.82

0.89

c

0.85

Standard error of the mean

0.01

0.008

c

0.07

0.007

0.009

c

0.005

Mean waist circumference

84.0

93.4

c

88.7

81.3

93.0

c

85.7

Standard error of the mean

1.58

1.03

c

1.00

1.48

1.31

c

1.09

% with raised waist-hip ratioa 14 % with raised waist circumferenceb 7 Chinese Mean WHR 0.84

41 15

c c

32 12

33 27

77 67

c c

50 43

0.90

[0.93]

0.87

0.77

0.82

c

0.81

Standard error of the mean

0.008

0.007

[0.014]

0.007

0.007

0.006

c

0.005

Mean waist circumference

82.8

90.6

[92.0]

86.8

73.8

79.5

c

77.6

Standard error of the mean

1.23

1.12

[2.21]

1.02

0.95

1.01

c

0.75

4 5

20 10

[53] [14]

17 8

12 9

25 19

c c

22 16

% with raised waist-hip ratioa % with raised waist circumferenceb

a Raised waist-hip ratio for men is 0.95 and over and for women is 0.85 and over. b Raised waist circumference for men is 102cm and over and for women is 88cm and over. c Results are not shown because of small bases. d Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken

from the 2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response. e Bases vary: those shown are for those aged 16 and over with a valid waist and hip measurement.

Continued…

190

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY

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WHR and waist circumference

Table 6.9 continued

Aged 16 and over with a valid waist and hip measurement WHR and waist circumference

2004

Age group

Men 16-34

Women 35-54

55+

All men

16-34

35-54

All 55+ women

Irish Mean WHR

0.88

0.92

0.97

0.93

0.80

0.82

0.85

0.83

Standard error of the mean

0.01

0.006

0.008

0.005

0.01

0.007

0.007

0.005

Mean waist circumference

91.0

96.3

102.3

97.3

85.6

86.6

89.3

87.4

Standard error of the mean

1.55

1.13

1.80

0.92

2.56

1.24

1.05

0.83

% with raised waist-hip ratioa 14 % with raised waist circumferenceb 16 General population (2003)d Mean WHR 0.87

28 28

60 49

36 33

30 28

32 38

47 56

37 43

0.93

0.96

0.92

0.79

0.82

0.85

0.82

Standard error of the mean

0.002

0.002

0.001

0.001

0.002

0.001

0.002

0.001

Mean waist circumference

89.6

98.3

101.4

96.5

81.0

86.4

90.8

86.4

Standard error of the mean

0.38

0.30

0.27

0.22

0.37

0.28

0.28

0.21

9 15

36 34

54 45

33 31

15 26

27 39

46 55

30 41

78 85 145 96 36 39 198 1740

83 69 181 69 27 24 352 1964

69 14 108 26 11 12 322 1693

231 169 434 192 75 75 872 5397

110 115 177 111 61 28 232 1643

144 99 230 76 31 40 463 1940

73 18 78 30 8 7 415 1971

327 232 485 217 100 75 1110 5554

60 68 94 97 61 85 67 1211

84 75 140 70 55 67 131 1843

65 13 76 30 22 30 113 1908

209 156 310 197 138 182 311 4962

92 95 120 114 103 66 82 1482

148 88 164 79 53 100 169 2206

74 17 61 31 15 19 154 2307

314 200 345 224 171 185 405 5995

% with raised waist-hip ratio % with raised waist circumferenceb Bases (weighted)e Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003)d Bases (unweighted)e Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003)d

a Raised waist-hip ratio for men is 0.95 and over and for women is 0.85 and over. b Raised waist circumference for men is 102cm and over and for women is 88cm and over. c Results are not shown because of small bases. d Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken

from the 2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response.

Copyright © 2006, The Information Centre. All rights reserved

e Bases vary: those shown are for those aged 16 and over with a valid waist and hip measurement.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY

191

Table 6.10 Body mass index (BMI), overweight and obesity, by equivalised household income tertile within minority ethnic group and sex Aged 16 and over with both valid height and weight measurements BMI (kg/m2) and BMI status (%)

2004

Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

Black Caribbean Over 25 (overweight including obese) Over 30 (obese) Mean BMI

77 25 27.5

64 20 26.3

70 32 27.9

66 27 27.5

61 36 28.2

69 40 29.2

Standard error of the mean

0.44

0.50

0.54

0.66

0.68

0.77

Black African Over 25 (overweight including obese) Over 30 (obese) Mean BMI

75 19 27.3

54 14 26.0

54 18 25.7

73 39 28.4

78 44 30.2

67 37 28.8

Standard error of the mean

0.52

0.53

0.55

0.62

0.80

0.95

Indian Over 25 (overweight including obese) Over 30 (obese) Mean BMI

55 12 25.9

57 15 25.8

53 17 25.6

48 14 25.4

63 21 26.6

56 29 26.9

Standard error of the mean

0.32

0.51

0.46

0.32

0.44

0.56

[60] [14] [25.8]

56 17 25.9

54 14 25.8

[45] [19] [25.5]

66 28 27.3

63 31 27.6

Pakistani Over 25 (overweight including obese) Over 30 (obese) Mean BMI Standard error of the mean

[0.65]

0.40

0.48

[0.94]

0.56

0.56

Bangladeshi Over 25 (overweight including obese) Over 30 (obese) Mean BMI

a a

48 4 24.9

46 7 24.9

a a

48 13 25.5

53 19 26.0

Standard error of the mean

a

0.35

0.27

a

0.43

0.43

Chinese Over 25 (overweight including obese) Over 30 (obese) Mean BMI

46 12 25.1

34 4 24.0

[21] [2] [23.1]

28 9 23.5

18 7 22.8

32 9 23.9

Standard error of the mean

0.39

0.47

[0.49]

0.45

0.54

0.50

Irish Over 25 (overweight including obese) Over 30 (obese) Mean BMI

71 21 27.5

70 31 27.5

43 16 25.6

55 16 25.9

62 24 27.3

60 31 28.4

Standard error of the mean

0.47

0.64

1.01

0.36

0.76

0.90

General population Over 25 (overweight including obese) Over 30 (obese) Mean BMI

68 21 27.1

70 27 27.5

63 26 26.9

49 19 26.0

35 28 27.6

38 29 27.6

Standard error of the mean

0.14

0.21

0.32

0.13

0.23

0.31

a Results are not shown because of small bases.

192

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY

Copyright © 2006, The Information Centre. All rights reserved

Observed

Table 6.10 continued

Aged 16 and over with both valid height and weight measurements BMI (kg/m2) and BMI status (%)

2004

Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

Black Caribbean Overweight, including obese

1.18

0.85

1.02

1.15

0.99

1.24

Standard error of the ratio

0.08

0.11

0.11

0.12

0.11

0.09

Obese

1.01

0.70

1.31

1.03

1.41

1.82

Standardised risk ratiosb

Standard error of the ratio

0.21

0.21

0.27

0.23

0.22

0.27

Mean BMI: ratio of means

1.02

0.95

1.03

1.02

1.04

1.10

Standard error of the ratio

0.02

0.02

0.02

0.03

0.03

0.03

Black African Overweight, including obese

1.18

0.89

0.87

1.37

1.41

1.33

Standard error of the ratio

0.09

0.10

0.12

0.09

0.10

0.10

Obese

0.72

0.87

0.66

2.03

1.96

2.03

Standard error of the ratio

0.23

0.34

0.21

0.31

0.30

0.34

Mean BMI: ratio of means

1.01

0.99

0.95

1.09

1.14

1.15

Standard error of the ratio

0.02

0.03

0.02

0.03

0.03

0.05

Indian Overweight, including obese

0.80

0.85

0.79

0.92

1.10

0.93

Standard error of the ratio

0.08

0.10

0.08

0.08

0.08

0.09

Obese

0.44

0.57

0.85

0.73

0.82

1.22

Standard error of the ratio

0.11

0.16

0.17

0.16

0.14

0.23

Mean BMI: ratio of means

0.95

0.95

0.95

0.96

0.99

1.00

Standard error of the ratio

0.01

0.02

0.02

0.01

0.02

0.02

[0.74]

0.87

0.82

[1.02]

1.25

1.23

[0.19]

0.07

0.08

[0.24]

0.09

0.09

[0.47]

0.83

0.63

[1.53]

1.39

1.70

Pakistani Overweight, including obese Standard error of the ratio

Obese Standard error of the ratio

Mean BMI: ratio of means

Copyright © 2006, The Information Centre. All rights reserved

Standard error of the ratio

[0.22]

0.20

0.16

[0.65]

0.21

0.25

[0.95]

0.97

0.96

[1.00]

1.05

1.06

[0.02]

0.02

0.02

[0.05]

0.02

0.02

Bangladeshi Overweight, including obese

a

0.82

0.67

a

0.96

1.09

Standard error of the ratio

a

0.08

0.10

a

0.12

0.09

Obese

-

0.23

0.27

-

0.76

0.89

Standard error of the ratio

-

0.12

0.09

-

0.25

0.17

Mean BMI: ratio of means

a

0.94

0.92

a

0.99

1.00

Standard error of the ratio

a

0.02

0.01

a

0.02

0.02

Chinese Overweight, including obese

0.69

0.54

[0.45]

0.54

0.32

0.54

Standard error of the ratio

0.08

0.10

[0.16]

0.11

0.08

0.11

Obese

0.52

0.16

[0.18]

0.31

0.31

0.36

Standard error of the ratio

0.15

0.09

[0.17]

0.10

0.11

0.16

Mean BMI: ratio of means

0.93

0.89

[0.87]

0.88

0.86

0.89

Standard error of the ratio

0.02

0.02

[0.02]

0.02

0.02

0.02

Irish Overweight, including obese

1.04

0.96

0.53

0.93

1.09

0.94

Standard error of the ratio

0.08

0.13

0.12

0.08

0.13

0.15

Obese

0.97

1.15

0.54

0.64

1.21

1.28

Standard error of the ratio

0.20

0.28

0.20

0.12

0.25

0.39

Mean BMI: ratio of means

1.02

0.98

0.92

0.97

1.05

1.06

Standard error of the ratio

0.02

0.03

0.03

0.02

0.04

0.05

a Results are not shown because of small

bases. b

Age-standardised ratios compare the results for men (or women) in each tertile of equivalised household income in each minority ethnic group with men (or women) in the general population, all tertiles of equivalised income combined.

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY

193

Table 6.10 continued

Aged 16 and over with both valid height and weight measurements BMI (kg/m2) and BMI status (%)

2004

Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

General population Overweight, including obese

1.01

1.02

0.93

0.90

1.11

1.07

Standard error of the ratio

0.03

0.04

0.05

0.03

0.04

0.06

Obese

0.89

1.18

1.11

0.81

1.19

1.20

Standardised risk ratiosb

Standard error of the ratio

0.07

0.10

0.14

0.06

0.10

0.11

Mean BMI: ratio of means

1.00

1.01

0.99

0.97

1.03

1.03

Standard error of the ratio

0.01

0.01

0.01

0.01

0.01

0.01

130 98 245 48 7 41 799 19656

95 79 213 98 37 33 349 9799

86 65 139 119 65 18 201 4547

130 104 280 37 8 45 943 16831

152 90 252 106 34 31 489 11803

133 107 176 142 69 21 301 5191

103 88 146 41 17 97 194 1206

74 94 138 96 83 70 105 638

76 71 90 136 149 41 67 286

117 82 163 30 20 99 234 1280

128 99 154 108 79 68 142 973

129 106 109 146 156 51 105 431

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

a Results are not shown because of small bases. b Age-standardised ratios compare the results for men (or women) in each tertile of equivalised household

194

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY

Copyright © 2006, The Information Centre. All rights reserved

income in each minority ethnic group with men (or women) in the general population, all tertiles of equivalised income combined.

Table 6.11 Waist-hip ratio (WHR) and waist circumference, by equivalised household income tertile within minority ethnic group and sex Aged 16 and over with a valid waist and hip measurement WHR and waist circumference

2004

Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

Observed % Black Caribbean Mean WHR

0.88

0.90

[0.92]

0.81

0.84

0.83

Standard error of the mean

0.009

0.013

[0.011]

0.009

0.010

0.012

Mean waist circumference

94.1

90.5

[97.2]

86.0

91.1

88.2

Standard error of the mean

1.59

1.96

[2.71]

1.73

2.03

2.18

% with raised waist-hip ratioa 13 % with raised waist circumferenceb 20 Black African Mean WHR 0.87

32 20

[44] [41]

19 34

48 58

33 47

[0.88]

[0.87]

[0.82]

0.81

0.81

Standard error of the mean

0.010

[0.016]

[0.013]

[0.015]

0.013

0.013

Mean waist circumference

91.3

[91.7]

[88.0]

[91.3]

92.1

90.3

Standard error of the mean

1.36

[2.20]

[2.59]

[3.53]

2.00

2.52

16

[23]

[15]

[40]

31

30

11

[13]

[27]

[49]

62

54

% with raised waist-hip ratioa % with raised waist circumferenceb Indian Mean WHR

0.92

0.92

0.94

0.81

0.82

0.83

Standard error of the mean

0.007

0.009

0.014

0.007

0.007

0.009

Mean waist circumference

93.8

92.4

93.9

82.0

84.4

84.3

Standard error of the mean

1.08

1.69

2.10

1.13

1.37

1.56

31 19

40 21

51 28

21 31

32 44

39 42

% with raised waist-hip ratioa % with raised waist circumferenceb Pakistani Mean WHR

c

0.93

0.93

c

0.84

0.83

Standard error of the mean

c

0.010

0.013

c

0.011

0.010

Mean waist circumference

c

95.7

95.3

c

88.2

87.8

Standard error of the mean

c

1.23

1.70

c

1.75

1.64

% with raised waist-hip ratioa % with raised waist circumferenceb Bangladeshi Mean WHR

c c

39 28

39 34

c c

43 49

35 50

c

c

0.91

c

[0.85]

0.84

Standard error of the mean

c

c

0.008

c

[0.011]

0.009

Mean waist circumference

c

c

87.4

c

[87.6]

84.3

Standard error of the mean

c

c

1.05

c

[1.87]

1.24

% with raised waist-hip ratioa % with raised waist circumferenceb

c c

c c

35 6

c c

[53] [46]

48 37

a Raised waist-hip ratio for men is 0.95 and over and for women is 0.85 and over. b Raised waist circumference for men is 102cm and over and for women is 88cm and over.

Copyright © 2006, The Information Centre. All rights reserved

c Results are not shown because of small bases. d Comparative data for the general population are not available on this topic from the 2004 survey, so data

have been taken from the 2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response. e Bases vary: those shown are for those aged 16 and over with a valid waist and hip measurement. f Age-standardised ratios compare the results for men (or women) in each tertile of equivalised household

income in each minority ethnic group with men (or women) in the general population, all tertiles of equivalised income combined.

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY

195

Table 6.11 continued

Aged 16 and over with a valid waist and hip measurement WHR and waist circumference

2004

Equivalised household income tertile

Men Highest

Women Middle

Lowest

Highest

Middle

Lowest

c

Observed % Chinese Mean WHR

0.88

[0.88]

c

0.81

[0.81]

Standard error of the mean

0.009

[0.011]

c

0.006

[0.014]

c

Mean waist circumference

89.2

[87.7]

c

78.2

[77.0]

c

Standard error of the mean

1.15

[1.27]

c

1.08

[2.13]

c

% with raised waist-hip ratioa 18 % with raised waist circumferenceb 11 Irish Mean WHR 0.92

[21] [5]

c c

25 18

[25] [18]

c c

0.94

[0.95]

0.81

0.84

0.84

Standard error of the mean

0.006

0.009

[0.018]

0.005

0.011

0.010

Mean waist circumference

96.7

96.8

[96.6]

85.7

87.7

90.9

Standard error of the mean

1.30

1.90

[2.93]

1.14

1.86

2.50

28

42

[43]

25

46

49

30

30

[31]

36

41

61

% with raised waist-hip ratioa % with raised waist circumferenceb General population 2003 Mean WHR

0.91

0.92

0.92

0.81

0.83

0.83

Standard error of the mean

0.002

0.002

0.004

0.002

0.002

0.002

Mean waist circumference

96.5

96.6

96.0

84.6

87.8

87.9

Standard error of the mean

0.28

0.41

0.66

0.29

0.37

0.51

29 30

37 34

38 32

24 35

35 45

38 49

Black Caribbean Raised waist-hip ratioa

0.41

0.71

[1.35]

0.65

1.55

1.39

Standard error of the ratio

0.15

0.21

[0.38]

0.19

0.23

0.24

Raised waist circumferenceb

0.62

0.45

[1.37]

0.85

1.27

1.31

% with raised waist-hip ratioa % with raised waist circumferenceb

Standardised risk ratiosf

0.18

0.20

[0.37]

0.16

0.18

0.19

Mean WHR: ratio of means

0.97

0.96

[1.01]

0.99

1.01

1.02

Standard error of the ratio

0.008

0.013

[0.013]

0.011

0.015

0.015

0.99 0.014

0.91 0.021

[1.02] [0.031]

1.00 0.020

1.03 0.025

1.05 0.026 1.73

Mean waist circumference: ratio of means Standard error of the ratio Black African Raised waist-hip ratioa

0.55

[0.93]

[0.68]

[1.83]

1.34

Standard error of the ratio

0.22

[0.42]

[0.30]

[0.41]

0.34

0.52

Raised waist circumferenceb

0.44

[0.38]

[1.34]

[1.48]]

1.67

1.13

Standard error of the ratio

0.21

[0.16]

[0.36]

[0.26]

0.22

0.29

Mean WHR: ratio of means

0.97

[0.96]

[0.98]

[1.02]

1.01

1.01

Standard error of the ratio

0.015

[[0.02]

[0.016]]

[0.021]

0.021

0.017

Mean waist circumference: ratio of means

0.97

[0.96]

[0.96]

[1.10]

1.09

1.05

Standard error of the ratio

0.02

[0.024]

[0.03]

[0.043]

0.029

0.026

Indian Raised waist-hip ratioa

0.97

1.20

1.50

0.83

1.20

1.42

Standard error of the ratio

0.19

0.20

0.29

0.19

0.20

0.24

Raised waist circumferenceb

0.58

0.66

1.01

0.84

1.05

1.05

Standard error of the ratio

0.15

0.18

0.24

0.14

0.15

0.17

a Raised waist-hip ratio for men is 0.95 and over

and for women is 0.85 and over. b Raised waist circumference for men is 102cm

and over and for women is 88cm and over. c Results are not shown because of small

bases. d Comparative data for the general population

are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response. e Bases vary: those shown are for those aged

16 and over with a valid waist and hip measurement.

Mean WHR: ratio of means

1.01

1.00

1.02

1.00

1.00

1.01

f Age-standardised ratios compare the results

Standard error of the ratio

0.009

0.011

0.016

0.009

0.011

0.012

for men (or women) in each tertile of equivalised household income in each minority ethnic group with men (or women) in the general population, all tertiles of equivalised income combined.

Mean waist circumference: ratio of means

0.98

0.95

0.97

0.97

0.98

0.98

Standard error of the ratio

0.013

0.019

0.025

0.014

0.016

0.019

Continued…

196

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY

Copyright © 2006, The Information Centre. All rights reserved

Standard error of the ratio

Table 6.11 continued

Aged 16 and over with a valid waist and hip measurement WHR and waist circumference

2004

Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

Pakistani Raised waist-hip ratioa

c

1.43

1.40

c

1.81

1.62

Standard error of the ratio

c

0.21

0.23

c

0.27

0.29

Raised waist circumferenceb

c

1.03

1.28

c

1.45

1.56

Standardised risk ratiosf

Standard error of the ratio

c

0.20

0.25

c

0.19

0.17

Mean WHR: ratio of means

c

1.03

1.02

c

1.05

1.04

Standard error of the ratio

c

0.011

0.015

c

0.014

0.014

Mean waist circumference: ratio of means

c

c

1.00

c

1.06

1.06

Standard error of the ratio

c

c

0.019

c

0.021

0.02

Bangladeshi Raised waist-hip ratioa

c

c

1.21

c

[2.50]

2.06

Standard error of the ratio

c

c

0.18

c

[0.42]

0.25

Raised waist circumferenceb Raised waist-hip ratioa

c

c

0.21

c

[1.59]

1.16

Mean WHR: ratio of means

c c

c c

0.11 1.00

c c

[0.34]] [1.07]

0.15 1.05

Standard error of the ratio

c

c

0.01

c

[0.019]

0.011

Mean waist circumference: ratio of means

c

c

0.91

c

[1.07]

1.01

Standard error of the ratio

c

c

0.012

c

[0.034]

0.017

Chinese Raised waist-hip ratioa

0.68

[0.79]

c

0.96

[1.19]

c

Standard error of the ratio

0.20

[0.28]

c

0.23

[0.42]

c

Raised waist circumferenceb

0.40

[0.15]

c

0.48

0.61]

c

Standard error of the ratio

0.13

[0.11]

c

0.13

[[0.27]

c

Mean WHR: ratio of means

0.97

[0.98]

c

1.00

[1.00]

c

Standard error of the ratio

0.01

[0.012]

c

0.008

[0.022]

c

Mean waist circumference: ratio of means

0.94

[0.93]

c

0.91

[0.92]

c

Standard error of the ratio

0.013

[0.013]

c

0.014

[0.034]

c

Irish Raised waist-hip ratioa

0.88

0.98

[0.82]

0.99

1.65

1.75

Standard error of the ratio

0.16

0.22

[0.29]

0.18

0.27

0.45

Raised waist circumferenceb

0.99

0.74

[0.59]

0.84

1.13

1.48

Standard error of the ratio

0.18

0.18

[0.24]

0.12

0.17

0.29

Mean WHR: ratio of means

1.00

1.01

[1.01]

1.00

1.02

1.03

Standard error of the ratio

0.007

0.012

[0.015]

0.008

0.015

0.018

Copyright © 2006, The Information Centre. All rights reserved

Mean waist circumference: ratio of means

a Raised waist-hip ratio for men is 0.95 and over

and for women is 0.85 and over. b Raised waist circumference for men is 102cm

and over and for women is 88cm and over. c Results are not shown because of small

1.00

0.98

[0.98]

1.00

1.04

1.07

Standard error of the ratio

0.015

0.024

[0.023]

0.014

0.031

0.051

General population 2003 Raised waist-hip ratioa

0.93

1.09

1.08

0.86

1.06

1.27

Standard error of the ratio

0.04

0.06

0.08

0.04

0.05

0.07

Raised waist circumferenceb

0.99

1.04

0.96

0.90

1.05

1.16

Standard error of the ratio

0.05

0.06

0.08

0.04

0.04

0.06

Mean WHR: ratio of means

1.00

1.00

1.00

0.99

1.00

1.02

Standard error of the ratio

0.002

0.003

0.005

0.003

0.003

0.004

Mean waist circumference: ratio of means

1.01

1.00

0.99

0.99

1.01

1.01

Standard error of the ratio

0.004

0.006

0.008

0.005

0.006

0.007

bases. d Comparative data for the general population

are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response. e Bases vary: those shown are for those aged

16 and over with a valid waist and hip measurement. f Age-standardised ratios compare the results

for men (or women) in each tertile of equivalised household income in each minority ethnic group with men (or women) in the general population, all tertiles of equivalised income combined.

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY

197

Table 6.11 continued

Aged 16 and over with a valid waist and hip measurement

2004

Equivalised household income tertile

Men

Bases (weighted)e Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population 2003d Bases (unweighted)e Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population 2003d

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

70 67 113 24 3 26 461 2535

59 30 128 74 14 17 223 1468

47 47 87 61 35 10 93 701

76 62 136 19 3 31 487 2242

92 60 140 62 17 13 317 1712

102 79 111 80 48 10 159 830

66 57 84 22 7 70 149

55 34 94 71 29 40 83

43 43 64 74 63 23 46

76 49 97 18 7 78 172

89 55 98 63 30 32 115

96 68 80 89 80 27 71

2358

1365

635

2428

1870

910

a Raised waist-hip ratio for men is 0.95 and over and for women is 0.85 and over. b Raised waist circumference for men is 102cm and over and for women is 88cm and over. c Results are not shown because of small bases. d Comparative data for the general population are not available on this topic from the 2004 survey, so data

have been taken from the 2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response. e Bases vary: those shown are for those aged 16 and over with a valid waist and hip measurement. f Age-standardised ratios compare the results for men (or women) in each tertile of equivalised household

198

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY

Copyright © 2006, The Information Centre. All rights reserved

income in each minority ethnic group with men (or women) in the general population, all tertiles of equivalised income combined.

Table 6.12 Comparison of body mass index (BMI), overweight and obesity in 2004 and 1999, age within minority ethnic groupa and sex Aged 16 and over with both valid height and weight measurements

Copyright © 2006, The Information Centre. All rights reserved

BMI (kg/m2) and BMI status (%)

2004, 1999

Age group

Men

Women

16-34

35-54

55+

All men

Black Caribbean 2004 Over 25 (overweight including obese) 58 Over 30 (obese) 18 Mean BMI 26.2

68 27 27.2

77 30 28.0

67 25 27.1

38 13 24.8

72 39 29.1

91 47 30.5

65 32 28.0

Standard error of the mean

16-34

35-54

All 55+ women

0.59

0.41

0.48

0.28

0.46

0.59

0.55

0.37

1999 Over 25 (overweight including obese) 40 Over 30 (obese) 10 Mean BMI 24.6

68 28 27.4

71 21 27.1

58 18 26.2

48 20 26.0

69 32 28.3

92 52 31.1

66 32 28.0

Standard error of the mean

0.29

0.41

0.30

0.19

0.35

0.36

0.42

0.23

Indian 2004 Over 25 (overweight including obese) 44 Over 30 (obese) 10 Mean BMI 24.7

64 21 26.9

49 6 25.3

53 14 25.8

35 11 24.1

64 25 27.3

76 27 27.8

55 20 26.2

Standard error of the mean

0.38

0.30

0.34

0.23

0.35

0.32

0.37

0.22

1999 Over 25 (overweight including obese) 38 Over 30 (obese) 9 Mean BMI 24.1

61 13 26.0

55 14 25.7

51 12 25.2

36 9 23.9

60 23 26.7

79 36 28.4

54 20 25.9

Standard error of the mean

0.35

0.26

0.37

0.19

0.36

0.31

0.42

0.22

Pakistani 2004 Over 25 (overweight including obese) 45 Over 30 (obese) 11 Mean BMI 24.9

68 16 26.8

[61] [26] [26.9]

55 15 25.9

46 14 25.2

79 41 29.2

[87] [52] [30.0]

62 28 27.1

Standard error of the mean

0.40

0.37

[0.49]

0.25

0.40

0.53

[0.84]

0.30

1999 Over 25 (overweight including obese) 44 Over 30 (obese) 10 Mean BMI 24.5

64 19 26.6

58 10 26.2

52 13 25.4

40 15 24.5

81 39 29.3

83 48 29.3

57 26 26.5

Standard error of the mean

0.25

0.30

0.45

0.18

0.28

0.39

0.81

0.24

Bangladeshi 2004 Over 25 (overweight including obese) 33 Over 30 (obese) 5 Mean BMI 24.0

57 8 25.8

[53] [1] [24.8]

44 6 24.7

39 13 24.5

79 28 28.4

[58] [21] [27.0]

51 17 25.7

Standard error of the mean

0.29

0.25

[0.53]

0.18

0.41

0.40

[0.85]

0.33

1999 Over 25 (overweight including obese) 25 Over 30 (obese) 3 Mean BMI 22.9

51 12 25.1

46 3 24.7

36 5 23.8

27 6 22.9

61 18 26.5

51 12 [25.5]

37 10 24.1

Standard error of the mean

0.36

0.37

0.18

0.24

0.37

[0.47]

0.20

0.23

a Black Africans were included in the 2004 survey but not in 1999, and are therefore excluded from this comparative table.

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY

199

Table 6.12 continued

Aged 16 and over with both valid height and weight measurements BMI (kg/m2) and BMI status (%)

2004, 1999

Age group

Men

Women

16-34

35-54

55+

All men

Chinese 2004 Over 25 (overweight including obese) 23 Over 30 (obese) 3 Mean BMI 23.0

54 11 25.6

44 5 24.9

37 6 24.1

18 6 22.3

29 9 23.8

[29] [5] [23.6]

25 8 23.2

Standard error of the mean

16-34

35-54

All 55+ women

0.25

0.33

0.57

0.23

0.36

0.37

[0.61]

0.28

1999 Over 25 (overweight including obese) 23 Over 30 (obese) 4 Mean BMI 23.0

43 5 24.7

43 12 24.9

36 6 24.1

20 3 22.4

37 6 23.9

40 2 24.6

33 5 23.6

Standard error of the mean

0.42

0.32

0.49

0.23

0.34

0.26

0.41

0.19

Irish 2004 Over 25 (overweight including obese) 51 Over 30 (obese) 19 Mean BMI 25.6

71 18 27.0

72 37 28.5

67 25 27.2

47 17 26.3

56 19 26.5

68 26 27.3

58 21 26.7

Standard error of the mean

0.73

0.40

0.68

0.34

0.83

0.43

0.42

0.29

1999 Over 25 (overweight including obese) 50 Over 30 (obese) 16 Mean BMI 25.7

68 21 26.9

69 24 27.3

63 20 26.7

41 14 24.9

56 24 27.1

69 25 27.3

55 21 26.5

Standard error of the mean

0.57

0.26

0.41

0.22

0.32

0.37

0.37

0.22

General population 2004 Over 25 (overweight including obese) 46 Over 30 (obese) 13 Mean BMI 25.2

77 27 28.0

76 27 28.0

67 23 27.1

43 15 25.1

58 25 27.1

68 28 27.8

57 23 26.8

Standard error of the mean

0.20

0.15

0.14

0.10

0.20

0.17

0.17

0.12

1999 Over 25 (overweight including obese) 45 Over 30 (obese) 13 Mean BMI 25.0

69 22 27.2

73 21 27.2

63 19 26.6

36 13 24.6

56 22 26.7

67 27 27.5

54 21 26.4

Standard error of the mean

0.12

0.12

0.08

0.15

0.14

0.15

0.09

0.14

a Black Africans were included in the 2004 survey but not in 1999, and are therefore excluded from this comparative table.

200

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY

Copyright © 2006, The Information Centre. All rights reserved

Continued…

Table 6.12 continued

Aged 16 and over with both valid height and weight measurements

2004, 1999

Age group

Men

Bases (weighted) Black Caribbean 2004 Black Caribbean 1999 Indian 2004 Indian 1999 Pakistani 2004 Pakistani 1999 Bangladeshi 2004 Bangladeshi 1999 Chinese 2004 Chinese 1999 Irish 2004 Irish 1999 General population 2004 General population 1999 Bases (unweighted) Black Caribbean 2004 Black Caribbean 1999 Indian 2004 Indian 1999 Pakistani 2004 Pakistani 1999 Bangladeshi 2004 Bangladeshi 1999 Chinese 2004 Chinese 1999 Irish 2004 Irish 1999 General population 2004 General population 1999

Women

16-34

35-54

55+

All men

113 128 290 187 165 175 74 57 68 32 369 358 12727 11478

158 83 338 217 130 109 53 28 43 41 628 655 14694 14604

109 107 170 96 42 41 16 21 23 18 578 376 11823 13042

380 318 798 501 336 325 143 106 135 91 1574 1389 39244 39124

171 162 350 218 207 185 100 66 51 31 445 510 11858 13214

220 160 412 226 135 104 38 24 67 59 898 794 14477 17401

109 99 159 93 46 26 15 11 17 15 665 477 13468 14682

500 422 921 537 387 316 153 101 136 106 2008 1781 39803 45298

95 184 177 196 182 294 170 215 156 101 99 126 643 955

131 124 203 231 119 195 122 110 101 122 173 221 868 1205

91 158 102 100 45 67 38 84 50 61 148 134 933 1044

317 466 482 527 346 556 330 409 307 284 420 481 2444 3204

150 240 202 228 209 320 231 256 118 98 132 179 747 1106

204 237 245 245 135 183 88 109 151 187 231 276 1176 1433

105 141 99 99 47 47 34 43 39 54 192 176 1212 1160

459 618 546 572 391 550 353 408 308 339 555 631 3135 3699

16-34

35-54

All 55+ women

Copyright © 2006, The Information Centre. All rights reserved

a Black Africans were included in the 2004 survey but not in 1999, and are therefore excluded from this comparative table.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY

201

Table 6.13 Comparison of waist-hip ratio (WHR) and waist circumference, in 2004 with 1999 by minority ethnic groupa and sex Aged 16 and over with a valid waist and hip measurement

Black Caribbean 2004 % with raised waist-hip ratiob % with raised waist circumferencec 1999 % with raised waist-hip ratiob % with raised waist circumferencec Indian 2004 % with raised waist-hip ratiob % with raised waist circumferencec 1999 % with raised waist-hip ratiob % with raised waist circumferencec Pakistani 2004 % with raised waist-hip ratiob % with raised waist circumferencec 1999 % with raised waist-hip ratiob % with raised waist circumferencec Bangladeshi 2004 % with raised waist-hip ratiob % with raised waist circumferencec 1999 % with raised waist-hip ratiob % with raised waist circumferencec Chinese 2004 % with raised waist-hip ratiob % with raised waist circumferencec 1999 % with raised waist-hip ratiob % with raised waist circumferencec Irish 2004 % with raised waist-hip ratiob % with raised waist circumferencec 1999 % with raised waist-hip ratiob % with raised waist circumferencec

2004, 1999

Age group

Men

Women

16-34

35-54

55+

All men

1 9

25 24

53 34

25 22

15 19

35 47

78 88

37 47

1 3

10 12

46 29

19 15

15 24

33 46

63 79

33 46

5 11

46 28

68 19

38 20

13 14

39 53

45 49

30 38

11 8

42 18

65 27

36 17

9 12

30 36

55 69

26 32

17 21

46 26

[84] [71]

37 30

22 29

47 57

[85] [96]

39 48

9 10

39 26

72 39

28 20

18 25

51 63

72 88

33 42

14 7

41 15

d d

32 12

33 27

77 67

d d

50 43

4 1

35 6

60 14

27 5

29 17

57 57

100 68

43 33

4 5

20 10

[53] [14]

17 8

12 9

25 19

d d

22 16

2 2

17 3

48 24

18 6

14 8

20 18

64 37

24 17

14 16

28 28

60 49

36 33

30 28

32 38

47 56

37 43

14 11

32 26

47 41

32 27

9 17

21 34

48 47

25 33

16-34

35-54

All 55+ women

a Black Africans were included in the 2004 survey but not in 1999, and are therefore excluded from this comparative table. b Raised waist-hip ratio for men is 0.95 and over and for women is 0.85 and over. c Raised waist circumference for men is 102cm and over and for women is 88cm and over. d Results are not shown because of small bases. e Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken

from the 2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response. f Bases vary: those shown are for those aged 16 and over with a valid waist and hip measurement. g Comparative data for the general population are not available on this topic from the 1999 survey itself, so data have been

taken from the 1998 survey, in which no weighting was involved.

Continued…

202

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Copyright © 2006, The Information Centre. All rights reserved

WHR and waist circumference (%)

Table 6.13 continued

Aged 16 and over with a valid waist and hip measurement WHR and waist circumference (%)

Men

General population(2003e,1998,g) 2003 % with raised waist-hip ratiob % with raised waist circumferencec 1998 % with raised waist-hip ratiob % with raised waist circumferencec Bases (weighted)f Black Caribbean 2004 Black Caribbean 1999 Indian 2004 Indian 1999 Pakistani 2004 Pakistani 1999 Bangladeshi 2004 Bangladeshi 1999 Chinese 2004 Chinese 1999 Irish 2004 Irish 1999 General population 2003e General population 1998g Bases (unweighted)f Black Caribbean 2004 Black Caribbean 1999 Indian 2004 Indian 1999 Pakistani 2004 Pakistani 1999 Bangladeshi 2004 Bangladeshi 1999 Chinese 2004 Chinese 1999 Irish 2004 Irish 1999 General population 2003e General population 1998

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2004, 1999

Age group

Women

16-34

35-54

55+

All men

9 15

36 34

54 45

33 31

15 26

27 39

46 55

30 41

7 10

27 25

46 36

28 24

7 16

17 31

34 44

20 31

78 145 145 218 96 191 36 70 39 34 198 385 1740 g

83 93 181 252 69 120 27 37 24 42 352 714 1964 g

69 130 108 125 26 47 11 29 12 19 322 448 1693 g

231 367 434 595 192 358 75 137 75 96 872 1546 5397 g

110 190 177 252 111 223 61 91 28 35 232 566 1643 g

144 190 230 256 76 117 31 33 40 62 463 879 1940 g

73 123 78 108 30 31 8 14 7 17 415 543 1971 g

327 503 485 616 217 370 100 139 75 113 1110 1988 5554 g

60 212 94 232 97 326 61 274 85 109 67 135 1211 2213

65 142 76 267 30 217 22 143 30 127 113 240 1908 2594

209 193 310 127 197 77 138 116 182 65 311 162 4962 2386

84 547 140 626 70 620 55 533 67 301 131 537 1843 7193

92 283 120 267 114 384 103 361 66 109 82 203 1482 2636

148 285 164 277 79 203 53 144 100 194 169 301 2206 3057

74 180 61 113 31 56 15 58 19 58 154 204 2307 3022

314 748 345 657 224 643 171 563 185 361 405 708 5995 8715

16-34

35-54

All 55+ women

a Black Africans were included in the 2004 survey but not in 1999, and are therefore excluded from this comparative table. b Raised waist-hip ratio for men is 0.95 and over and for women is 0.85 and over. c Raised waist circumference for men is 102cm and over and for women is 88cm and over. d Results are not shown because of small bases. e Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken

from the 2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response. f Bases vary: those shown are for those aged 16 and over with a valid waist and hip measurement. g Comparative data for the general population are not available on this topic from the 1999 survey itself, so data have been

taken from the 1998 survey, in which no weighting was involved.

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203

Blood pressure

7

Moushumi Chaudhury & Paola Zaninotto

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Summary ●

Age-standardised ratios of mean systolic blood pressure (SBP) were significantly lower for Chinese men (0.96) and South Asian men, particularly Bangladeshis (0.94), and higher for Black Caribbean men (1.02) compared with men in the general population (set at 1.0).

●

Age-standardised ratios of mean SBP were significantly lower in Indian women (0.98) than women in the other minority ethnic groups, and those in the general population.

●

In general, mean diastolic blood pressure (DBP) (age-adjusted ratios) for men did not show any significant differences from the men in the general population, except for Indian men (1.02).

●

Age-adjusted ratios for women showed DBP in the Pakistani group (1.02) to be slightly higher than the general population (set at 1.0).

●

Age-adjusted ratios of mean pulse pressure (PP) were low among Chinese men (0.90) and the South Asian groups: Indian (0.92 men, 0.94 women), Pakistani (0.91 men, 0.94 women), and Bangladeshi informants (0.89 men, 0.96 women).

●

The prevalence of high blood pressure was significantly lower among Bangladeshi men (0.63) than men in the general population (set at 1.0). There were no other differences between ethnic groups.

●

Black Caribbean (risk ratio 1.58), Black African (1.71) and Bangladeshi (1.43) women were significantly more likely to have high blood pressure than women in the general population.

●

No clear pattern was observed between urinary sodium, potassium and high blood pressure.

●

There was no clear relationship between high blood pressure and equivalised income for either men or women in the different minority ethnic groups.

●

Mean SBP was lower in 2004 than in 1999 in general, in both sexes, but the decrease was not significant in many groups. Changes in SBP were statistically significant among Indian male informants and men in the general population. The decrease in SBP was highly significant in Indian, Pakistani and Chinese women and women in the general population.

●

No significant differences were found in mean DBP between 1999 and 2004, in any of the minority ethnic groups, except for Pakistani women.

●

The prevalence of hypertension was higher in 2004 than in 1999 in most minority ethnic groups, although many of the increases were not statistically significant. The largest increases in 2004 were in the prevalence of controlled hypertension, while the largest decreases were in the prevalence of untreated hypertension.

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205

7.1 Introduction Hypertension is a persistently raised blood pressure (BP) above a designated threshold.1 Hypertension is an important public health challenge in both economically developing, and developed, countries. Numerous national and regional studies have been conducted worldwide to estimate the prevalence of hypertension: hypertension rates have varied from 3.4% in rural Indian men to as high as 72.5% in Polish women.2,3 Hypertension is one of the main risk factors for heart attack and stroke.4 It appears to be more common among African Caribbeans and South Asians in Britain.5,6 A number of studies in the UK have shown that mortality rates for stroke, coronary heart disease (CHD) and end-stage renal failure are higher in South Asians than white Europeans.7,8 This report follows the most recent (2004) guidelines from the British Hypertension Society 9 in defining hypertension as blood pressure of 140/90 or above (systolic BP (SBP) ≥140mmHg and/or diastolic BP (DBP) ≥90mmHg). Drug treatment is recommended in all people with sustained levels of blood pressure ≥160/100, and at lower levels in those with additional risk factors, such as diabetes, or with end-organ damage. The guidelines recommend a reduction of BP to <140/85, but give lower target BP levels (<130/80) for patients with diabetes or chronic renal failure.9 There are a number of unmodifiable predisposing risk factors in those more at risk of hypertension, such as age, gender, family history and ethnicity.1 Ethnic groups differ in their prevalence of hypertension.10 Some of the differences are thought to be related to the way the body reacts to salt (salt–sensitivity)11 and the differences in various hormones that control blood pressure (vasoactive neuropeptides) in blood.1 The majority of UK-based surveys have shown that people of Black African or Black Caribbean origin have higher average BP levels and rates of hypertension than their white counterparts.12,13,14 Recent reviews of population-based studies have examined the prevalence of hypertension and mean blood pressure among different ethnic groups in the UK. The majority, but not all, of these studies reported a greater prevalence of hypertension and significantly raised BP among Black Caribbeans compared with white Europeans.15,16 Recent studies have demonstrated high prevalence of hypertension amongst British South Asians, although mean BP was comparable to the white population.9,14,15 Epidemiological, clinical and animal experimental evidence show a direct relationship between dietary electrolyte consumption and blood pressure.9 Clinical trials have shown that reduction of salt (sodium chloride, NaCl) intake reduces BP levels in normotensive and hypertensive populations and prevents the development of hypertension.17 This chapter presents blood pressure levels, and the prevalence of high blood pressure (hypertension), in minority ethnic groups for informants aged 16 and over. Variations in blood pressure between socio-economic groups, and comparisons with HSE 1999, are also presented. The concentration of urinary sodium and potassium and their correlation with blood pressure are also reported.

7.2.1

BP measurements In HSE 2003, a new oscillometric automated device, the Omron HEM 907, was introduced to measure blood pressure, as a replacement for the Dinamap 8100, which had become obsolete.18 The Omron was used again in HSE 2004. A calibration study for HSE 2003 provided suitable regression equations to derive, for adults aged 16 and over, predicted Omron readings from Dinamap readings and vice versa. Both ‘Dinamap to Omron’ conversions and ‘Omron to Dinamap’ conversions were derived. For this report, the Dinamap values obtained in 1999 were converted into Omron values when comparing blood pressure measurements over time, as follows:

206

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7.2 Methods and definitions

For systolic blood pressure (SBP): Predicted Omron=8.90 (SE=2.94) + 0.91 (SE=0.02) * Dinamap For diastolic blood pressure (DBP): Predicted Omron=19.78 (SE=1.86) + 0.73 (SE=0.03) * Dinamap The protocol for the measurement of blood pressure remained unchanged from previous years. Using an appropriately sized cuff, three blood pressure readings were taken at oneminute intervals on the right arm with the informant in a seated position after five minutes’ rest. Systolic and diastolic pressures were displayed on the Omron from each measurement. The BP variables used in this chapter are the means of the second and third measurements obtained from informants providing three valid readings. Those who had smoked, drunk, eaten, or exercised vigorously in the preceding half hour were excluded, as were pregnant women. Pulse pressure (PP) is the difference between DBP and SBP. Mean arterial pressure (MAP) was obtained by calculating one-third of the difference between DBP and SBP and adding the result to DBP. Hypertension is defined in Section 7.5. 7.2.2

Urine sample collection and analysis Sodium consumption can be estimated by measuring its levels excreted in 24 hour urine collection. In the present survey as with 2003, a spot urine sample was collected. Although urine samples do not allow definitive quantification of sodium intake, they can distinguish between subgroups of the population with higher or lower sodium excretion, and enable examination of trends in sodium excretion over time.18 The spot urine sample was collected from both men and women aged 16 and over in minority ethnic groups during the nurse visit. Sodium and potassium were measured in informants’ urine samples. Although there is large day-to-day variation in excretion of sodium, potassium and water, creatinine excretion changes relatively little from day-to-day.19 Sodium/creatinine and potassium/creatinine ratios are less sensitive to random variation due to urine dilution, so are a more useful measure than excretion of the individual analytes.

7.3 Response rates

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In 2004, nurse visits were offered to all individuals in minority ethnic groups in the boost sample. The general population data presented are from HSE 2003, as the general population did not receive a nurse visit in 2004. Response rates for BP measurements and urine samples are based on those receiving a nurse visit, though women who were pregnant were not asked for a urine sample. In 2003 only a sub sample of informants in the general population were asked to give a urine sample. Section 6.3 in Volume 2 gives more details of 2004 response rates to the different stages of the survey. Among those who participated in a nurse visit, the proportion with three valid blood pressure readings ranged from 69% of Bangladeshi men, to 84% of Chinese and Indian men. Among women, the proportion with three valid blood pressure readings ranged from 71% of Black African women to 84% of Indian women. Table 7.1 presents the proportions of participants who were excluded from the analysis for a variety of reasons. Informants were excluded if they were pregnant or had eaten, drunk, exercised vigorously or smoked in the half hour before the measurement; a proportion of the remainder refused to have their blood pressure taken or failed to complete the measurements or measurements were not possible for technical reasons. Table 7.1 The proportion with a valid urine sample ranged from 76% of Pakistani men to 89% of Irish men. In women, a valid spot urine sample was obtained from 73% of Pakistani women, rising to 87% of Irish women aged 16 and over (who were asked to provide a sample). A small proportion of men and women refused to give a sample; for the remainder, the sample was not obtained for reasons other than refusal, for example being unable to provide a urine sample at that time. Table 7.2 HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE 207

7.4 Blood pressure measurements 7.4.1

Blood pressure measurements by minority ethnic group and sex Among minority ethnic groups, Bangladeshi men showed lower observed mean blood pressure measurements (SBP121.0mmHg, DBP 72.2mmHg, PP 48.9mmHg and MAP 88.4mmHg) than the general population and the other minority ethnic groups. Age-standardised risk ratios are used to take account of differences in the age profile of different minority ethnic groups (see chapter 1, section 1.6.5). After age standardisation, the risk ratios of Bangladeshi men, relative to the general population, remained significantly lower than 1.0 for mean SBP (0.94), DBP (0.98), PP (0.89), and MAP (0.96). Other groups of Asian origin also showed significantly low age-standardised risk ratios for mean PP: Indian 0.92, Pakistani 0.91, and Chinese 0.90. Chinese women had the lowest observed SBP, DBP and MAP (115.1mmHg, 70.0mmHg and 85.0mmHg respectively), while Pakistani women had the lowest observed PP (43.8mmHg). After adjusting for age, risk ratios were significantly lower than the general population (set at 1.0) among Chinese women, who had the lowest mean DBP and MAP risk ratios (0.97 for both) and Indian women, who had the lowest mean SBP risk ratio (0.98) and a PP risk ratio of 0.94, the same value obtained for Pakistani women. Table 7.3 Mean SBP and DBP Black Caribbean Men Observed mean SBP (mmHg) Standardised ratio of means Observed mean DBP (mmHg) Standardised ratio of means Women Observed mean SBP (mmHg) Standardised ratio of means Observed mean DBP (mmHg) Standardised ratio of means

7.4.2

Black African

Indian

Chinese

Irish

General population (2003)

133.3

128.0

127.3

124.2

121.0

125.2

131.5

131.4

1.02

1.01

0.97

0.97

0.94

0.96

1.01

1

74.7

73.5

75.2

73.8

72.2

74.1

73.9

74.3

1.02

1.01

1.02

1.01

0.98

1.01

0.98

1

123.0

118.1

119.2

117.1

116.4

115.1

124.6

125.9

1.01

1.00

0.98

0.99

0.99

0.97

0.99

1

73.7

72.8

73.7

73.2

72.3

70.0

73.2

73.2

1.01

1.02

1.01

1.02

1.02

0.97

0.99

1

Pakistani Bangladeshi

Systolic blood pressure (SBP), by age within minority ethnic group

Overall, women in minority ethnic groups had lower mean SBP than females in the general population (125.9mmHg), ranging from 115.1mmHg in Chinese women to 123.0mmHg and 124.6mmHg in Black Caribbean and Irish women, respectively. Mean SBP increased significantly with age in Black Caribbean men and women, Black African men, Indian men and women, Irish women, and in both sexes in the general population. Table 7.4, Figure 7A 7.4.3

Diastolic blood pressure (DBP), by age within minority ethnic group Mean diastolic blood pressure (DBP) was higher in all Indian informants (75.2mmHg in males and 73.7 mmHg in females) and Black Caribbean females (73.7mmHg), than among 208

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Mean systolic blood pressure (SBP) was higher among men than women in each minority ethnic group and in the general population. Among men, mean SBP was highest among Black Caribbean (133.3mmHg) and Irish informants (131.5mmHg), a level similar to that of men in the general population (131.4mmHg), and lowest in Bangladeshi men (121.0mmHg).

Figure 7A Systolic blood pressure, by age group

16 to 34 35 to 54 55+

Men 160 140

SBP (mmHg)

120 100 80 60 40 20 0 al er on en ti G ula p po

Iri

al er on en ti G ula p po

sh

ne

i sh de

se

la

ni

Iri

hi C

ng

Ba

a st

ki

n

a di

Pa

In

k ac Bl can ri Af

k n ac ea Bl ibb ar C

Women 160 140

SBP (mmHg)

120 100 80 60 40 20 0 C ne

sh

hi i

sh

de

se

la

i

an

st

ng

ki

Ba

Pa

an

di

In

k ac Bl can ri

Af

k n ac ea Bl ibb ar

C

the other minority ethnic groups and the general population. In the general population, DBP tends to peak in middle age (45-64) and fall thereafter.18 There were insufficient numbers of older informants to confirm whether this pattern was also seen in some minority ethnic groups. DBP was higher in those aged 55 and over than in those aged 35-54 in Black Caribbean men, and Irish men and women, and in Indian women, but numbers did not permit separate analysis by smaller age-bands. Table 7.5

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7.4.4

Pulse pressure (PP), by age within minority ethnic group Pulse pressure (PP) is the change in blood pressure seen during a contraction of the heart. It is the difference between the systolic pressure and the diastolic pressure and is an indicator of arterial stiffness. Recent prospective data from the Framingham study suggested that it appears to be a more sensitive measure of risk than other indices of BP. High PP is a strong indicator of heart problems, in particular in older adults.20 Men had higher mean PP than women in each minority ethnic group and in the general population. PP ranged from 48.9mmHg among Bangladeshi men to 58.6mmHg in Black Caribbean males. Among women, PP was highest among Irish informants and those in the general population (51.5mmHg and 52.7mmHg respectively) and lowest in Pakistani women (43.8mmHg). Table 7.6

7.4.5

Mean arterial pressure (MAP), by age within minority ethnic group Mean arterial pressure (MAP) is a term used to describe a notional average blood pressure in an individual. Mean arterial pressure is defined as the diastolic pressure plus 1/3 of the HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE

209

pulse pressure. MAP increased with age for male and female informants, in each minority ethnic group and in the general population. Overall, women had lower mean MAP than men across the age groups, in each minority ethnic group, and in the general population. Table 7.7

7.5. Hypertension 7.5.1

Definitions Hypertension is defined in accordance with the latest guidelines on hypertension management9 using the threshold values of 140/90: informants were considered hypertensive if their SBP was 140mmHg or over, their DBP was 90mmHg or over, or they were taking medicine prescribed to treat high blood pressure. It should be noted that HSE 2004 measures blood pressure as a one-off measurement in a cross sectional survey and does not provide information on whether high BP is sustained over time, so this survey may slightly overestimate the prevalence of hypertension. The HSE 2004 report has introduced a change in terminology from previous years’ reports. The specific definitions of the four levels used in the HSE 2004 report are: Normotensive untreated

SBP <140mmHg and DBP <90mmHg and not taking medicine prescribed for high blood pressure

Hypertensive controlled

SBP <140mmHg and DBP <90mmHg and taking medicine prescribed for high blood pressure

Hypertensive uncontrolled SBP ≥140mmHg and/or DBP ≥90mmHg and taking medicine prescribed for high blood pressure Hypertensive untreated

SBP ≥140mmHg and/or DBP ≥90mmHg and not taking medicine prescribed for high blood pressure

These four categories were labelled in previous HSE reports as normotensive-untreated, normotensive treated, hypertensive-treated and hypertensive untreated; the definitions, though not the category labels, are the same as those used in HSE 1998 and 2003. All those in any of the last three categories are classified as having hypertension. Treatment rates for hypertension were estimated by examining the proportion of all those defined as having high blood pressure at the time of the survey (as defined above, using a combination of the BP measured and the drugs recorded at the nurse visit) who were on drug treatment for hypertension at the time of the survey. Efficacy of treatment was assessed as the proportion of those on treatment for hypertension whose BP was controlled (SBP <140mmHg and DBP <90mmHg). The British Hypertension Guidelines 20049 state that anyone with a sustained SBP ≥160mmHg or DBP ≥100mmHg should be treated with drugs, in conjunction with lifestyle advice and support. We have therefore also reported the proportion of informants who had BP ≥160/100mmHg but were not on drug treatment for hypertension.

7.5.2

SBP ≥160mmHg or DBP ≥100mmHg and not taking medicine prescribed for high blood pressure

Prevalence of hypertension The observed prevalence of hypertension was higher for Black Caribbean informants (38% men, 32% women) and Irish informants (36% men, 29% women) than in the other minority ethnic groups. 32% of men from the general population were found to be hypertensive, while for women the prevalence was 29%. Bangladeshi men had the lowest prevalence of hypertension (16%). Among women, the lowest prevalence of hypertension was among Pakistani and Chinese informants (15% and 16% respectively). The age-standardised risk ratio for hypertension was significantly higher for Black Caribbean women (1.58), while only Bangladeshi men had significantly lower prevalence of 210

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Hypertensive untreated (160 /100)

hypertension (risk ratio 0.63), than the general population. Bangladeshi women (1.43) had a significantly higher risk of hypertension than women in the general population but Bangladeshi men had a lower likelihood of hypertension than men in the general population. Table 7.8, Figure 7B Figure 7B Prevalence of hypertension Women

Risk ratio, logarithmic scale

Men 10.0

10.0

2.0

2.0

1.0

1.0

0.5

0.5

0.10

0.10

ar C

ar C

sh Iri se i ne hi sh C de la ng Ba ni a st ki Pa an an di In ric n Af a be ib k

k

ac

Bl

ac

Bl

sh Iri se i ne hi sh C de la ng Ba ni a st ki Pa an an di In ric n Af a be ib k

k

ac

Bl

ac

Bl

General population = 1.0. Error bars indicate 95% confidence limits.

Prevalence of hypertension Black Caribbean Men Observed % Standardised risk ratio (of being hypertensive) Women Observed % Standardised risk ratio (of being hypertensive)

Black African

Indian

Chinese

Irish

General population (2003)

38.4

25.1

32.6

19.9

15.9

20.2

36.4

31.7

1.37

1.21

1.15

0.98

0.63

0.78

1.13

1

31.7

19.3

17.6

14.5

18.6

16.2

28.6

29.5

1.58

1.71

0.91

1.01

1.43

1.12

0.95

1

Pakistani Bangladeshi

The prevalence of hypertension increased across the age groups for men and women in each minority ethnic group, and in the general population. The majority of men and women aged 55 and over had raised blood pressure or were on treatment for hypertension. The prevalence of hypertension in this age group was 73% in Black Caribbean men, 65% in Indian men, 64% in Irish men, and 58% among men in the general population. For women, the figures were 80%, 59%, 59% and 61% respectively for those four groups. The bases were too small in the other minority ethnic groups to comment. Table 7.9

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7.5.3

Treatment of hypertension Irish informants were more likely to have untreated hypertension ≥140/90 mmHg (23% of all men with valid BP measurements and 15% of women), than Bangladeshi and Chinese informants and than Indian and Pakistani women. Indian (11%) and Black Caribbean (10%) men were more likely to be on treatment that controlled their hypertension than men in the general population (5%). Table 7.8 The proportion of men in minority ethnic groups with untreated BP ≥160/100 mmHg ranged from 1% of Bangladeshi men to 5% of Irish men; 4% of men within the general population had untreated BP ≥160/100mmHg. These differences were not significant. Among women in minority ethnic groups, the prevalence of untreated BP ≥160/100mmHg was highest for Black African women (4%) and lowest among Black Caribbean and Chinese women (1% HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE

211

and 2% respectively) but no significant differences were found between the minority ethnic groups and the general population (3%). Table 7.8 Proportion of men and women with hypertension who were being treated, and proportion of those whose blood pressure was controlled Black Caribbean

Black African

Indian

%

%

%

%

51

36

52

48

40

60 48

Men Drug treatment ratea Adequate control of BPb Women Drug treatment ratea Adequate control of BPb a b

Chinese

Irish

General population (2003)

%

%

%

%

44

58

44

37

43

67

74

36

47

51

55

39

58

66

61

56

46

51

71

44

44

56

64

32

42

Pakistani Bangladeshi

Percentage on drug treatment for hypertension as a proportion of those found in the survey to have hypertension (defined as a raised BP (SBP ≥140mmHg or DBP ≥90mmHg) and/or on treatment for hypertension). Percentage of those on treatment for hypertension whose measured BP was <140/90.

The table above shows the proportion of informants with hypertension (≥140/90 mmHg), as defined in this survey, who were on drug treatment. Among those with hypertension, a higher proportion of Black Caribbean, Bangladeshi and Indian men and women, and Pakistani women, were on drug treatment than informants in the general population. However, a significantly lower proportion of Black African women with hypertension were on drug treatment (compared with women in the general population). Considering only those on drug treatment, adequate control of BP (<140/90) was achieved in over half of Indian, Pakistani, and Irish men and males in the general population. Adequate BP control was attained in more than three-fifths of Black African and Chinese women, significantly more than among women in the general population (42%).

7.6 Urinary sodium and potassium and their relationship with blood pressure Sodium:creatinine (Na/Cre) ratio shows little change with age,18 so differences between minority ethnic groups are likely to reflect difference in sodium intake in the diet rather than differences to ethnicity. Potassium:creatinine (K/Cre) ratio varied more between ethnic groups in women than men. Correlation coefficients between blood pressure and urinary sodium, potassium and creatinine were generally low between all minority ethnic groups for men and women. The highest correlations were found for Na/Cre ratio among Bangladeshi women (0.39 for SBP and 0.28 for DBP). Tables 7.10 and 7.11

This section presents the observed prevalence of blood pressure levels, and the standardised risk ratios of hypertension, by equivalised household income tertile within minority ethnic group. Equivalised household income is a measure of household income that takes account of the number of persons in the household. The sample was divided into tertiles which were applied to all minority ethnic groups: they are not group specific, and do not divide each group into equal thirds. Due to small bases is not possible to comment on the relationship between blood pressure levels and equivalised income across most minority ethnic groups. However is possible to make some comments on hypertension for informants from the Indian and the general population group.

212

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7.7 Blood pressure levels by equivalised household income

The observed prevalence of hypertension was higher among informants in the lowest than the highest income tertile for Indian informants (43% for men and 20% for women) and the general population (40% for men and for women). Age standardisation confirmed the observed results only for Indian men (risk ratio 1.58 in the lowest tertile and 1.15 in the highest, risk ratios not significant in Indian women), and for women in the general population (1.18 for women in the lowest and 0.86 in the highest tertile). Table 7.12

7.8 Comparison of systolic and diastolic blood pressure in 2004 and 1999 This section compares results for SBP and DBP by age, within minority ethnic group, in 2004 and 1999. To allow for comparisons between the 1999 and 2004 surveys, the Dinamap values (from HSE 1999) were converted into Omron values using equations described in Section 7.2. Comparative data for the general population are taken from HSE 2003 and HSE 1998 (as there was no nurse visit for the general population in 1999 or 2004). The pattern of SBP differences between minority ethnic groups was similar in 2004 to that seen in 1999. Mean SBP was lower in 2004 than in 1999 in general in both sexes but the decrease was not significant in many groups. The fall was statistically significant among Indian men (130.8 mmHg in 1999 to 127.3 mmHg in 2004) and men in the general population (133.4 mmHg in 1999 to 125.9 mmHg). Among women, the decrease in SBP from 1999 to 2004 was highly significant in Indian (123.8 mmHg in 1999 to 119.2 mmHg in 2004), Pakistani (120.8 mmHg in 1999 to 117.1 mmHg in 2004) and Chinese (122.8 mmHg in 1999 to 115.1 mmHg) informants, and in the general population. Within the specific age groups, bigger falls in SBP were seen from 1999 to 2004 among women than men. Informants aged 16-34 from most ethnic groups (and from the general population) had noticeably decreased mean SBP in 2004 compared with 1999 (2003 and 1998 for the general population).These differences were significant for Indian male informants and male informants in the general population, and in women from the majority of minority ethic groups (except Bangladeshi women) and in the general population. Among women, mean SBP also decreased in 2004 from 1999. The differences were significant in Pakistani and Chinese informants, and in women in the general population. In general, DBP results for HSE 2004 reflect the findings of the 1999 report, across age groups and minority ethnic groups for males and females. No significant differences were found in mean DBP between the two years except for Pakistani women and men and women in the general population.

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Unlike SBP, DBP was slightly higher in young women in most minority ethnic groups and in women in the general population (in 2004 and 2003 respectively) than it had been in 1999 and 1998. However these rises were not significant, except for women in the general population in those aged 16-34 and 35-54. Table 7.13

7.9 Comparison of prevalence of hypertension (140/90 mmHg) in 2004 and 1999 The prevalence of hypertension among men was higher in 2004 than in 1999 in most minority ethnic groups, although the differences were not statistically significant. For Bangladeshi and Chinese men, there was no difference between the two surveys. Among women, the largest significant increase between 1999 and 2004 was seen for Bangladeshi women (19% in 2004 compared with 10% in 1999). For Indian and Chinese women there was a non-significant decrease in prevalence. In each minority ethnic group, where a rise in hypertension was seen, the largest increase in 2004 was in the prevalence of controlled hypertension, while the largest fall was in the prevalence of untreated hypertension. Table 7.14 HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE

213

References and notes 1 Maryon-Davis, A, Press V Easing the pressure: tackling hypertension. A toolkit for developing a local strategy to tackle high blood pressure. Faculty of Public Health and the National Heart Forum, London, 2005. 2 Kearney PM, Whelton M, Reynolds K et al. Worldwide prevalence of hypertension: a systematic review. J Hypertens. 2004; 22:11-19. 3 Ezzati M, Lopez AD, Rodgers A et al. Comparative Risk Assessment Collaborating Group. Selected major risk factors and global and regional burden of disease. Lancet. 2002; 360:1347-1360. 4 Carroll K, Murad S, Eliahu J, Majeed A. Stroke incidence and risk factors in a population-based cohort study. Office of National Statistics Health Quarterly (12) Winter 2001, 18-26. www.statistics.gov.uk/downloads/theme_health/HSQ12_v2.pdf 5 Lane DA, Gregory YH, Lip YH et al. Ethnic differences in cardiovascular and all-cause mortality in Birmingham, England: The Birmingham Screening Project. J Hypertens. 2005; 7:1347-1353. 6 Hajat C, Tilling K, Stewart JA, Lemic-Stojcevic N, Wolfe CDA. Ethnic Differences in Risk Factors for Ischemic Stroke: A European Case-Control Study. Stroke. 2004; 35:1562-1567. 7 Balarajan R. Ethnicity and variations in mortality from coronary heart disease. Health Trends. 1996; 28: 45-51. 8 Raleigh VS, Kiri V, Balarajan. Variations in mortality from diabetes mellitus, hypertension and renal disease in England and Wales by country of birth. Health Trends. 1997; 28:122-127. 9 Williams B, Poulter NR, Brown MJ et al. Guidelines for management of hypertension: report of the fourth working party of the British Hypertension Society, 2004-BHS IV. J Hum Hypertens. 2004; 18:139-85. 10 Erens, B, Primatesta P, Prior G, eds. Health Survey for England 1999 – The Health of Minority Ethnic Groups. The Stationery Office, London, 1999. 11 Stewart JA, Dundas R, Howard RS et al. Ethnic differences in incidence of stroke: prospective study with stroke register. BMJ. 1997; 313:967-971. 12 Cappuccio FP, Cooj DG, Atkinson RW et al. The Wandsworth Heart and Stroke Study. A population based study of CVD risk factors in different ethnic groups. Methods and baseline findings. Nutr Metab Cardiovasc Dis. 1998; 8:371-385. 13 Lane D, Beevers DG, Lip GYH. Ethnic differences in blood pressure and prevalence of hypertension in England. J Human Hypertens. 2002; 16:267-273. 14 Primetesta P, Bost L, Poulter NR. Blood pressure levels and hypertension status among ethnic groups in England. J Human Hypertens. 2000; 14:143-148. 15 Lane DA, Lip GHY. Ethnic differences in hypertension and blood pressure control in the UK. QJM. 2001; 94:391-396. 16 Agyemang C, Bhopal RS. Is the blood pressure of South Asian adults in the UK higher or lower that that in European white adults? A review of cross-sectional data. J Hum Hypertens. 2003; 17:523-534. 17 Sacks FM, Svetkey LP, Vollmer WM, et al. DASH-Sodium Collaborative Research Group. Effects on blood pressure of reduced dietary sodium and the dietary approaches to stop hypertension (DASH) diet. N Engl J Med 2001; 344:3-10. 18 Falaschetti E. Blood pressure. In Sproston K, Primatesta P (eds). Health survey for England 2003. Volume 2. Risk factors for cardiovascular disease. TSO, London, 2004. 19 Bingham SA, Williams R, Cole TJ, et al. Reference values for analytes of 24-h urine samples known to be complete. Ann Clin Biochem. 1988; 25:610.

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20 Nawrot TS, Staessen JA, Thijs L et al. Should pulse pressure become part of the Framingham risk score?. J Hum Hypertens, 2004; 18:279–286.

Tables

7.1 Response to blood pressure measurement, by minority ethnic group and sex 7.2 Response to urine spot sample, by minority ethnic group and sex 7.3 Blood pressure measurement, by minority ethnic group and sex 7.4 Systolic blood pressure (SBP), by age within minority ethnic group and sex 7.5 Diastolic blood pressure (DBP), by age within minority ethnic group and sex 7.6 Pulse pressure (PP), by age within minority ethnic group and sex 7.7 Mean arterial pressure (MAP), by age within minority ethnic group and sex 7.8 Blood pressure levels, by minority ethnic group and sex 7.9 Blood pressure levels, by age within minority ethnic group and sex 7.10 Urinary sodium (Na), potassium (K) and creatinine (Cre), by minority ethnic group and sex 7.11 Pearsons correlation coefficient for blood pressure with urinary sample, by minority ethnic groups and sex 7.12 Blood pressure levels, by equivalised household income tertile within minority ethnic group and sex

Copyright © 2006, The Information Centre. All rights reserved

7.13 Comparison of mean systolic blood pressure (SBP) in 2004 and 1999, by age within minority ethnic group and sex 7.14 Comparison of mean diastolic blood pressure (DBP) in 2004 and 1999, by age within minority ethnic group and sex 7.15 Comparison of blood pressure levels in 2004 and 1999, by age within minority ethnic group and sex

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE

215

Table 7.1 Response to blood pressure measurement, by minority ethnic group and sex Aged 16 and over who had a nurse visit Response to blood pressure measurement

2004

Minority ethnic group

General population (2003)a

Black Caribbean

Black African

Indian

%

%

%

%

71

75

84

25

21

2

Pakistani Bangladeshi

Chinese

Irish

%

%

%

%

78

69

84

75

81

14

20

27

14

23

17

3

1

0

1

1

1

2

1

1

1

1

3

1

1

1

74

71

84

80

78

83

78

80

22

23

12

9

18

10

20

15

2 1

2 4

1 3

2 8

3

2 4

1 1

2 2

-

-

1

0

2

1

0

1

218 327

165 216

316 382

208 260

143 185

183 199

320 418

5086 6322

Men Valid blood pressure measurementb Ate, drank, exercised or smoked in previous half hour Three valid readings not obtained Refused, attempted but not obtained, not attempted

Women Valid blood pressure measurementb Ate, drank, exercised or smoked in previous half hour Three valid readings not obtained Pregnant Refused, attempted but not obtained, not attempted Bases (unweighted) Men Women

216

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE

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a Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey. b Three valid readings of systolic and diastolic blood pressure obtained.

Table 7.2 Response to urine spot sample, by minority ethnic group and sex Aged 16 and over who were asked to give urine sample Response to urine sample

2004

Minority ethnic group

General population (2003)a

Black Caribbean

Black African

Indian

%

%

%

%

78 1

83 -

85 0

9

10

12

Pakistani Bangladeshi

Chinese

Irish

%

%

%

%

76 -

82 -

81 1

89 0

87 1

8

14

8

5

3

6

7

6

10

10

13

8

6

81 -

86 -

85 0

73 0

75 -

78 -

87 0

87 0

8

5

8

13

13

8

5

7

10

9

7

14

12

14

8

6

218 324

165 207

316 370

208 238

143 180

183 191

320 414

852 1085

Men Urine sample obtained Attempted but not obtained Respondent refused to give urine sample Unable to obtain urine sample for reason other than refusal

Women Urine sample obtained Attempted but not obtained Respondent refused to give urine sample Unable to obtain urine sample for reason other than refusal Bases (unweighted) Men Women

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a Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE

217

Table 7.3 Blood pressure measurements, by minority ethnic group and sex Aged 16 and over with valid blood pressure reading SBP, DBP, MAP, PP (mmHg)

2004

Minority ethnic group

General population (2003)a

Black Caribbean

Black African

Indian

Observed % Systolic blood pressure (SBP) Mean 133.3

Pakistani Bangladeshi

Chinese

Irish

Men

128.0

127.3

124.2

121.0

125.2

131.5

131.4

1.43

1.71

1.18

1.28

1.36

1.42

1.23

0.30

Diastolic blood pressure (DBP) Mean 74.7

73.5

75.2

73.8

72.2

74.1

73.9

74.3

Standard error of the mean

1.07

1.51

0.79

0.95

0.86

1.10

1.04

0.22

Pulse pressure (PP) Mean

58.6

54.5

52.1

50.4

48.9

51.2

57.6

57.1

Standard error of the mean

1.05

1.06

0.84

0.83

1.15

0.94

0.81

0.24

Mean arterial pressure (MAP) Mean

94.2

91.7

92.6

90.7

88.4

91.1

93.1

93.3

Standard error of the mean

1.10

1.50

0.85

1.00

0.90

1.13

1.04

0.22

Standardised ratios of means Mean SBP

1.02

1.01

0.97

0.97

0.94

0.96

1.01

1

Standard error of the ratio

0.01

0.02

0.01

0.01

0.01

0.01

0.01

Mean DBP

1.02

1.01

1.02

1.01

0.98

1.01

0.98

Standard error of the ratio

0.02

0.02

0.01

0.01

0.01

0.01

0.02

Mean PP

1.02

1.01

0.92

0.91

0.89

0.90

1.04

Standard error of the ratio

0.02

0.03

0.02

0.02

0.02

0.02

0.02

Mean MAP

1.02

1.01

1.00

0.99

0.96

0.99

0.99

Standard error of the ratio

0.01

0.02

0.01

0.01

0.01

0.01

0.01

Observed Systolic blood pressure (SBP) Mean 123.0

Standard error of the mean

1 1 1

Women

118.1

119.2

117.1

116.4

115.1

124.6

125.9

1.35

1.72

1.14

1.01

1.73

1.28

1.36

0.33

Diastolic blood pressure (DBP) Mean 73.7

72.8

73.7

73.2

72.3

70.0

73.2

73.2

Standard error of the mean

0.88

1.15

0.65

0.77

1.29

0.83

0.81

0.19

Pulse pressure (PP) Mean

49.4

45.2

45.6

43.8

44.1

45.1

51.5

52.7

Standard error of the mean

1.12

1.04

0.87

0.78

0.85

0.90

1.15

0.25

Mean arterial pressure (MAP) Mean

90.1

87.9

88.9

87.8

87.0

85.0

90.3

90.8

Standard error of the mean

0.92

1.28

0.74

0.78

1.40

0.91

0.87

0.21

Standardised ratios of means Mean SBP

1.01

1.00

0.98

0.99

0.99

0.97

0.99

1

Standard error of the ratio

0.01

0.02

0.01

0.01

0.02

0.02

0.01

Mean DBP

1.01

1.02

1.01

1.02

1.02

0.97

0.99

Standard error of the ratio

0.01

0.02

0.01

0.01

0.02

0.01

0.01

Mean PP

1.01

0.98

0.94

0.94

0.96

0.97

0.99

Standard error of the ratio

0.03

0.03

0.02

0.02

0.02

0.03

0.02

Mean MAP

1.01

1.01

1.00

1.01

1.01

0.97

0.99

Standard error of the ratio

0.01

0.02

0.01

0.01

0.02

0.01

0.01

169 249

136 183

361 442

159 207

53 83

63 66

667 923

4420 4702

155 243

123 154

265 320

162 207

99 144

153 166

240 328

4108 5075

Bases (weighted) Men Women Bases (unweighted) Men Women

1 1 1

a Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response.

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Standard error of the mean

Table 7.4 Systolic blood pressure (SBP), by age within minority ethnic group and sex Aged 16 and over with valid blood pressure readings Systolic blood pressure (mmHg)

Black Caribbean Mean Standard error of the mean

Black African Mean Standard error of the mean

Indian Mean Standard error of the mean

Pakistani Mean Standard error of the mean

Bangladeshi Mean Standard error of the mean

Chinese Mean Standard error of the mean

Irish Mean Standard error of the mean

General population (2003)b Mean

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Standard error of the mean

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003)b Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003)b

2004

Age group

Men

Women

16-34

35-54

55+

All men

[126.3]

132.0

141.8

133.3

113.1

121.1

140.2

123.0

[1.84]

2.07

2.77

1.43

1.67

1.23

3.05

1.35

120.3

134.0

a

128.0

112.1

121.1

a

118.1

1.84

2.52

a

1.71

1.43

2.07

a

1.72

119.8

127.6

136.8

127.3

108.8

119.3

138.3

119.2

1.38

1.43

2.26

1.18

1.11

1.24

2.43

1.14

122.1

123.9

a

124.2

110.6

117.9

a

117.1

1.83

1.92

a

1.28

1.06

1.71

a

1.01

[117.9]

[120.5]

a

121.0

109.3

[122.6]

a

116.4

[2.34]

[1.64]

a

1.36

1.30

[3.45]

a

1.73

123.9

124.3

a

125.2

108.8

114.8

a

115.1

1.24

2.28

a

1.42

1.31

1.66

a

1.28

[128.3]

127.0

138.6

131.5

110.6

119.7

137.7

124.6

[1.82]

1.75

2.10

1.23

1.22

1.69

2.64

1.36

124.9

129.6

139.1

131.4

113.8

120.6

140.0

125.9

0.39

0.38

0.54

0.30

0.33

0.39

0.52

0.33

59 66 117 79 25 33 119 1335

53 59 156 58 22 19 301 1601

57 11 89 22 6 11 247 1484

169 136 361 159 53 63 667 4420

78 94 151 102 48 24 194 1327

113 78 209 77 28 35 377 1620

58 12 82 28 8 7 352 1755

249 183 442 207 83 66 923 4702

43 50 77 79 41 73 48

59 62 119 57 45 54 105

53 11 69 26 13 26 87

155 123 265 162 99 153 240

70 73 103 101 83 59 68

114 71 151 77 47 88 130

59 10 66 29 14 19 130

243 154 320 207 144 166 328

927

1505

1676

4108

1194

1831

2050

5075

16-34

35-54

All 55+ women

a Results are not shown because of small bases. b Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken

from the 2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE

219

Table 7.5 Diastolic blood pressure (DBP), by age within minority ethnic group and sex Aged 16 and over with valid blood pressure readings

Black Caribbean Mean

2004

Age group

Men

Women

16-34

35-54

55+

All men

16-34

35-54

All 55+ women

[70.2]

78.6

75.7

74.7

68.0

75.7

77.4

73.7

Standard error of the mean

[1.85]

1.60

1.98

1.07

1.36

1.19

1.29

0.88

Black African Mean

66.3

81.2

a

73.5

68.6

76.7

a

72.8

Standard error of the mean

1.94

2.00

a

1.51

1.30

1.42

a

1.15

Indian Mean

70.9

78.5

75.1

75.2

69.7

75.4

76.4

73.7

Standard error of the mean

1.20

1.21

1.21

0.79

1.05

0.84

1.23

0.65

Pakistani Mean

71.0

76.7

a

73.8

70.3

75.5

a

73.2

Standard error of the mean

1.54

1.36

a

0.95

1.25

1.18

a

0.77

Bangladeshi Mean

[68.8]

[75.4]

a

72.2

68.3

[77.6]

a

72.3

Standard error of the mean

[1.29]

[1.18]

a

0.86

1.30

[2.03]

a

1.29

Chinese Mean

71.4

78.1

a

74.1

67.7

71.0

a

70.0

Standard error of the mean

1.20

1.68

a

1.10

1.28

1.07

a

0.83

Irish Mean

[70.3]

73.8

76.0

73.9

69.5

73.7

74.6

73.2

Standard error of the mean

[2.57]

1.41

1.51

1.04

1.48

1.27

1.33

0.81

General population (2003)b Mean

68.7

77.5

75.8

74.3

69.5

74.4

74.9

73.2

Standard error of the mean

0.39

0.31

0.31

0.22

0.32

0.28

0.28

0.19

59 66 117 79 25 33 119 1335

53 59 156 58 22 19 301 1601

57 11 89 22 6 11 247 1484

169 136 361 159 53 63 667 4420

78 94 151 102 48 24 194 1327

113 78 209 77 28 35 377 1620

58 12 82 28 8 7 352 1755

249 183 442 207 83 66 923 4702

43 50 77 79 41 73 48

59 62 119 57 45 54 105

53 11 69 26 13 26 87

155 123 265 162 99 153 240

70 73 103 101 83 59 68

114 71 151 77 47 88 130

59 10 66 29 14 19 130

243 154 320 207 144 166 328

927

1505

1676

4108

1194

1831

2050

5075

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003)b Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003)b

a Results are not shown because of small bases. b Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken

from the 2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response.

220

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE

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Diastolic blood pressure (mmHg)

Table 7.6 Pulse pressure (PP), by age within minority ethnic group and sex Aged 16 and over with valid blood pressure readings Pulse pressure (mmHg)

2004

Age group

Men

Black Caribbean Mean

16-34

35-54

55+

16-34

35-54

All 55+ women

[56.1]

53.4

66.1

58.6

45.1

45.4

62.8

49.4

Standard error of the mean

[1.43]

1.23

1.87

1.05

1.17

0.89

3.44

1.12

Black African Mean

54.1

52.8

a

54.5

43.5

44.4

a

45.2

Standard error of the mean

1.54

1.01

a

1.06

1.01

1.35

a

1.04

Indian Mean

48.9

49.1

61.7

52.1

39.1

43.8

61.9

45.6

Standard error of the mean

1.15

0.77

1.71

0.84

0.73

0.94

2.17

0.87

Pakistani Mean

51.0

47.2

a

50.4

40.2

42.4

a

43.8

Standard error of the mean

1.32

1.35

a

0.83

0.74

1.21

a

0.78

Bangladeshi Mean

[49.1]

45.1

a

48.9

41.0

[45.1]

a

44.1

Standard error of the mean

[1.68]

1.39

a

1.15

0.86

[1.79]

a

0.85

Chinese Mean

52.5

46.2

a

51.2

41.1

43.8

a

45.1

Standard error of the mean

1.04

1.35

a

0.94

0.93

1.07

a

0.90

Irish Mean

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Women All men

[58.0]

53.2

62.6

57.6

41.0

46.0

63.1

51.5

Standard error of the mean

[1.80]

1.03

1.64

0.81

1.11

1.02

2.22

1.15

General population (2003)b Mean

56.2

52.1

63.3

57.1

44.3

46.2

65.1

52.7

Standard error of the mean

0.36

0.25

0.45

0.2

0.25

0.24

0.45

0.25

59 66 117 79 25 33 119 1335

53 59 156 58 22 19 301 1601

57 11 89 22 6 11 247 1484

169 136 361 159 53 63 667 4420

78 94 151 102 48 24 194 1327

113 78 209 77 28 35 377 1620

58 12 82 28 8 7 352 1755

249 183 442 207 83 66 923 4702

43 50 77 79 41 73 48

59 62 119 57 45 54 105

53 11 69 26 13 26 87

155 123 265 162 99 153 240

70 73 103 101 83 59 68

114 71 151 77 47 88 130

59 10 66 29 14 19 130

243 154 320 207 144 166 328

927

1505

1676

4108

1194

1831

2050

5075

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003)b Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003)b

a Results are not shown because of small bases. b Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken

from the 2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE

221

Table 7.7 Mean arterial pressure (MAP), by age within minority ethnic group and sex Aged 16 and over with valid blood pressure readings

Black Caribbean Mean

2004

Age group

Men

Women

16-34

35-54

55+

All men

16-34

35-54

All 55+ women

[88.9]

96.4

97.7

94.2

83.0

90.8

98.3

90.1

Standard error of the mean

[1.72]

1.67

2.10

1.10

1.36

1.12

1.26

0.92

Black African Mean

84.3

98.8

a

91.7

83.1

91.5

a

87.9

Standard error of the mean

1.76

2.13

a

1.50

1.26

1.54

a

1.28

Indian Mean

87.2

94.8

95.7

92.6

82.7

90.1

97.0

88.9

Standard error of the mean

1.14

1.23

1.43

0.85

1.01

0.90

1.38

0.74

Pakistani Mean

88.1

92.4

a

90.7

83.7

89.6

a

87.8

Standard error of the mean

1.53

1.43

a

1.00

1.14

1.25

a

0.78

Bangladeshi Mean

[85.1]

90.4

a

88.4

82.0

[92.6]

a

87.0

Standard error of the mean

[1.51]

1.17

a

0.90

1.24

[2.45]

a

1.40

Chinese Mean

88.9

93.5

a

91.1

81.4

85.6

a

85.0

Standard error of the mean

1.10

1.78

a

1.13

1.22

1.19

a

0.91

Irish Mean

[89.6]

91.5

96.8

93.1

83.2

89.0

95.6

90.3

Standard error of the mean

[2.17]

1.45

1.55

1.04

1.29

1.33

1.55

0.87

General population (2003)b Mean

87.5

94.9

96.9

93.3

84.2

89.8

96.6

90.8

Standard error of the mean

0.35

0.32

0.34

0.22

0.30

0.30

0.31

0.21

59 66 117 79 25 33 119 1335

53 59 156 58 22 19 301 1601

57 11 89 22 6 11 247 1484

169 136 361 159 53 63 667 4420

78 94 151 102 48 24 194 1327

113 78 209 77 28 35 377 1620

58 12 82 28 8 7 352 1755

249 183 442 207 83 66 923 4702

43 50 77 79 41 73 48

59 62 119 57 45 54 105

53 11 69 26 13 26 87

155 123 265 162 99 153 240

70 73 103 101 83 59 68

114 71 151 77 47 88 130

59 10 66 29 14 19 130

243 154 320 207 144 166 328

927

1505

1676

4108

1194

1831

2050

5075

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003)b Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003)b

a Results are not shown because of small bases. b Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken

from the 2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response.

222

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Mean arterial pressure (mmHg)

Table 7.8 Blood pressure levels, by minority ethnic group and sex Aged 16 and over with valid blood pressure readings Blood pressure levels

2004

Minority ethnic group

General population (2003)a

Black Caribbean

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Men Observed % Normotensive untreatedb Hypertensive controlledb Hypertensive uncontrolledb Hypertensive untreatedb All with hypertension Hypertensive untreatedc Standardised risk ratios All with hypertension

62 10 10 19 38 2

75 4 5 16 25 4

67 11 6 16 33 3

80 6 2 11 20 2

84 3 6 7 16 1

80 4 5 11 20 2

64 7 7 23 36 5

68 5 6 20 32 5

1.37

1.21

1.15

0.98

0.63

0.78

1.13

1

Standard error of the ratio

0.19

0.22

0.13

0.19

0.14

0.13

0.18

68

81

82

85

81

84

71

71

Hypertensive uncontrolledb Hypertensive untreatedb All with hypertension Hypertensive untreatedc Standardised risk ratios All with hypertension

9 10 13 32 1

5 2 12 19 4

4 6 7 18 3

4 5 5 15 3

6 5 7 19 3

6 3 7 16 2

4 9 15 29 3

6 8 16 29 5

1.58

1.71

0.91

1.01

1.43

1.12

0.95

1

Standard error of the ratio

0.19

0.37

0.12

0.18

0.22

0.20

0.14

169 249

136 183

361 442

159 207

53 82

63 66

667 923

4420 4702

155 243

123 154

265 320

162 207

99 144

153 166

240 328

4108 5075

Women Observed % Normotensive untreatedb Hypertensive controlledb

Bases (weighted) Men Women Bases (unweighted) Men Women

a Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which was

weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response. b Normotensive untreated:

SBP <140mmHg and DBP <90mmHg and not taking medicine prescribed for high blood pressure Hypertensive controlled: SBP <140mmHg and DBP <90mmHg and taking medicine prescribed for high blood pressure Hypertensive uncontrolled: SBP ≥140mmHg or DBP ≥90mmHg and taking medicine prescribed for high blood pressure Hypertensive untreated: SBP ≥140mmHg or DBP ≥90mmHg and not taking medicine prescribed for high blood pressure.

Copyright © 2006, The Information Centre. All rights reserved

c Hypertensive untreated (160/100): SBP ≥160mmHg or DBP ≥100mmHg and not taking medicine prescribed for high blood pressure

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE

223

Table 7.9 Blood pressure levels, by age within minority ethnic group and sex Aged 16 and over with valid blood pressure readings Blood pressure levels

2004

Age group

Men

Black Caribbean Normotensive untreateda Hypertensive controlleda Hypertensive uncontrolleda Hypertensive untreateda All with hypertension Hypertensive untreatedb Black African Normotensive untreateda Hypertensive controlleda Hypertensive uncontrolleda Hypertensive untreateda All with hypertension Hypertensive untreatedb Indian Normotensive untreateda Hypertensive controlleda Hypertensive uncontrolleda Hypertensive untreateda All with hypertension Hypertensive untreatedb Pakistani Normotensive untreateda Hypertensive controlleda Hypertensive uncontrolleda Hypertensive untreateda All with hypertension Hypertensive untreatedb Bangladeshi Normotensive untreateda Hypertensive controlleda Hypertensive uncontrolleda Hypertensive untreateda All with hypertension Hypertensive untreatedb

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

[89] [1] [-] [10] [11] [1]

69 1 4 26 31 3

27 26 27 20 73 3

62 10 10 19 38 2

91 1 8 9 1

77 4 4 15 23 1

20 32 32 16 80 3

68 9 10 13 32 1

91 2 7 9 -

62 6 9 24 38 7

c c c c c c

75 4 5 16 25 4

97 3 3 0

72 7 4 17 28 3

c c c c c c

81 5 2 12 19 4

90 1 9 10 1

69 13 4 15 31 2

35 23 17 26 65 6

67 11 6 16 33 3

97 1 2 3 1

88 2 3 6 12 1

41 18 20 21 59 10

82 4 6 7 18 3

94 6 6 3

79 4 1 15 21 2

c c c c c c

80 6 2 11 20 2

96 4 4 2

87 4 6 3 13 3

c c c c c c

85 4 5 5 15 3

[93] [-] [-] [7] [7] [-]

78 7 11 5 22 -

c c c c c c

84 3 6 7 16 1

98 2 2 -

[66] [14] [9] [11] [34] [6]

c c c c c c

81 6 5 7 19 3

16-34

35-54

All 55+ women

a Normotensive untreated:

b Hypertensive untreated (160/100): SBP ≥160mmHg or DBP ≥100mmHg and not taking medicine prescribed for high blood

pressure c Results are not shown because of small bases. d Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the

2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and nonresponse.

Continued…

224

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE

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SBP <140mmHg and DBP <90mmHg and not taking medicine prescribed for high blood pressure Hypertensive controlled: SBP <140mmHg and DBP <90mmHg and taking medicine prescribed for high blood pressure. Hypertensive uncontrolled: SBP ≥140mmHg or DBP ≥90mmHg and taking medicine prescribed for high blood pressure. Hypertensive untreated: SBP ≥140mmHg or DBP ≥90mmHg and not taking medicine prescribed for high blood pressure. These four categories were labelled in the previous reports as follows: normotensive untreated, normotensive treated, hypertensive treated, hypertensive untreated.

Table 7.9 continued Aged 16 and over with valid blood pressure readings Blood pressure levels

2004

Age group

Men

Chinese Normotensive untreateda Hypertensive controlleda Hypertensive uncontrolleda Hypertensive untreateda All with hypertension Hypertensive untreatedb Irish Normotensive untreateda Hypertensive controlleda Hypertensive uncontrolleda Hypertensive untreateda All with hypertension Hypertensive untreatedb General population (2003)d Normotensive untreateda Hypertensive controlleda Hypertensive uncontrolleda Hypertensive untreateda All with hypertension Hypertensive untreatedb

Copyright © 2006, The Information Centre. All rights reserved

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003)d Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003)d

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

94 6 6 -

72 5 5 18 28 4

c c c c c c

80 4 5 11 20 2

100 -

86 6 1 8 14 1

c c c c c c

84 6 3 7 16 2

[85] [-] [1] [13] [15] [3]

78 3 3 16 22 3

36 14 13 37 64 9

64 7 7 23 36 5

98 2 2 -

86 0 2 12 14 -

41 11 21 27 59 9

71 4 9 15 29 3

91 0 0 9 9 1

74 3 3 20 26 4

42 12 16 30 58 9

68 5 6 20 32 5

96 0 0 3 4 0

83 3 2 12 17 2

39 13 19 29 61 10

71 6 8 16 29 5

59 66 117 79 25 33 119 1335

53 59 156 58 22 19 301 1601

57 11 89 22 6 11 247 1484

169 136 361 159 53 63 667 4420

78 94 151 102 48 24 194 1327

113 78 209 77 28 35 377 1620

58 12 82 28 8 7 352 1755

249 183 442 207 83 66 923 4702

43 50 77 79 41 73 48

59 62 119 57 45 54 105

53 11 69 26 13 26 87

155 123 265 162 99 153 240

70 73 103 101 83 59 68

114 71 151 77 47 88 130

59 10 66 29 14 19 130

243 154 320 207 144 166 328

927

1505

1676

4108

1194

1831

2050

5075

16-34

35-54

All 55+ women

a Normotensive untreated:

SBP <140mmHg and DBP <90mmHg and not taking medicine prescribed for high blood pressure Hypertensive controlled: SBP <140mmHg and DBP <90mmHg and taking medicine prescribed for high blood pressure. Hypertensive uncontrolled: SBP ≥140mmHg or DBP ≥90mmHg and taking medicine prescribed for high blood pressure. Hypertensive untreated: SBP ≥140mmHg or DBP ≥90mmHg and not taking medicine prescribed for high blood pressure. These four categories were labelled in the previous reports as follows: normotensive untreated, normotensive treated, hypertensive treated, hypertensive untreated.

b Hypertensive untreated (160/100): SBP ≥160mmHg or DBP ≥100mmHg and not taking medicine prescribed for high blood

pressure c Results are not shown because of small bases. d Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the

2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and nonresponse.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE

225

Table 7.10 Urinary sodium (Na), potassium (K) and creatinine (Cre) by minority ethnic group and sex Aged 16 and over with valid spot urine sample Urinary sodium, potassium, creatinine

2004

Minority ethnic group Black Caribbean

General population (2003)a

Black African

Indian

8.4

9.5

12.8

9.0

10.5

11.0

9.6

11.2

0.35

0.46

0.68

0.53

0.51

0.45

0.40

0.27

Pakistani Bangladeshi

Chinese

Irish

Men Na/Cre ratio Mean Standard error of the mean

K/Cre ratio Mean Standard error of the mean

Sodium (mmol/l) Mean

4.2

4.2

5.7

4.5

3.6

4.8

5.3

5.7

0.18

0.22

0.19

0.20

0.18

0.21

0.17

0.15

139.5

140.9

138.4

116.9

115.0

132.7

111.8

122.7

Standard error of the mean

6.24

6.92

4.02

5.37

5.04

5.62

4.28

3.46

Potassium (mmol/l) Mean

70.7

66.7

69.7

65.2

45.4

63.6

66.6

68.3

Standard error of the mean

3.03

4.09

2.84

2.93

2.35

3.44

2.84

7.14

Creatinine (mmol/l) Mean

18.5

16.9

13.9

16.5

14.0

14.0

14.0

14.1

Standard error of the mean

0.85

0.72

0.61

0.87

0.83

0.52

0.58

0.81

Women Na/Cre ratio Mean

10.1

9.6

15.1

13.2

13.7

13.6

11.9

12.9

Standard error of the mean

0.45

0.47

0.62

0.70

0.75

0.62

0.84

0.42

K/Cre ratio Mean Standard error of the mean

Sodium (mmol/l) Mean

4.9

4.6

6.7

6.3

4.4

6.4

7.4

7.2

0.20

0.21

0.18

0.26

0.18

0.27

0.25

0.16

130.0

134.4

126.3

116.1

116.6

111.7

90.0

102.4

Standard error of the mean

4.48

5.16

3.89

5.11

7.04

5.35

3.66

2.66

Potassium (mmol/l) Mean

70.1

70.4

62.7

64.2

45.3

58.0

62.5

61.3

Standard error of the mean

2.58

2.91

2.58

3.34

3.06

3.77

2.64

4.26

Creatinine (mmol/l) Mean

16.2

17.3

10.8

11.8

11.0

10.1

10.4

10.1

Standard error of the mean

0.65

0.86

0.48

0.74

0.79

0.62

0.59

0.47

186 273

151 208

374 435

156 171

64 78

60 60

801 1008

821 870

170 263

137 178

270 314

159 173

117 135

148 149

284 359

737 938

Bases (weighted) Men Women Bases (unweighted) Men Women

a Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which

226

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE

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was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response.

Table 7.11 Pearsons correlation coefficient for blood pressure with urinary sample, by minority ethnic group and sex Aged 16 and over with a valid spot urine sample and valid blood pressure readings Correlation coefficients

2004

Minority ethnic group

General population (2003)a

Black Caribbean

Black African

Indian

0.04 0.11 -0.09 -0.07 -0.17

-0.11 0.01 -0.25c -0.05 -0.07

0.05 0.02 -0.04 -0.09 -0.15c

-0.04 0.07 -0.11 -0.15 -0.18c

0.12 -0.13 0.13 -0.08 -0.01

-0.13 -0.10 -0.21b -0.09 -0.03

-0.02 -0.09 0.00 -0.06 -0.04

0.12 0.09 -0.25c -0.19c -0.18b

-0.07 0.04 -0.20b -0.05 -0.06

0.04 -0.07 -0.06 -0.16b -0.11

Pakistani Bangladeshi

Chinese

Irish

0.07 0.10 -0.09 0.06 -0.04

0.22 0.04 0.17 0.01 -0.08

0.16c 0.09b -0.01 0.01 -0.03

0.12c 0.10b -0.04 -0.08b -0.09b

0.04 0.02 -0.06 -0.17 -0.19b

0.06 -0.04 -0.16 -0.13 -0.10

0.08 0.03 0.03 0.00 -0.07

0.03 0.06 -0.04 0.09b 0.09b

0.07 0.04 -0.03 -0.05 -0.08b

0.11b 0.14c -0.17c -0.08c -0.14c

0.02 0.05 -0.29c -0.22c -0.24c

0.39c -0.04 -0.05 -0.31b -0.32b

0.07 0.04 -0.02 -0.06 -0.16

0.07b -0.03 0.00 -0.14c -0.11c

0.14c 0.17c -0.12c -0.12c -0.11c

-0.13 -0.03 -0.16b -0.03 0.05

0.09 0.10b -0.07 0.01 -0.06

0.06 0.05 -0.15 -0.15 -0.18b

0.28b -0.08 -0.19 -0.35c -0.34c

0.05 -0.09 -0.03 -0.18 -0.16

-0.05 -0.05 -0.04 -0.06 0.02

0.03 -0.04 0.04 -0.08b -0.01

135 202

120 158

322 383

127 153

46 62

51 51

615 832

684 693

125 201

107 131

237 276

129 153

86 108

124 128

219 288

608 740

Men Correlation of SBP with: Na/Cre ratio K/Cre ratio Sodium result Potassium result Creatinine result Correlation of DBP with: Na/Cre ratio K/Cre ratio Sodium result Potassium result Creatinine result

Women Correlation of SBP with: Na/Cre ratio K/Cre ratio Sodium result Potassium result Creatinine result Correlation of DBP with: Na/Cre ratio K/Cre ratio Sodium result Potassium result Creatinine result Bases (weighted) Men Women Bases (unweighted) Men Women

a Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which

was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response.

Copyright © 2006, The Information Centre. All rights reserved

b Correlation is significant at the 0.05 level (2-tailed). c Correlation is significant at the 0.01 level (2-tailed).

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE

227

Table 7.12 Blood pressure levels, by equivalised household income tertile within minority ethnic group and sex Aged 16 and over with valid blood pressure readings Blood pressure levels

2004

Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

%

%

%

%

%

%

62 7 3 28 38

[54] [14] [21] [10] [46]

b b b b b

78 5 6 11 22

58 6 15 22 42

77 7 8 8 23

[69] [5] [8] [18] [31]

b b b b b

[84] [2] [8] [5] [16]

[70] [9] [4] [17] [30]

[80] [3] [17] [20]

89 4 1 6 11

75 7 1 17 25

69 10 7 15 31

57 17 11 14 43

90 2 4 5 10

85 4 6 6 15

80 6 6 9 20

b b b b b

76 10 2 12 24

78 6 4 12 22

b b b b b

89 2 6 3 11

85 3 6 5 15

b b b b b

b b b b b

[80] [4] [8] [8] [20]

b b b b b

b b b b b

83 5 4 8 17

83 3 3 11 17

b b b b b

b b b b b

91 3 2 3 9

b b b b b

b b b b b

Observed Black Caribbean Normotensive untreateda Hypertensive controlleda Hypertensive uncontrolleda Hypertensive untreateda All with hypertension Black African Normotensive untreateda Hypertensive controlleda Hypertensive uncontrolleda Hypertensive untreateda All with hypertension Indian Normotensive untreateda Hypertensive controlleda Hypertensive uncontrolleda Hypertensive untreateda All with hypertension Pakistani Normotensive untreateda Hypertensive controlleda Hypertensive uncontrolleda Hypertensive untreateda All with hypertension Bangladeshi Normotensive untreateda Hypertensive controlleda Hypertensive uncontrolleda Hypertensive untreateda All with hypertension Chinese Normotensive untreateda Hypertensive controlleda Hypertensive uncontrolleda Hypertensive untreateda All with hypertension

pressure was 90 mmHg or over or they were taking medicine prescribed for high blood pressure. The specific definitions of the four levels were: Normotensive untreated: SBP <140mmHg and DBP <90mmHg and not taking medicine prescribed for high blood pressure. Hypertensive controlled: SBP <140mmHg and DBP <90mmHg and taking medicine prescribed for high blood pressure. Hypertensive uncontrolled: SBP ≥140mmHg or DBP ≥90mmHg and taking medicine prescribed for high blood pressure. Hypertensive untreated: SBP≥140mmHg or DBP ≥90mmHg and not taking medicine prescribed for high blood pressure. These four categories were labelled in the previous reports as follows: normotensive untreated, normotensive treated, hypertensive treated, hypertensive untreated. b Results are not shown because of small bases.

Continued…

228

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE

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a Informants were considered hypertensive if their systolic blood pressure was 140 mmHg or over or their diastolic blood

Table 7.12 continued

Aged 16 and over with valid blood pressure readings Blood pressure levels

2004

Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

%

%

%

%

%

%

71 5 2 21 29

56 11 7 26 44

[55] [6] [12] [27] [45]

81 3 2 14 19

67 1 14 17 33

[63] [14] [10] [13] [37]

73 4 4 19 27

66 7 7 20 34

60 8 9 22 40

81 4 3 12 19

64 7 11 18 36

60 8 12 20 40

All with hypertension Black Caribbean

1.59

[1.15]

b

1.03

1.85

1.16

Standard error of the ratio

0.32

[0.37]

b

0.28

0.31

0.27

[1.71]

b

[0.90]

[2.16]

[1.38]

0.43

Observed Irish Normotensive untreateda Hypertensive controlleda Hypertensive uncontrolleda Hypertensive untreateda All with hypertension General population (2003) Normotensive untreateda Hypertensive controlleda Hypertensive uncontrolleda Hypertensive untreateda All with hypertension

Standardised risk ratios

Black African Standard error of the ratio

[0.56]

b

[0.37]

[0.74]

[0.54]

0.17

Indian

1.15

1.17

1.58

0.78

0.86

0.77

Standard error of the ratio

0.23

0.22

0.37

0.25

0.20

0.22

b

1.13

1.01

b

0.82

0.94

Standard error of the ratio

b

0.27

0.26

b

0.27

0.28

Bangladeshi

b

b

[0.81]

b

b

1.49

Standard error of the ratio

b

b

[0.29]

b

b

0.31

0.73

b

b

0.74

b

b

Pakistani

Copyright © 2006, The Information Centre. All rights reserved

Chinese Standard error of the ratio

0.19

b

b

0.30

b

b

Irish

0.98

1.24

[1.99]

0.79

1.00

[0.89]

Standard error of the ratio

0.23

0.33

[0.57]

0.18

0.26

[0.31]

General population (2003)c

0.96

1.03

1.10

0.86

1.10

1.18

Standard error of the ratio

0.05

0.07

0.10

0.05

0.07

0.09

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003) Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003)

55 56 95 16 2 23 367 2103 52 47 71 14 4 60 119 1961

45 25 108 60 11 12 182 1210 42 27 82 57 23 29 66 1138

30 38 71 57 26 8 61 540 26 33 53 65 47 19 33 507

54 48 129 18 3 25 426 1917 56 36 93 17 7 65 149 2077

77 46 124 59 14 12 268 1442 73 43 91 57 25 29 94 1569

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE

74 63 105 76 39 10 124 685 75 53 76 83 67 27 49 758

a Informants were considered hypertensive if

their systolic blood pressure was 140 mmHg or over or their diastolic blood pressure was 90 mmHg or over or they were taking medicine prescribed for high blood pressure. The specific definitions of the four levels were: Normotensive untreated: SBP <140mmHg and DBP <90mmHg and not taking medicine. prescribed for high blood pressure. Hypertensive controlled: SBP <140mmHg and DBP <90mmHg and taking medicine prescribed for high blood pressure. Hypertensive uncontrolled: SBP ≥140mmHg or DBP ≥90mmHg and taking medicine prescribed for high blood pressure. Hypertensive untreated: SBP≥140mmHg or DBP ≥90mmHg and not taking medicine prescribed for highblood pressure. These four categories were labelled in the previous reports as follows: normotensive untreated, normotensive treated, hypertensive treated, hypertensive untreated. b Results are not shown because of small

bases. c Comparative data for the general

population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response.

229

Table 7.13 Comparison of mean systolic blood pressure (SBP) in 2004 with 1999a, by age within minority ethnic groupb and sex Aged 16 and over with valid blood pressure readings

Black Caribbean 2004 Mean Standard error of the mean

1999 Mean Standard error of the mean

Indian 2004 Mean Standard error of the mean

1999 Mean Standard error of the mean

Pakistani 2004 Mean Standard error of the mean

1999 Mean Standard error of the mean

Bangladeshi 2004 Mean Standard error of the mean

1999 Mean Standard error of the mean

Chinese 2004 Mean Standard error of the mean

1999 Mean Standard error of the mean

Irish 2004 Mean Standard error of the mean

1999 Mean Standard error of the mean

General population 2003d Mean Standard error of the mean

1998e Mean Standard error of the mean

Age group

Men

Women

16-34

35-54

55+

All men

16-34

35-54

55+

All women

[126.3]

132.0

141.8

133.3

113.1

121.1

140.2

123.0

[1.84]

2.07

2.77

1.43

1.67

1.23

3.05

1.35

125.4

129.6

143.7

133.0

118.0

125.2

143.0

126.6

0.92

1.29

1.81

0.94

0.81

1.26

1.98

0.87

119.8

127.6

136.8

127.3

108.8

119.3

138.3

119.2

1.38

1.43

2.26

1.18

1.11

1.24

2.43

1.14

125.3

130.4

141.8

130.8

114.7

122.2

146.5

123.8

0.99

1.08

2.11

0.78

0.82

1.12

2.48

0.91

122.1

123.9

c

124.2

110.6

117.9

c

117.1

1.83

1.92

c

1.28

1.06

1.71

c

1.01

122.9

126.8

[142.0]

127.0

115.1

123.8

[148.9]

120.8

0.96

1.16

[2.80]

0.82

0.75

1.31

[4.08]

0.86

[117.9]

[120.5]

c

121.0

109.3

[122.6]

c

116.4

[2.34]

[1.64]

c

1.36

1.30

[3.45]

c

1.73

118.8

122.6

135.4

124.0

112.6

125.1

[134.2]

118.2

1.01

1.68

2.68

1.05

0.61

1.80

[3.52]

0.86

123.9

124.3

c

125.2

108.8

114.8

c

115.1

1.24

2.28

c

1.42

1.31

1.66

c

1.28

124.3

125.4

[138.6]

127.7

113.5

122.4

[145.2]

122.8

1.43

1.40

[2.73]

1.06

1.15

1.24

[4.37]

1.15

and 2003, Dinamap values were translated into Omron for 1998 and 1999 data.

[128.3]

127.0

138.6

131.5

110.6

119.7

137.7

124.6

[1.82]

1.75

2.10

1.23

1.22

1.69

2.64

1.36

127.2

129.3

141.7

132.5

117.3

122.7

144.1

127.6

1.32

1.00

1.88

0.85

0.76

0.94

1.79

0.85

b Black Africans were included in the

2004 survey but not in the 1999, and are therefore excluded from this comparative table. c Results are not shown because of

small bases. d Comparative data for the general

113.8

120.6

140.0

125.9

113.8

120.6

140.0

125.9

0.33

0.39

0.52

0.33

0.33

0.39

0.52

0.33

126.9

130.6

141.8

133.4

118.4

125.0

143.0

129.5

0.26

0.30

0.44

0.22

0.24

0.31

0.43

0.24

Continued…

230

a To allow for comparison with 2004

population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which was weighted for nonresponse. The 2004 survey is weighted for differential selection probabilities and non-response. e Comparative data for the general

population are not available on this topic from the 1999 survey, so data have been taken from the 1998 survey, in which no weighting was involved.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE

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Systolic blood pressure (mmHg)

2004, 1999

Table 7.13 continued

Aged 16 and over with valid blood pressure readings

2004, 1999

Age group

Men 16-34 Bases (weighted) Black Caribbean 2004 59 Black Caribbean 1999 83 Indian 2004 117 Indian 1999 140 Pakistani 2004 79 Pakistani 1999 94 Bangladeshi 2004 25 Bangladeshi 1999 26 Chinese 2004 33 Chinese 1999 17 Irish 2004 119 Irish 1999 232 General population (2003)d 1335 General population (1998)e e Bases (unweighted) Black Caribbean 2004 43 Black Caribbean 1999 117 Indian 2004 77 Indian 1999 142 Pakistani 2004 79 Pakistani 1999 152 Bangladeshi 2004 41 Bangladeshi 1999 105 Chinese 2004 73 Chinese 1999 55 Irish 2004 48 Irish 1999 74 General population (2003)d 927 General population (1998)e 1578

Women 35-54

55+

All men

16-34

35-54

55+

All women

53 45 156 170 58 72 22 16 19 27 301 465 1601 e

57 73 89 77 22 26 6 14 11 11 247 292 1484 e

169 201 361 388 159 192 53 56 63 56 667 988 4420 e

78 106 151 154 102 123 48 40 24 19 194 357 1327 e

113 118 209 172 77 67 28 17 35 43 377 612 1620 e

58 66 82 73 28 18 8 7 7 9 352 404 1755 e

249 291 442 400 207 209 83 64 66 70 923 1373 4702 e

59 65 119 179 57 125 45 58 54 80 105 154 1505 1962

53 105 69 80 26 42 13 51 26 38 87 110 1676 1861

155 287 265 401 162 319 99 214 153 173 240 338 4108 5401

70 160 103 160 101 213 83 162 59 59 68 118 1194 1834

114 176 151 183 77 118 47 74 88 130 130 199 1831 2354

59 96 66 75 29 31 14 23 19 30 130 143 2050 2295

243 432 320 418 508 362 144 259 166 219 328 460 5075 6483

a To allow for comparison with 2004 and 2003, Dinamap values were translated into Omron for 1998 and 1999 data. b Black Africans were included in the 2004 survey but not in the 1999, and are therefore excluded from this

comparative table. c Results are not shown because of small bases. d Comparative data for the general population are not available on this topic from the 2004 survey, so data have

been taken from the 2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response. e Comparative data for the general population are not available on this topic from the 1999 survey, so data have

Copyright © 2006, The Information Centre. All rights reserved

been taken from the 1998 survey, in which no weighting was involved.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE

231

Table 7.14 Comparison of mean diastolic blood pressure (DBP) in 2004 with 1999a, by age within minority ethnic groupb and sex Aged 16 and over with valid blood pressure reading

Black Caribbean 2004 Mean

Age group

Men

Women

16-34

35-54

55+

All men

16-34

35-54

55+

All women

[70.2]

78.6

75.7

74.7

68.0

75.7

77.4

73.7

Standard error of the mean

[1.85]

1.60

1.98

1.07

1.36

1.19

1.29

0.88

1999 Mean

67.8

76.1

80.7

74.3

67.3

74.6

77.1

72.5

Standard error of the mean

0.68

0.95

0.81

0.56

0.57

0.67

0.81

0.43

Indian 2004 Mean

70.9

78.5

75.1

75.2

69.7

75.4

76.4

73.7

Standard error of the mean

1.20

1.21

1.21

0.79

1.05

0.84

1.23

0.65

1999 Mean

70.6

79.7

80.0

76.5

68.5

73.3

76.6

72.1

Standard error of the mean

0.68

0.65

0.95

0.47

0.58

0.63

1.04

0.43

Pakistani 2004 Mean

71.0

76.7

c

73.8

70.3

75.5

c

73.2

Standard error of the mean

1.54

1.36

c

0.95

1.25

1.18

c

0.77

1999 Mean

68.0

77.1

[77.5]

72.7

67.4

72.2

[78.9]

69.9

Standard error of the mean

0.65

0.69

[1.47]

0.52

0.52

0.66

[1.83]

0.44

Bangladeshi 2004 Mean

[68.8]

[75.4]

c

72.2

68.3

[77.6]

78.3

72.3

Standard error of the mean

[1.29]

[1.18]

c

0.86

1.30

[2.03]

3.17

1.29

1999 Mean

68.6

76.3

77.3

73.0

67.8

75.4

[75.0]

70.6

Standard error of the mean

0.69

0.96

1.22

0.59

0.49

0.99

[1.41]

0.49

Chinese 2004 Mean

71.4

78.1

c

74.1

67.7

71.0

c

70.0

Standard error of the mean

1.20

1.68

c

1.10

1.28

1.07

c

0.83

1999 Mean

69.5

77.6

[77.4]

75.0

67.6

71.9

[78.8]

71.6

Standard error of the mean

1.11

0.98

[1.38]

0.71

0.93

0.66

[2.47]

0.60

Irish 2004 Mean

and 2003, Dinamap values were translated into Omron for 1998 and 1999 data.

[70.3]

73.8

76.0

73.9

69.5

73.7

74.6

73.2

Standard error of the mean

[2.57]

1.41

1.51

1.04

1.48

1.27

1.33

0.81

1999 Mean

70.1

77.1

77.4

75.5

68.4

72.6

74.9

72.2

Standard error of the mean

0.85

0.65

0.86

0.47

0.59

0.55

0.67

0.37

b Black Africans were included in the

2004 survey but not in the 1999, and are therefore excluded from this comparative table. c Results are not shown because of

small bases. d Comparative data for the general

General population 2003d Mean

68.7

77.5

75.8

74.3

69.5

74.4

74.9

73.2

Standard error of the mean

0.39

0.31

0.31

0.22

0.32

0.28

0.28

0.19

1998e Mean

69.1

77.2

78.8

75.4

68.5

72.9

75.4

72.5

Standard error of the mean

0.19

0.18

0.21

0.13

0.16

0.17

0.19

0.11

Continued…

232

a To allow for comparison with 2004

population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which was weighted for nonresponse. The 2004 survey is weighted for differential selection probabilities and non-response. e Comparative data for the general

population are not available on this topic from the 1999 survey, so data have been taken from the 1998 survey, in which no weighting was involved.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE

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Diastolic blood pressure (mmHg)

2004, 1999

Table 7.14 continued

Aged 16 and over with valid blood pressure readings

2004, 1999

Age group

Men 16-34 Bases (weighted) Black Caribbean 2004 59 Black Caribbean 1999 83 Indian 2004 117 Indian 1999 140 Pakistani 2004 79 Pakistani 1999 94 Bangladeshi 2004 25 Bangladeshi 1999 26 Chinese 2004 33 Chinese 1999 17 Irish 2004 119 Irish 1999 232 General population (2003)d 1335 General population (1998)e e Bases (unweighted) Black Caribbean 2004 43 Black Caribbean 1999 117 Indian 2004 77 Indian 1999 142 Pakistani 2004 79 Pakistani 1999 152 Bangladeshi 2004 41 Bangladeshi 1999 105 Chinese 2004 73 Chinese 1999 55 Irish 2004 48 Irish 1999 74 General population (2003)d 927 General population (1998)e 1578

Women 35-54

55+

All men

16-34

35-54

55+

All women

53 45 156 170 58 72 22 16 19 27 301 465 1601 e

57 73 89 77 22 26 6 14 11 11 247 292 1484 e

169 201 361 388 159 192 53 56 63 56 667 988 4420 e

78 106 151 154 102 123 48 40 24 19 194 357 1327 e

113 118 209 172 77 67 28 17 35 43 377 612 1620 e

58 66 82 73 28 18 8 7 7 9 352 404 1755 e

249 291 442 400 207 209 83 64 66 70 923 1373 4702 e

59 65 119 179 57 125 45 58 54 80 105 154 1505 1962

53 105 69 80 26 42 13 51 26 38 87 110 1676 1861

155 287 265 401 162 319 99 214 153 173 240 338 4108 5401

70 160 103 160 101 213 83 162 59 59 68 118 1194 1834

114 176 151 183 77 118 47 74 88 130 130 199 1831 2354

59 96 66 75 29 31 14 23 19 30 130 143 2050 2295

243 432 320 418 508 362 144 259 166 219 328 460 5075 6483

a To allow for comparison with 2004 and 2003, Dinamap values were translated into Omron for 1998 and 1999 data. b Black Africans were included in the 2004 survey but not in the 1999, and are therefore excluded from this

comparative table. c Results are not shown because of small bases. d Comparative data for the general population are not available on this topic from the 2004 survey, so data have

been taken from the 2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response. e Comparative data for the general population are not available on this topic from the 1999 survey, so data have

Copyright © 2006, The Information Centre. All rights reserved

been taken from the 1998 survey, in which no weighting was involved.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE

233

Table 7.15 Comparison of blood pressure levels in 2004 and 1999a, by age within minority ethnic groupb and sex Aged 16 and over with valid blood pressure readings Age group

Men 16-34

35-54

55+

%

%

%

%

%

%

%

%

[89] [1] [-] [11] [11]

69 1 4 26 31

27 26 27 20 73

62 10 10 19 38

91 1 8 9

77 4 4 15 23

20 32 32 16 80

68 9 10 13 32

89 1 10 11

78 3 5 14 22

29 14 20 36 71

65 6 8 21 35

96 1 3 4

80 8 5 7 20

33 19 23 26 67

75 8 7 10 25

Black Caribbean 2004 Normotensive untreatedc Hypertensive controlledc Hypertensive uncontrolledc Hypertensive untreatedc All with hypertension 1999 Normotensive untreated Hypertensive controlled Hypertensive uncontrolled Hypertensive untreated All with hypertension Indian 2004 Normotensive untreatedc Hypertensive controlledc Hypertensive uncontrolledc Hypertensive untreatedc All with hypertension 1999 Normotensive untreated Hypertensive controlled Hypertensive uncontrolled Hypertensive untreated All with hypertension Pakistani 2004 Normotensive untreatedc Hypertensive controlledc Hypertensive uncontrolledc Hypertensive untreatedc All with hypertension 1999 Normotensive untreated Hypertensive controlled Hypertensive uncontrolled Hypertensive untreated All with hypertension Bangladeshi 2004 Normotensive untreatedc Hypertensive controlledc Hypertensive uncontrolledc Hypertensive untreatedc All with hypertension 1999 Normotensive untreated Hypertensive controlled Hypertensive uncontrolled Hypertensive untreated All with hypertension

234

Women All men

16-34

35-54

55+

All women

a To allow for comparison with 2004

and 2003, Dinamap values were translated into Omron for 1998 and 1999 data. b Black Africans were included in the

90 1 9 10

69 13 4 15 31

35 23 17 26 65

67 11 6 16 33

97 1 2 3

88 2 3 6 12

41 18 20 21 59

82 4 6 7 18

88 1 11 12

72 4 7 18 28

38 10 17 35 62

71 4 7 19 29

99 1 1

83 4 4 9 17

35 5 16 44 65

80 3 5 12 20

94 6 6

79 4 1 15 21

d d d d d

80 6 2 11 20

96 4 4

87 4 6 3 13

d d d d d

85 4 5 5 15

93 7 7

83 2 4 12 17

[38] [7] [15] [41] [63]

82 2 3 13 18

96 1 3 4

86 2 3 9 14

[22] [15] [14] [50] [78]

87 2 2 9 13

2004 survey but not in the 1999, so are therefore excluded from this comparative table. c Informants were considered

hypertensive if their systolic blood pressure was 140 mmHg or over or their diastolic blood pressure was 90mmHg or over or they were taking medicine prescribed for high blood pressure. The specific definitions of the four levels were: Normotensive untreated: SBP <140mmHg and DBP <90mmHg and not taking medicine prescribed for high blood pressure. Hypertensive controlled: SBP <140mmHg and DBP <90mmHg and taking medicine prescribed for high blood pressure. Hypertensive uncontrolled: SBP ≥140mmHg or DBP ≥90mmHg and taking medicine prescribed for high blood pressure. Hypertensive untreated: SBP ≥140mmHg or DBP ≥90mmHg and not taking medicine prescribed for high blood pressure. These four categories were labelled in the previous reports as follows: normotensive untreated, normotensive treated, hypertensive treated, hypertensive untreated. d Results are not shown because of

small bases. e Comparative data for the general

[93] [-] [-] [7] [7]

78 7 11 5 22

d d d d d

84 3 6 7 16

98 2 2

[66] [14] [9] [11] [35]

d d d d d

81 6 5 7 19

96 3 1 4

81 7 3 9 19

64 5 5 26 36

84 5 2 9 16

100 -

81 3 7 9 19

d d d d d

90 2 2 6 10

population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey which was weighted for nonresponse. The 2004 survey is weighted for differential selection probabilities and non-response. f Comparative data for the general

population are not available on this topic from the 1999 survey, so data have been taken from the 1998 survey, in which no weighting was involved.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE

Continued…

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Blood pressure levels

2004, 1999

Table 7.15 continued

Aged 16 and over with valid blood pressure readings Blood pressure levels

Men

Women

16-34

35-54

55+

All men

%

%

5

%

%

%

%

%

94 6 6

72 5 5 18 28

d d d d d

80 4 5 11 20

100 -

86 6 1 8 14

d d d d d

84 6 3 7 16

95 5

84 2 14

[45] [7] [18] [31]

79 2 4 15

100 -

83 4 2 11

[30] [12] [13] [46]

81 4 3 12

All with hypertension 5 Irish 2004 Normotensive untreatedc [85] Hypertensive controlledc [-] Hypertensive uncontrolledc [2] Hypertensive untreatedc [13] All with hypertension [15] 1999 Normotensive untreatedc 88 Hypertensive controlledc Hypertensive uncontrolledc 1 Hypertensive untreatedc 11 All with hypertension 12 General population 2003e Normotensive untreatedc 91 Hypertensive controlledc 0 Hypertensive uncontrolledc 0 Hypertensive untreatedc 9 All with hypertension 9 1998f Normotensive untreated 90 Hypertensive controlled 0 Hypertensive uncontrolled 0 Hypertensive untreated 10 All with hypertension 10

16

[56]

21

-

17

[71]

19

78 3 3 16 22

36 14 13 37 64

64 7 7 23 36

98 2 2

86 0 2 12 14

41 11 21 27 59

71 4 9 15 29

76 1 3 20 24

40 5 15 41 60

68 2 6 24 32

100 -

85 3 2 9 15

40 8 15 37 60

76 4 5 15 24

74 3 3 20 26

42 12 16 30 58

68 5 6 20 32

96 0 0 3 4

83 3 2 12 17

39 13 19 29 61

71 6 8 16 29

77 3 2 18 23

42 7 13 33 42

68 3 5 23 32

97 0 0 3 3

83 2 2 12 17

40 8 17 35 60

72 4 7 18 28

Chinese 2004 Normotensive untreatedc Hypertensive controlledc Hypertensive uncontrolledc Hypertensive untreatedc All with hypertension 1999 Normotensive untreated Hypertensive controlled Hypertensive uncontrolled Hypertensive untreated

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2004, 1999

Age group

16-34

35-54

55+

All women

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE

235

Table 7.15 continued

Aged 16 and over with valid blood pressure readings

2004, 1999

Age group

Men

Women

16-34

35-54

55+

All men

Bases (weighted) Black Caribbean 2004 59 Black Caribbean 1999 83 Indian 2004 117 Indian 1999 140 Pakistani 2004 79 Pakistani 1999 94 Bangladeshi 2004 25 Bangladeshi 1999 26 Chinese 2004 33 Chinese 1999 17 Irish 2004 119 Irish 1999 234 General population (2003)e 1335

53 45 156 170 58 72 22 16 19 27 301 465

57 73 89 77 22 26 6 14 11 11 247 292

169 201 361 388 159 192 53 56 63 56 667 990

78 106 151 154 102 123 48 40 24 19 194 357

113 118 209 172 77 67 28 17 35 43 377 612

58 66 82 73 28 18 8 7 7 9 352 404

249 291 442 400 207 208 83 63 66 70 923 1373

1601 f

1484 f

4420 f

1327 f

1620 f

1755 f

4702 f

59 65 119 179 57 125 45 58 54 80 105 154 1505 1962

53 105 69 80 26 42 13 51 26 38 87 110 1676 1861

155 287 265 401 162 319 99 214 153 173 240 339 4108 5401

70 160 103 160 101 212 83 161 59 59 68 118 1194 1834

114 176 151 183 77 118 47 74 88 130 130 199 1831 2354

59 96 66 75 29 31 14 23 19 30 130 143 2050 2295

243 432 320 418 508 361 144 258 166 219 328 460 5075 6483

General population (1998)f f Bases (unweighted) Black Caribbean 2004 43 Black Caribbean 1999 117 Indian 2004 77 Indian 1999 142 Pakistani 2004 79 Pakistani 1999 152 Bangladeshi 2004 41 Bangladeshi 1999 105 Chinese 2004 73 Chinese 1999 55 Irish 2004 48 Irish 1999 75 General population (2003)e 927 General population (1998)f 1578

16-34

35-54

55+

All women

a To allow for comparison with 2004 and 2003, Dinamap values were translated into Omron for 1998 and 1999 data. b Black Africans were included in the 2004 survey but not in the 1999, so are therefore excluded from this comparative table. c Informants were considered hypertensive if their systolic blood pressure was 140 mmHg or over or their diastolic

d Results are not shown because of small bases. e Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from

the 2003 survey which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response. f Comparative data for the general population are not available on this topic from the 1999 survey, so data have been taken from

the 1998 survey, in which no weighting was involved.

236

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE

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blood pressure was 90mmHg or over or they were taking medicine prescribed for high blood pressure. The specific definitions of the four levels were: Normotensive untreated: SBP <140mmHg and DBP <90mmHg and not taking medicine prescribed for high blood pressure. Hypertensive controlled: SBP <140mmHg and DBP <90mmHg and taking medicine prescribed for high blood pressure. Hypertensive uncontrolled: SBP ≥140mmHg or DBP ≥90mmHg and taking medicine prescribed for high blood pressure. Hypertensive untreated: SBP ≥140mmHg or DBP ≥90mmHg and not taking medicine prescribed for high blood pressure. These four categories were labelled in the previous reports as follows: normotensive untreated, normotensive treated, hypertensive treated, hypertensive untreated.

Physical activity

8

Emmanuel Stamatakis

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Summary ●

In the general population, over a third of men (37%) and a quarter of women (25%) met the current physical activity recommendations. As in 1999, Asian (Indian, Pakistani, Bangladeshi and Chinese) men and women had lower age-standardised risk ratios of meeting the physical activity recommendations than the general population. Agestandardised risk ratios ranged from 0.58 in Bangladeshi men to 0.75 in Indian men, and from 0.32 in Bangladeshi women to 0.81 in Indian women.

●

79% of men and 75% of women in the general population took part in some physical activity for at least 30 continuous minutes in the four weeks prior to interview. In agreement with the patterns observed in 1999, age-adjusted participation in any physical activity of at least moderate intensity was lower in most minority ethnic groups than the general population (ranging from 0.58 in Bangladeshi men, to 0.95 in Black Caribbean men, and from 0.45 in Bangladeshi women to 0.93 in Black African women).

●

32% of men and 27% of women in the general population reported brisk walking for at least 30 minutes in the four weeks prior to interview. All Black and Asian minority ethnic groups had lower age-adjusted participation in walking than the general population. Among Asian informants, age-standardised ratios ranged from 0.38 in Pakistani men to 0.57 in Indian and Chinese men, and from 0.21 in Bangladeshi women to 0.60 in Indian women.

●

41% of men and 34% of women in the general population had participated in sports and exercise in the four weeks prior to interview. Indian, Pakistani, Bangladeshi and Black African men and women had lower age-standardised risk ratios of participation in sports and exercise than men and women in the general population (agestandardised risk ratios ranged from 0.46 in Bangladeshi men to 0.99 in Chinese men, and from 0.24 in Bangladeshi women to 0.96 in Black Caribbean women).

●

Overall participation in any activities decreased with age among men and women in the general population and most minority ethnic groups. Exceptions were Black African, Indian and Chinese women, whose participation in any activities remained relatively stable up to age 54 (or even increased).

●

Participation in any activity at least once a week on average increased by 4 percentage points (p.p.) for men and women in the general population (from 64% to 68% in men, and from 57% to 61% in women) between 1999 and 2004. Increases were also observed among Bangladeshi and Chinese men (increases of 6 and 10 p.p., respectively). In contrast, a notable reduction in regular physical activity participation was found among Pakistani men (7 p.p.)

●

Overall increases in activity among the general population were accompanied by an increase (4 p.p. for both men and women) in the percentage meeting the activity recommendations between 1999 and 2004. Notable increases were also observed among Chinese men (increase of 7 p.p.) and Indian women (increase of 6 p.p.).

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 8: PHYSICAL ACTIVITY

237

8.1 Introduction Physical inactivity is associated with increased risk of many chronic conditions, most notably cardiovascular disease, obesity, type 2 diabetes, some types of cancers, and osteoporosis.1,2 Adults who are physically active have 20-30% reduced risk of premature death, and up to 50% reduced risk of developing major chronic diseases.2 Beyond its role in the development of obesity, physical inactivity and associated poor cardio-respiratory fitness pose direct health risks. For example, lean unfit men may have higher risk of cardiovascular disease and death than obese fit men.3,4 It has been estimated that 37% of coronary heart disease in the UK is attributable to physical inactivity.5 The World Health Organisation rated physical inactivity as one of the leading causes of death in developed countries, and estimated that it is responsible for 22-23% of coronary heart disease, 1617% of colon cancer, 15% of diabetes, 12-13% of stroke and 11% of breast cancer.6 In terms of economic impact, inactivity in England is estimated to cost £8.2 billion a year, including costs such as lost productivity due to sickness absence, and costs to the National Health Service.1 It is not, therefore, surprising that promoting physical activity has been described as ‘public health’s best buy’.7 The 2005 public health document Physical Activity Plan8 specified the action that needs to be taken at national, regional and local level to improve people’s health through increasing physical activity. Physical activity recommendations for optimal health have been available since the mid to late 1970s.9 The current guidelines for adults are that they should take part in at least 30 minutes of moderate activity on a regular basis (at least five days a week).2 The latest guidance is that this 30 minutes can be achieved through bouts of activity of 10 minutes or more. However, the physical activity questions included in HSE 2004 were the same as those used in 1999 (in order to enable comparison between the two years), and these questions asked only about sessions of at least 30 minutes duration (15 minutes for sports and exercise). Consequently, these findings may slightly underestimate the proportion of the population who meet the current recommendations (through shorter bouts of activity). Self-reported physical activity measures are subject to recall limitations, social desirability bias and lack of objectivity. Despite these limitations, questionnaires are the most practical and cost-effective way of measuring physical activity in large-scale epidemiological research. Questions relating to the physical activity of adults (aged 16 and over) have been included in the Health Survey since its inception in 1991. The Health Survey questions for adults were originally based on a major national study of activity carried out in 1990, the Allied Dunbar National Fitness Survey.10 The physical activity module was repeated in HSE 1991-1994 with minor changes, and received more substantial revisions in 1997. A shorter version of the questionnaire was first introduced in 1999 when the focus was minority ethnic groups; the shorter questionnaire was repeated in the 2002, 2003 and 2004 surveys. This chapter focuses on participation in physical activity among minority ethnic groups and reports on the proportion of people achieving the recommended guidelines. In this chapter the term ‘Asian’ refers to the Indian, Pakistani, Bangladeshi and Chinese groups, while the term ‘South Asian’ refers to the Indian, Pakistani and Bangladeshi groups.

8.2.1

The physical activity questionnaire Adults’ physical activity in the four weeks prior to interview was measured by examining overall participation in any activity, frequency of participation in activities that lasted at least 30 minutes (15 minutes for sports and exercise), and type of activity. Information on the specific duration of activities was collected for sports and exercise only, while a question related to intensity was asked for sports and exercise and walking only. There was a single question relating to occupational activity levels: ‘Thinking about your job in general would you say that you are very physically active, fairly physically active, not very physically active, or not at all physically active?’ Responses to this question were taken into account for the

238

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8.2 Methods

estimation of the summary activity levels, as explained in section 8.3.2. Activity types, frequency, duration, and intensity Details of three main types of physical activity were asked about in the questionnaire: ●

Home activity (consisting of housework and gardening/DIY/building) that lasted 30 minutes or more. The lead-in question was: ‘Have you done any housework (or gardening/ DIY/building - in a separate question) in the last four weeks?‘ Informants were shown a card with a list of examples of housework (or gardening/DIY/building) and were asked if they had done any of the listed activities such as hoovering, dusting and ironing (or decorating, planting flower seeds and minor house repairs for the gardening/DIY/building category). Frequency of heavy housework (or heavy gardening/DIY/building) was assessed by showing another card with higher intensity activities, such as carrying heavy shopping and moving furniture (or digging and bricklaying for the gardening/DIY/building category) and asking informants: ‘During the past four weeks on how many days have you done this kind of (heavy housework or heavy gardening/DIY/building activities) for at least 30 minutes a time?’ Frequency of non-heavy home activity (i.e. those activities listed in the first set of show cards) was not assessed.

●

Walks of 30 minutes or more. The key question was: ‘During the past four weeks, on how many days did you do a walk of least 30 minutes?’ Walking intensity was assessed by asking informants to rate their usual walking pace (slow/average/fairly brisk/fast).

●

Sport and exercise activities that lasted 15 minutes or more. For sports and exercise activities in the four weeks prior to interview, informants were asked: ‘Can you tell me on how many separate days did you do (name of specific sport and exercise activity) for at least 15 minutes at a time during the past four weeks…?’, followed by a question about the activity’s usual duration on these days. The intensity of these activities was assessed by asking informants whether or not the activity had made them ‘out of breath or sweaty’. For comparability with the other activity types (where the minimum was set at 30 minutes) the lower duration limit for sport and exercise activities, at the analysis stage, was also set to 30 minutes.

Assumptions underlying the intensity level classification of physical activities All analyses presented in this chapter refer to physical activity of at least moderate intensity. Walks at a ‘fairly brisk’ or ‘fast pace’ were classified as ‘moderate’. Walks at a ‘slow’ or ‘average’ pace were classified as ‘light’. For home activity, (housework, manual/gardening/DIY) informants were given examples of types of housework/gardening /DIY that counted as ‘heavy’ and ‘light’. Heavy housework and heavy gardening/DIY were classified as ‘moderate’, other gardening/DIY as ‘light’, and light housework only as ‘inactive’.11

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For sports and exercise, activities were classified according to the nature of the activity, and the informant’s own assessment of the amount of effort involved in doing that activity. For example, ‘swimming’ was counted as ‘vigorous’ if the effort was usually enough to make the informant ‘out of breath or sweaty’, otherwise as ‘moderate’.12

8.3 Participation in different types of physical activity, and summary activity levels 8.3.1

Participation in each activity type, by minority ethnic group Table 8.1 presents overall participation in each physical activity category for at least 30 minutes in the four weeks prior to interview, and each component of physical activity, by minority ethnic group and sex. Physical activity is expressed as any participation for at

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239

least 30 minutes in the four weeks prior to interview, and as regular participation (i.e. participation at least once a week on average). Please note that only activity of moderate to vigorous intensity is included in these measures. Any physical activities 79% of men and 75% of women in the general population took part in some physical activity for at least 30 continuous minutes in the four weeks prior to interview. Among minority ethnic groups, participation rates ranged from 54% among Bangladeshi men to 78% among Irish men, and from 41% among Bangladeshi women to 81% among Irish women. Two thirds of men in the general population reported regular participation in any physical activity (at least once a week on average). Regular participation was also reported by about two thirds of those in the Irish, Black Caribbean, Black African minority ethnic groups. Participation levels were lower in the other groups, at around half of Pakistani and Bangladeshi men, and about six in ten Indian and Chinese men. Six in ten women in the general population participated regularly in physical activity. Among minority ethnic groups regular participation ranged from around a third of Bangladeshi women to two thirds of Irish women. Irish women had higher rates, while Indian, Pakistani Bangladeshi and Chinese women had lower regular participation rates, than women in the general population. Age-standardised risk ratios are used to take into account the differences in the age profile of different minority ethnic groups (see chapter 1). As Figure 8A shows, the pattern of participation in any physical activity (in the form of age-standardised ratios) was almost identical between men and women. Black African (0.88) and Asian (0.85 for Indian, 0.58 for Bangladeshi, 0.67 for Pakistani and 0.90 for Chinese) men had lower age-adjusted risk ratios than men in the general population. Among women, Black African (0.81), Black Caribbean (0.93) and Asian (0.83 for Indian, 0.45 for Bangladeshi, 0.70 for Pakistani, 0.80 for Chinese) women had lower age-adjusted risk ratios than women in the general population. This lower age-standardised activity rate among Asian minority ethnic groups confirms the pattern found in 1999. Table 8.1, Figure 8A Figure 8A Age-standardised ratios for participation in any physical activity, by minority ethnic group

2.0

2.0

1.0

1.0

0.5

0.5

0.1

0.1

Risk ratio, logarithmic scale

10.0

sh

Iri

se i ne sh de

hi

C

i

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st

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ki

Ba

n

an

an be

n

ca

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C

an

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an

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ca

ib ar

ri Af

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sh Iri se i ne hi sh C de la ng Ba ni a st ki

Pa

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Bl

General population = 1.0. Error bars indicate 95% confidence limits.

Home activity 38% of men and 55% of women in the general population participated in heavy housework in the four weeks prior to interview. Among minority ethnic groups, rates ranged from 19% among Bangladeshi and 20% among Pakistani men, to 42% in Black Caribbean men. In 240

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Women

Men 10.0

women, rates ranged from around a third of Bangladeshi women to about half of Black Caribbean, Black African, Indian, Pakistani, and more than six in ten Irish women. Table 8.1 A considerably lower age-adjusted proportion of Pakistani and Bangladeshi men participated in heavy housework compared with men in the general population (ratios of 0.48 and 0.44, respectively). There were no other significant differences among men. Among women, with the exception of Irish informants who had higher age-standardised risk ratios than the general population, all other minority ethnic groups had lower ageadjusted risk ratios of participation in housework than women in the general population (ratios ranged from 0.50 in Bangladeshi women to 0.90 in Black Caribbean women). Table 8.1

29% of men and 11% of women in the general population carried out heavy gardening/DIY/building in the four weeks prior to interview. Among men, rates were under 20% in each minority ethnic group with the exception of Irish men (24%). With the exception of Black Caribbean (10%) and Irish (10%) women, all other minority ethnic groups had lower participation rates (range 4-6%) than women in the general population. Table 8.1

As with the observed results, all minority ethnic groups, except Irish men, had significantly lower age-standardised risk ratios of participation in heavy gardening/DIY/building than men in the general population. This finding was particularly marked among Asian groups, where age-standardised risk ratios ranged from 0.22 (Bangladeshi men) to 0.50 (Indian men). With the exception of Black Caribbean women, all other minority ethnic groups had significantly lower age-standardised risk ratios of participation in heavy gardening/ DIY/building than women in the general population. Age-standardised risk ratios of participation in heavy gardening/DIY/building were markedly lower in Asian groups (range 0.31 to 0.51) and Black African women (0.30). Table 8.1 Walking Participation in brisk walking for at least 30 continuous minutes in the four weeks prior to interview was reported by 32% of men and 27% of women of the general population. With the exception of Irish men and women (32% and 33% respectively), minority ethnic groups had lower participation rates (range 14-27% in men and 8-24% in women) than the general population. South Asian (Indian, Bangladeshi and Pakistani) men and women had the lowest walking rates (consistently under 20%). Table 8.1 As with the observed results, all minority ethnic groups, with the exception of Irish men and women, had significantly lower age-standardised risk ratios of participation in walking (for at least 30 continuous minutes) than general population men and women. The agestandardised ratio for participation in walking was lowest among Asian men (ratios ranged from 0.38 in Pakistani men to 0.57 in Indian and Chinese men) and women (range from 0.21 in Bangladeshi to 0.60 in Indian women). Table 8.1, Figure 8B

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Sports and exercise Participation in sports and exercise in the four weeks prior to interview was reported by 41% of men and 34% of women in the general population. Chinese men (49%) were more likely to participate in sports and exercise than men in the general population, whereas Irish (39%) and Black African (43%) men had comparable rates to the general population. Sports and exercise participation among Black Caribbean and Chinese women was comparable to that of women in the general population (between 34 and 36%) while Irish women had higher participation rates. Lower than the general population participation rates in sports and exercise were reported by Bangladeshi (12%), Pakistani (16%), Indian (27%) and Black African (28%) women . Table 8.1 South Asian and Black African men had lower age-standardised risk ratios of participation in sports and exercise (for at least 30 continuous minutes) than men in the general population. Age-adjusted risk ratios ranged from 0.46 in Bangladeshi men to 0.83 in Black African men. After age standardisation, risk ratios among Chinese men were no longer significantly different from the general population. Among women, as with the observed results, age-standardised sports and exercise risk ratios were lower in South Asian and

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Figure 8B Age-standardised ratios for participation in brisk walking, by minority ethnic group Women

Men 10.0

2.0

2.0

1.0

1.0

0.5

0.5

0.1

0.1

Risk ratio, logarithmic scale

10.0

sh

Iri

se i sh de

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ne

hi C

ni

an

a be ib

ric Af

a st

ng

ki

Ba

k

ar C

n

a di

Pa

In

ac

k

ac

Bl

Bl

sh

Iri

an

se i sh de

la

ne

hi C

ni

ric Af

a st

ng

ki

Ba

k a be ib

ar C

n

a di

Pa

In

ac

k

ac

Bl

Bl

n

n

General population = 1.0. Error bars indicate 95% confidence limits.

Black African informants than women in the general population. The lowest standardised rate was found among Bangladeshi women (a ratio of 0.24) followed by Pakistani (0.35) and Black African (0.64) women. Table 8.1, Figure 8C Figure 8C Age-standardised ratios for participation in sports and exercise, by minority ethnic group Women

Men 10.0

2.0

2.0

1.0

1.0

0.5

0.5

0.1

0.1

Risk ratio, logarithmic scale

10.0

an

an

be

an

ric

ib

ar

Af

C

sh Iri se i ne hi sh C de la ng Ba ni a st ki Pa an

di

In

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a Bl

a Bl

be

an

ric

ib

ar

Af

C

sh Iri se i ne hi sh C de la ng Ba ni a st ki Pa an

di

In

ck

ck

a Bl

a Bl

General population = 1.0. Error bars indicate 95% confidence limits.

Summary activity levels by minority ethnic group Summary measure The summary measure of physical activity levels classifies informants according to current physical activity guidelines (which are that adults should take part in activity of at least moderate intensity for 30 minutes or more, on five or more days per week). For this analysis it was assumed that activity sessions were done on different days. The measure aims to incorporate the basic dimensions of the informant’s overall activity level (frequency, intensity and duration). However, the summary variable may underestimate overall activity levels, as the questionnaire only collected information on bouts of activity that lasted 30 minutes or more; shorter bouts of activity, which may have accumulated to 30 minutes, were not recorded. As in 1999, full-time workers who reported being at least moderately 242

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8.3.2

active in their work are counted as having done 20 days’ activity in the four weeks prior to interview, part-time workers as 12 days’ activity. The summary activity level classification is presented in this chapter as follows: ●

Low activity: fewer than three occasions of moderate or vigorous activity of at least 30 minutes’ duration in the four weeks prior to interview (less than once a week).

●

High activity: 20 or more occasions of moderate or vigorous activity of at least 30 minutes’ duration in the four weeks prior to interview (at least five days a week). It is noted that the term ‘high’ is relative in this context and corresponds to the minimum activity level required to acquire some general health benefits (e.g. reduction in the relative risk for cardiovascular morbidity). However, it does not necessarily indicate the extent of activity required for optimal cardiovascular fitness or for optimal weight control.

Adherence to the physical activity recommendations 37% of men and 25% of women in the general population had high activity levels, defined as meeting the current physical activity recommendations. Among minority ethnic groups, Irish (39%) and Black Caribbean (37%) men had the highest observed rates of adherence to the recommendations. Among women, Black Caribbean, Black African and Irish informants had the highest rates (31%, 29% and 29%, respectively). Only 11% of Bangladeshi and 14% of Pakistani women did the recommended amounts of physical activity in the four weeks prior to interview. As in 1999, Asian men and women had lower age-standardised ratios for meeting the physical activity recommendations than general population men and women. Among Asians, age-standardised risk ratios ranged from 0.58 in Bangladeshi men to 0.75 in Indian men, and from 0.32 in Bangladeshi women to 0.81 in Indian women. Table 8.2, Figure 8D Figure 8D Age-standardised ratios for meeting the physical activity recommendations, by minority ethnic group Women

Risk ratio, logarithmic scale

Men 10.0

10.0

2.0

2.0

1.0

1.0

0.5

0.5

0.1

0.1

Af

an ric n a be ib

ar

C

an ric n a be ib

sh Iri se i ne hi sh C de la ng Ba ni a st ki Pa n ia

d In

k

k

ac

ac

Bl

Bl

Af

ar

C

sh Iri se i ne hi sh C de la ng Ba ni a st ki Pa n ia

d In

k

k

ac

ac

Bl

Bl

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General population = 1.0. Error bars indicate 95% confidence limits.

Prevalence of low activity Table 8.2 also shows the observed proportions of men and women who had low activity levels, defined as participation in less than one 30-minute moderate or vigorous activity session a week on average. 32% of men and 39% of women in the general population had low activity levels. The highest prevalence of low activity levels was observed among Bangladeshi and Pakistani men (both 51%), and Bangladeshi (68%) and Pakistani (52%) women. Table 8.2

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8.3.3

Participation in each activity type, by age within minority ethnic group Table 8.3 presents overall participation and regular participation (at least once a week) in any activities, and each activity type, by age, minority ethnic group and sex. Any physical activities Overall participation in any activities decreased with age among men in the general population and most minority ethnic groups. Among general population women, participation was relatively stable in informants aged 16-24 and 35-54. The same was true for Black African, Black Caribbean, Indian and Chinese women, whose participation in any activities remained relatively stable or even increased among those aged 35-54. Table 8.3 Home activity Participation in heavy housework and heavy gardening/DIY/building peaked for men and women aged 35-54 in the general population and the majority of minority ethnic groups. Table 8.3

Walking

Walking continuously for at least 30 minutes, on one or more occasion in the four weeks prior to interview, declined with age in the general population, from 42% among men aged 16-34 to 20% of men aged 55 and over, and from 34% among women aged 16-34 to 17% among women aged 55 and over. Walking participation followed the same pattern for all minority ethnic groups for men and for most minority ethnic groups for women. Markedly low walking rates were recorded among Asian women aged 55 and over (range 0-6%). Table 8.3

Sports and exercise

There was a consistent decline in participation in sports and exercise with increasing age across all minority ethnic groups and in the general population. Rates in the general population fell from 63% in men aged 16-34 to 18% in men aged 55 and over, and from 49% in women aged 16-34 to 17% in women aged 55 and over. Table 8.3 8.3.4

Summary activity levels by age within minority ethnic group In general population men, the percentage of informants with high activity levels (those who met the activity recommendations) decreased with age from 51% in men aged 16-34, to 39% among those aged 35-54, and 22% in men aged 55 and over. Among minority ethnic groups, decreases with age were found among Black Caribbean, Pakistani and Irish men, while among Black African, Indian, Bangladeshi and Chinese men rates remained relatively unchanged to the age of 35-54. In women, rates of adherence to the guidelines tended to remain relatively stable between age groups 16-34 and 35-54, and then to decrease. The exception to this was Bangladeshi women, whose rates decreased from 15% in those aged 16-34, to 7% among those aged 35-54, and 2% among those aged 55 and over. Table 8.4

8.3.5

Participation in physical activity, by household income within minority ethnic group Equivalised household income is a measure of household income that takes account of the number of persons in the household. An equivalised household income tertile is 1/3 of the equivalised household income distribution of the general population, e.g. the top tertile refers to the top 1/3 of the equivalised household income distribution (see also Chapter 1). Observed participation in any physical activity increased with income tertile for both men and women in the general population as shown in Table 8.5. 87% of men in the highest income tertile had taken part in physical activity, decreasing to 63% among men in the lowest tertile. Similarly, 86% of women in the highest income tertile in the general

244

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The prevalence of low activity levels (defined as participation in less than 30 minutes a week in activity of at least moderate intensity) increased with age in most groups, except for women in the general population and Black African and Chinese women, whose rates stayed relatively unchanged up to age 54. The prevalence of low activity was markedly high among older (aged 55 and over) South Asian men (at least 68%) and women (at least 74%).

population had taken part in physical activity, compared with 64% among women in the lowest tertile. Reductions in physical activity participation rates with decreasing income were observed across most minority ethnic groups. Table 8.5 also shows participation in any physical activity in the form of age-standardised ratios. South Asian men in the middle and lowest income tertiles had significantly lower age-standardised risk ratios of participation in any physical activity than the general population as a whole. The same pattern of age-standardised ratios with equivalised income was found among South Asian and Black African women. Table 8.5 8.3.6

Percentage meeting the physical activity recommendations, by household income within minority ethnic group Table 8.6 shows the observed percentages and age-standardised risk ratios for meeting the physical activity recommendations, by equivalised household income tertile. There was a decrease in the observed proportion of men and women meeting the recommendations with decreasing household income, in the general population and most minority ethnic groups. Table 8.6 also shows the age-standardised risk ratios for the proportions of men and women meeting the physical activity recommendations, by equivalised household income and minority ethnic group. South Asian men in the middle and bottom income tertiles were less likely to meet the physical activity recommendations than men, overall, in the general population (age-standardised risk ratios ranged from 0.49 among Bangladeshi men in the middle tertile to 0.58 in Indian and Bangladeshi men in the lowest tertiles). The same pattern was found in Bangladeshi and Pakistani women in the middle and bottom income tertiles, compared with women in the general population. Table 8.6

8.4 Physical activity comparisons between 1999 and 2004 8.4.1

Comparison of regular participation in any physical activity in 1999 and 2004 Table 8.7 compares regular participation rates (moderate to vigorous activity at least once a week on average) in any physical activity in 1999 and 2004 by age and minority ethnic group. Regular participation rates increased by 4 percentage points (p.p.) for men and women in the general population (from 64% to 68% in men, and from 57% to 61% in women). Increases were also observed among Bangladeshi men (6 p.p., from 43% to 49%), Chinese men (10 p.p., from 52% to 62%) and Irish women (5 p.p., from 62% to 67%). In contrast, notable reductions in regular physical activity participation were found among Pakistani men (decrease by 7 p.p., from 56% to 49%). Table 8.7

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8.4.2

Comparison of the percentage meeting the physical activity recommendations in 1999 and 2004 The increases in regular activity participation in the general population described in the previous section, were accompanied by same size increases of 4 p.p. for both men (from 33% to 37%) and women (from 21% to 25%) in the percentage meeting the activity recommendations (participation in activity of at least moderate intensity on five or more days per week, at least 30 minutes on each ocassion). Notable increases were recorded among Chinese men (increase of 7 p.p., from 23% to 30%) and Indian women (increase of 6 p.p., from 17% to 23%). It should be noted that figures and bases for 1999 differ from the published figures (in the 1999 report) due to changes in the analyses and weighting to make results comparable between the two years. Table 8.8, Figure 8E

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Figure 8E Comparison of the percentage meeting the physical activity recommendations in 1999 and 2004, by ethnic group Women

Men

Percent

1999 2004

45

45

40

40

35

35

30

30

25

25

20

20

15

15

10

10

5

5

0

0 al er on en ti G ula p po sh Iri se i ne hi sh C de la ng Ba ni a st ki Pa an di In k n ac ea Bl ibb ar C

al er on en ti G ula p po sh Iri se i ne hi sh C de la ng Ba ni a st ki Pa an di In k n ac ea Bl ibb ar C

References and notes 1 Chakravarthy MV, Joyner MJ, Booth FW. An obligation for primary care physicians to prescribe physical activity to sedentary patients to reduce the risk of chronic health conditions. Mayo Clinic Proceedings, 2002; 77:165-173 2 The Chief Medical Officer. At least five a week: evidence on the impact of physical activity and its relationship to health. Department of Health, London, 2004. 3 Lee CD, Blair SN, Jackson AS. Cardiorespiratory fitness, body composition, and all-cause and cardiovascular disease mortality in men. American Journal of Clinical Nutrition 1999; 69:373-380. 4 Stevens J, Evenson KR, Thomas O, et al. Associations of fitness and fatness with mortality in Russian and American men in the lipids research clinics study. International Journal of Obesity, 2004; 28:1463-1470. 5 McPherson K, Britton A, Causer L. Coronary heart disease. Estimating the impact of changes in risk factors. The Stationery Office, London, 2002. 6 World Health Organisation. World Health Report. World Health Organisation, Geneva, 2002. 7 Morris JN. Exercise in the prevention of coronary heart disease – today’s best buy in public health. Medicine and Science in Sports and Exercise, 1994; 26:807-814. 8 Department of Health. Choosing Activity: a physical activity action plan . Department of Health London, 2005. http://www.dh.gov.uk/assetRoot/04/10/57/10/04105710.pdf 9 Blair SN, LaMonte MJ, Nichaman MZ. The evolution of physical activity recommendations: how much is enough? American Journal of Clinical Nutrition, 2004; 79:913-920. 10 Allied Dunbar National Fitness Survey, Health Education Authority and Sports Council, London, 1992. 11 Home activities: Examples of ‘heavy’ gardening or DIY work classified as moderate intensity: Digging, clearing rough ground, building in stone/bricklaying, mowing large areas with a hand mower, felling trees, chopping wood, mixing/laying concrete, moving heavy loads, refitting a kitchen or bathroom or any similar heavy manual work.

Walking with heavy shopping for more than 5 minutes, moving heavy furniture, spring cleaning, scrubbing floors with a scrubbing brush, cleaning windows, or other similar heavy housework. Examples of ‘light’ gardening or DIY work classified as light intensity: Hoeing, weeding, pruning, mowing with a power mower, planting flowers/seeds, decorating, minor household repairs, car washing and polishing, car repairs and maintenance. 12 Sports and exercise activities - Intensity classification Vigorous: a) All occurrences of running/jogging, squash, boxing, kick boxing, skipping, trampolining. b) Sports were coded as vigorous intensity if they had made the informant breathe heavily or sweaty, but otherwise coded as moderate intensity including: cycling, aerobics, keep fit, gymnastics, dance for fitness, weight training, football, rugby, swimming, tennis, badminton.

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Examples of ‘heavy’ housework classified as moderate intensity:

Moderate: a) See ‘vigorous’ category b). b) All occasions of a large number of activities including: basketball, canoeing, fencing, field athletics, hockey, ice skating, lacrosse, netball, roller skating, rowing, skiing, volleyball. c) Sports were coded as moderate intensity if they had made the informant breathe heavily or sweaty, but otherwise coded as light intensity, including: exercise (press-ups, sit-ups etc), dancing. Light: a) See ‘moderate’ category c).

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b) All occasions of a large number of activities including: abseiling, baseball, bowls, cricket, croquet, darts, fishing, golf, riding, rounders, sailing, shooting, snooker, snorkelling, softball, table tennis, yoga.

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Tables

8.1 Participation in each activity type, by minority ethnic group and sex 8.2 Summary activity levels, by minority ethnic group and sex 8.3 Participation in each activity type, by age within minority ethnic group and sex 8.4 Summary activity levels, by age within minority ethnic group and sex 8.5 Participation in any physical activity, by equivalised household income tertile within minority ethnic group and sex 8.6 Percentage meeting physical activity recommendations, by equivalised household income tertile within minority ethnic group and sex 8.7 Comparison of regular participation in any physical activity in 2004 and 1999, by age within minority ethnic group and sex

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8.8 Comparison of the proportion meeting the physical activity recommendations in 2004 and 1999, by age within minority ethnic group and sex

Table 8.1 Participation in each activity type, by minority ethnic group and sex Aged 16 and over

2004

Participation in moderate or vigorous activity in the four weeks prior to interview

Minority ethnic group

General population

Black Caribbean

Black African

Indian

42 22

34 18

35 14

20 7

18 11

9 3

15 7

24 18

27 25

46 39

Pakistani Bangladeshi

Chinese

Irish

19 10

34 16

38 20

38 17

10 5

5 3

10 4

24 15

29 16

19 15

14 11

17 16

21 17

32 23

32 25

43 35

32 26

31 25

26 22

49 39

39 33

41 33

74 66

75 65

68 56

58 49

54 49

76 62

78 67

79 68

Heavy housework Anya

1.11

0.89

0.90

0.48

0.44

0.89

1.04

1

Standard error of the ratio

0.09

0.09

0.07

0.06

0.08

0.08

0.09

At least once a weekb

1.29

1.09

0.81

0.40

0.54

0.98

1.29

Standard error of the ratio

0.20

0.18

0.11

0.10

0.13

0.13

0.18

Heavy gardening/DIY/building Anya

0.58

0.31

0.50

0.32

0.22

0.37

0.90

Standard error of the ratio

0.09

0.07

0.06

0.06

0.06

0.07

0.11

At least once a weekb

0.63

0.20

0.43

0.30

0.20

0.27

0.98

Standard error of the ratio

0.14

0.07

0.09

0.09

0.06

0.09

0.16

Walking Anya

0.77

0.77

0.57

0.38

0.44

0.57

1.08

Standard error of the ratio

0.10

0.09

0.06

0.05

0.08

0.06

0.11

At least once a weekb

0.73

0.93

0.60

0.41

0.53

0.61

0.96

Standard error of the ratio

0.12

0.11

0.07

0.06

0.09

0.08

0.12

Sports and exercise Anya

1.10

0.83

0.73

0.63

0.46

0.99

1.02

Standard error of the ratio

0.08

0.07

0.05

0.07

0.04

0.06

0.09

At least once a weekb

1.16

0.83

0.73

0.61

0.49

0.98

1.09

Standard error of the ratio

0.09

0.08

0.06

0.07

0.05

0.08

0.11

Any physical activities Anya

0.95

0.88

0.85

0.67

0.58

0.90

1.01

Standard error of the ratio

0.03

0.04

0.03

0.04

0.05

0.03

0.03

At least once a weekb

0.99

0.87

0.79

0.65

0.61

0.85

1.03

Standard error of the ratio

0.04

0.05

0.03

0.05

0.05

0.04

0.04

Bases (weighted) Bases (unweighted)

477 409

373 386

901 549

420 429

177 408

151 348

1776 497

Men Observed % Heavy housework Anya At least once a weekb Heavy gardening/DIY/building Anya At least once a weekb Walking Anya At least once a weekb Sports and exercise Anya At least once a weekb Any physical activities Anya At least once a weekb

Copyright © 2006, The Information Centre. All rights reserved

Standardised risk ratios

1

1 1

1 1

1 1

1 1

46089 2873

a Participation for at least 30 minutes in moderate or vigorous intensity activity in the four weeks prior to interview. b Participation for at least 30 minutes a week on average in moderate or vigorous intensity, i.e. at least four sessions in the four weeks prior to interview.

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 8: PHYSICAL ACTIVITY

249

Table 8.1 continued Aged 16 and over Participation in moderate or vigorous activity in the four weeks prior to interview

2004 Minority ethnic group

General population

Black Caribbean

Black African

Indian

50 29

47 27

48 29

49 31

10 4

4 1

6 2

24 18

22 17

36 27

Pakistani Bangladeshi

Chinese

Irish

32 19

42 26

63 36

55 31

4 1

4 2

4 1

9 2

11 4

18 16

12 9

8 7

17 14

33 28

27 22

28 20

27 21

16 13

12 11

34 27

38 29

34 25

73 61

70 57

68 55

60 48

41 32

67 53

81 67

75 61

Heavy housework Anya

0.90

0.75

0.81

0.81

0.50

0.70

1.11

1

Standard error of the ratio

0.05

0.06

0.05

0.05

0.06

0.05

0.05

At least once a weekb

0.90

0.78

0.84

0.86

0.53

0.72

1.11

Standard error of the ratio

0.08

0.10

0.07

0.07

0.09

0.07

0.09

Heavy gardening/DIY/building Anya

0.87

0.30

0.51

0.40

0.31

0.38

0.71

Standard error of the ratio

0.15

0.10

0.11

0.12

0.09

0.12

0.12

At least once a weekb

0.76

0.11

0.48

0.34

0.47

0.33

0.43

Standard error of the ratio

0.23

0.07

0.20

0.14

0.19

0.21

0.15

Walking Anya

0.77

0.65

0.60

0.34

0.21

0.52

1.12

Standard error of the ratio

0.07

0.08

0.06

0.05

0.05

0.07

0.10

At least once a weekb

0.76

0.66

0.66

0.32

0.21

0.52

1.20

Standard error of the ratio

0.08

0.09

0.07

0.06

0.05

0.08

0.13

Sports and exercise Anya

0.96

0.64

0.67

0.35

0.24

0.85

1.05

Standard error of the ratio

0.07

0.07

0.05

0.05

0.04

0.08

0.08

At least once a weekb

0.98

0.61

0.70

0.38

0.29

0.91

1.13

Standard error of the ratio

0.09

0.08

0.06

0.05

0.05

0.10

0.10

Any physical activities Anya

0.93

0.81

0.83

0.70

0.45

0.80

1.04

Standard error of the ratio

0.03

0.04

0.03

0.03

0.04

0.04

0.03

At least once a weekb

0.94

0.80

0.81

0.67

0.42

0.78

1.06

Standard error of the ratio

0.04

0.05

0.04

0.04

0.05

0.05

0.04

Bases (weighted) Bases (unweighted)

673 648

472 467

1067 634

499 508

207 477

163 375

2369 656

Women Observed % Heavy housework Anya At least once a weekb Heavy gardening/DIY/building Anya At least once a weekb Walking Anya At least once a weekb Sports and exercise Anya At least once a weekb Any physical activities Anya At least once a weekb

Standardised risk ratios

250

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 8: PHYSICAL ACTIVITY

1 1

1 1

1 1

1 1

48643 3818 Copyright © 2006, The Information

a Participation for at least 30 minutes in moderate or vigorous intensity activity in the four weeks prior to interview. b Participation for at least 30 minutes a week on average in moderate or vigorous intensity, i.e. at least four sessions in the four weeks prior to interview.

1

Table 8.2 Summary activity levels, by minority ethnic group and sex Aged 16 and over

2004

Summary activity levelsa,b

Minority ethnic group

General population

Black Caribbean

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Men Observed % Low levels High levels Standardised risk ratios High levels

34 37

35 35

44 30

51 28

51 26

38 30

33 39

32 37

1.03

0.84

0.75

0.64

0.58

0.74

1.05

1

Standard error of the ratio

0.09

0.09

0.06

0.07

0.07

0.07

0.08

Women Observed % Low levels High levels Standardised risk ratios High levels

39 31

43 29

45 23

52 14

68 11

47 17

33 29

39 25

1.17

1.03

0.81

0.46

0.32

0.59

1.08

1

Standard error of the ratio

0.10

0.10

0.07

0.06

0.06

0.07

0.11

477 673

373 472

901 1067

420 499

177 207

151 163

1776 2369

46089 48643

409 648

386 467

549 634

429 508

408 477

348 375

497 656

2873 3818

Bases (weighted) Men Women Bases (unweighted) Men Women

a High levels indicate adherence to the physical activity recommendations (30 minutes or more at least moderate activity on at least

five days a week). Low levels indicate inactivity defined as less than one 30-minute moderate or vigorous activity session a week.

Copyright © 2006, The Information Centre. All rights reserved

b The ‘medium activity levels’ category (30 minutes or more at least moderate activity on one to four days a week) is not presented in this table.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 8: PHYSICAL ACTIVITY

251

Table 8.3 Participation in each activity type, by age within minority ethnic group and sex Aged 16 and over Participation in moderate or vigorous activity in the four weeks prior to interview

Black Caribbean Heavy housework Anya At least once a weekb Heavy gardening/DIY/building Anya At least once a weekb Walking Anya At least once a weekb Sports and exercise Anya At least once a weekb Any physical activities Anya At least once a weekb Black African Heavy housework Anya At least once a weekb Heavy gardening/DIY/building Anya At least once a weekb Walking Anya At least once a weekb Sports and exercise Anya At least once a weekb Any physical activities Anya At least once a weekb

2004 Age group

Men

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

41 21

50 26

32 17

42 22

57 33

56 31

32 19

50 29

9 5

28 18

12 6

18 11

7 3

14 6

7 1

10 4

37 25

25 19

10 8

24 18

26 22

28 21

12 9

24 18

68 60

55 45

11 9

46 39

51 43

35 23

16 10

36 27

88 83

85 78

46 34

74 66

81 72

78 63

53 43

73 61

30 12

37 21

[42] [28]

34 18

45 25

55 32

[21] [16]

47 27

5 0

12 7

[11] [4]

9 3

3 0

5 1

[4] [0]

4 1

33 31

21 19

[23] [23]

27 25

27 21

18 15

[13] [11]

22 17

58 48

34 26

[12] [11]

43 35

33 26

25 16

[6] [2]

28 20

77 67

74 65

[67] [55]

75 65

69 57

75 62

[42] [31]

70 57

16-34

35-54

All 55+ women

a Participation for at least 30 minutes in moderate or vigorous intensity activity in the four weeks prior to the interview. b Participation for at least 30 minutes a week on average in moderate or vigorous intensity, i.e. in at least four sessions in the

four weeks prior to interview.

252

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 8: PHYSICAL ACTIVITY

Copyright © 2006, The Information Centre. All rights reserved

Continued…

Table 8.3 continued Aged 16 and over

2004

Participation in moderate or vigorous activity in the four weeks prior to interview

Indian Heavy housework Anya At least once a weekb Heavy gardening/DIY/building Anya At least once a weekb Walking Anya At least once a weekb Sports and exercise Anya At least once a weekb Any physical activities Anya At least once a weekb Pakistani Heavy housework Anya At least once a weekb Heavy gardening/DIY/building Anya At least once a weekb Walking Anya At least once a weekb Sports and exercise Anya At least once a weekb Any physical activities Anya At least once a weekb

Age group

Men

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

37 11

37 18

25 12

35 14

51 28

57 37

22 13

48 29

9 3

19 9

16 9

15 7

4 2

9 3

3 0

6 2

25 20

18 15

10 10

19 15

27 24

16 13

6 5

18 16

47 41

32 23

9 7

32 26

39 30

25 20

4 3

27 21

78 65

73 60

44 32

68 56

77 65

76 60

31 21

68 55

21 7

25 8

5 2

20 7

52 36

50 26

31 19

49 31

9 4

12 7

5 3

10 5

2 0

6 3

7 1

4 1

18 14

12 10

5 5

14 11

15 12

9 6

2 2

12 9

43 34

27 23

4 1

31 25

20 16

12 11

4 2

16 13

69 61

60 50

20 12

58 49

68 56

58 44

34 26

60 48

16-34

35-54

All 55+ women

a Participation for at least 30 minutes in moderate or vigorous intensity activity in the four weeks prior to the interview. b Participation for at least 30 minutes a week on average in moderate or vigorous intensity, i.e. in at least four sessions in the

four weeks prior to interview.

Copyright © 2006, The Information Centre. All rights reserved

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 8: PHYSICAL ACTIVITY

253

Table 8.3 continued Aged 16 and over Participation in moderate or vigorous activity in the four weeks prior to interview

Bangladeshi Heavy housework Anya At least once a weekb Heavy gardening/DIY/building Anya At least once a weekb Walking Anya At least once a weekb Sports and exercise Anya At least once a weekb Any physical activities Anya At least once a weekb Chinese Heavy housework Anya At least once a weekb Heavy gardening/DIY/building Anya At least once a weekb Walking Anya At least once a weekb Sports and exercise Anya At least once a weekb Any physical activities Anya At least once a weekb

2004 Age group

Men

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

19 9

21 11

[10] [7]

19 10

35 20

32 22

11 5

32 19

5 4

5 3

[4] [1]

5 3

3 2

6 4

0 0

4 2

20 18

14 14

[12] [12]

17 16

11 8

6 4

0 0

8 7

40 35

15 12

[2] [2]

26 22

16 14

7 6

1 1

12 11

64 58

49 43

[25] [22]

54 49

48 38

36 29

14 8

41 32

36 13

31 16

35 23

34 16

34 14

51 37

33 19

42 26

4 3

13 4

20 9

10 4

1 0

6 2

5 4

4 1

25 20

16 13

20 19

21 17

21 17

18 15

2 2

17 14

65 51

38 29

23 23

49 39

46 38

31 22

13 11

34 27

85 70

74 57

55 50

76 62

69 55

73 58

41 33

67 53

16-34

35-54

All 55+ women

a Participation for at least 30 minutes in moderate or vigorous intensity activity in the four weeks prior to the interview. b Participation for at least 30 minutes a week on average in moderate or vigorous intensity, i.e. in at least four sessions in the

four weeks prior to interview.

254

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 8: PHYSICAL ACTIVITY

Copyright © 2006, The Information Centre. All rights reserved

Continued…

Table 8.3 continued Aged 16 and over

2004

Participation in moderate or vigorous activity in the four weeks prior to interview

Irish Heavy housework Anya At least once a weekb Heavy gardening/DIY/building Anya At least once a weekb Walking Anya At least once a weekb Sports and exercise Anya At least once a weekb Any physical activities Anya At least once a weekb

Copyright © 2006, The Information Centre. All rights reserved

General population Heavy housework Anya At least once a weekb Heavy gardening/DIY/building Anya At least once a weekb Walking Anya At least once a weekb Sports and exercise Anya At least once a weekb Any physical activities Anya At least once a weekb Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

Age group

Men

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

41 23

46 25

29 14

38 20

69 39

64 37

59 32

63 36

29 17

27 17

19 11

24 15

8 1

12 3

6 1

9 2

48 31

38 27

16 15

32 23

35 31

38 31

26 22

33 28

64 58

45 35

17 14

39 33

51 43

41 31

26 19

38 29

93 89

87 73

59 47

78 67

91 79

84 72

70 54

81 67

38 15

41 18

35 17

38 17

55 31

64 39

45 24

55 31

23 11

35 20

28 16

29 16

8 3

15 5

10 4

11 4

42 33

33 25

20 17

32 25

34 28

32 25

17 14

27 22

63 52

42 34

18 13

41 33

49 37

39 29

17 12

34 25

90 80

84 74

63 49

79 68

84 72

85 71

58 43

75 61

140 176 325 205 91 74 412 14734

194 157 384 151 65 50 678 16665

143 40 192 64 21 27 686 14690

477 373 901 420 177 151 1776 46089

217 238 408 276 135 63 497 14649

291 198 466 161 51 78 1038 16895

164 37 193 62 21 22 833 17098

673 472 1067 499 207 163 2369 48643

120 177 200 222 210 172 114 737

164 170 231 142 150 118 194 974

125 39 118 65 48 58 189 1162

409 386 549 429 408 348 497 2873

198 234 240 279 309 148 149 914

289 190 275 164 118 176 275 1372

161 43 119 65 50 51 232 1532

648 467 634 508 477 375 656 3818

16-34

35-54

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 8: PHYSICAL ACTIVITY

All 55+ women

a Participation for at least 30

minutes in moderate or vigorous intensity activity in the four weeks prior to the interview. b Participation for at least 30

minutes a week on average in moderate or vigorous intensity, i.e. in at least four sessions in the four weeks prior to interview.

255

Table 8.4 Summary activity levels, by age within minority ethnic group and sex Aged 16 and over

Black Caribbean Low levels High levels Black African Low levels High levels Indian Low levels High levels Pakistani Low levels High levels Bangladeshi Low levels High levels Chinese Low levels High levels Irish Low levels High levels General population Low levels High levels Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

2004 Age group

Men

Women

16-34

35-54

55+

All men

16-34

35-54

55+

All women

%

%

%

%

%

%

%

%

17 49

22 39

66 22

34 37

28 37

37 36

57 17

39 31

33 36

35 34

[45] [33]

35 35

43 33

38 26

[69] [21]

43 29

35 34

40 33

68 18

44 30

35 26

40 26

79 11

45 23

39 37

50 26

88 5

51 28

44 15

56 13

74 10

52 14

42 29

57 27

[78] [9]

51 26

62 15

71 7

92 2

68 11

30 31

43 28

50 31

38 30

45 16

42 19

67 15

47 17

11 54

27 41

53 27

33 39

21 30

28 36

46 19

33 29

20 51

26 39

51 22

32 37

28 31

29 31

57 14

39 25

140 176 325 205 91 74 412 14734

194 157 384 151 65 50 678 16665

143 40 192 64 21 27 686 14690

477 373 901 420 177 151 1776 46089

217 238 408 276 135 63 497 14649

291 198 466 161 51 78 1038 16895

164 37 193 62 21 22 833 17098

673 472 1067 499 207 163 2369 48643

120 177 200 222 210 172 114 737

164 170 231 142 150 118 194 974

125 39 118 65 48 58 189 1162

409 386 549 429 408 348 497 2873

198 234 240 279 309 148 149 914

289 190 275 164 118 176 275 1372

161 43 119 65 50 51 232 1532

648 467 634 508 477 375 656 3818

a High levels indicate adherence to the physical activity recommendations (30 minutes or more at least moderate

activity on at least 5 days a week). Low levels indicate inactivity defined as less than one 30-minute moderate or vigorous activity session a week.

256

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 8: PHYSICAL ACTIVITY

Copyright © 2006, The Information Centre. All rights reserved

Summary activity levelsa

Table 8.5 Participation in any physical activity, by equivalised household income tertile within minority ethnic group and sex Aged 16 and over

2004

Participation in moderate or vigorous activity in the four weeks prior to interview

Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

90 83

72 68

67 55

84 75

72 60

73 57

78 68

74 64

70 58

79 66

66 56

64 54

81 62

67 58

45 38

72 59

68 54

62 46

[75] [67]

60 49

46 38

[74] [69]

55 43

64 47

c c

41 41

53 47

c c

30 28

42 32

84 71

74 66

[63] [50]

72 58

59 47

64 58

91 80

71 54

51 42

90 74

75 66

70 51

87 76

74 61

63 54

86 73

69 54

64 50

Black Caribbean Anya

1.08

0.98

0.86

1.04

0.92

0.91

Standard error of the ratio

0.04

0.06

0.09

0.05

0.05

0.06

Black African Anya

0.91

0.93

0.85

0.93

0.80

0.77

Standard error of the ratio

0.07

0.06

0.07

0.08

0.07

0.07

Indian Anya

0.96

0.81

0.61

0.84

0.84

0.82

Standard error of the ratio

0.04

0.05

0.07

0.06

0.06

0.06

[0.97]

0.71

0.56

[0.86]

0.59

0.76

[0.07]

0.07

0.05

[0.12]

0.06

0.05

Bangladeshi Anya

c

0.46

0.60

c

0.34

0.46

Standard error of the ratio

c

0.07

0.06

c

0.07

0.07

Chinese Anya

1.00

0.87

[0.79]

0.86

0.70

0.84

Standard error of the ratio

0.05

0.08

[0.08]

0.07

0.11

0.08

Observed % Black Caribbean Anya At least once a weekb Black African Anya At least once a weekb Indian Anya At least once a weekb Pakistani Anya At least once a weekb Bangladeshi Anya At least once a weekb Chinese Anya At least once a weekb Irish Anya At least once a weekb General population Anya At least once a weekb

Standardised risk ratios

Pakistani Anya

Copyright © 2006, The Information Centre. All rights reserved

Standard error of the ratio

a Participation for at least 30 minutes in

Irish Anya

1.10

0.97

0.82

1.13

1.01

0.97

Standard error of the ratio

0.04

0.06

0.09

0.03

0.06

0.06

General population Anya

1.06

0.98

0.82

1.07

0.95

0.88

Standard error of the ratio

0.02

0.02

0.03

0.02

0.02

0.03

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 8: PHYSICAL ACTIVITY

moderate or vigorous intensity activity in the four weeks prior to the interview. b Participation for at least 30 minutes a week

on average in moderate or vigorous intensity, i.e. in at least four sessions in the four weeks prior to interview. c Results not shown because of small bases.

257

Table 8.5 continued

Aged 16 and over Participation in moderate or vigorous activity in the four weeks prior to interview

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

2004 Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

152 111 263 55 8 44 833 21844

115 89 241 117 39 36 398 11506

105 90 150 136 74 21 270 5635

156 123 305 56 9 52 1040 19490

188 114 287 134 44 34 568 14286

179 150 203 168 84 24 347 6523

123 103 158 47 19 105 207 1341

89 105 155 112 89 77 122 752

95 94 97 154 170 49 89 353

149 102 179 46 23 120 257 1471

163 122 173 135 101 74 163 1178

178 149 126 176 190 58 123 536

a Participation for at least 30 minutes in moderate or vigorous intensity activity in the four weeks prior to

the interview. b Participation for at least 30 minutes a week on average in moderate or vigorous intensity, i.e. in at least

four sessions in the four weeks prior to interview.

258

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 8: PHYSICAL ACTIVITY

Copyright © 2006, The Information Centre. All rights reserved

c Results not shown because of small bases.

Table 8.6 Percentage meeting physical activity recommendations, by equivalised household income tertile within minority ethnic group and sex Aged 16 and over

2004

Percentage meeting the physical activity recommendations (high activity levels)

Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

45 42 29 [35] a 31 45 40

40 34 39 29 21 29 35 38

30 27 21 21 26 [30] 23 30

38 33 26 [26] a 13 29 31

31 31 23 13 12 15 31 21

33 27 18 13 13 21 23 20

Black Caribbean Standardised risk ratio

1.16

1.14

0.83

1.38

1.12

1.18

Standard error of the ratio

0.15

0.18

0.19

0.21

0.17

0.17

Black African Standardised risk ratio

0.98

0.88

0.65

1.16

1.07

0.97

Standard error of the ratio

0.18

0.17

0.15

0.20

0.17

0.20

Indian Standardised risk ratio

0.72

0.94

0.58

0.91

0.79

0.68

Standard error of the ratio

0.10

0.10

0.11

0.13

0.11

0.16

Pakistani Standardised risk ratio

[0.92]

0.66

0.51

[1.11]

0.43

0.42

Standard error of the ratio

[0.23]

0.10

0.09

[0.33]

0.10

0.10

Bangladeshi Standardised risk ratio

a

0.49

0.58

a

0.32

0.41

Standard error of the ratio

a

0.13

0.08

a

0.11

0.10

Chinese Standardised risk ratio

0.75

0.73

[0.67]

0.56

0.46

0.75

Standard error of the ratio

0.13

0.15

[0.16]

0.15

0.14

0.18

Irish Standardised risk ratio

1.13

1.03

0.76

0.99

1.31

0.90

Standard error of the ratio

0.11

0.18

0.16

0.14

0.22

0.23

General population Standardised risk ratio

0.99

1.11

0.81

1.11

0.93

0.82

Standard error of the ratio

0.05

0.07

0.08

0.06

0.07

0.09

152 111 263 55 8 44 833 21844

115 89 241 117 39 36 398 11506

105 90 150 136 74 21 270 5635

156 123 305 56 9 52 1040 19490

188 114 287 134 44 34 568 14286

179 150 203 168 84 24 347 6523

123 103 158 47 19 105 207 1341

89 105 155 112 89 77 122 752

95 94 97 154 170 49 89 353

149 102 179 46 23 120 257 1471

163 122 173 135 101 74 163 1178

178 149 126 176 190 58 123 536

Observed % Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

Copyright © 2006, The Information Centre. All rights reserved

Standardised risk ratios

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 8: PHYSICAL ACTIVITY

a Results not shown because of small bases.

259

Table 8.7 Comparison of regular participation in any physical activity in 2004 and 1999, by age within minority ethnic groupa and sex Aged 16 and over

Black Caribbean 2004 1999 Indian 2004 1999 Pakistani 2004 1999 Bangladeshi 2004 1999 Chinese 2004 1999 Irish 2004 1999 General population 2004 1999 Bases (weighted) Black Caribbean 2004 Black Caribbean 1999 Indian 2004 Indian 1999 Pakistani 2004 Pakistani 1999 Bangladeshi 2004 Bangladeshi 1999 Chinese 2004 Chinese 1999 Irish 2004 Irish 1999 General population 2004 General population 1999 Bases (unweighted) Black Caribbean 2004 Black Caribbean 1999 Indian 2004 Indian 1999 Pakistani 2004 Pakistani 1999 Bangladeshi 2004 Bangladeshi 1999 Chinese 2004 Chinese 1999 Irish 2004 Irish 1999 General population 2004 General population 1999

260

2004 Age group

Men

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

83 83

78 73

34 43

66 66

72 66

63 70

43 41

61 61

65 70

60 62

32 33

56 59

65 61

60 55

21 22

55 51

61 67

50 50

12 27

49 56

56 55

44 53

26 15

48 51

58 57

43 38

[22] 15

49 43

38 41

29 27

8 8

32 35

70 71

57 46

50 32

62 52

55 56

58 52

33 36

53 51

89 75

73 69

47 48

67 65

79 78

72 64

54 42

67 62

80 81

74 69

49 43

68 64

72 68

71 65

43 38

61 57

140 213 325 223 205 324 91 266 74 107 412 130 14734 1047

194 134 384 257 151 203 65 141 50 134 678 239 16665 1313

143 189 192 129 64 80 21 109 27 62 686 151 14690 1215

477 536 901 609 420 606 177 516 151 303 1776 519 46089 3575

217 277 408 262 276 374 135 355 63 109 497 191 14649 1261

291 278 466 266 161 196 51 129 78 193 1038 297 16895 1590

164 181 193 113 62 51 21 56 22 53 833 183 17098 1398

673 736 1067 641 499 622 207 539 163 355 2369 671 48643 4249

120 211 200 229 222 326 210 273 172 108 114 135 737 1034

164 140 231 265 142 217 150 142 118 127 194 238 974 1300

125 191 118 126 65 77 48 116 58 65 189 162 1162 1218

409 542 549 620 429 620 408 531 348 300 497 535 2873 3552

198 281 240 267 279 383 309 361 148 109 149 203 914 1241

289 283 275 276 164 202 118 143 176 194 275 301 1372 1586

161 180 119 112 65 56 50 58 51 58 232 204 1532 1408

648 744 634 655 508 641 477 562 375 361 656 708 3818 4235

16-34

35-54

All 55+ women

a Black Africans were included in the

2004 survey but not in 1999, and are therefore excluded from this comparative table. b Participation for at least 30 minutes

a week on average, i.e. at least four sessions in the four weeks prior to interview.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 8: PHYSICAL ACTIVITY

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Regular paricipationb in moderate or vigorous vigorous activity in the four weeks prior to interview

Table 8.8 Comparison of the proportion meeting the physical activity recommendationsa in 2004 and 1999, by age within minority ethnic groupb and sex Aged 16 and over

2004

Percentage meeting the physical activity recommendations

Age group

Men

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Black Caribbean 2004 1999 Indian 2004 1999 Pakistani 2004 1999 Bangladeshi 2004 1999 Chinese 2004 1999 Irish 2004 1999 General population 2004 1999 Bases (weighted) Black Caribbean 2004 Black Caribbean 1999 Indian 2004 Indian 1999 Pakistani 2004 Pakistani 1999 Bangladeshi 2004 Bangladeshi 1999 Chinese 2004 Chinese 1999 Irish 2004 Irish 1999 General population 2004 General population 1999 Bases (unweighted) Black Caribbean 2004 Black Caribbean 1999 Indian 2004 Indian 1999 Pakistani 2004 Pakistani 1999 Bangladeshi 2004 Bangladeshi 1999 Chinese 2004 Chinese 1999 Irish 2004 Irish 1999 General population 2004 General population 1999

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

49 54

39 44

22 20

37 39

37 27

36 38

17 14

31 28

34 34

33 38

18 22

30 33

26 18

26 23

11 2

23 17

37 33

26 28

5 15

28 29

15 17

13 18

10 6

14 16

29 31

27 26

[9] 7

26 25

15 13

7 7

2 1

11 10

31 30

28 23

31 13

30 23

16 18

19 19

15 14

17 18

54 42

41 40

27 22

39 35

30 32

36 31

19 10

29 26

51 48

39 36

22 18

37 33

31 26

31 27

14 11

25 21

140 213 325 223 205 324 91 266 74 107 412 130 14734 1047

194 134 384 257 151 203 65 141 50 134 678 239 16665 1313

143 189 192 129 64 80 21 109 27 62 686 151 14690 1215

477 536 901 609 420 606 177 516 151 303 1776 519 46089 3575

217 277 408 262 276 374 135 355 63 109 497 191 14649 1261

291 278 466 266 161 196 51 129 78 193 1038 297 16895 1590

164 181 193 113 62 51 21 56 22 53 833 183 17098 1398

673 736 1067 641 499 622 207 539 163 355 2369 671 48643 4249

120 211 200 229 222 326 210 273 172 108 114 135 737 1034

164 140 231 265 142 217 150 142 118 127 194 238 974 1300

125 191 118 126 65 77 48 116 58 65 189 162 1162 1218

409 542 549 620 429 620 408 531 348 300 497 535 2873 3552

198 281 240 267 279 383 309 361 148 109 149 203 914 1241

289 283 275 276 164 202 118 143 176 194 275 301 1372 1586

161 180 119 112 65 56 50 58 51 58 232 204 1532 1408

648 744 634 655 508 641 477 562 375 361 656 708 3818 4235

16-34

35-54

All 55+ women

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 8: PHYSICAL ACTIVITY

a Participation in 30 minutes or more

of moderate to vigorous physical activity on at least 5 days a week. b Black Africans were included in the

2004 survey but not in 1999, and are therefore excluded from this comparative table.

261

Eating habits

9

Rachel Craig, Melanie Doyle and Dhriti Jotangia

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Summary ●

Over a third of Indian and Chinese men met the recommended guidelines of consuming five or more portions of fruit and vegetables a day (37% and 36%, respectively), and with the exception of Irish men, the proportion of men meeting the ‘5 a day’ guidelines was significantly higher among all minority ethnic groups than among men in the general population (23%).

●

Similarly to men, the proportion eating five or more portions of fruit and vegetables per day was highest among Chinese and Indian women (42% and 36%, respectively). Among the general population, a significantly higher proportion of women than men met the recommendation of consuming five or more portions of fruit and vegetables (27% and 23%, respectively).

●

Fat intake among men in the general population was greater than for all the minority ethnic groups, with a mean fat score of 24.3, and 72% having a low fat score. Irish men were the most similar to the general population, with a mean fat score of 23.5, and a low fat score among 77%. Indian, Chinese and Black African men had the lowest fat intakes (mean fat scores between 18.6 and 20.4, and 89%, 86% and 86%, respectively, with low fat scores).

●

Patterns of fat intake among women in the general population were different from men. The mean fat score, at 21.2, was significantly lower than the score for men in the general population, and 84% of women had low fat scores (compared with 72% of men). Irish women were the most similar to women in the general population (mean fat score 20.5), while women in all other minority ethnic groups apart from Pakistani women had lower fat scores. Indian and Black Caribbean women had the lowest mean fat scores (17.3, 17.9).

●

The pattern of salt use in cooking was similar for men and women. Use of salt in cooking was higher among men in minority ethnic groups (from 74% among Black African men to 95% among Bangladeshi men) than among of men in the general population (56%). Similarly more women in minority ethnic groups added salt to food during cooking (ranging from 69% among Black Caribbean women to 92% among Indian women) than did women in the general population (53%).The exception was the Irish group, with fewer using salt in cooking than in the general population (45% of men, 46% of women).

●

There were slight differences in salt use at the table, with men in the general population and Irish men more likely to report that they generally add salt without tasting (24% and 23%) than other groups (6% to 17%). Following the same pattern, more women in the general population and Irish women generally added salt without tasting (15% and 16%, respectively, compared with 5% to 12% among other groups). More Chinese and Black Caribbean men and women said they rarely or never add salt at the table (50% and 49%, respectively among men, 53% and 64% among women).

●

Between 1999 and 2004, there was a reduction in the proportion of men who used salt in cooking among those from Chinese and Irish backgrounds, though little change among other groups. The proportion of women who used salt in cooking decreased

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

263

slightly over the same period in all minority ethnic groups, with the greatest differences among Chinese, Irish, Black Caribbean and Pakistani women.

264

Salt use at the table also decreased between 1999 and 2004 among adults in most minority ethnic groups. The proportion of adults who add salt at the table decreased most markedly among Irish and Indian men and women, and among Pakistani men. There was little change in use of salt at the table among Bangladeshi and Black Caribbean groups.

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●

9.1 Introduction Diet and nutrition play a critical role in the prevention of many chronic diseases such as cardiovascular disease and its associated risk factors, and many forms of cancer. It is suggested that diets high in fat (particularly saturated fats) and salt and low in fruit and vegetables are likely to be associated with the increased risk of heart disease, stroke, obesity and some cancers.1,2 Strategies aimed at improving dietary habits therefore play a key part in reducing early deaths from these diseases. Evidence from the 1999 Health Survey suggests that eating habits vary between different minority ethnic groups.3 The latest government white paper: Choosing Health, sets out the objective of reducing health inequalities between disadvantaged groups such as those from socio-economically deprived backgrounds and those from minority ethnic groups.4 This chapter examines data from the Health Survey for England 2004 and looks at fruit and vegetable consumption and fat and salt intake. Fruit and vegetable consumption The introduction of the ‘5 a day’ programme in July 2000 was one of the government’s key strategies aimed at preventative health behaviour. The principal objective of the ‘5 a day’ initiative is to increase consumption levels of a variety of different fruits and vegetables to at least five portions (400g) per day. This is in accordance with dietary recommendations around the world, including those set out by the World Health Organisation (WHO).5 Health benefits of a diet rich in fruit and vegetables include improving bowel function and helping to manage diabetes.6 As well as promoting the health benefits of fruit and vegetable consumption, the ‘5 a day’ message also aims to raise awareness of, and access to, information about the advantages of eating a healthy well balanced diet among the population. A number of key initiatives have been introduced to increase awareness of the programme and motivate people to make healthier choices, such as the introduction of the ‘5 a day’ Logo, the National School Fruit Scheme and ‘5 a day’ community initiatives.7 Fat intake Levels of fat intake in the diet are also important, with high fat intake directly linked to obesity and associated health risks, while a diet with a low fat intake provides protective health benefits. Recommended upper limits for fat intake are expressed in terms of total energy intake. The WHO report (2003), recommended a total fat intake between 15% and 30%, with levels as high as 35% for selected groups. The current UK recommendation is that total fat intake should contribute no more than 35% of daily food energy intake. In 2003, the average daily intake of total fat for men (86.5g) represented 36% of total food energy intake, whilst average total fat intake for women (61.4g) represented 35% of total food energy intake.8 Evidence indicates that the traditional diets of Black Caribbean, Indian, Pakistani and Bangladeshi communities are more in line with the lower end of the recommendation (15%) of dietary fat intake than those of the white population.9,10

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Salt intake High salt intake has been linked to increased prevalence of high blood pressure, and reducing salt intake has been shown to benefit people with high blood pressure.11 The WHO have recommended that individuals limit their intake of dietary sodium from all sources to less than 5g per day and, in the UK, the Scientific Advisory Committee on Nutritions aim to reduce current intake among adults from 9g per day to 6g per day.12 Around three quarters of salt intake comes from processed foods.11 The Department of Health is working with the food industry to reduce the salt content of processed foods and to improve information on food labels.11 Other sources of salt are salt used in cooking and salt added to food at the table. The Food Standards Agency has recently launched a campaign to increase public awareness of the health risks associated with diets high in salt.13 HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

265

9.2 Methodology Fruit and vegetable consumption Informants aged five and over were asked questions about their daily fruit and vegetable consumption. These questions have been included in the Health Survey series since 2001, and are administered via Computer Assisted Personal Interviewing (CAPI). The module is designed to collect information on and monitor consumption in line with the ‘5 a day’ programme. Questions examine levels of consumption on the day before the interview, which was defined as 24 hours from midnight to midnight. This 24-hour period was used to ensure that variations in informants’ meal times and work patterns did not affect the measure of daily consumption reported. Portion size Fruit and vegetable consumption in the Health Survey series has been examined using the guidelines specified in the ‘5 a day’ programme. Five portions are defined as 400g of fruit and vegetables per day (an average portion is 80g). A variety of different foodstuffs represents a portion, including vegetables (fresh, frozen, canned), vegetables in composite dishes, salads, pulses, fruit (fresh, frozen, canned, dried), fruit in composites and fruit juice. In order to aid informants to report on how much of the different food items they had consumed, portion sizes were converted into everyday measures. For example, informants were asked how many tablespoons of vegetables, cereal bowlsful of salad, pieces of medium sized fruit (such as apples), or handfuls of small fruit (such as berries) they had eaten in the previous 24 hours. The table below illustrates the portion sizes defined for each of the different food items included in the analysis. Food item Vegetables (fresh, raw, tinned and frozen) Pulses Salad Vegetables in composites, such as vegetable curry Very large fruit, such as melon Large fruit, such as grapefruit Medium fruit, such as apples Small fruit, such as plums Very small fruit, such as blackberries Dried fruit Frozen fruit/canned fruit Fruit in composites, such as stewed fruit Fruit juice

Portion size 3 tablespoons 3 tablespoons 1 cereal bowl 3 tablespoons 1 average slice Half a fruit 1 fruit 2 fruits 1 handful 1 tablespoon 3 tablespoons 3 tablespoons 1 small glass (150 ml)

The ‘5 a day’ policy clearly advises which food items count towards the recommendation; these guidelines were incorporated within questions asked of informants, so for example questions about vegetable consumption specified the exclusion of potatoes. Additionally, fruit juice, pulses and dried fruit were counted as one portion, regardless of how much had been consumed in a given day. Interpretation of data Data collected on fruit and vegetable consumption are based on self-reported information collected during a 24-hour period. Every attempt has been made to ensure that informants report an accurate picture of consumption levels through identifying portions in everyday measures. However, survey estimates can be sensitive to under or over-reporting, and the data may be prone to variations in the way questions are interpreted by informants, for instance in assessing the amount of fruit contained in foods such as apple pie. Selfreported data are also susceptible to social desirability biases and difficulties with recall. Nevertheless, survey estimates can still provide useful comparisons of consumption patterns of the population. 266

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

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9.2.1

Within specific groups, mean consumption may also be increased by a small number of informants eating a large amount of fruit and vegetables. Median consumption is shown, where appropriate, to give an indication of the mid-range value as an alternative measure that is not influenced by extreme values. Both observed results and age-standardised risk ratios are shown where data are not analysed in separate age groups. Age-standardised risk ratios are used to take account of differences in the age profile of different minority ethnic groups (see Chapter 1). 9.2.2

Fat intake Questions used to assess intake of saturated fats were administered in self-completion format to those aged 16 and over. These were administered during the nurse visit so the sample size is smaller than for the fruit and vegetable data. Informants in the general population were not offered a nurse visit in 2004, so data for minority ethnic groups are compared with that for the 2003 general population sample. The questions were based on those introduced in HSE 1998. These were derived from the Dietary Instrument for Nutritional Education (DINE) questionnaire, developed by the Imperial Cancer Research Fund’s General Practice Research Group.14 The DINE questionnaire is a weighted food frequency questionnaire designed to assess fat and fibre intake. Fat and fibre consumption is based on the 19 key food groups which together account for 70% of the fat and fibre in a typical UK diet (according to the National Food Survey15) as well as types of spreads and cooking fats used. The 2003 and 2004 self-completion questionnaire included questions about fat consumption, but excluded those on fibre consumption. Informants were asked how often, on average, they consumed foods such as cheese, white meat, red meat, fried foods, snacks and cakes, and the type and amount of milk and spreads consumed in an average day. Fat scores were based on frequency of consumption of these foods and the fat content of a standard portion.16 Scores were grouped into three categories: low intake (less than 30), medium intake (30-40) and high intake (more than 40). A total fat score of less than 30 (low intake) represents a fat intake of 83g/day or less, whilst a fat score of more than 40 represents a fat intake greater than 122g/day. Mean fat scores were also calculated in 1999, with an adjustment for energy requirement, but the method for deriving the scores was different from that used in 2004, and it is therefore not possible to compare results from the two years.

9.2.3

Salt intake

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Adults aged 16 and over were asked about their use of salt in cooking and at the table. The questions were also included in the self-completion questionnaire administered by the nurse. While objective measures, such as sodium content in urine, are more appropriate for assessing total salt intake, self-report data may be used to assess the extent to which informants add salt to their food. Informants in the general population were not offered a nurse visit in 2004, so data for minority ethnic groups are compared with that for the 2003 general population sample.

9.3 Fruit and vegetable consumption 9.3.1

Fruit and vegetable consumption by minority ethnic group Consumption among men Among men, 23% of the general population met the recommended guidelines of consuming five or more portions of fruit and vegetables a day. With the exception of Irish men, the proportion of men meeting the guidelines was significantly higher among all minority ethnic groups. Over a third of Indian and Chinese men met the ‘5 a day’ recommendation (37% and 36%, respectively), and among other minority ethnic groups the HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

267

proportion consuming five or more portions ranged from 26% among Irish men to 33% among Pakistani men. Similar patterns were found in the mean number of portions consumed, with men in minority ethnic groups consuming, on average, more portions than men in the general population (3.3 portions). Mean daily fruit and vegetable consumption was highest among Chinese and Pakistani men (4.4 and 4.3 portions per day, respectively). Proportion of men consuming 5 or more portions of fruit and vegetables per day Black Caribbean Men Observed % Standardised risk ratio Mean portions

Black African

Indian

32

31

37

33

1.40 3.9

1.40 3.7

1.64 4.2

1.47 4.3

Chinese

Irish

General population

32

36

26

23

1.48 3.8

1.66 4.4

1.14 3.6

1 3.3

Pakistani Bangladeshi

These differences remained after adjusting for age profiles within the minority ethnic groups. Chinese and Indian men were 1.66 and 1.64 times more likely to consume at least five portions of fruit and vegetables per day than men in the general population. With the exception of Irish men, all minority ethnic groups were more likely to consume the recommended five portions a day than men in the general population. In the general population, and in most minority ethnic groups, fruit and vegetable consumption among men tended to increase with age and this was most marked among Black Caribbean, Black African and Indian men. The exception was Bangladeshi men, where the proportion meeting the ‘5 a day’ recommendations did not vary much by age. Tables 9.1, 9.2, Figure 9A

Figure 9A Consumption of five portions or more, by minority ethnic group Women

Men 10.0

2.0

2.0

1.0

1.0

0.5

0.5

0.10

0.10

Risk ratio, logarithmic scale

10.0

h

s Iri

se i ne sh

hi

C

i

de la

an

st

ng

an

be

an

ric

ib

ar

Af

C

an

ki

Ba

Pa

di In

k ac

k ac

Bl

Bl

h

s Iri

se i ne sh

hi

C

i

de la

an

st

ng

an

be

an

ric

ib

ar

Af

C

an

ki

Ba

Pa

di In

k ac

k ac

Bl

Bl

Consumption among women In the general population, a significantly higher proportion of women than men met the ‘5 a day’ recommendation of consuming five or more portions of fruit and vegetables per day (27% and 23%, respectively). Similarly to men, the proportion eating five or more portions was higher among Chinese and Indian women (42% and 36%, respectively) than the general population. Mean daily fruit and vegetable consumption was highest among Chinese and Indian women (4.9 and 4.4 portions per day, respectively). Bangladeshi women and women in the general population had lower mean levels of daily consumption (both 3.6 portions). The age-adjusted risk ratios showed that Chinese women differed the most from the 268

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

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General population = 1.0. Error bars indicate 95% confidence limits.

general population in being likely to consume the recommended five portions a day (risk ratio: 1.65). Black African, Indian, Chinese and Irish women all had significantly higher risk ratios than the general population. Proportion of women consuming 5 or more portions of fruit and vegetables per day Black Caribbean Women Observed % Standardised risk ratio Mean portions

Black African

Indian

31

32

36

32

1.16 3.9

1.23 3.8

1.37 4.4

1.19 4.0

Chinese

Irish

General population

28

42

32

27

1.00 3.6

1.65 4.9

1.24 3.9

1 3.6

Pakistani Bangladeshi

As with men, women in the oldest age group (55 and over) tended to consume the most fruit and vegetables, although this pattern was not apparent among women of Irish or Bangladeshi origin. The increase in consumption of fruit and vegetables with age was most marked among Indian women. In most minority ethnic groups the proportion of adults meeting the guidelines was similar for men and women. The exception was the Irish group, where the proportion reporting consuming five or more portions per day was significantly higher among women than men (32% and 26%, respectively). Tables 9.1, 9.2, Figure 9B Figure 9B Mean fruit and vegetable consumption, by minority ethnic group and sex

Men Women

Mean portions consumed per day

6 5 4

3 2

1 0 sh

e

i

sh de

la ng

i an

s ne hi

Iri

C

Ba

st

ki

Pa

an

di In

k ac Bl can ri

Af

k n ac ea Bl ibb ar

C

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9.3.2

Fruit and vegetable consumption by equivalised household income Equivalised household income is a measure of household income that takes account of the number of persons in the household. Among the general population, a clear relationship was found between equivalised household income and fruit and vegetable consumption. Men and women in the highest income tertile were most likely to meet the recommended guidelines of consuming five or more portions per day (26% and 33%, respectively), while those in the middle and lowest income tertiles were less likely to do so (17% and 20%, respectively among men, 22% and 17%, respectively among women). The same pattern was marked among men and women of Black Caribbean origin: 41% of men and 42% of women in the highest income tertile met the daily guidelines of consuming five portions a day, compared with 27% of men and 20% of women in the lowest income tertile. This pattern was also evident among women of Pakistani and Irish origin: 44% and 41% consumed at least five portions in the highest income tertile, compared with 26% and 13%, respectively, in the lowest income tertile. There were no significant associations between equivalised household income and fruit and vegetable consumption in the other minority ethnic groups. Table 9.3 HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

269

Type of fruit and vegetables consumed by minority ethnic group Informants were asked about their consumption of individual food items in the previous 24 hours. This included questions about the consumption of vegetables (fresh, raw, tinned and frozen), vegetables in composites, salads, pulses, fresh fruit, dried fruit, fruit in composites and fruit juice. Summary measures were created to take into account total consumption of fruit and vegetables (including portions or parts of portions). These summary measures included total fruit and vegetable consumption, total vegetable and salad consumption (including fresh, raw, tinned and frozen vegetables and vegetables in composites and salad) and total fruit consumption (including fresh, frozen and tinned fruit and fruit in composites). Table 9.4 shows the proportion of adults consuming the individual food items, table 9.5 shows consumption levels by age, and table 9.6 shows the mean number of portions consumed for each individual food item. Vegetable consumption among men In the general population 67% of men had consumed fresh, raw, tinned or frozen vegetables, vegetables in composites or salad in the previous 24 hours. In all minority ethnic groups apart from the Irish, two thirds or more men had eaten these types of vegetables, with the highest consumption among Chinese and Bangladeshi groups (86% and 82%, respectively) and lowest among Irish men (64%). Fresh, raw, tinned and frozen varieties of vegetables were consumed by over half of men. Vegetables in composites were less commonly eaten by men than other types of vegetables (ranging from 5% among Irish men to 38% among Bangladeshi men). Chinese and Pakistani men were more likely to report eating fresh, raw, tinned and frozen vegetables than men in all other minority ethnic groups and the general population (ranging from 51% among Irish men and 52% among the general population, to 78% among Chinese men). The mean number of portions of vegetables and salad eaten the previous day was highest among Chinese and Indian men (both 2.2 portions per day), and Chinese men also consumed more portions of vegetables i.e. fresh, raw, tinned and frozen varieties (1.6 portions per day) than all other minority ethnic groups (0.5-0.8 portions per day) and the general population (0.7 portions per day). The proportion consuming pulses was higher among men of Indian origin (55%) than other minority ethnic groups. A lower proportion of Chinese men consumed pulses (23%) than other minority ethnic groups and the general population (34%). Fruit consumption among men Among men in the general population, 64% had consumed fresh, frozen and tinned fruit and fruit in composites in the last 24 hours. Consumption of any type of fruit was higher among Chinese and Pakistani men (both 73%) than other minority ethnic groups and the general population. The mean daily number of portions of fruit consumed was also highest among Pakistani men (2.5 portions per day, compared with 2.0 – 2.3 portions among other minority ethnic groups and 1.9 among the general population). Fresh fruit was eaten by at least 60% of all minority ethnic groups. A higher proportion of Chinese men (70%) consumed fresh fruit than men in Black Caribbean, Black African and Irish groups (60-62%), and men in the general population (58%). Fresh fruit consumption was significantly lower among men in the general population (58%) than among Pakistani, Bangladeshi and Chinese men. Frozen fruit was the least commonly consumed (ranging from 1% among Indian men to 6% among Irish men). Fruit juice consumption was highest among Black African and Black Caribbean men (58% and 57%). Lower levels of fruit juice consumption were found in Irish and Chinese men (37% and 38%) than other minority ethnic groups and the general population (41%). Tables 9.4, 9.5, 9.6

270

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

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9.3.3

Vegetable consumption among women Patterns of consumption of fruit and vegetables were broadly similar between men and women. In the general population 74% of women had eaten fresh, raw, tinned or frozen vegetables, vegetables in composites or salad in the previous 24 hours. At a slightly higher level than men, 70% or more of women in all minority ethnic groups had eaten any vegetables. Mean portions of total vegetables consumed were highest among women of Chinese origin (2.4 portions per day), and Chinese women ate more portions of vegetables (1.6 portions per day) i.e. fresh, raw, tinned and frozen varieties, than other minority ethnic groups. Fresh, raw, tinned and frozen types of vegetables were eaten by more than half of women, apart from Pakistani women who had the lowest levels of consumption (43%). A higher proportion of Chinese women (82%) consumed fresh, raw, tinned and frozen vegetables than all other minority ethnic groups (43%-62%) and the general population (56%). Vegetables in composites were the least commonly consumed (ranging from 7% among women in the general population to 35% among Bangladeshi women). Similarly to men, the proportion of women who had eaten pulses was significantly higher among informants of Indian origin (54%) than other minority groups (24%-42%) and the general population (30%). As with men, the lowest levels of consumption were found among women of Chinese origin (24%). Fruit consumption among women Fresh fruit was the most common form of fruit eaten, by about two thirds of women in each group. Within minority ethnic groups a higher proportion of Chinese women (83%) ate fresh fruit (2.0 portions per day) than other minority ethnic groups and the general population. Among informants of Chinese origin, the consumption of fresh fruit was higher among women than men (83% and 70%, respectively). This difference between the sexes was not significant for other minority ethnic groups and the general population. Black African women consumed more fruit juice (62%) than other minority ethnic groups. Lowest levels of consumption were found in Chinese women (36%). Tables 9.4, 9.5, 9.6 Variations in consumption by age Levels of vegetable consumption increased with age among men and women in the general population and of Black Caribbean origin, and among men of Chinese, Pakistani and Irish origin. Fruit consumption increased with age among men and women in most of the minority ethnic groups, though not among Black African, Pakistani and Bangladeshi women. Table 9.5

9.4 Fat intake

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9.4.1

Fat intake by minority ethnic group As a measure of fat intake, mean fat scores have been calculated, based on consumption of certain foods, as described in section 9.2.2, and this measure is used to compare groups of informants. Informants were also classified as having low, medium and high fat scores. The general population data are taken from the 2003 survey, since these questions were included in the 2004 survey only for informants from minority ethnic groups. Fat intake among men Fat intake among men in the general population was greater than for all the minority ethnic groups, with a mean fat score of 24.3, and 72% having a low fat score, 22% a medium fat score and 6% a high fat score. Irish men were the most similar to the general population, with a mean fat score of 23.5, and a low fat score among 77%. Indian, Chinese and Black African men had the lowest fat intakes (mean fat scores between 18.6 and 20.4, and 89%, 86% and 86%, respectively, with low fat scores). Age-adjusted risk ratios confirmed these differences. HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

271

Fat intake among women Patterns of fat intake among women in the general population were different from men. The mean fat score, at 21.2, was significantly lower than the score for men in the general population, and 84% of women had low fat scores (compared with 72% of men). Comparing mean fat scores among women in the general population with those in minority ethnic groups, Irish women were the most similar (mean fat score 20.5), while women in all other groups had lower fat scores. Indian and Black Caribbean women had the lowest mean fat scores (17.3, 17.9). Risk ratios, adjusting for the different age profiles among each minority ethnic group, confirmed that Indian and Black Caribbean women had low risk ratios compared with the general population (0.81 and 0.84, respectively), and that those with Bangladeshi backgrounds also had a low fat intake compared with the general population (0.84). The difference in fat intake between men and women in the general population was also apparent among the Black Caribbean, Bangladeshi and Irish groups, with lower mean fat scores, and greater proportions with a low fat intake among women than men. However, there was very little difference in mean fat score among Black African, Indian, Pakistani and Chinese men and women. Table 9.7 Variations in fat intake by age Mean fat scores were highest among informants aged 16-34 both among the general population and among all the minority ethnic groups. Among men in the general population, there was a significant decrease in fat score between those aged 16-34 and those aged 3554 (26.1 to 23.9) and a further but smaller decrease in fat score among those aged 55 and over (to 23.1). There was the same pattern among men and women with Black Caribbean and Indian backgrounds and Irish men, where sample sizes were sufficient to provide data for those aged 55 and over. Among women in the general population, the difference between the fat scores for those aged 16-34 and 35-54 was less marked (22.0 and 20.6) than among men, and there was little difference between those aged 35-54 and 55 and over. Similarly there was little difference by age among Irish women. Table 9.8 Comparisons between 1999 and 2004 are not possible for mean fat scores, since adjustments for energy requirement were made in 1999, and the scores were calculated differently.

9.5 Use of salt in cooking and at the table Use of salt, by minority ethnic group Use of salt among men 56% of men in the general population reported that they added salt to food in cooking. Compared with the general population, use of salt in cooking was higher among men in minority ethnic groups (from 74% among Black African men to 95% among Bangladeshi men). The exception was Irish men, where a smaller proportion of men used salt in cooking (45%), although they were more likely than most groups to add salt at the table without tasting the food first. Thus there were slight differences in salt use at the table, with men in the general population and Irish men more likely to report that they generally add salt without tasting (24% and 23%) than other groups (6% to 15%) apart from Bangladeshi men. More Chinese and Black Caribbean men said that they rarely or never add salt at the table (50% and 49%, respectively, compared with 38% of the general population). Use of salt among women A similar pattern of salt use in cooking was observed for women. The prevalence of salt use in cooking was higher for women in minority ethnic groups (ranging from 69% among Black Caribbean women to 92% among Indian women) than for women in the general population (53%). Irish women were again the exception, with fewer using salt in cooking than in the general population (46%). Use of salt at the table also followed a similar pattern to men, 272

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9.5.1

with more women in the general population and Irish women generally adding salt without tasting (15% and 16%, respectively) than Black Caribbean, Black African, Indian or Chinese women (5% to 9% ), and more Black Caribbean and Chinese women rarely or never adding salt (64% and 53%, respectively). Table 9.10 Variations in salt use with age Table 9.11 shows use of salt in cooking and at the table by age within minority ethnic group. It is not possible to comment on the pattern of results for men and women aged 55 and over due to the small base sizes in most minority ethnic groups. Among men in the general population, the use of salt in cooking was more common among those aged 55 and over than among other age groups (60%, compared with 56% among men aged 16-34, and 52% among men aged 35-54). There were varying levels of use of salt in cooking across the different minority ethnic groups, as noted above, but little variation according to age within the minority ethnic groups. Salt use in cooking showed more variation by age among women. Mirroring the pattern for men in the general population, more women in the general population aged 55 and over reported using salt in cooking than younger women (60% of those aged 55 and over, 50% among women aged 16-34 and 35-54). A similar pattern was observed for Irish women. There were significant differences in using salt in cooking between those aged 16-34 and 35-54 among both Black Caribbean women (61% and 75%, respectively) and Bangladeshi women (87% and 97%). There was higher prevalence of using salt in cooking among Chinese women aged 16-34 than those aged 35-54 (84% and 69%, respectively). Use of salt at the table showed little variation across age groups among men in the general population and there was similarly little variation by age in most of the ethnic minority groups. Among Black Caribbean, Black African and Bangladeshi men, there was a consistent, though not statistically significant difference in salt use at the table between those aged 16-34 and 35-54: more of the younger than older informants reported that they tasted food and occasionally added salt, while more of the older group than the younger group reported that they rarely or never added salt at the table. This pattern was also apparent among Black Caribbean and Black African and women, and in these instances significantly more of those aged 35-54 than those aged 16-34 reported that they rarely or never used salt at the table. Table 9.11 9.5.2

Comparison of salt use in 1999 and 2004 Table 9.12 shows use of salt in cooking and at the table by age within minority ethnic group, in 1999 and 2004. Comparative data for general population or for Black African informants are not available on this topic for 1999, so data for these groups are not shown. The inset table below shows the proportion of men and women who reported using salt in cooking, in 1999 and 2004.

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Between 1999 and 2004, there was a reduction in the proportion of men who used salt in cooking among those from Chinese and Irish backgrounds, though little change among other groups. The proportion of women who used salt in cooking decreased slightly over the same period in all minority ethnic groups, with the greatest differences among Chinese, Irish, Black Caribbean and Pakistani women. Use of salt in cooking in 2004 and 1999, by sex Black Caribbean

Indian

77 83

93 95

93 96

69 81

92 97

88 97

Pakistani Bangladeshi

Chinese

Irish

95 97

82 94

45 66

91 98

75 94

46 59

Men 2004 1999 Women 2004 1999

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273

Salt use at the table also decreased between 1999 and 2004 among adults in most minority ethnic groups. There were marked changes in the balance between the proportion of adults who add salt to food at the table, or rarely or never add salt. The inset table below shows the proportion of men and women who add salt to food at the table, whether generally without tasting, or generally or occasionally after tasting. Between 1999 and 2004, the proportion of adults who add salt at the table decreased among Irish and Indian men and women, and among Pakistani men. There was little change in use of salt at the table among Bangladeshi and Black Caribbean groups. Use of salt at the table in 2004 and 1999, by sex

Men 2004 1999 Women 2004 1999

Black Caribbean

Indian

51 49

53 64

53 64

36 37

50 59

54 59

Pakistani Bangladeshi

Chinese

Irish

61 59

50 56

57 73

62 58

47 56

55 66

Although use of salt in cooking was already lower among Irish informants than among other minority ethnic groups in 1999, it is among the Irish community that there has been the most marked decrease in use, both in cooking and at the table, between 1999 and 2004. Among the minority ethnic groups who were most likely to use salt in 1999, there is some evidence of reduced use of salt in 2004, either in cooking (among Pakistani and Chinese women), or at the table (among Indian men and women, and Pakistani men). There appears to have been little change among the Bangladeshi group, where use of salt in cooking remained consistently high between 1999 and 2004. Table 9.12 Use of salt by equivalised household income Among the general population, for both men and women, those in the lower tertile for equivalised household income were the most likely to add salt during cooking, but there was little variation across the tertiles in patterns of salt use at the table. There was a similar pattern among Irish men and women for salt in cooking, and among this group there was also a difference for table use, with more in the highest income tertile reporting that they rarely or never used salt at the table (44% of men, 54% of women), than in the lowest tertile (29% of men, 37% of women). Salt use in cooking was more likely among Black Caribbean women in the lowest income tertile than the highest (77% and 62%, respectively), and fewer Black African women in the lowest tertile rarely or never used salt at the table compared with those in the highest tertile (34% and 58%, respectively). Among Indian men and women, there was no comparable gradient of salt use across the income groups. It is not possible to comment on other minority ethnic groups due to small base sizes. Table 9.13

References and notes 1 For information about the ‘5 a day’ programme see the Department of Health website: http://www.dh.gov.uk/PolicyAndGuidance/HealthAndSocialCareTopics/FiveADay/fs/en 2 Nutritional Aspects of Cardiovascular Disease. Department of Health. 1994. London: HMSO. 3 Primatesta P and Sproston K (eds). The Health Survey for England 1999. The Stationery Office, London, 2000. 4 Choosing Health: making healthier choices easier. Department of Health, 2004. (For further information see: http://www.dh.gov.uk/assetRoot/04/12/07/92/04120792.pdf). 5 World Health Organisation Diet, Nutrition and the prevention of Chronic Diseases: Report of a joint WHO/FAO expert consultation. WHO Technical Report Series, Geneva, Switzerland, 2003; 916 6 For information about the ‘5 a day’ programme see the department of Health website: http://www.dh.gov.uk/PolicyAndGuidance/HealthAndSocialCareTopics/FiveADay/fs/en 7 Choosing Health? Resource pack. Department of Health, 2004. (For further information, see: http:/www.dh.gov.uk/assetRoot/04/07/60/76/04076076.pdf).

274

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9.5.3

8 Henderson L, Gregory J, Irving K, Swann G. The National Diet and Nutrition Survey: Adults aged 19 to 64 years. Volume 2: Energy, protein, carbohydrate, fat and alcohol intake. The Stationery Office, London, 2003. 9 Hill SE. More than Rice and Peas: Guidelines to improve food provision for black and ethnic minorities in Britain. The Food Commision, 1990. 10 Jarvis M. Different but not unhealthy. Health Service Journal p1105, 1986. 11 Hooper L, Bartlett C, Davey Smith G, Ebrahim S. Systematic review of long term effects of advice to reduce dietary salt in adults. British Medical Journal, 2002, 325:628 12 Salt and Health. Food Standards Agency, 2003. See Food Standards Agency website for further information: http://www.food.gov.uk/healthiereating/dailydiet/salt/ 13 The Food Standards Agency campaign, featuring 'Sid' the slug, was launched on 13 September, 2004. For further information see: http://www.salt.gov.uk/ 14 Roe L, Strong C, Whiteside C, Neil A, Mant D. Dietary intervention in primary care: Validity of the DINE method for assessment. Family Pract., 1994; 11: 375-381. 15 The Ministry of Agriculture Fisheries and Food (MAFF). Household food consumption and expenditure. Annual Report of the National Food Survey Committee. The Stationery Office, London, 1998.

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16 In 2004, fat scores were derived in a different way from 1999 so direct comparisons between 2004 and 1999 data are not possible.

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275

Tables

9.1 Fruit and vegetable consumption, by minority ethnic group and sex 9.2 Fruit and vegetable consumption, by age within minority ethnic group and sex 9.3 Fruit and vegetable consumption, by equivalised household income tertile within minority ethnic group and sex 9.4 Type of fruit and vegetable consumption, by minority ethnic group and sex 9.5 Type of fruit and vegetable consumption, by age within minority ethnic group and sex 9.6 Mean fruit and vegetable consumption, by food item, minority ethnic group and sex 9.7 Fat intake, by minority ethnic group and sex 9.8 Fat intake, by age within minority ethnic group and sex 9.9 Fat intake, by equivalised household income tertile within minority ethnic group and sex 9.10 Use of salt, by minority ethnic group and sex 9.11 Use of salt, by age within minority ethnic group and sex 9.12 Comparison of salt use, in 2004 and 1999, by age within minority ethnic group and sex

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9.13 Use of salt, by equivalised household income tertile within minority ethnic group and sex

Table 9.1 Fruit and vegetable consumption, by minority ethnic group and sex Aged 16 and over Portions per day

2004 Minority ethnic group Black Caribbean

General population

Black African

Indian

8 2

8 3

4 2

4 3

16

16

13

16

16

14

Pakistani Bangladeshi

Chinese

Irish

6 2

3 3

11 3

8 4

13

14

9

18

16

15

14

17

15

14

19

13

15

15

14

19

15

16

12 32 3.9

14 31 3.7

14 37 4.2

17 33 4.3

17 32 3.8

13 36 4.4

14 26 3.6

14 23 3.3

0.19

0.18

0.18

0.19

0.19

0.21

0.18

0.05

3.3

3.3

4.0

4.0

3.7

3.8

3.0

3.0

Standardised risk ratios Consumed 5 or more portions

1.40

1.40

1.64

1.47

1.48

1.66

1.14

1

Standard error of risk ratio

0.16

0.16

0.15

0.14

0.20

0.16

0.13

7 1

5 2

3 1

4 4

5 5

1 1

5 3

6 3

17

18

9

13

14

10

15

16

18

14

19

17

18

13

17

18

13

14

17

14

17

15

17

16

13 31 3.9

15 32 3.8

15 36 4.4

16 32 4.0

13 28 3.6

17 42 4.9

11 32 3.9

14 27 3.6

0.14

Men Observed % None Less than 1 portion 1 portion or more but less than 2 portions 2 portions or more but less than 3 portions 3 portions or more but less than 4 portions 4 portions or more but less than 5 portions 5 portions or more Mean portions consumed Standard error of the mean

Median

Women Observed % None Less than 1 portion 1 portion or more but less than 2 portions 2 portions or more but less than 3 portions 3 portions or more but less than 4 portions 4 portions or more but less than 5 portions 5 portions or more Mean portions consumed

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Standard error of the mean

0.12

0.15

0.16

0.15

0.19

0.12

0.05

Median Standardised risk ratios Consumed 5 or more portions

3.3

3.7

4.0

3.7

3.2

4.3

3.5

3.3

1.16

1.23

1.37

1.19

1.00

1.65

1.24

1

Standard error of risk ratio

0.09

0.11

0.11

0.11

0.13

0.13

0.12

479 675

377 476

903 1067

422 499

178 208

151 163

1776 2369

46178 48719

412 652

390 469

550 634

432 508

411 478

348 375

497 656

2878 3825

Bases (weighted) Men Women Bases (unweighted) Men Women

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277

Table 9.2 Fruit and vegetable consumption, by age within minority ethnic group and sex Aged 16 and over

2004 Age group

Men

Black Caribbean None Less than 1 portion 1 portion or more but less than 2 portions 2 portions or more but less than 3 portions 3 portions or more but less than 4 portions 4 portions or more but less than 5 portions 5 portions or more Mean portions consumed Standard error of the mean

Median Black African None Less than 1 portion 1 portion or more but less than 2 portions 2 portions or more but less than 3 portions 3 portions or more but less than 4 portions 4 portions or more but less than 5 portions 5 portions or more Mean portions consumed Standard error of the mean

Median Indian None Less than 1 portion 1 portion or more but less than 2 portions 2 portions or more but less than 3 portions 3 portions or more but less than 4 portions 4 portions or more but less than 5 portions 5 portions or more Mean portions consumed Standard error of the mean

Median Pakistani None Less than 1 portion 1 portion or more but less than 2 portions 2 portions or more but less than 3 portions 3 portions or more but less than 4 portions 4 portions or more but less than 5 portions 5 portions or more Mean portions consumed Standard error of the mean

Median

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

10 3 19 21 15 12 20 3.2

7 1 18 14 15 12 33 3.9

6 2 9 13 13 14 44 4.4

8 2 16 16 14 12 32 3.9

11 2 21 22 13 10 21 3.2

5 1 18 16 13 13 35 4.1

5 1 11 14 14 18 37 4.3

7 1 17 18 13 13 31 3.9

0.33

0.28

0.29

0.19

0.25

0.20

0.25

0.14

2.7

3.3

4.0

3.3

2.3

3.7

4.0

3.3

11 4 19 14 15 14 23 3.1

4 3 15 17 12 14 35 4.0

[5] [2] [6] [17] [6] [16] [49] [4.9]

8 3 16 16 13 14 31 3.7

7 2 18 15 14 15 29 3.5

3 1 16 14 16 15 35 4.0

[-] [-] [21] [17] [3] [20] [38] [3.9]

5 2 18 14 14 15 32 3.8

0.25

0.21

[0.59]

0.18

0.17

0.19

[0.41]

0.12

3.0

3.7

[4.7]

3.3

3.5

4.0

[4.0]

3.7

5 2 15 16 15 17 30 3.8

4 2 12 17 14 12 39 4.4

5 2 12 8 15 13 45 4.7

4 2 13 15 15 14 37 4.2

4 1 12 20 17 17 28 4.0

2 1 7 19 21 13 37 4.6

2 4 6 15 9 14 50 4.7

3 1 9 19 17 15 36 4.4

0.19

0.26

0.32

0.18

0.22

0.22

0.23

0.15

3.7

4.0

4.4

4.0

3.5

3.8

4.9

4.0

6 4 18 11 18 14 29 3.9

2 2 12 18 13 17 37 4.4

3 4 2 18 8 26 40 5.1

4 3 13 14 15 17 33 4.3

3 4 17 16 13 14 33 4.0

5 4 9 19 16 18 30 3.9

2 2 8 18 18 21 32 4.1

4 4 13 17 14 16 32 4.0

0.24

0.25

0.47

0.19

0.20

0.22

0.36

0.16

3.5

4.0

4.2

4.0

3.7

3.7

4.1

3.7

16-34

35-54

All 55+ women

Continued…

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Portions per day

Table 9.2 continued Aged 16 and over

2004

Portions per day

Age group

Men

Bangladeshi None Less than 1 portion 1 portion or more but less than 2 portions 2 portions or more but less than 3 portions 3 portions or more but less than 4 portions 4 portions or more but less than 5 portions 5 portions or more Mean portions consumed Standard error of the mean

Median Chinese None Less than 1 portion 1 portion or more but less than 2 portions 2 portions or more but less than 3 portions 3 portions or more but less than 4 portions 4 portions or more but less than 5 portions 5 portions or more Mean portions consumed Standard error of the mean

Median Irish None Less than 1 portion 1 portion or more but less than 2 portions 2 portions or more but less than 3 portions 3 portions or more but less than 4 portions 4 portions or more but less than 5 portions 5 portions or more Mean portions consumed

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Standard error of the mean

Median General population None Less than 1 portion 1 portion or more but less than 2 portions 2 portions or more but less than 3 portions 3 portions or more but less than 4 portions 4 portions or more but less than 5 portions 5 portions or more Mean portions consumed Standard error of the mean

Median

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

5 3 15 18 10 14 36 3.9

5 3 14 13 19 19 26 3.7

[8] [-] [6] [21] [15] [19] [30] [3.8]

6 2 14 17 14 17 32 3.8

4 5 14 20 17 11 29 3.6

5 3 13 16 15 21 27 3.7

8 9 15 12 23 12 21 3.2

5 5 14 18 17 13 28 3.6

0.22

0.22

[0.30]

0.19

0.17

0.21

0.35

0.15

3.9

3.6

[4.0]

3.7

3.0

3.7

3.0

3.2

5 5 14 16 18 7 34 4.0

3 3 6 14 20 20 34 4.4

2 15 21 17 45 5.6

3 3 9 15 19 13 36 4.4

2 1 13 13 14 16 40 4.7

1 6 13 19 18 43 5.0

6 13 12 3 18 48 4.7

1 1 10 13 15 17 42 4.9

0.26

0.22

0.73

0.21

0.27

0.22

0.40

0.19

3.3

4.0

4.6

3.8

4.3

4.3

4.7

4.3

15 2 29 13 6 9 25 3.2

13 3 13 12 19 19 21 3.4

6 3 15 16 16 13 32 4.1

11 3 18 14 15 14 26 3.6

7 1 17 15 16 10 33 3.7

4 2 14 19 17 14 30 3.9

5 5 13 17 18 8 34 3.9

5 3 15 17 17 11 32 3.9

0.48

0.22

0.30

0.18

0.29

0.18

0.21

0.12

2.0

3.2

3.3

3.0

3.7

3.5

3.5

3.5

12 4 20 20 13 12 18 2.9

8 4 16 20 17 14 22 3.3

4 4 13 17 18 15 29 3.8

8 4 16 19 16 14 23 3.3

10 3 19 20 13 13 21 3.1

5 2 16 16 18 14 29 3.8

3 3 14 18 18 16 30 3.8

6 3 16 18 16 14 27 3.6

0.08

0.09

0.08

0.05

0.09

0.07

0.06

0.05

2.3

3.0

3.5

3.0

2.7

3.3

3.5

3.3

16-34

35-54

All 55+ women

Continued…

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279

Table 9.2 continued Aged 16 and over

2004 Age group

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

280

Women

16-34

35-54

55+

All men

140 179 327 205 92 74 412 14800

196 159 384 153 65 50 678 16676

143 40 192 64 21 27 686 14703

479 377 903 422 178 151 1776 46178

219 240 408 276 135 63 497 14649

292 198 466 161 51 78 1038 16924

165 37 193 62 21 22 833 17146

675 476 1067 499 208 163 2369 48719

121 179 201 222 212 172 114 740

166 172 231 145 150 118 194 975

125 39 118 65 49 58 189 1163

412 390 550 432 411 348 497 2878

200 235 240 279 310 148 149 914

290 190 275 164 118 176 275 1374

162 44 119 65 50 51 232 1537

652 469 634 508 478 375 656 3825

16-34

35-54

All 55+ women

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

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Men

Table 9.3 Fruit and vegetable consumption, by equivalised household income tertile within minority ethnic group and sex Aged 16 and over

2004

Portions per day

Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

41 4.6

28 3.7

27 3.4

42 4.8

28 3.6

20 3.3

0.34

0.34

0.32

0.31

0.26

0.20

35 3.8

33 3.7

27 3.6

37 3.9

31 3.8

28 3.5

0.39

0.23

0.35

0.25

0.23

0.24

42 4.5

38 4.3

36 4.4

41 4.5

31 4.1

32 4.1

0.24

0.34

0.36

0.22

0.25

0.31

Consumed 5 or more portions Mean portions consumed

[32] [4.9]

36 4.6

31 3.9

[44] [4.8]

36 4.3

26 3.6

Standard error of the mean

0.69

0.37

0.25

[0.54]

0.29

0.25

a 4.0

51 4.6

30 3.8

a a

37 3.9

31 3.6

0.52

0.29

0.26

a

0.34

0.25

40 4.6

39 4.9

[43] [4.4]

47 5.1

34 4.7

51 5.1

0.32

0.37

[0.35]

0.29

0.38

0.38

28 3.7

22 3.1

29 3.7

41 4.6

21 3.1

13 2.6

0.25

0.29

0.43

0.21

0.21

0.26

26 3.6

17 3.0

20 3.0

33 4.0

22 3.3

17 2.8

0.08

0.09

0.17

0.08

0.08

0.10

Consumed 5 or more portions Black Caribbean

1.97

1.01

1.10

1.65

1.00

0.81

Standard error of risk ratio

0.31

0.28

0.24

0.22

0.17

0.14

Black African

1.74

1.71

1.31

1.60

1.26

1.12

Observed % Black Caribbean Consumed 5 or more portions Mean portions consumed Standard error of the mean

Black African Consumed 5 or more portions Mean portions consumed Standard error of the mean

Indian Consumed 5 or more portions Mean portions consumed Standard error of the mean

Pakistani

Bangladeshi Consumed 5 or more portions Mean portions consumed Standard error of the mean

Chinese Consumed 5 or more portions Mean portions consumed Standard error of the mean

Irish Consumed 5 or more portions Mean portions consumed Standard error of the mean

General population Consumed 5 or more portions Mean portions consumed Standard error of the mean

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Standardised risk ratios

Standard error of risk ratio

0.38

0.32

0.28

0.26

0.19

0.23

Indian

1.91

1.76

1.56

1.70

1.20

1.14

Standard error of risk ratio

Pakistani Standard error of risk ratio

Bangladeshi

0.23

0.23

0.29

0.19

0.17

0.22

[1.21]

1.76

1.43

[1.39]

1.37

0.98

[0.35]

0.29

0.21

[0.37]

0.20

0.18

1.91a

2.30

1.36

a

1.33

1.23

Standard error of risk ratio

0.50a

0.39

0.23

a

0.23

0.21

Chinese

1.89

1.77

[1.79]

1.83

1.25

2.07

Standard error of risk ratio

0.28

0.28

[0.33]

0.25

0.27

0.26

Irish

1.29

0.97

1.60

1.73

0.77

0.33

Standard error of risk ratio

0.17

0.21

0.44

0.19

0.15

0.12

General population

1.20

0.67

0.90

1.29

0.79

0.60

Standard error of risk ratio

0.08

0.07

0.13

0.08

0.07

0.07

a Results are not shown because of small bases.

Continued…..

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

281

Table 9.3 continued

Aged 16 and over

2004 Equivalised household income tertile

Men

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

152 113 264 55 8 44 833 21894

115 89 241 119 39 36 398 11517

106 90 150 137 75 21 270 5635

156 123 305 56 9 52 1040 19500

188 115 287 134 44 34 568 14317

179 153 203 168 84 24 347 6537

123 104 159 47 19 105 207 1343

90 105 155 114 89 77 122 753

96 94 97 155 171 49 89 353

148 102 179 46 23 120 257 1472

163 123 173 135 101 74 163 1181

179 150 126 176 191 58 123 537

282

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

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a Results are not shown because of small bases.

Table 9.4 Type of fruit and vegetables consumed, by minority ethnic group and sex Aged 16 and over Food item

2004 Minority ethnic group

General population

Black Caribbean

Black African

Indian

%

%

%

%

92 66 64 54 41 28 8 62 5 7 2 57

92 69 63 54 38 28 9 60 5 6 2 58

96 81 69 57 55 45 25 64 3 14 1 40

93 70 67 54 33 36 8 64 4 9 3 51

95 73 68 58 39 30 13 63 5 7 3 62

479 675 412 652

Pakistani Bangladeshi

Chinese

Irish

%

%

%

%

96 73 73 74 32 46 23 68 6 10 3 50

94 82 66 59 36 39 38 65 1 5 1 52

97 86 73 78 23 25 9 70 5 7 2 38

89 64 66 51 39 26 5 62 7 8 6 37

92 67 64 52 34 27 7 58 7 8 4 41

97 86 75 62 54 47 25 70 3 15 3 44

96 74 74 43 42 45 21 69 6 7 2 51

95 82 67 60 34 35 35 65 1 5 1 46

99 92 83 82 24 30 12 83 2 10 1 36

95 77 75 55 31 38 8 71 8 13 4 41

94 74 73 56 30 36 7 67 8 12 5 43

377 476

903 1067

422 499

178 208

151 163

1776 2369

46178 48719

390 469

550 634

432 508

411 478

348 375

497 656

2878 3825

Men Total fruit and vegetables Total vegetables (excludes pulses) Total fruit (excludes fruit juice) Vegetables Pulses Salad Vegetables in composites Fresh fruit Fruit in composites Dried fruit Frozen fruit Fruit juice

Women Total fruit and vegetables Total vegetables (excludes pulses) Total fruit (excludes fruit juice) Vegetables Pulses Salad Vegetables in composites Fresh fruit Fruit in composites Dried fruit Frozen fruit Fruit juice

Copyright © 2006, The Information Centre. All rights reserved

Bases (weighted) Men Women Bases (unweighted) Men Women

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

283

Table 9.5 Type of fruit and vegetables consumed, by age within minority ethnic group and sex Aged 16 and over

Black Caribbean Total fruit and vegetables Total vegetables (excludes pulses) Total fruit (excludes fruit juice) Vegetables Pulses Salad Vegetables in composites Fresh fruit Fruit in composites Dried fruit Frozen fruit Fruit juice Black African Total fruit and vegetables Total vegetables (excludes pulses) Total fruit (excludes fruit juice) Vegetables Pulses Salad Vegetables in composites Fresh fruit Fruit in composites Dried fruit Frozen fruit Fruit juice Indian Total fruit and vegetables Total vegetables (excludes pulses) Total fruit (excludes fruit juice) Vegetables Pulses Salad Vegetables in composites Fresh fruit Fruit in composites Dried fruit Frozen fruit Fruit juice

2004 Age group

Men

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

90 57 54 42 31 23 12 49 6 6 3 53

93 70 61 62 43 28 9 59 8 8 0 56

94 70 79 56 47 33 2 79 6 3 62

92 66 64 54 41 28 8 62 5 7 2 57

89 62 53 45 30 32 8 47 3 9 4 57

95 72 70 53 34 39 10 66 5 9 3 50

95 77 81 66 34 36 5 81 4 9 2 46

93 70 67 54 33 36 8 64 4 9 3 51

89 66 58 54 29 23 7 55 9 3 1 59

96 71 64 54 46 31 10 64 1 6 2 58

[95] [74] [81] [54] [44] [34] [13] [69] [8] [16] [6] [56]

92 69 63 54 38 28 9 60 5 6 2 58

93 71 63 55 39 30 14 58 4 7 4 66

97 76 72 62 42 31 12 69 5 6 3 61

[100] [75] [75] [63] [25] [28] [7] [68] [6] [7] [-] [49]

95 73 68 58 39 30 13 63 5 7 3 62

95 77 61 52 54 37 27 56 4 9 0 49

96 83 72 57 51 48 26 67 2 16 1 36

95 85 74 64 62 52 21 71 3 19 2 34

96 81 69 57 55 45 25 64 3 14 1 40

96 81 68 56 52 45 22 63 3 11 2 50

98 89 79 64 54 49 27 74 4 15 4 37

98 87 80 67 59 45 27 76 4 22 2 46

97 86 75 62 54 47 25 70 3 15 3 44

16-34

35-54

All 55+ women

Continued…..

284

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

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Type of fruit and vegetable

Table 9.5 continued

Aged 16 and over

2004

Type of fruit and vegetable

Age group

Men

Pakistani Total fruit and vegetables Total vegetables (excludes pulses) Total fruit (excludes fruit juice) Vegetables Pulses Salad Vegetables in composites Fresh fruit Fruit in composites Dried fruit Frozen fruit Fruit juice

Copyright © 2006, The Information Centre. All rights reserved

Bangladeshi Total fruit and vegetables Total vegetables (excludes pulses) Total fruit (excludes fruit juice) Vegetables Pulses Salad Vegetables in composites Fresh fruit Fruit in composites Dried fruit Frozen fruit Fruit juice Chinese Total fruit and vegetables Total vegetables (excludes pulses) Total fruit (excludes fruit juice) Vegetables Pulses Salad Vegetables in composites Fresh fruit Fruit in composites Dried fruit Frozen fruit Fruit juice

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

94 65 69 36 28 38 24 60 9 9 2 50

98 77 76 41 31 51 19 73 2 11 4 51

97 89 86 58 48 58 29 81 2 12 2 48

96 73 74 41 32 46 23 68 6 10 3 50

97 73 71 41 43 42 23 66 6 5 3 55

95 72 78 38 41 52 20 72 5 12 2 46

98 86 76 63 40 43 16 70 8 5 1 44

96 74 74 43 42 45 21 69 6 7 2 51

95 82 64 61 35 38 38 64 1 3 1 62

95 82 64 58 37 38 38 62 2 7 1 45

[92] [78] [81] [55] [38] [48] [41] [81] [-] [4] [-] [31]

94 82 66 59 36 39 38 65 1 5 1 52

96 80 64 59 36 36 34 61 1 5 1 50

95 81 76 58 34 36 40 74 7 2 39

92 88 67 64 25 34 36 67 1 32

95 82 67 60 34 35 35 65 1 5 1 46

95 80 64 74 22 25 8 59 5 5 1 42

97 90 79 82 23 24 10 78 3 6 3 31

100 95 88 83 28 27 13 88 6 11 4 40

97 86 73 78 23 25 9 70 5 7 2 38

98 90 75 79 26 27 13 74 2 11 41

99 91 88 83 25 32 11 88 2 11 2 35

100 96 91 88 19 29 11 91 5 7 3 25

99 92 83 82 24 30 12 83 2 10 1 36

16-34

35-54

All 55+ women

Continued…..

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

285

Table 9.5 continued

Aged 16 and over

2004 Age group

Men

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

Irish Total fruit and vegetables Total vegetables (excludes pulses) Total fruit (excludes fruit juice) Vegetables Pulses Salad Vegetables in composites Fresh fruit Fruit in composites Dried fruit Frozen fruit Fruit juice

85 46 50 40 37 15 8 47 1 6 4 37

87 66 68 51 34 32 6 61 6 6 5 37

94 72 75 58 44 27 2 71 11 10 8 38

89 64 66 51 39 26 5 62 7 8 6 37

93 79 69 51 27 42 11 65 5 8 6 48

96 73 73 50 33 41 10 71 8 13 3 39

95 80 80 64 31 32 5 76 10 16 5 40

95 77 75 55 31 38 8 71 8 13 4 41

General population Total fruit and vegetables Total vegetables (excludes pulses) Total fruit (excludes fruit juice) Vegetables Pulses Salad Vegetables in composites Fresh fruit Fruit in composites Dried fruit Frozen fruit Fruit juice

88 60 51 44 30 25 6 46 5 5 2 45

92 67 64 50 34 29 8 59 6 8 3 39

96 75 78 63 38 26 5 71 12 11 9 40

92 67 64 52 34 27 7 58 7 8 4 41

90 67 61 47 26 33 7 55 5 8 2 48

95 77 73 56 31 40 9 68 6 12 3 42

97 79 83 62 34 34 4 76 11 16 9 41

94 74 73 56 30 36 7 67 8 12 5 43

140 179 327 205 92 74 412 14800

196 159 384 153 65 50 678 16676

143 40 192 64 21 27 686 14703

479 377 903 422 178 151 1776 46178

219 240 408 276 135 63 497 14649

292 198 466 161 51 78 1038 16924

165 37 193 62 21 22 833 17146

675 476 1067 499 208 163 2369 48719

121 179 201 222 212 172 114 740

166 172 231 145 150 118 194 975

125 39 118 65 49 58 189 1163

412 390 550 432 411 348 497 2878

200 235 240 279 310 148 149 914

290 190 275 164 118 176 275 1374

162 44 119 65 50 51 232 1537

652 469 634 508 478 375 656 3825

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

286

16-34

35-54

All 55+ women

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

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Type of fruit and vegetable

Table 9.6 Mean fruit and vegetable consumption, by food item, minority ethnic group and sex Aged 16 and over

2004

Portions per day

Minority ethnic group Black Caribbean

Black African

General population Indian

Pakistani Bangladeshi

Chinese

Irish

Men Total fruit and vegetables Standard error of the mean

Total vegetables and salads Standard error of the mean

Total fruit (excludes fruit juice) Standard error of the mean

Vegetables Standard error of the mean

Pulses Standard error of the mean

Salad Standard error of the mean

Vegetables in composites Standard error of the mean

Fresh fruit Standard error of the mean

Fruit in composites Standard error of the mean

Dried fruit Standard error of the mean

Frozen fruit Standard error of the mean

Fruit juice Standard error of the mean

3.9

3.7

4.2

4.3

3.8

4.4

3.6

3.3

0.19

0.18

0.18

0.19

0.19

0.21

0.18

0.05

1.6

1.6

2.2

1.7

1.9

2.2

1.5

1.4

0.09

0.10

0.08

0.10

0.11

0.13

0.09

0.03

2.3

2.1

2.1

2.5

2.0

2.2

2.1

1.9

0.14

0.12

0.13

0.15

0.12

0.14

0.14

0.04

0.7

0.8

0.8

0.5

0.7

1.6

0.8

0.7

0.05

0.06

0.04

0.05

0.05

0.12

0.07

0.02

0.4

0.4

0.5

0.3

0.3

0.2

0.3

0.3

0.03

0.03

0.03

0.02

0.03

0.02

0.02

0.01

0.3

0.3

0.5

0.6

0.4

0.3

0.3

0.3

0.04

0.04

0.04

0.06

0.04

0.03

0.03

0.01

0.1

0.1

0.4

0.3

0.5

0.1

0.1

0.1

0.04

0.02

0.05

0.06

0.07

0.03

0.02

0.01

1.6

1.4

1.5

1.8

1.4

1.7

1.5

1.3

0.12

0.10

0.10

0.14

0.11

0.13

0.12

0.03

0.1

0.1

0.0

0.1

0.0

0.1

0.1

0.1

0.03

0.03

0.01

0.03

0.00

0.02

0.02

0.01

0.1

0.1

0.1

0.1

0.0

0.1

0.1

0.1

0.01

0.01

0.02

0.02

0.01

0.01

0.01

0.01

0.0

0.0

0.0

0.1

0.0

0.0

0.1

0.0

0.02

0.02

0.00

0.02

0.00

0.01

0.02

0.00

0.6

0.6

0.4

0.5

0.5

0.4

0.4

0.4

0.03

0.03

0.03

0.03

0.03

0.03

0.03

0.01

Women Total fruit and vegetables Standard error of the mean

Total vegetables and salads Standard error of the mean

Total fruit (excludes fruit juice) Standard error of the mean

Vegetables Standard error of the mean

Pulses Standard error of the mean

Salad Standard error of the mean

Vegetables in composites Standard error of the mean

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Fresh fruit Standard error of the mean

Fruit in composites Standard error of the mean

Dried fruit Standard error of the mean

Frozen fruit Standard error of the mean

Fruit juice Standard error of the mean

3.9

3.8

4.4

4.0

3.6

4.9

3.9

3.6

0.14

0.12

0.15

0.16

0.15

0.19

0.12

0.05

1.5

1.6

2.1

1.7

1.7

2.4

1.4

1.4

0.06

0.07

0.07

0.09

0.08

0.12

0.05

0.02

2.4

2.2

2.3

2.3

1.9

2.5

2.4

2.2

0.11

0.09

0.15

0.10

0.10

0.13

0.10

0.04

0.7

0.7

0.8

0.5

0.6

1.6

0.7

0.7

0.04

0.05

0.04

0.05

0.04

0.11

0.04

0.02

0.3

0.3

0.5

0.4

0.3

0.2

0.2

0.2

0.02

0.02

0.02

0.02

0.03

0.02

0.02

0.01

0.4

0.3

0.5

0.6

0.4

0.3

0.4

0.4

0.03

0.04

0.03

0.06

0.04

0.03

0.03

0.01

0.1

0.2

0.3

0.3

0.4

0.2

0.1

0.1

0.02

0.03

0.03

0.04

0.06

0.04

0.01

0.01

1.7

1.5

1.6

1.6

1.3

2.0

1.7

1.5

0.09

0.09

0.09

0.09

0.09

0.11

0.09

0.03

0.0

0.1

0.0

0.1

0.0

0.0

0.1

0.1

0.01

0.01

0.01

0.02

0.00

0.01

0.02

0.00

0.1

0.1

0.1

0.1

0.0

0.1

0.1

0.1

0.01

0.01

0.02

0.01

0.02

0.02

0.02

0.01

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.01

0.01

0.01

0.01

0.00

0.01

0.01

0.00

0.5

0.6

0.4

0.5

0.5

0.4

0.4

0.4

0.03

0.03

0.03

0.03

0.02

0.03

0.03

0.01

Continued…..

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

287

Table 9.6 continued Aged 16 and over

2004 Minority ethnic group

Bases (weighted) Men Women Bases (unweighted) Men Women

General population

Black Caribbean

Black African

Indian

479 675

377 476

903 1067

422 499

412 652

390 469

550 634

432 508

Pakistani Bangladeshi

Chinese

Irish

178 208

151 163

1776 2369

46178 48719

411 508

348 375

497 656

2878 3825

Table 9.7 Fat intake, by minority ethnic group and sex Aged 16 and over Fat score

2004 Minority ethnic group

General population (2003)

Black Caribbean

Black African

Indian

Observed % Low fat Medium fat High fat Mean fat score

82 14 5 20.8

86 10 4 20.1

89 10 1 18.6

80 16 4 20.9

Standard error of mean

0.82

0.75

0.51

Standardised risk ratios Mean fat score

0.85

0.82

Standard error of the ratio

0.04

0.03

Observed % Low fat Medium fat High fat Mean fat score

89 11 1 17.9

Standard error of mean

Standardised risk ratios Mean fat score Standard error of the ratio

Pakistani Bangladeshi

Chinese

Irish

83 12 5 22.6

86 13 0 20.4

77 19 4 23.5

72 22 6 24.3

0.87

0.86

0.73

0.70

0.16

0.76

0.84

0.89

0.80

0.98

1

0.02

0.04

0.04

0.03

0.04

82 14 4 19.6

94 5 1 17.3

87 11 2 20.0

88 10 3 18.9

84 15 1 18.9

84 15 1 20.5

84 14 3 21.2

0.69

0.92

0.48

0.68

0.78

0.99

0.44

0.12

0.84

0.92

0.81

0.91

0.84

0.90

1.00

1

0.04

0.04

0.02

0.04

0.04

0.06

0.02

210 286

149 215

392 459

173 201

62 88

69 72

817 1044

5144 5511

186 277

145 186

281 321

175 214

113 150

168 178

293 382

4742 5928

Men

Bases (weighted): Men Women Bases (unweighted): Men Women

288

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

Copyright © 2006, The Information Centre. All rights reserved

Women

Table 9.8 Fat intake, by age within minority ethnic group and sex Aged 16 and over Fat score

2004 Age group

Men

Women

16-34

35-54

55+

All men

16-34

35-54

55+

All women

%

%

%

%

%

%

%

%

Black Caribbean Low fat Medium fat High fat Mean fat score

66 26 8 24.4

94 5 2 19.4

86 10 4 18.3

82 14 5 20.8

81 19 0 21.1

90 9 1 17.1

98 2 14.0

89 11 1 17.9

Standard error of mean

1.64

0.92

1.55

0.82

1.15

0.82

1.00

0.69

Black African Low fat Medium fat High fat Mean fat score

81 12 8 21.4

93 6 1 18.3

a a a a

86 10 4 20.1

82 16 2 20.4

80 12 8 19.1

a a a a

82 14 4 19.6

Standard error of mean

1.27

0.91

a

0.75

0.85

1.20

a

0.92

Low fat Medium fat High fat Mean fat score

81 16 3 21.9

90 9 1 18.2

97 3 14.2

89 10 1 18.6

91 6 3 19.6

95 5 16.5

98 2 13.7

94 5 1 17.3

Standard error of mean

0.95

0.67

0.84

0.51

0.81

0.54

0.70

0.48

Pakistani Low fat Medium fat High fat Mean fat score

77 20 4 22.7

84 12 5 20.0

a a a a

80 16 4 20.9

82 15 2 21.6

91 6 3 19.3

a a a a

87 11 2 20.0

Standard error of mean

1.34

1.41

a

0.87

0.87

0.96

a

0.68

[71] [21] [9] [26.3]

[92] [5] [3] [20.1]

a a a a

83 12 5 22.6

85 11 4 20.7

[91] [9] [-] [16.0]

a a a a

88 10 3 18.9

Standard error of mean

[1.49]

[1.08]

a

0.86

0.90

[1.34]

a

0.78

Chinese Low fat Medium fat High fat Mean fat score

76 23 1 22.9

96 4 17.6

a a a a

86 13 0 20.4

74 24 2 21.7

91 9 17.7

a a a a

84 15 1 18.9

Standard error of mean

1.16

0.88

a

0.73

1.49

0.90

a

0.99

Irish Low fat Medium fat High fat Mean fat score

72 21 7 25.7

75 21 4 23.6

83 14 3 21.9

77 19 4 23.5

86 14 0 21.0

86 14 0 20.2

81 17 2 20.5

84 15 1 20.5

Standard error of mean

Indian

Copyright © 2006, The Information Centre. All rights reserved

Bangladeshi Low fat Medium fat High fat Mean fat score

1.94

1.13

0.89

0.70

0.92

0.63

0.95

0.44

General population (2003) Low fat 66 Medium fat 25 High fat 9 Mean fat score 26.1

75 21 4 23.9

76 20 4 23.1

72 22 6 24.3

82 15 3 22.0

86 12 2 20.6

83 14 3 20.9

84 14 3 21.2

Standard error of mean

0.24

0.23

0.16

0.23

0.18

0.21

0.12

0.32

a Results not shown because of small bases.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

Continued…

289

Table 9.8 continued Aged 16 and over

2004 Age group

Men 16-34

Bases (weighted) Black Caribbean 74 Black African 73 Indian 139 Pakistani 81 Bangladeshi 29 Chinese 35 Irish 184 General population (2003) 1654 Bases (unweighted) Black Caribbean 56 Black African 60 Indian 89 Pakistani 81 Bangladeshi 48 Chinese 79 Irish 61 General population (2003) 1153

Women 35-54

55+

All men

16-34

35-54

55+

All women

76 63 161 66 24 22 355 1878

60 14 92 25 8 11 278 1611

210 149 392 173 62 69 817 5144

104 112 185 103 57 27 223 1704

121 91 209 75 25 37 450 1922

62 12 65 22 6 8 371 1886

286 215 459 201 88 72 1044 5511

75 71 125 66 49 62 130 1764

55 14 67 28 16 27 102 1825

186 145 281 175 113 168 293 4742

88 93 124 112 97 65 77 1534

125 82 146 77 42 93 162 2190

64 11 51 25 11 20 143 2204

277 186 321 214 150 178 382 5928

290

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

Copyright © 2006, The Information Centre. All rights reserved

a Results not shown because of small bases.

Table 9.9 Fat intake, by equivalised household income tertile within minority ethnic group and sex Aged 16 and over

2004

Fat score

Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

Black Caribbean Low fat Medium fat High fat Mean fat score

84 11 5 20.8

76 22 2 21.4

[77] [13] [10] [22.4]

95 5 17.7

92 7 1 16.8

88 12 0 18.3

Standard error of mean

1.52

1.78

[2.24]

0.83

1.22

1.28

Black African Low fat Medium fat High fat Mean fat score

94 6 17.3

[89] [9] [2] [20.4]

[74] [13] [13] [23.5]

93 5 2 17.7

[80] [15] [5] [19.7]

74 19 7 21.0

Standard error of mean

0.95

[1.45]

[1.76]

1.14

[1.93]

1.86

Low fat Medium fat High fat Mean fat score

90 10 18.7

87 11 2 18.5

88 10 1 18.1

95 3 1 17.1

97 3 16.8

93 7 18.0

Standard error of mean

Observed %

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Indian

0.82

1.12

1.01

0.77

0.71

0.96

Pakistani Low fat Medium fat High fat Mean fat score

a a a a

87 10 3 20.3

76 20 4 20.5

a a a a

92 8 0 19.6

88 8 3 19.5

Standard error of mean

a

1.42

1.27

a

1.03

1.09

Bangladeshi Low fat Medium fat High fat Mean fat score

a a a a

a a a a

87 11 3 21.2

a a a a

a a a a

93 7 18.3

Standard error of mean

a

a

1.32

a

a

0.90

Chinese Low fat Medium fat High fat Mean fat score

84 14 1 19.8

[89] [11] [-] [20.9]

a a a a

76 23 1 21.0

[88] [12] [ -] [17.8]

a a a a

Standard error of mean

1.18

[1.24]

a

1.70

[1.90]

a

Irish Low fat Medium fat High fat Mean fat score

75 20 4 24.2

81 13 6 22.9

[79] [16] [5] [23.2]

84 16 0 20.2

85 14 1 20.6

80 17 2 20.4

Standard error of mean

0.93

1.71

[1.58]

0.72

0.77

1.30

General Population (2003) Low fat Medium fat High fat Mean fat score

74 21 5 24.2

69 24 6 24.9

73 19 7 24.0

86 12 2 20.7

81 15 3 21.8

82 15 4 21.2

Standard error of mean

0.20

0.30

0.42

0.18

0.22

0.33

a Results not shown because of small bases.

Continued…..

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

291

Table 9.9 continued

Aged 16 and over Fat score

2004 Equivalised household income tertile

Men

Women

Highest

Middle

Lowest

Highest

Middle

Lowest

Mean fat score Black Caribbean

0.82

0.93

[0.90]

0.82

0.82

0.82

Standard error of the ratio

0.07

0.08

[0.09]

0.04

0.06

0.06

Black African

0.71

[0.84]

[0.90]

0.80

[0.90]

0.98

Standard error of the ratio

0.05

[0.06]

[0.06]

0.05

[0.08]

0.09

Indian

0.74

0.78

0.76

0.78

0.78

0.85

Standard error of the ratio

0.04

0.05

0.04

0.04

0.04

0.05

a

0.81

0.83

a

0.86

0.89

Standard error of the ratio

a

0.06

0.05

a

0.05

0.05

Bangladeshi

a

a

0.86

a

a

0.77

Standardised risk ratios

Pakistani

Standard error of the ratio

a

a

0.06

a

a

0.05

Chinese

0.80

[0.85]

0.76

1.02

[0.87]

a

Standard error of the ratio

0.05

[0.05]

0.07

0.11

[0.11]

a

Irish

0.99

1.01

[0.99]

0.94

0.97

1.00

Standard error of the ratio

0.04

0.14

[0.06]

0.04

0.04

0.05

General population (2003)

0.99

1.03

0.99

0.98

1.03

1.02

Standard error of the ratio

0.01

0.02

0.02

0.01

0.01

0.02

68 60 116 22 3 25 443 2465

53 30 118 60 12 16 208 1387

36 41 75 59 29 8 87 647

69 61 144 22 4 31 472 2274

83 48 133 66 13 12 285 1672

89 76 103 70 41 10 148 815

62 53 84 20 6 66 142 2296

50 34 87 61 24 39 79 1295

33 39 56 65 51 18 44 590

72 50 100 20 9 76 169 2450

78 47 91 68 25 30 104 1819

86 63 73 80 67 26 66 894

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003) Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003)

292

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

Copyright © 2006, The Information Centre. All rights reserved

a Results not shown because of small bases.

Table 9.10 Use of salt, by minority ethnic group and sex Aged 16 and over

2004

Adds salt to fooda,b

Minority ethnic group Black Caribbean

General population (2003)

Black African

Indian

77

74

93

93

Pakistani Bangladeshi

Chinese

Irish

95

82

45

56

Men Observed % Adds salt during cooking Generally adds salt at table, without tasting Tastes, generally adds salt at table Tastes, occasionally adds salt at table Rarely, or never, adds salt at table Standardised risk ratios Adds salt during cooking

9 18 24 49

10 16 31 43

6 14 32 47

15 13 25 47

17 16 28 39

10 11 29 50

23 19 15 43

24 14 24 38

1.38

1.38

1.69

1.69

1.73

1.42

0.83

1

Standard error of the ratio

0.07

0.08

0.04

0.04

0.04

0.07

0.07

69

83

92

88

91

75

46

53

5 10 21 64

9 17 29 45

9 14 28 50

12 21 22 46

11 21 30 38

7 15 25 53

16 12 26 45

15 13 26 46

Standardised risk ratios Adds salt during cooking

1.33

1.60

1.78

1.70

1.79

1.49

0.87

1

Standard error of the ratio

0.07

0.08

0.05

0.06

0.05

0.08

0.08

230 332

171 245

435 523

196 229

73 103

74 77

870 1134

5455 5814

208 321

157 212

309 370

199 242

134 178

179 191

312 413

5022 6255

Women Observed % Adds salt during cooking Generally adds salt at table, without tasting Tastes, generally adds salt at table Tastes, occasionally adds salt at table Rarely, or never, adds salt at table

Bases (weighted)c Men Women Bases (unweighted)c Men Women

a Adds salt during cooking, or adds salt to food at table b Excludes salt alternative

Copyright © 2006, The Information Centre. All rights reserved

c Bases shown are for use of salt at table; those for use of salt in cooking are slightly different, and are not shown in this table.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

293

Table 9.11 Use of salt, by age within minority ethnic group and sex Aged 16 and over

2004 Age group

Men

Black Caribbean Adds salt during cooking Generally adds salt at table, without tasting Tastes, generally adds salt at table Tastes, occasionally adds salt at table Rarely, or never, adds salt at table Black African Adds salt during cooking Generally adds salt at table, without tasting Tastes, generally adds salt at table Tastes, occasionally adds salt at table Rarely, or never, adds salt at table Indian Adds salt during cooking Generally adds salt at table, without tasting Tastes, generally adds salt at table Tastes, occasionally adds salt at table Rarely, or never, adds salt at table Pakistani Adds salt during cooking Generally adds salt at table, without tasting Tastes, generally adds salt at table Tastes, occasionally adds salt at table Rarely, or never, adds salt at table Bangladeshi Adds salt during cooking Generally adds salt at table, without tasting Tastes, generally adds salt at table Tastes, occasionally adds salt at table Rarely, or never, adds salt at table Chinese Adds salt during cooking Generally adds salt at table, without tasting Tastes, generally adds salt at table Tastes, occasionally adds salt at table Rarely, or never, adds salt at table Irish Adds salt during cooking Generally adds salt at table, without tasting Tastes, generally adds salt at table Tastes, occasionally adds salt at table Rarely, or never, adds salt at table General population (2003) Adds salt during cooking Generally adds salt at table, without tasting Tastes, generally adds salt at table Tastes, occasionally adds salt at table Rarely, or never, adds salt at table

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

73 12 16 30 43

80 12 17 22 50

77 3 21 20 56

77 9 18 24 49

61 7 7 30 55

75 4 7 16 72

71 3 19 15 63

69 5 10 21 64

73 10 17 39 34

73 9 18 29 44

a a a a a

74 10 16 31 43

79 11 21 32 37

88 6 14 26 54

a a a a a

83 9 17 29 45

91 11 12 37 40

96 4 13 38 45

91 4 19 16 61

93 6 14 32 47

88 9 11 28 53

93 8 14 30 47

96 9 19 19 52

92 9 14 28 50

96 18 13 27 42

92 9 15 27 49

[88] [16] [9] [15] [60]

93 15 13 25 47

88 13 19 23 45

89 14 21 18 47

[87] [4] [28] [24] [44]

88 12 21 22 46

95 16 18 30 36

93 21 11 25 43

a a a a a

95 17 16 28 39

87 9 20 32 39

97 15 25 24 36

a a a a a

91 11 21 30 38

86 11 9 29 52

78 10 11 33 46

[76] [7] [18] [23] [52]

82 10 11 29 50

84 5 19 31 45

69 6 13 23 57

a a a a a

75 7 15 25 53

54 25 14 15 47

30 21 16 16 47

56 25 26 15 35

45 23 19 15 43

36 19 12 25 44

38 18 12 27 42

61 13 13 25 49

46 16 12 26 45

56 24 13 24 38

52 23 13 24 39

60 23 17 22 38

56 24 14 24 38

50 18 12 27 44

50 14 14 26 46

60 13 14 26 48

53 15 13 26 46

16-34

35-54

All 55+ women

a Results not shown because of small bases. b Adds salt during cooking, or adds salt to food at table. c Excludes salt alternative.

294

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

Copyright © 2006, The Information Centre. All rights reserved

Adds salt to foodb,c

Table 9.11 continued Aged 16 and over

2004 Age group

Men

Bases (weighted)d Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003) Bases (unweighted)d Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2003)

Women

16-34

35-54

55+

All men

76 85 146 97 36 39 194 1754

83 69 179 70 27 23 360 1969

71 17 110 29 10 12 316 1731

230 171 435 196 73 74 870 5455

114 125 201 118 65 29 227 1767

144 103 241 84 31 40 478 2012

74 16 82 27 7 8 429 2035

332 245 523 229 103 77 1134 5814

59 67 94 97 60 85 64 1219

83 75 137 70 55 64 133 1849

66 15 78 32 19 30 115 1954

208 157 309 199 134 179 312 5022

96 106 136 126 112 70 79 1591

149 91 169 86 53 101 175 2285

76 15 65 30 13 20 159 2379

321 212 370 242 178 191 413 6255

16-34

35-54

All 55+ women

a Results not shown because of small bases. b Adds salt during cooking, or adds salt to food at table.

Copyright © 2006, The Information Centre. All rights reserved

c Excludes salt alternative. d Bases shown are for use of salt at table; those for use of salt in cooking are slightly different, and are not shown in this table.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

295

Table 9.12 Comparison of salt use, in 2004 and 1999 by age within minority ethnic group and sex Aged 16 and over Use of saltb,c

1999, 2004 Age group

Men

Black Caribbean 2004 Adds salt during cooking Generally adds salt, without tasting Tastes, generally adds salt Tastes, occasionally adds salt Rarely, or never, adds salt 1999 Adds salt during cooking Generally adds salt, without tasting Tastes, generally adds salt Tastes, occasionally adds salt Rarely, or never, adds salt Basesd Bases 2004 (weighted) Bases 2004 (unweighted) Bases 1999 (weighted) Bases 1999 (unweighted) Indian 2004 Adds salt during cooking Generally adds salt, without tasting Tastes, generally adds salt Tastes, occasionally adds salt Rarely, or never, adds salt 1999 Adds salt during cooking Generally adds salt, without tasting Tastes, generally adds salt Tastes, occasionally adds salt Rarely, or never, adds salt Basesd Bases 2004 (weighted) Bases 2004 (unweighted) Bases 1999 (weighted) Bases 1999 (unweighted)

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

73 12 16 30 43

80 12 17 22 50

77 3 21 20 56

77 9 18 24 49

61 7 7 30 55

75 4 7 16 72

71 3 19 15 63

69 5 10 21 64

82 16 13 24 47

83 11 17 27 45

84 12 13 12 63

83 14 14 21 52

82 14 6 25 55

79 5 12 17 65

83 5 10 10 75

81 8 10 19 63

76 59 98 137

83 83 62 92

71 66 86 125

230 208 245 354

114 96 134 198

144 149 142 210

74 76 77 110

332 321 353 518

91 11 12 37 40

96 4 13 38 45

91 4 19 16 61

93 6 14 32 47

88 9 11 28 53

93 8 14 30 47

96 9 19 19 52

92 9 14 28 50

96 12 19 33 37

95 16 23 23 39

95 17 15 34 34

95 15 20 29 37

97 13 15 33 40

97 17 15 25 44

94 9 21 29 40

97 14 16 29 41

146 94 159 165

179 137 197 209

110 78 84 88

435 309 441 462

201 136 175 187

241 169 184 201

82 65 70 77

523 370 428 465

16-34

35-54

All 55+ women

c Excludes salt alternative. d Bases shown are for use of salt at table; those for use of salt in cooking are slightly different, and are not shown in this table. e Comparison data for the General population is not available.

Continued…..

296

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

Copyright © 2006, The Information Centre. All rights reserved

a Results not shown because of small bases. b Adds salt during cooking, or adds salt to food at table.

Table 9.12 continued

Aged 16 and over

1999, 2004

Use of saltb,c

Age group

Men

Pakistani 2004 Adds salt during cooking Generally adds salt, without tasting Tastes, generally adds salt Tastes, occasionally adds salt Rarely, or never, adds salt 1999 Adds salt during cooking Generally adds salt, without tasting Tastes, generally adds salt Tastes, occasionally adds salt Rarely, or never, adds salt Basesd Bases 2004 (weighted) Bases 2004 (unweighted) Bases 1999 (weighted) Bases 1999 (unweighted) Bangladeshi 2004 Adds salt during cooking Generally adds salt, without tasting Tastes, generally adds salt Tastes, occasionally adds salt Rarely, or never, adds salt 1999 Adds salt during cooking Generally adds salt, without tasting Tastes, generally adds salt Tastes, occasionally adds salt Rarely, or never, adds salt Basesd Bases 2004 (weighted) Bases 2004 (unweighted) Bases 1999 (weighted) Bases 1999 (unweighted)

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

96 18 13 27 42

92 9 15 27 49

[88] [16] [9] [15] [60]

93 15 13 25 47

88 13 19 23 45

89 14 21 18 47

[87] [4] [28] [24] [44]

88 12 21 22 46

94 17 21 26 36

99 15 26 25 34

[97] [11] [16] [19] [54]

96 16 23 25 37

97 12 19 30 39

96 10 19 29 42

[96] [14] [20] [13] [53]

97 12 19 28 41

97 97 110 184

70 70 84 145

29 32 26 44

196 199 220 373

118 126 146 250

84 86 71 123

27 30 19 34

229 242 236 407

95 16 18 30 36

93 21 11 25 43

c c c c c

95 17 16 28 39

87 9 20 32 39

97 15 25 24 36

c c c c c

91 11 21 30 38

96 15 22 29 34

99 15 15 29 41

97 9 7 33 50

97 13 16 30 40

98 19 22 22 7

98 7 20 25 49

a a a a a

98 15 20 23 42

86 39 33 128

27 55 20 77

10 19 18 65

73 134 72 270

65 112 49 194

31 53 19 80

7 13 7 28

103 178 75 302

16-34

35-54

All 55+ women

Copyright © 2006, The Information Centre. All rights reserved

a Results not shown because of small bases. b Adds salt during cooking, or adds salt to food at table. c Excludes salt alternative. d Bases shown are for use of salt at table; those for use of salt in cooking are slightly different, and are not shown in this table. e Comparison data for the General population is not available.

Continued…..

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

297

Table 9.12 continued

Aged 16 and over Use of saltb,c

1999, 2004 Age group

Men

Chinese 2004 Adds salt during cooking Generally adds salt, without tasting Tastes, generally adds salt Tastes, occasionally adds salt Rarely, or never, adds salt 1999 Adds salt during cooking Generally adds salt, without tasting Tastes, generally adds salt Tastes, occasionally adds salt Rarely, or never, adds salt Basesd Bases 2004 (weighted) Bases 2004 (unweighted) Bases 1999 (weighted) Bases 1999 (unweighted) Irish 2004 Adds salt during cooking Generally adds salt, without tasting Tastes, generally adds salt Tastes, occasionally adds salt Rarely, or never, adds salt 1999 Adds salt during cooking Generally adds salt, without tasting Tastes, generally adds salt Tastes, occasionally adds salt Rarely, or never, adds salt Basesd Bases 2004 (weighted) Bases 2004 (unweighted) Bases 1999 (weighted) Bases 1999 (unweighted)

Women

16-34

35-54

55+

All men

%

%

%

%

%

%

%

%

86 11 9 29 52

78 10 11 33 46

[76] [7] [18] [23] [52]

82 10 11 29 50

84 5 19 31 45

69 6 13 23 57

c c c c c

75 7 15 25 53

89 11 9 31 49

97 10 23 30 37

[92] [5] [9] [33] [54]

94 9 16 31 44

94 4 12 43 40

95 6 16 34 44

91 10 15 23 53

94 6 15 35 44

39 85 19 62

23 64 31 93

12 30 12 40

74 179 62 195

29 70 21 66

40 101 48 150

8 20 10 36

77 191 80 252

54 25 14 15 47

30 21 16 16 47

56 25 26 15 35

45 23 19 15 43

36 19 12 25 44

38 18 12 27 42

61 13 13 25 49

46 16 12 26 45

56 27 23 15 35

67 34 17 24 25

72 36 22 16 27

66 33 20 20 28

55 24 12 33 32

53 19 22 24 36

74 21 20 26 33

59 21 18 27 34

194 64 277 92

360 133 568 184

316 115 331 125

870 312 1176 401

227 79 471 163

478 175 699 229

429 159 421 155

1134 413 1591 547

16-34

35-54

All 55+ women

c Excludes salt alternative. d Bases shown are for use of salt at table; those for use of salt in cooking are slightly different, and are not shown in this table. e Comparison data for the General population is not available.

298

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

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a Results not shown because of small bases. b Adds salt during cooking, or adds salt to food at table.

Table 9.13 Use of salt, by equivalised household income tertile within minority ethnic group and sex Aged 16 and over Use of saltb,c

2004 Equivalised household income tertile

Men

Women

Highest

Middle

Lowest Highest

Middle

Lowest

Observed %

Copyright © 2006, The Information Centre. All rights reserved

Black Caribbean Adds salt during cooking Generally adds salt at table, without tasting Tastes, generally adds salt at table Tastes, occasionally adds salt at table Rarely, or never, adds salt at table Black African Adds salt during cooking Generally adds salt at table, without tasting Tastes, generally adds salt at table Tastes, occasionally adds salt at table Rarely, or never, adds salt at table Indian Adds salt during cooking Generally adds salt at table, without tasting Tastes, generally adds salt at table Tastes, occasionally adds salt at table Rarely, or never, adds salt at table Pakistani Adds salt during cooking Generally adds salt at table, without tasting Tastes, generally adds salt at table Tastes, occasionally adds salt at table Rarely, or never, adds salt at table Bangladeshi Adds salt during cooking Generally adds salt at table, without tasting Tastes, generally adds salt at table Tastes, occasionally adds salt at table Rarely, or never, adds salt at table Chinese Adds salt during cooking Generally adds salt at table, without tasting Tastes, generally adds salt at table Tastes, occasionally adds salt at table Rarely, or never, adds salt at table Irish Adds salt during cooking Generally adds salt at table, without tasting Tastes, generally adds salt at table Tastes, occasionally adds salt at table Rarely, or never, adds salt at table General population Adds salt during cooking Generally adds salt at table, without tasting Tastes, generally adds salt at table Tastes, occasionally adds salt at table Rarely, or never, adds salt at table

65 11 16 27 45

82 6 29 25 40

[83] [17] [7] [23] [54]

62 2 6 23 70

65 9 11 18 63

77 7 8 19 66

75 7 11 45 37

[78] [9] [10] [18] [63]

[60] [18] [28] [23] [32]

86 7 4 30 58

84 13 19 26 42

80 10 27 29 34

93 4 15 42 38

94 8 11 23 58

91 7 19 31 43

89 6 11 32 51

94 12 10 27 51

88 11 17 27 44

a a a a a

93 10 22 15 53

93 19 7 31 42

a a a a a

91 8 22 19 50

86 20 21 23 36

a a a a a

[95] [26] [14] [26] [34]

94 19 15 24 42

a a a a a

[89] [23] [21] [14] [42]

90 12 22 31 36

80 6 10 28 55

[74] [8] [13] [30] [49]

a a a a a

70 2 23 19 55

[75] [9] [3] [48] [40]

a a a a a

42 20 17 18 44

47 31 15 15 39

59 32 39 0 29

38 8 9 30 54

55 22 20 24 34

56 37 11 16 37

51 18 13 27 42

53 25 14 21 39

62 27 15 23 35

49 13 12 28 47

53 16 14 25 45

61 18 15 24 43

a Values not shown due to small base sizes (unweighted bases <30). b Adds salt during cooking, or adds salt to food at table. c Excludes salt alternative. d Bases shown are for use of salt at table; those for use of salt in cooking are

slightly different, and are not shown in this table. HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

Continued…

299

Table 9.13 continued

Aged 16 and over Use of saltb,c

2004 Equivalised household income tertile

Men

Women

Highest

Middle

Lowest Highest

Middle

Lowest

Adds salt during cooking Black Caribbean

1.16

1.47

[1.53]

Standard error of the ratio

0.15

0.15

[0.12]

1.14

1.22

1.51

0.15

0.16

Black African

1.47

[1.43]

[1.09]

0.09

1.56

1.61

1.56

Standard error of the ratio

0.12

[0.15]

[0.19]

0.20

0.12

0.12

Indian

1.69

1.72

1.70

1.75

1.81

1.71

Standard error of the ratio

0.06

0.07

0.07

0.08

0.07

0.09

a

1.72

1.70

a

1.76

1.67

Standardised risk ratios

Pakistani Standard error of the ratio

a

0.06

0.07

a

0.09

0.10

Bangladeshi

a

[1.76]

1.73

a

[1.77]

1.82

Standard error of the ratio

a

[0.07]

0.08

a

[0.11]

0.05

Chinese

1.46

[1.37]

a

1.48

[1.53]

a

Standard error of the ratio

0.10

[0.14]

a

0.11

[0.15]

a

Irish

0.87

0.77

[1.30]

0.73

0.99

0.91

Standard error of the ratio

0.09

0.16

[0.19]

0.10

0.14

0.15

General population (2003)

0.95

1.00

1.18

0.96

0.98

1.14

Standard error of the ratio

0.03

0.04

0.05

0.03

0.03

0.04

71 68 118 24 3 25 452 2549

59 34 123 70 15 17 224 1489

42 44 89 67 34 10 100 709

74 65 152 24 5 32 493 2349

96 63 149 69 17 13 316 1781

103 82 122 80 49 11 171 880

66 57 85 22 7 67 147 2371

55 36 91 68 30 40 84 1389

40 41 65 76 60 23 48 645

76 52 106 22 10 79 175 2532

93 59 103 72 32 32 115 1939

98 69 88 92 80 29 76 965

Bases (weighted)d Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population Bases (unweighted)d Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population

a Values not shown due to small base sizes (unweighted bases <30). b Adds salt during cooking, or adds salt to food at table.

in this table.

300

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

Copyright © 2006, The Information Centre. All rights reserved

c Excludes salt alternative. d Bases shown are for use of salt at table; those for use of salt in cooking are slightly different, and are not shown

Blood analytes

10

Emanuela Falaschetti & Moushumi Chaudhury

Summary Analytes from non-fasting blood sample

Copyright © 2006, The Information Centre. All rights reserved

Blood samples were taken only from minority ethnic groups in HSE 2004, so comparisons with the general population are made with HSE 2003. ●

Mean total cholesterol was lower in Black Caribbean, Black African and Chinese men (5.1 mmol/l) than men in the general population (5.5 mmol/l); this remained significant after age standardisation. Age-standardised risk ratios, comparing each minority ethnic group with the general population set at 1.0, were significantly lower for Indian (0.95), Black Caribbean, Pakistani, Chinese and Irish (all 0.96) women.

●

Prevalence of raised total cholesterol (≥ 5.0 mmol/l) was lower in Black Caribbean men (age-standardised risk ratio 0.82) and in Indian women (age-standardised risk ratio 0.86) than in the general population.

●

The prevalence of low HDL-cholesterol (<1.0 mmol/l) was significantly higher than in the general population in Pakistani (risk ratio 3.00) and Bangladeshi men (2.82) and Bangladeshi women (4.64). The age-standardised risk ratio for the prevalence of low HDL-cholesterol was significantly lower than 1 in Black African men (0.31).

●

The prevalence of elevated levels of C-reactive protein was high for Pakistani informants (risk ratio 1.64 in men and 1.50 in women). Chinese women were less likely than the general population to have high levels of C-reactive protein (risk ratio 0.33).

●

Mean C-reactive protein generally did not change for different minority ethnic groups between 1999 and 2004 except for Pakistani men, in whom a significant increase was found in the proportion of informants with high levels (from 14% in 1999 to 29% in 2004).

●

Age-standardised ratios of mean fibrinogen were lower among Black Caribbean men (0.95) and Chinese women (0.91) than in the general population, whereas Pakistani women had a significantly higher mean fibrinogen level (standardised risk ratio 1.12).

●

Fibrinogen levels in 2004 were higher than 1999 in almost all minority ethnic groups and in the general population, except Black Caribbean and Bangladeshi men and Chinese men and women.

●

The prevalence of anaemia was very low among men, ranging from 0% in Chinese and Irish men to 4.4% in Black Caribbean men. Anaemia was more common among women: it was lowest in Chinese (7.3%) and Irish (5.7%) women but otherwise ranged from 16.4% in Black Caribbean women to 29.0% in Indian women.

●

Mean haemoglobin did not change between 1999 and 2004 in either sex or any minority ethnic group except for Pakistani women. The prevalence of anaemia decreased in Black Caribbean women (to 16.4% in 2004 from 25.5% in 1999) and in Pakistani women (to 20.5% from 30.3%).

●

The prevalence of low ferritin (levels between the cut-offs for the bottom quintile of the general population in 1998) was higher among Indian men (33%) than the other ethnic

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groups, with a low prevalence among Chinese men (3%). Among women, prevalence of low ferritin was higher in South Asian groups (Indian 48%, Pakistani 38% and Bangladeshi women 29%) than in Black Caribbean (19%), Chinese (14%) or Irish women (14%). ●

Between 1999 and 2004, mean ferritin increased significantly in Pakistani and Irish men, and in Black Caribbean and Bangladeshi women.

●

The age-standardised prevalence of high glycated haemoglobin (≥7%) was considerably raised in Bangladeshi men (risk ratio 5.16) and women (6.20) and Pakistani women (6.39) and significantly lower in Irish men (0.44) and women (0.36), compared with the general population.

●

With the exception of Pakistani and Irish women, mean glycated haemoglobin was lower in 2004 than in 1999 in each minority ethnic group and in the general population.

Analytes from fasting blood sample

●

Among males aged 35 and over, no significant difference was found in agestandardised mean or prevalence of raised LDL-cholesterol (≥3 mmol/l) between minority ethnic groups and the general population (risk ratios not different from 1). Chinese women showed a standardised risk ratio significantly lower than 1 for both mean and prevalence of raised LDL-cholesterol (0.89 and 0.69 respectively).

●

Black Caribbean women showed significant increases in both mean LDL-cholesterol, from 3.1 mmol/l in 1999 to 3.4 mmol/l in 2004, and in the prevalence of raised LDLcholesterol, from 49% to 68%.

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Black Caribbean and Black African men and women, Irish men, and Chinese women aged 35 and over had lower mean triglyceride levels than the general population after age standardisation.

●

The prevalence of raised triglycerides (≥1.6 mmol/l) was lower in Black Caribbean men (risk ratio 0.32) and Black African men (risk ratio 0.45) and women (risk ratio 0.11) compared with the general population. Raised triglycerides were more common among Pakistani men (62%) than men in the general population, although after standardisation the risk ratio was not significantly different from 1.

●

Mean triglyceride levels in 2004 were lower than in 1999 among Irish men and women, Black Caribbean and Indian men, and Chinese women. The prevalence of raised triglyceride levels decreased among Black Caribbean and Irish men between the two years.

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Age-standardised mean fasting glucose levels were not significantly different between minority ethnic groups and the general population among male informants. Among women, Pakistani informants had a higher mean glucose level (risk ratio 1.21).

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There was a significant decrease in glucose levels from 1999 to 2004 in all minority ethnic groups in both sexes, except among Pakistani and Bangladeshi men and women, for whom the bases were too small to allow comparison.

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Fasting blood samples were not taken from adults under 35 before 2004, so for comparison with the general population (in 2003), summary results are those for adults aged 35 and over.

10.1 Introduction This chapter presents findings on blood analytes from a non-fasting and a fasting blood sample collected from seven minority ethnic groups - Black Caribbean, Black African, Indian, Pakistani, Bangladeshi, Chinese, and Irish - during the HSE 2004 nurse visit. The general population data presented are from HSE 2003, as the general population did not receive a nurse visit in 2004. Measurements taken on the non-fasting blood samples were total and HDL- cholesterol, Creactive protein, fibrinogen, haemoglobin, ferritin, and glycated haemoglobin. LDLcholesterol, triglycerides, and glucose were measured on the fasting blood samples. For each of these, introductory information is presented, followed by the results of the analyses. These same analytes were measured in HSE 1999, and comparisons are made where possible. Tables comparing 2004 data with 1999 do not include Black African informants, who were not included in HSE 1999.

10.2 Response to non-fasting and fasting blood samples and percentage of valid samples for each analyte Response rates for the non-fasting blood sample were highest from Indian and Irish men (77% of those who had a nurse visit, the same as for men in the general population), while for the other minority ethnic groups the percentage ranged from 58% in Chinese men to 67% in Black Caribbean and Pakistani men. Among women, response rates were slightly lower than among men. They were above 70% only in Irish women (78%) and women in the general population (72%), and otherwise ranged from 53% in Bangladeshi women to 67% in Indian women. The remainder of informants refused to give a blood sample, were ineligible (because on anticoagulants or were pregnant), or the nurse was unable to obtain a sample from them. Section 6.3 in Volume 2 gives more details of response rates to the different stages of the survey. Table 10.1 Among non-fasting blood sample analytes, there was a lower proportion of valid fibrinogen and haemoglobin samples analysed than for the other analytes in each ethnic group. Table 10.2

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All those aged 16 and over in minority ethnic groups were eligible to give a fasting blood sample in HSE 2004. The proportion of informants providing fasting blood samples was low, ranging from 23% of Bangladeshi men to 46% of Irish men (compared with 59% of men in the general population), and from 18% of Bangladeshi women to 50% of Irish women (compared with 60% of women in the general population). However, fasting blood samples were sought from (all) adults aged 16 and over from minority ethnic groups in 2004 who had a nurse visit, but only from (a random sample of) adults aged 35 and over in the general population in 2003, so response rates are not directly comparable. Tables 10.1, 10.2 The small numbers of available cases in some groups, especially for fasting blood, result in large confidence intervals. In some groups, the samples have been judged too small for data to be shown in the tables. Consequently, tables by income are not presented in this chapter. Where the response rate is low, there is also a possibility that those who do not provide blood have different characteristics from those who do. Some caution is therefore necessary when interpreting the results.

10.3 Total cholesterol and HDL-cholesterol 10.3.1

Introduction Cholesterol is a lipid (fat-like substance) that is essential for the body in small amounts. It is present in cell membranes and is used to form steroid hormones and bile acids. Some is made in the liver and some is obtained from the diet. Blood levels depend to a large extent on dietary saturated fat intake and on body weight1 but also on genetic ability to handle

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cholesterol. Raised blood cholesterol levels are associated with the development of atheroma in arteries, narrowing or blocking them, limiting blood supply to that part of the body. Reducing total cholesterol levels with drugs, particularly statins, significantly reduces the risks of developing or dying from ischaemic heart disease (IHD) in people with existing disease (secondary prevention)2,3 and in those without (primary prevention)4 without increasing risks of other diseases. This report uses high risk level thresholds as defined in the 1998 Joint British Recommendations on prevention of coronary heart disease in clinical practice,5 to facilitate comparisons with HSE 1999. Revised recommendations (JBS 2) were published in 2005. These recommended an optimal level for total cholesterol of <4.0 mmol/l in those with established cardiovascular disease (CVD), people with diabetes, or those at high risk of developing CVD (10 year risk ≥20%) but recommended retaining 5.0 mmol/l as an audit standard.6 Results from HSE 1999 showed that mean total cholesterol was generally lower in minority ethnic groups than in the general population, except for Indian and Irish men. Prevalence of raised cholesterol was lower than in the general population in Black Caribbean, Pakistani and Chinese men and in women from each minority ethnic group except for Irish women.7 Cholesterol is carried round the body in three main forms: LDL-cholesterol (see section 10.10); VLDL-cholesterol (rich in triglycerides, see section 10.11); and HDL-cholesterol. HDL- (High Density Lipoprotein-) cholesterol is protective against IHD. Physiologically, the role of HDL-cholesterol is to transport excess cholesterol from peripheral tissues to the liver for excretion. It may also reduce the risk of thrombosis by inhibiting platelet activation and aggregation.8 The link between low levels of HDL-cholesterol and an increased risk of IHD is well established.9 Recommendations to manage low HDL-cholesterol in clinical practice were set up by a panel of international experts in 2002.10 The cut-off point of ≥1.0 mmol/l is the recommended goal to be achieved for patients with CVD, and those who are at high risk of the disease. Both animal and epidemiological studies have suggested that raising the level of HDLcholesterol may prevent the development of atherosclerosis.11 Lifestyle modifications which lead to cardiovascular benefits, such as regular aerobic exercise, smoking cessation, weight control, moderate alcohol consumption, and a diet moderate in unsaturated fat, have been shown to increase HDL-cholesterol.1,10,12,13,14 These improvements are greatest in those with the highest HDL levels.11 A number of ‘lipid-lowering’ drugs increase HDL levels as well as decreasing levels of LDL-cholesterol and triglycerides. HDL-cholesterol levels in American studies were higher in Black than in white participants.15 HSE 1999 found that mean HDL-cholesterol levels and prevalence of desirable HDL levels were lower in the Pakistani and Bangladeshi populations and in Indian women, but were higher than the general population in Black Caribbean men.7 Tables presenting cholesterol data in this chapter include informants who reported taking lipid-lowering drugs. Total cholesterol and HDL-cholesterol, by minority ethnic group Among men, mean total cholesterol was lower in Black Caribbean, Black African and Chinese informants (5.1 mmol/l) than the general population (5.5 mmol/l); this remained after age standardisation. Age-standardised risk ratios are used to take account of differences in the age profile of different minority ethnic groups (see chapter 1, section 1.6.5). Risk ratios in these three minority ethnic groups were 0.93, 0.95 and 0.96 respectively. Among women, mean total cholesterol levels were higher in the general population and Irish informants (5.6 mmol/l in each) than among women in other ethnic groups, but after age standardisation, the risk ratio in Black African and Bangladeshi women was not significantly different from the general population. No significant sex differences were observed within the minority ethnic groups for mean total cholesterol. Mean total cholesterol increased with age in both sexes.

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10.3.2

The prevalence of high total cholesterol (≥5.0 mmol/l) was significantly lower among Black Caribbean (51%) and Pakistani (55%) men than among Irish men (67%) and men in the general population (66%), but after age standardisation, only Black Caribbean men had a risk ratio significantly below 1 (0.82). Irish women and women in the general population had greater prevalence of high total cholesterol (both 67%) than women in other ethnic groups, where prevalence ranged from 56% of Black Caribbean women down to 44% of Black African women. Nevertheless, after age standardisation, only Indian women had a standardised risk ratio significantly lower than 1 (0.86). Mean HDL-cholesterol was generally higher in women than in men in each minority ethnic group and in the general population. Mean HDL-cholesterol was lower in Indian (1.3 mmol/l), Chinese (1.3 mmol/l), Pakistani (1.2 mmol/l) and Bangladeshi (1.1 mmol/l) men than among men in the general population (1.4 mmol/l). Black African, Indian and Pakistani women (each 1.4 mmol/l) and Bangladeshi women (1.2 mmol/l) had lower mean HDLcholesterol than women in the general population (1.6 mmol/l). After standardisation, Indian, Pakistani and Bangladeshi informants had a risk ratio significantly below 1 in both sexes. Apart from Chinese informants, prevalence of low HDL-cholesterol (<1.0 mmol/l) was considerably higher among the groups with a lower mean HDL-cholesterol: Indian (11.0% of men and 3.9% of women), Pakistani (19.8% of men and 5.6% of women) and Bangladeshi (19.5% of men and 8.1% of women) than in the general population (6.3% of men and 1.9% of women). After standardisation, the risk ratio for the prevalence of low HDL-cholesterol was significantly higher than 1 only in Pakistani men (3.00) and Bangladeshi men (2.82) and women (4.64), while it was significantly lower than 1 in Black African men (0.31). Table 10.3, Figure 10A Figure 10A Prevalence of low HDL, by minority ethnic group Women

Risk ratio, logarithmic scale

Men 10.0

10.0

2.0

2.0

1.0

1.0

0.5

0.5

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Bl

General population = 1.0. Error bars indicate 95% confidence limits.

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10.3.3

Comparison of total cholesterol and HDL-cholesterol levels in 2004 and 1999, by minority ethnic group Overall, the patterns of total and HDL-cholesterol seen in minority ethnic groups differed little in 2004 from those seen in 1999. Pakistani and Bangladeshi men and women and Black Caribbean women showed an increase in mean total cholesterol from 1999 to 2004. Due to this rise, the differences in mean total cholesterol between the minority ethnic groups and the general population reduced in 2004 compared with 1999. No significant change was found in mean HDL-cholesterol comparing 2004 with 1999. Tables 10.4, 10.5

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10.4 C-reactive protein C-reactive protein (CRP) is an acute phase reactant that increases during the host response to tissue injury, including that caused by infection, trauma, malignant disease and chronic inflammatory conditions.16 CRP levels are positively associated with the risk of myocardial infarction (heart attack),17 stroke,18 peripheral arterial disease,17 and cognitive disorders, including dementia.18 CRP is associated with impaired endothelial function and is positively correlated with smoking, BMI, and impaired lung function.19 CRP levels increase with age20 and are higher in women than men both in the general population16 and in minority ethnic groups.7,21 There is an inverse relationship between CRP levels and income20 but no general relationship with social class.7 Black adults in America have higher CRP levels than white.21 CRP levels are higher in South Asian populations and lower in African-Caribbean groups than Europeans in the UK.15 Compared with the general population, high CRP levels were more prevalent in Pakistani women in HSE 1999 and were less common in Chinese men and women and Black Caribbean men.7 Circulating levels of CRP are usually low in healthy people (median 1mg/l) but can rise to 1,000mg/l during the acute phase response to injury or inflammation. Distribution is therefore not normal, being skewed to the left, as only small numbers of individuals in the general population have such high levels at any one time. Both the arithmetic mean and the median are therefore presented in the tables. There are no population-based thresholds for CRP in the general population or for minority ethnic groups. For this report, the definition for the proportion of informants with the highest levels was set as those with C-reactive protein levels >3.6 mg/l in men and >5.2 mg/l in women, to correspond with the sex-specific thresholds for the top quintile in the 2003 general population. However, for comparison with 1999, the quintile distribution from 1998 general population was used in table 10.7. 10.4.1

C-reactive protein, by minority ethnic group Mean C-reactive protein ranged from 1.3 mg/l and 1.2 mg/l in Chinese men and women to 4.7 mg/l and 4.0 mg/l in Pakistani men and women, respectively. There were no statistically significant sex differences in mean C-reactive protein levels among minority ethnic groups. In the general population the mean value was higher among women (3.8 mg/l) than men (3.1 mg/l). Mean C-reactive protein increased with age in all the groups. After age standardisation, Chinese informants showed lower C-reactive protein levels than the general population in both sexes (risk ratio 0.59 among men and 0.54 among women). The proportion of informants with C-reactive protein in the top quintile was also lower in Chinese men (7%) and women (3%), with standardised risk ratio significantly lower only for women (0.33). Pakistani informants were significantly more likely to have a high level of Creactive protein (30% of men, 24% of women, risk ratios 1.64 and 1.50 respectively). Tables 10.6, 10.7

Comparison of C-reactive protein levels in 2004 and 1999, by minority ethnic group Mean C-reactive protein generally did not change between 1999 and 2004, showing similar patterns between the different ethnic groups. The only significant increase was found in the proportion of informants with C-reactive protein in the top quintile among Pakistani men (from 14% in 1999 to 29% in 2004). Table 10.7

10.5 Fibrinogen 10.5.1

Introduction Fibrinogen, a glycoprotein, is a determinant of platelet aggregation and blood viscosity. It is strongly and independently associated with cardiovascular risk.22 Raised fibrinogen is a major risk factor for ischaemic heart disease, stroke, hypertension, and cancer.23,24,25 306

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10.4.2

Fibrinogen levels increase with age and are higher in women than men;7,20 no ethnic differences were found in HSE 19997 but fibrinogen is related to socio-economic position.20 10.5.2

Fibrinogen, by minority ethnic group Black Caribbean, Black African and Chinese men had lower levels of fibrinogen (mean 2.6 g/l) than the other minority ethnic groups (mean 2.8 g/l to 2.9 g/l). Chinese women had lower fibrinogen levels (mean 2.7 g/l) than women in the other minority ethnic groups. After age standardisation, Black Caribbean men and Chinese women had lower mean fibrinogen levels than the general population (standardised ratio 0.95, 0.91 respectively), while Pakistani women had a significantly higher mean level (standardised risk ratio 1.12). Mean and median fibrinogen generally increased with age and were higher in women than in men in all groups. Tables 10.8, 10.9

10.5.3

Comparison of fibrinogen levels in 2004 and 1999, by minority ethnic group Mean fibrinogen levels in 2004 were higher than in 1999 in most minority ethnic groups and in the general population, except in Black Caribbean and Bangladeshi men and Chinese men and women. The increase was considerable in most groups, with increases of 0.4 g/l in Pakistani men and women and Bangladeshi women. Since the levels of fibrinogen rose in some ethnic groups but not others between 1999 and 2004, the general pattern between the minority ethnic groups was different in 2004 from that seen in 1999. No difference between the ethnic groups was found in 1999. In 2004, the standardised risk ratios were significantly lower than 1 in Black Caribbean men and Chinese women. Table 10.9

10.6 Haemoglobin 10.6.1

Introduction Haemoglobin, an iron-containing protein in red blood cells, carries oxygen from the lungs to the rest of the body. Low levels of haemoglobin can be caused by blood loss, dietary deficiencies, or problems with producing haemoglobin (such as sickle cell disease), leading to anaemia. Certain physiological adjustments can also lead to a low haemoglobin. Raised levels (polycythaemia or erythrocytosis) can also occur in response to physiological changes or disease. Mean haemoglobin levels are higher in men than women, due to menstrual blood loss in women of childbearing age. HSE 1999 found that anaemia was a little more common in Pakistani men and about three times higher in Black Caribbean, Indian, Pakistani and Bangladeshi women than in the general population.7

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10.6.2

Haemoglobin, by minority ethnic group Mean haemoglobin (Hb) was lower in Black Caribbean (14.5 g/dl), Black African (14.8 g/dl) and Indian (14.8 g/dl) men than Pakistani (15.2 g/dl), Bangladeshi (15.2 g/dl) and Chinese (15.1 g/dl) men. Among women, mean haemoglobin ranged from 12.5 g/dl in Black African women to 13.5 g/dl in Irish women. Mean haemoglobin was lower in women than in men in each minority ethnic group. Haemoglobin was not measured in HSE 2003, so no comparisons have been made with the general population and risk ratios are not presented in Table 10.10. To facilitate comparison with HSE 1999 results, anaemia was defined in the same way (haemoglobin <12.0 g/dl). The prevalence of anaemia was very low among men, ranging from 0% in Chinese and Irish informants to 4.4% in Black Caribbean men. Anaemia was much more common among women. It was lower among Chinese (7.3%) and Irish (5.7%) informants than in other women, but otherwise ranged from 16.4% in Black Caribbean women to 29.0% in Indian women. Table 10.10, Figure 10B

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Figure 10B Prevalence of anaemia (Hb <12g/dl), by minority ethnic group

Men Women

30 25

Percent

20

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10.6.3

Comparison of haemoglobin levels in 2004 and 1999, by minority ethnic group With the exception of Pakistani women, who showed an increase in mean haemoglobin from 12.4 g/dl in 1999 to 13.0 g/dl in 2004, mean haemoglobin did not change between 1999 and 2004, showing similar patterns between the different ethnic groups. The prevalence of anaemia decreased in Black Caribbean women (to 16.4% in 2004 from 25.5% in 1999) and in Pakistani women (to 20.5% from 30.3%). Table 10.11

10.7 Ferritin 10.7.1

Introduction Ferritin is the main protein for the storage of iron. Serum ferritin levels correlate directly with the amount of iron stored in the body. Low ferritin levels indicate iron-deficiency. Plasma ferritin levels can be raised by iron overload, liver disease, infections, inflammation, and malignancy. This report focuses on prevalence of low ferritin levels. Low ferritin levels were found more commonly in HSE 1999 than in Indian and Pakistani men and women and Bangladeshi women in the general population.7 Ferritin, by minority ethnic group Mean ferritin was higher in men than in women in each minority ethnic group. Among men, mean ferritin was lowest in Indian (91.3 ng/ml) and Bangladeshi (100.0 ng/ml) informants and highest in Chinese informants (220.7 ng/ml). Among women, it was lowest in Indian informants (33.8 ng/ml) and highest in Chinese informants (79.3 ng/ml). Ferritin was not measured in HSE 2003, so no comparisons have been made with the general population and risk ratios are not presented in table 10.12. The prevalence of low ferritin (levels equivalent to the bottom quintile of the general population in 1998) among Indian men was higher (33%) than among any other ethnic group, with a very low prevalence among Chinese men (3%). Among women, the proportion with low ferritin ranged from 14% in Chinese informants to 48% in Indian informants. Prevalence of low ferritin was higher in Indian, Pakistani and Bangladeshi women than in Black Caribbean, Chinese or Irish women. Among women, mean ferritin increased with age in most minority ethnic groups but the pattern was less clear among men. Tables 10.12, 10.13

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10.7.2

10.7.3

Comparison of ferritin levels in 2004 and 1999, by minority ethnic group Mean ferritin increased in almost every group between 1999 and 2004 but the rise was statistically significant only in Pakistani and Irish men, and in Black Caribbean and Bangladeshi women. Pakistani men and Bangladeshi women also showed a decrease in the proportion of informants with ferritin in the bottom quintile. Overall patterns between the different ethnic groups did not change. Table 10.13

10.8 Glycated haemoglobin 10.8.1

Introduction Glycated haemoglobin (HbA1c) is circulating haemoglobin to which glucose is bound. Levels of glycated haemoglobin indicate the average blood glucose levels over the preceding three months. It is used to monitor control of blood sugar in diabetics: high levels indicate individuals at higher risk of micro- and macro-vascular complications. It has also been suggested as a screening test for diabetes.26 Raised levels are taken as 7% or above. Given the known increased risk of diabetes in Black Caribbean and South Asian groups, it is not surprising that glycated haemoglobin levels were higher in these groups, and also in Chinese informants, than in the general population or Irish participants in HSE 1999.7

10.8.2

Glycated haemoglobin, by minority ethnic group Mean glycated haemoglobin was generally slightly higher in minority ethnic groups than in the general population (5.3% in both sexes), with the exception of Chinese and Irish men and women and Black African women. There was no gender difference in mean glycated haemoglobin, which increased with age in both sexes. After age standardisation, mean levels in Indian, Pakistani and Bangladeshi men and women, Black African men, and Black Caribbean women were significantly higher than in the general population. The proportion of informants with high glycated haemoglobin (≥7%) was higher in Indian (6.4%), Pakistani (6.5%) and Bangladeshi (10.7%) men than among men in the general population (2.8%), and in Black Caribbean (4.9%), Pakistani (7.0%) and Bangladeshi (6.9%) women than among women in the general population (2.4%). After age standardisation, the likelihood of high glycated haemoglobin was significantly raised in Bangladeshi men (risk ratio 5.16) and women (6.20) and Pakistani women (6.39) and significantly lower in Irish men and women (0.44 in men and 0.36 in women), compared with the general population. Tables 10.14, 10.15

10.8.3

Comparison of glycated haemoglobin levels in 2004 and 1999, by minority ethnic group

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With the exception of Pakistani and Irish women, mean glycated haemoglobin levels in each minority ethnic group and in the general population were lower in 2004 than in 1999. The change over time was consistent in all groups, so patterns between the different ethnic groups did not change. Table 10.15, Figure 10C

10.9 Fasting blood samples Levels of LDL-cholesterol, triglycerides, and glucose vary in response to meals, with postprandial samples being transiently raised. Analysis of these substances was therefore made on fasting blood samples. Fewer informants agreed to fast prior to giving a blood sample (see Tables 10.1 and 10.2), so the bases are small for some groups. Care is therefore needed when interpreting the results; results have been commented on in the text below only when there were at least 50 informants in the group or where the difference was statistically significant, even allowing for the small base. General population comparisons are made with results from HSE 2003, in which fasting blood samples were requested only from a random sample of informants aged 35 and over.

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Figure 10C Mean glycated haemoglobin levels in 1999 and 2004, by minority ethnic group Women

Men

Percent

1999 2004

6.5

6.5

6.0

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5.5

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al er on en ti G ula p po sh Iri se i ne hi sh C de la ng Ba n i a st ki Pa an di In k n ac ea Bl ibb ar C

10.10 LDL-cholesterol 10.10.1 Introduction Low-density lipoprotein (LDL), the predominant form of cholesterol in the blood, is the complex of fat and protein that transports cholesterol into the blood from the liver. Whereas HDL-cholesterol is protective against cardiovascular disease, LDL-cholesterol is the main cause of fatty deposits (atheromatous plaques) on the walls of the arteries (‘narrowing of the arteries’). The higher the LDL-cholesterol level, the greater the risk of heart disease.27 Reducing LDL-cholesterol by drugs, particularly statins, reduces heart disease,2,3,4 strokes,28 and all-cause mortality.29 New guidance from NICE (National Institute for Health and Clinical Excellence) has recommended the use of statins for prevention of cardiovascular disease in adults who have a 20% or greater 10-year risk of developing cardiovascular disease.30

In HSE 1999, prevalence of high LDL-cholesterol was higher in Indian and Irish men and women and Black Caribbean and Chinese men, while levels were slightly lower in Pakistani men and women, Bangladeshi men, and Black Caribbean and Chinese women, than in informants in the general population.7 Other studies have also found lower levels of LDLcholesterol in the Bangladeshi population.33,34 There is no information available about the effectiveness of statins or the effects of cholesterol-lowering in most minority ethnic groups30 but one study has found greater effectiveness of statin treatment in Black than white participants, although LDL-cholesterol levels are generally lower in the Black population.15 10.10.2 LDL-cholesterol, by minority ethnic group Among men aged 16 and over, Indian informants had the highest mean LDL-cholesterol level (3.6 mmol/l), while Black African and Chinese informants had the lowest (each 3.1 mmol/l). Among women aged 16 and over, mean LDL-cholesterol was lowest in Chinese informants (2.7 mmol/l). It was highest in Irish informants (3.5 mmol/l), being significantly higher than in any other minority ethnic group. LDL-cholesterol levels were higher in Indian and Chinese men than in women from the same ethnic group. 310

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Although there is no definite threshold below which LDL-cholesterol is not associated with lower risk of cardiovascular disease,31 the current Department of Health recommendation is for LDL-cholesterol to be below 3.0 mmol/l in people at high risk of cardiovascular disease.32 In this report, an LDL-cholesterol level of 3.0 mmol/l or above is referred to as ‘high’.

The prevalence of high LDL-cholesterol levels (≥3.0 mmol/l) among males aged 16 and over in minority ethnic groups ranged from 56% in Black African to 68% in Indian and Irish men and 72% in Bangladeshi men. However, caution is needed for this last result because of small numbers. The proportion with raised LDL-cholesterol was significantly lower in Chinese females (30%) than Irish females (67%) and Black Caribbean females (60%) among those aged 16 and over. Among informants aged 35 and over, mean LDL-cholesterol ranged from 3.3 mmol/l in Black Caribbean to 3.7 mmol/l in Indian men. Only Black Caribbean men (61%), Black African women (52%) and Chinese women (46%) had significantly lower prevalence of raised LDL-cholesterol than the general population (77% of men, 74% of women). However, after age standardisation, no significant difference was found between minority ethnic groups and the general population among men. Among women, Chinese women showed a risk ratio significantly lower than 1 for both mean and prevalence of raised LDLcholesterol (0.89 and 0.69 respectively). Table 10.16 10.10.3 Comparison of LDL-cholesterol levels in 2004 and 1999, by minority ethnic group Comparison between the two years for fasting blood samples is possible only for informants aged 35 and over, as fasting blood samples were not taken from informants under 35 in HSE before 2004. Consequently the bases in most groups are too small to comment on changes. The only significant change was found in Black Caribbean women, who showed an increase from 3.1 mmol/l in 1999 to 3.4 mmol/l in 2004 in mean LDLcholesterol, and from 49% to 68% in the prevalence of raised LDL-cholesterol. Table 10.17

10.11 Triglycerides 10.11.1 Introduction Triglycerides, comprising fatty acids and glycerol, are formed in the intestine from dietary fat. They appear in the blood after fat-containing meals. Triglyceride levels are inversely related to HDL-cholesterol but raised triglyceride levels, which are associated with diabetes, are also independently associated with cardiovascular disease.35 High serum triglyceride levels are found more commonly in Bangladeshi men and women.7,34,35 Higher levels than in the general population were also found in Indian, Pakistani and Irish men and women and Chinese women in HSE 1999.7 Levels are generally lower in Black adults.15 10.11.2 Triglycerides, by minority ethnic group

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Among men aged 16 and over, Indian, Pakistani, Bangladeshi and Irish informants had higher mean triglycerides than the other minority ethnic groups. Pakistani and Bangladeshi men also had higher prevalence of raised triglycerides (52% and 53%) than any other ethnic group. A similar pattern was found among women: Indian, Pakistani, Bangladeshi and Irish informants had higher mean triglycerides and higher prevalence of raised triglycerides than Black Caribbean and Black African informants. Black Caribbean and Black African men and women, Irish men, and Chinese women aged 35 and over had lower mean triglyceride levels than the general population, confirmed after age standardisation. Black Caribbean and Black African men and women aged 35 and over also had lower prevalence of raised triglycerides (≥1.6 mmol/l) (Black Caribbean: 14% of both men and women; Black African: 18% men and 4% women) compared with the general population (41% men and 31% women), Irish (36% men and 25% women) and Indian (42% men and 29% women) groups. However, raised triglycerides was more common among Pakistani men (62%) than among men in the general population. After age standardisation, the risk

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES

311

ratio was significantly lower than 1 in Black Caribbean men (0.32) and Black African men (0.45) and women (0.11). Mean triglycerides and prevalence of raised triglycerides were generally higher among men than women. Table 10.18 10.11.3 Comparison of triglycerides in 2004 and 1999, by minority ethnic group Comparing 2004 with 1999, there was a decrease over time in mean triglycerides among Irish men and women, Black Caribbean and Indian men, and Chinese women. Black Caribbean and Irish men also showed a decrease in the prevalence of raised triglyceride levels. The pattern between the ethnic groups changed between the two years as the differences between the minority ethnic groups and the general population reduced: Irish men and Indian men, and Chinese women had significantly higher triglycerides than the general population in 1999 but not in 2004. Table 10.19

10.12 Glucose 10.12.1 Introduction Glucose (‘blood sugar’) is a source of energy for tissue cells, and the only source of energy for some types of cell. Blood levels are regulated by the liver, which removes glucose after meals and produces glucose during overnight fast. High blood glucose levels are harmful, causing damage to the eye,36 kidneys,37 and nerves,38 as well as increasing the risk of cardiovascular disease.39 The UK uses the WHO guidelines level for diagnosing diabetes: a fasting glucose of 7.0 mmol/l or above.40 Mean fasting glucose and the prevalence of raised levels both increase with age.20 Type 2 diabetes is much more common in Black Caribbean and South Asian groups.41 Both mean fasting glucose and prevalence of raised levels were higher in Asian populations than the general population in England in HSE 1999; prevalence of raised levels but not mean levels were also higher in Irish and Black Caribbean men.7 10.12.2 Glucose, by minority ethnic group Among informants aged 16 and over, mean glucose ranged from 4.8 mmol/l in Chinese men and women to 5.6 mmol/l in Black African men and 6.0 mmol/l in Pakistani women. The prevalence of raised glucose ranged from 2.3% in Chinese men to 9.7% in Black African men, and from 0% in Chinese women to 9.9% in Pakistani women. (Prevalence of raised glucose was 10.2% in Bangladeshi women but the base size was small.)

10.12.3 Comparison of glucose in 2004 and 1999, by minority ethnic group There was a general and significant decrease in mean glucose levels in all minority ethnic groups in both sexes, with the exception of Pakistani and Bangladeshi men and women, for whom the bases were too small to enable comparison. The pattern between ethnic groups did not change over time. Table 10.21

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HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES

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Irish men aged 35 and over had lower mean glucose (5.1 mmol/l) than general population men (5.3 mmol/l) but after age standardisation the risk ratio was not significantly different from 1. Among women aged 35 and over, after age standardisation, only Pakistani informants had a higher mean glucose level (risk ratio 1.21) than the general population. Black African and Indian men aged 35 and over had higher prevalence of raised glucose (≥7 mmol/l) (16.2% and 12.0% respectively) than men in the general population (5.1%), though numbers of Black African informants were small. After age standardisation, no significant difference was found in the prevalence of raised glucose between any minority ethnic group and the general population in men or women. Table 10.20

References and notes 1 Denke MA, Sempos CT, Grundy SM. Excess body weight: an underrecognized contributor to high blood cholesterol levels in white American men. Arch Intern Med 1993; 153:1093-1103. 2 Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol-lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study. Lancet. 1994; 344:1383-1389. 3 Heart Protection Study Collaborative Group. MRC / BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lancet. 2002; 360:7-22. 4 Shepherd J, Cobbe SM, Ford I et al. Prevention of Coronary Heart Disease with pravastatin in men with hypercholesterolemia. N Engl J Med 1995; 333:1301-1308. 5 Wood DA, Durrington P, Poulter N, et al. Joint British recommendations on prevention of coronary heart disease in clinical practice. Heart. 1998; 80:S1-29. 6 British Cardiac Society, British Hypertension Society, Diabetes UK, HEART UK, Primary Care Cardiovascular Society, The Stroke Association. JBS 2: Joint British Societies’ guidelines on prevention of cardiovascular disease in clinical practice. Heart. 2005; 91 (Suppl V):v1-v52. 7 Falaschetti E, Primatesta P. Blood analytes. In Erens B, Primatesta P, Prior G (eds). Health Survey for England: The health of minority ethnic groups 1999. Volume 1: Findings. TSO, London, 2001. 8 Shah PK, Kaul S, Nilsson J et al. Exploiting the vascular protective effects of high-density lipoprotein and its apolipoproteins: an idea whose time for testing is coming. Circulation 2001; 104:2376-2383. 9 AssmannG, Schulte H, von Eckartstein A, et al. High density lipoprotein cholesterol as a predictor of coronary heart disease risk. The PROCAM experience and pathophysiological implications for reverse cholesterol transport. Atherosclerosis, 1996; 79:8-15. 10 Sacks FM, For the Expert Group on HDL-cholesterol. The role of high density lipoprotein (HDL) cholesterol on the prevention of coronary heart disease; Expert Group Recommendations. Am J Cardiol, 2002; 90:139-143. 11 Ashen MD, Blumenthal RS. Low HDL cholesterol levels. N Eng J Med, 2005; 353:1252-1260. 12 King AC, Haskell WL, Young DR et al. Long-term effects of varying intensities and formats of physical activity on participation rates, fitness, and lipoproteins in men and women aged 50 to 65 years. Circulation 1995; 91:2596-2604. 13 Ellison RC, Zhang Y, Qureshi MM et al. Lifestyle determinants of high-density lipoprotein cholesterol: the national Heart, Lung and Blood Institute Family Heart Study. Am Heart J 2004; 1478:529-535. 14 Meksawan K, Pendergast DR, Leddy JJ et al. Effects of low and high fat diets on nutrient intakes and selected cardiovascular risk factors in sedentary men and women. J Am Coll Nutr 2004; 23:131-140. 15 Albert MA, Torres J, Glynn RJ et al. Perspective on selected issues in cardiovascular disease research with a focus on Black Americans. Circulation. 2004; 110:e7-e12. 16 Ledue TB, Rifai N. Preanalytical and analytical sources of variations in C-reactive protein measurement: implications for cardiovascular disease risk assessment. Clin Chem 2003; 49:1258-1271. 17 SitzerM, Markis HS, Mendell MA et al. C-reactive protein and carotid intimal medial thickness in a community populaton. Journal of Cardiovascular Risk, 2002; 9:97-103 18 Kuo H-K, Chang C-H, Kuo C-K, Chen J-H, Sorond F. Relation of C-reactive protein to stroke, cognitive disorders, and depression in the general population: systematic review and meta-analysis. Lancet Neurol 2005; 4:371-380. 19 Danesh J, Whincup PH, Walker M. Low-grade inflammation and coronary heart disease: new prospective studies and updated meta-analyses. BMJ. 2000; 32:199-204. 20 Chaudhury M. Blood analytes. In Sproston K, Primatesta P. Health Survey for England 2003. Volume 2: Risk factors for cardiovascular disease. TSO, London, 2004. 21 Khera A, McGuire DK, Murphy SA. Race and gender differences in C-reactive protein levels. J Am Coll Cardiol. 2005 46:464-469. Copyright © 2006, The Information Centre. All rights reserved

22 Koeing W. Fibrinogen in cardiovascular disease: an update. Thrombosis Haemostasis. 2003; 89:601-609. 23 Kannel WP, Wolf PA, Catelli WP et al. Fibrinogen and risk of cardiovascular disease: the Framingham Study. JAMA, 1987; 258:1183-1186. 24 Ernst E, Resch KL. Fibrinogen as a cardiovascular risk factor: a meta-analysis and review of the literature. Ann Inern Med, 1993; 118:956-963. 25 Mauriello A, Sangiorgi G, Palmieri G et al. Hyperfibrinogenemia is associated with specific histocytological composition and complications of atherosclerotic carotid plagues in patients affected by transient ischemic attacks. Circulation, 2000; 1017:744-750. 26 McCance DR, Hanson RL, Charles M-A, et al. Comparison of tests for glycated haemoglobin and fasting and two hour plasma glucose concentrations as diagnostic methods of diabetes. BMJ. 1994; 308:13231328.

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27 Stamler J, Vaccaro O, Neaton JD, Wentworth D, for the Multiple Risk Factor Intervention Trial Group. Diabetes, other risk factors, and 12-year cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care. 1993; 16:434-444. 28 Heart Protection Study Collaborative Group. Effect of cholesterol-lowering with simvastatin on stroke and other major vascular events in 20,536 people with cerebrovascular disease or other high-risk conditions. Lancet. 2004; 363:757-767. 29 Cholesterol Treatment Trialists’ Collaborators. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005; 366:1267-1278. 30 National Institute for Health and Clinical Excellence. Statins for the prevention of cardiovascular events. Technical appraisal 094. NICE, London, 2006. www.nice.org.uk/page.aspx?o=TA094guidanceword 31 Chen Z, Peto R, Collins R, et al. Serum cholesterol concentration and coronary heart disease in population with low cholesterol concentrations. BMJ. 1991; 303:276-282. 32 Department of Health. Coronary heart disease: national service framework for coronary heart disease modern standards and service models. DH, London, 2000. 33 McKeigue PM, Marmot MG, Sundercombe Court YD, et al. Diabetes, hyperinsulinaemia, and coronary risk factors in Bangladeshis in East London. Br Heart J. 1988; 60:390-396. 34 Bhopal R, Unwin N, White M, et al. Heterogeneity of coronary heart disease risk factors in Indian, Pakistani, Bangladeshi, and European origin populations: cross sectional study. BMJ. 1999;319:215-220. 35 Austin MA, Hokanson JE, Edwards KL. Hypertriglyceridaemia as a significant independent risk factor in coronary artery disease. Am J Cardiol. 1998; 81:7B-12B. 36 Swanson M. Retinopathy screening in individuals with type 2 diabetes: who, how, how often, and at what cost--an epidemiologic review. Optometry. 2005; 76:636-646. 37 O'Connor AS, Schelling JR. Diabetes and the Kidney. Am J Kidney Dis. 2005; 46:766-773. 38 Rathur HM, Boulton AJM. Recent advances in the diagnosis and management of diabetic neuropathy. J Bone Joint Surg Br 2005; 87-B:1605-1610. 39 Huxley R, Barzi F, Woodward M. Excess risk of fatal coronary heart disease associated with diabetes in men and women: meta-analysis of 37 prospective cohort studies. BMJ. 2006; 332:73-78. 40 Definition, diagnosis and classification of diabetes mellitus and its complications: a report of a WHO consultation. Part 1: Diagnosis and classification of diabetes mellitus. WHO, Department of Noncommunicable Disease Surveillance, Geneva, 1999 (WHO/NCD/99.2).

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41 Aspinall P, Jacobson B. Ethnic disparities in health and health care: A focused review of the evidence and selected examples of good practice. London Health Observatory, London, 2004.

Tables

10.1 Response to non-fasting and fasting blood samples, by minority ethnic group and sex 10.2 Percentages providing valid samples for each analyte, by minority ethnic group and sex

10.20 Glucose, by minority ethnic group and sex 10.21 Comparison of glucose in 2004 and 1999, by minority ethnic group and sex

10.3 Total cholesterol and HDL-cholesterol, by minority ethnic group and sex 10.4 Comparison of total cholesterol in 2004 and 1999, by age within minority ethnic group and sex 10.5 Comparison of HDL-cholesterol in 2004 and 1999, by age within minority ethnic group and sex 10.6 C-reactive protein, by minority ethnic group and sex 10.7 Comparison of C-reactive protein in 2004 and 1999, by age within minority ethnic group and sex 10.8 Fibrinogen, by minority ethnic group and sex 10.9 Comparison of fibrinogen, in 2004 and 1999, by age within minority ethnic group and sex 10.10 Haemoglobin, by minority ethnic group and sex 10.11 Comparison of haemoglobin in 2004 and 1999, by age within minority ethnic group and sex 10.12 Ferritin, by minority ethnic group and sex 10.13 Comparison of ferritin in 2004 and 1999, by age within minority ethnic group and sex

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10.14 Glycated haemoglobin, by minority ethnic group and sex 10.15 Comparison of glycated haemoglobin in 2004 and 1999, by age within minority ethnic group and sex 10.16 LDL-cholesterol, by minority ethnic group and sex 10.17 Comparison of LDL-cholesterol in 2004 and 1999, by minority ethnic group and sex 10.18 Triglycerides, by minority ethnic groups and sex 10.19 Comparison of triglycerides in 2004 and 1999, by minority ethnic group and sex HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES

315

Table 10.1 Response to non-fasting and fasting blood samples, by minority ethnic group and sex Aged 16 and over who had a nurse visit Whether blood obtained

2004

Minority ethnic group

General population (2003)a

Black Caribbean

Black African

Indian

%

%

%

%

67

66

77

3 8 22 40

7 2 26 39

1 8 51

Pakistani Bangladeshi

Chinese

Irish

%

%

%

%

67

60

58

77

77

2 4 16 39

5 3 25 39

3 1 36 23

5 2 35 38

4 6 12 46

3 5 15 59

1 2 58

3 4 54

1 3 58

3 1 72

2 2 59

1 6 46

13 5 22

64 5 4 26 41

56 6 7 31 35

67 8 6 19 41

56 4 13 26 24

53 10 5 31 18

57 5 5 34 39

78 4 4 14 50

72 5 7 16 60

2 4 52

4 7 54

2 6 52

2 13 61

6 5 70

1 5 56

1 4 45

12 5 23

218 327

165 216

316 382

208 260

143 185

183 199

320 418

5086 6322

218 327

165 216

316 382

208 260

143 185

183 199

320 418

659 800

Men Non-fasting blood obtained Consent given, no fasting blood obtained Ineligibleb Refused Fasting blood obtainedc Consent given, no fasting blood obtained Ineligible for fasting blood Refused fasting blood

Women Non-fasting blood obtained Consent given, no blood obtained Ineligibleb Refused Fasting blood obtainedc Consent given, no fasting blood obtained Ineligible for fasting blood Refused fasting blood Bases (unweighted) Non-fasting blood Men Women Fasting blood Men Women

a Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey. b On anticoagulant drugs or pregnant. c Fasting blood samples were sought from all adults aged 16 and over from minority ethnic groups in 2004 and from a random sample of adults aged 35

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and over in the general population in 2003.

Table 10.2 Percentages providing valid samples for each analyte, by minority ethnic group and sex Aged 16 and over who had a nurse visit Valid blood samples obtained

2004

Minority ethnic group

General population (2003)a

Black Caribbean

Black African

Indian

%

%

%

%

65 65 65 60 54 64 64

64 64 64 51 59 63 64

75 75 74 73 62 74 74

36 35 38

38 38 39

62 62 62 57 56 62 62

Pakistani Bangladeshi

Chinese

Irish

%

%

%

%

67 67 67 63 58 65 66

60 60 60 57 51 57 60

53 53 53 54 46 54 53

75 75 75 75 64 73 74

74 74 74 73 63 c c

35 34 39

34 34 38

21 19 22

35 35 37

42 41 44

51 49 58

54 54 54 44 50 51 52

66 66 65 64 60 62 63

56 56 56 54 46 52 53

51 51 51 52 44 48 47

55 55 55 55 50 53 53

77 77 77 75 66 76 77

70 70 69 69 59 c c

36 36 40

33 33 34

38 38 41

20 20 24

16 16 18

38 38 37

46 46 49

53 52 57

218 327

165 216

316 382

208 260

143 185

183 199

320 418

5086 6322

218 327

165 216

316 382

208 260

143 185

183 199

320 418

659 800

Men Non-fasting blood obtained Total cholesterol HDL-cholesterol C-reactive protein Fibrinogen Haemoglobin Ferritin Glycated haemoglobin Fasting blood obtainedb LDL-cholesterol Triglycerides Glucose

Women Non-fasting blood obtained Total cholesterol HDL-cholesterol C-reactive protein Fibrinogen Haemoglobin Ferritin Glycated haemoglobin Fasting blood obtainedb LDL-cholesterol Triglycerides Glucose Bases (unweighted) Non-fasting blood Men Women Fasting bloodb Men Women

a Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey. b Fasting blood samples were sought from all adults aged 16 and over from minority ethnic groups in 2004 and from a random sample of adults aged 35

and over in the general population in 2003.

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c Ferritin and glycated haemoglobin were not measured in blood samples from the general population in 2003.

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Table 10.3 Total cholesterol and HDL-cholesterol, by minority ethnic group and sex Aged 16 and over with valid total cholesterol measurement Total cholesterol/HDLcholesterol (mmol/l)

2004

Minority ethnic group Black Caribbean

Black African

General population (2003)a Indian

Pakistani Bangladeshi

Chinese

Irish

Men Total cholesterol Observed Mean Standard error of the mean

5.1

5.1

5.3

5.3

5.3

5.1

5.4

5.5

0.11

0.13

0.10

0.10

0.13

0.10

0.08

0.02

% ≥5.0 mmol/l Standardised risk ratios Mean total cholesterol: ratio of means

51

55

60

55

60

60

67

66

0.93

0.95

0.98

0.98

0.97

0.96

0.99

1

Standard error of the ratio

0.02

0.02

0.02

0.02

0.03

0.02

0.02

% ≥5.0 mmol/l (risk ratio)

0.82

0.87

0.94

0.90

0.93

1.05

1.02

Standard error of the ratio

0.08

0.09

0.07

0.07

0.09

0.08

0.08

HDL- cholesterol Observed Mean Standard error of the mean

1

1.4

1.4

1.3

1.2

1.1

1.3

1.4

1.4

0.03

0.04

0.02

0.03

0.03

0.03

0.02

0.01

% <1.0 mmol/l Standardised risk ratios Mean total cholesterol: ratio of means

3.6

2.1

11.0

19.8

19.5

7.7

5.1

6.3

1.01

1.02

0.92

0.85

0.84

0.97

1.01

1

Standard error of the ratio

0.02

0.04

0.02

0.02

0.02

0.03

0.02

% <1.0 mmol/l (risk ratio)

0.60

0.31

1.61

3.00

2.82

2.23

0.65

Standard error of the ratio

0.33

0.31

0.34

0.66

0.65

1.06

0.23

1

Women

Standard error of the mean

5.2

4.8

5.1

5.1

5.1

5.1

5.6

5.6

0.08

0.10

0.07

0.08

0.12

0.11

0.10

0.02

% ≥5.0 mmol/l Standardised risk ratios Mean total cholesterol: ratio of means

56

44

53

53

55

52

67

67

0.96

0.95

0.95

0.96

0.98

0.96

0.96

1

Standard error of the ratio

0.02

0.03

0.01

0.02

0.02

0.02

0.02

% ≥5.0 mmol/l (risk ratio)

0.88

0.92

0.86

0.92

0.98

0.90

0.85

Standard error of the ratio

0.08

0.09

0.06

0.08

0.09

0.09

0.08

HDL- cholesterol Observed Mean Standard error of the mean

1

1.6

1.4

1.4

1.4

1.2

1.7

1.6

1.6

0.03

0.03

0.02

0.03

0.02

0.04

0.03

0.01

% <1.0 mmol/l Standardised risk ratios Mean total cholesterol: ratio of means

1.3

3.1

3.9

5.6

8.1

1.3

1.8

1.9

0.97

0.97

0.87

0.84

0.76

1.04

0.96

1

Standard error of the ratio

0.02

0.05

0.01

0.02

0.02

0.03

0.02

% <1.0 mmol/l (risk ratio)

0.54

1.07

1.82

2.68

4.64

0.54

0.94

Standard error of the ratio

0.55

0.57

0.76

1.31

1.55

0.39

0.56

139 199

109 142

267 304

123 148

44 64

39 48

510 675

4020 4249

137 195

103 118

234 256

137 143

87 98

101 108

244 300

3814 4460

Bases (weighted) Men Women Bases (unweighted) Men Women

a Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey.

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Copyright © 2006, The

Total cholesterol Observed Mean

Table 10.4 Comparison of total cholesterol in 2004 and 1999, by age within minority ethnic group and sexa Aged 16 and over with valid total cholesterol measurement Total cholesterol (mmol/l)

Men 16-34

Women 35-54

55+

All men

16-34

35-54

55+

All women

Black Caribbean 2004 Mean

[4.7]

5.4

[5.2]

5.1

[4.7]

5.2

[5.9]

5.2

Standard error of the mean

[0.15]

0.17

[0.22]

0.11

[0.11]

0.13

[0.13]

0.08

% ≥5.0 mmol/l 1999 Mean

[32]

69

[48]

51

[32]

58

[83]

56

4.6

5.3

5.3

5.0

4.5

4.9

5.8

4.9

Standard error of the mean

0.09

0.13

0.10

0.06

0.08

0.08

0.12

0.06

31

62

68

52

27

44

80

45

% ≥5.0 mmol/l Indian 2004 Mean Standard error of the mean

% ≥5.0 mmol/l 1999 Mean Standard error of the mean

% ≥5.0 mmol/l Pakistani 2004 Mean Standard error of the mean

% ≥5.0 mmol/l 1999 Mean Standard error of the mean

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2004, 1999

Age group

5.1

5.7

5.0

5.3

4.6

5.2

[5.8 ]

5.1

0.17

0.11

0.18

0.10

0.10

0.09

[0.17 ]

0.07

45

75

52

60

29

64

[82]

53

4.8

5.7

5.6

5.4

4.6

5.1

5.6

5.0

0.09

0.07

0.13

0.06

0.07

0.07

0.14

0.05

41

72

74

62

35

52

76

50

5.0

5.7

[5.2]

5.3

4.9

5.3

b

5.1

0.15

0.15

[0.24]

0.10

0.08

0.14

b

0.08

49

66

[49]

55

44

61

b

53

4.7

5.3

[5.1]

5.0

4.5

5.1

b

4.8

0.09

0.08

[0.16]

0.06

0.06

0.09

b

0.06

35

62

[63]

49

28

57

b

41

% ≥5.0 mmol/l Bangladeshi 2004 Mean

[4.9]

[5.6]

b

5.3

4.8

[5.5]

b

5.1

Standard error of the mean

[0.19]

[0.18]

b

0.13

0.15

[0.14]

b

0.12

% ≥5.0 mmol/l 1999 Mean

[51]

[68]

b

60

43

[72]

b

55

4.5

5.4

[5.4]

5.0

4.5

[5.1]

b

4.7

Standard error of the mean

0.09

0.13

[0.14]

0.07

0.07

[0.15]

b

0.07

% ≥5.0 mmol/l Chinese 2004 Mean

32

64

[62]

48

24

[53]

b

36

[4.7]

[5.7]

b

5.1

[4.8]

5.2

b

5.1

Standard error of the mean

[0.12]

[0.12]

b

0.10

[0.15]

0.12

b

0.11

a Black Africans were included in the

2004 survey but not in 1999, and are therefore excluded from this comparative table.

% ≥5.0 mmol/l 1999 Mean

[46]

[78]

b

60

[42]

59

b

52

b Results are not shown because of

[4.5]

5.4

[5.4]

5.1

[4.6]

5.0

b

5.1

c Comparative data for the general

Standard error of the mean

[0.14]

0.10

[0.21]

0.08

[0.14]

0.08

b

0.07

[19]

72

[67]

56

[29]

51

b

49

% ≥5.0 mmol/l

small bases.

Continued…

population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which was weighted for nonresponse. The 2004 survey is weighted for differential selection probabilities and for non-response. d Comparative data for the general

population are not available on this topic from the 1999 survey, so data have been taken from the 1998 survey, in which no weighting was involved.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES

319

Table 10.4 continued

Aged 16 and over with valid total cholesterol measurement

Men 16-34

Irish 2004 Mean Standard error of the mean

% ≥5.0 mmol/l 1999 Mean Standard error of the mean

% ≥5.0 mmol/l General population 2003c Mean Standard error of the mean

% ≥5.0 mmol/l 1998d Mean Standard error of the mean

% ≥5.0 mmol/l

Women 35-54

55+

All men

16-34

35-54

55+

All women

5.2

5.5

5.5

5.4

[4.6]

5.5

6.2

5.6

0.15

0.12

0.16

0.08

[0.20]

0.11

0.19

0.10

62

71

66

67

[29]

67

84

67

4.9

5.6

5.5

5.4

4.7

5.4

6.1

5.4

0.13

0.07

0.09

0.06

0.08

0.07

0.09

0.05

40

77

72

68

34

62

91

63

4.9

5.8

5.6

5.5

4.8

5.6

6.2

5.6

0.04

0.03

0.03

0.02

0.03

0.03

0.03

0.02

45

79

72

66

43

69

85

67

4.9

5.6

5.7

5.5

4.8

5.4

6.3

5.6

0.03

0.02

0.03

0.02

0.02

0.02

0.03

0.02

41

74

78

66

39

66

90

67

52 54 119 173 45 67 18 15 13 24 191 454 1463 d

41 68 62 61 25 22 6 12 5 9 189 282 1268 d

139 201 267 357 123 177 44 53 39 47 510 947 4020 d

66 88 116 132 79 96 39 29 23 13 125 302 1289 d

86 113 147 162 52 54 18 11 22 35 277 597 1469 d

48 50 41 59 17 13 6 3 3 7 273 365 1491 d

199 252 304 353 148 162 64 43 48 56 675 1264 4249 d

59 79 117 185 51 115 38 56 41 73 100 151 1478 1897

40 96 52 65 27 37 12 39 16 31 87 104 1488 1644

137 285 234 379 137 301 87 198 101 149 244 326 3814 4874

47 131 82 136 70 164 56 114 43 41 49 107 942 1417

99 167 133 176 55 94 32 49 57 110 126 197 1716 2147

49 70 41 64 18 23 10 13 8 24 125 135 1802 1894

195 368 256 376 143 281 98 176 108 175 300 439 4460 5458

Bases (weighted) Black Caribbean 2004 46 Black Caribbean 1999 80 Indian 2004 85 Indian 1999 123 Pakistani 2004 53 Pakistani 1999 88 Bangladeshi 2004 21 Bangladeshi 1999 26 Chinese 2004 20 Chinese 1999 14 Irish 2004 130 Irish 1999 211 General population (2003)c 1288 General population (1998) d Bases (unweighted) Black Caribbean 2004 38 Black Caribbean 1999 110 Indian 2004 65 Indian 1999 129 Pakistani 2004 59 Pakistani 1999 149 Bangladeshi 2004 37 Bangladeshi 1999 103 Chinese 2004 44 Chinese 1999 45 Irish 2004 57 Irish 1999 71 General population (2003)c 848 General population (1998)d 1333

320

2004, 1999

Age group

a Black Africans were included in the

2004 survey but not in 1999, and are therefore excluded from this comparative table. b Results are not shown because of

small bases. c Comparative data for the general

population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which was weighted for nonresponse. The 2004 survey is weighted for differential selection probabilities and for non-response. d Comparative data for the general

population are not available on this topic from the 1999 survey, so data have been taken from the 1998 survey, in which no weighting was involved.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES

Copyright © 2006, The Information Centre. All rights reserved

Total cholesterol (mmol/l)

Table 10.5 Comparison of HDL-cholesterol in 2004 and 1999, by age within minority ethnic group and sexa Aged 16 and over with valid HDL-cholesterol measurement HDL-cholesterol (mmol/l)

Men 16-34

Women 35-54

55+

All men

16-34

35-54

55+

All women

Black Caribbean 2004 Mean

[1.4]

1.4

[1.4]

1.4

[1.5]

1.6

[1.6]

1.6

Standard error of the mean

[0.06]

0.04

[0.05]

0.03

[0.05]

0.04

[0.06]

0.03

[10.0]

0.6

[-]

3.6

[3.9]

-

[-]

1.3

% <1.0 mmol/l 1999 Mean Standard error of the mean

% <1.0 mmol/l Indian 2004 Mean Standard error of the mean

% <1.0 mmol/l 1999 Mean

1.5

1.4

1.5

1.5

1.6

1.6

1.6

1.6

0.04

0.05

0.04

0.02

0.04

0.03

0.05

0.02

9.1

10.9

8.5

9.4

3.9

3.9

0.3

3.2

1.3

1.3

1.2

1.3

1.4

1.4

[1.5 ]

1.4

0.03

0.04

0.05

0.02

0.03

0.03

[0.03 ]

0.02

6.5

12.2

15.1

11.0

5.1

3.4

[2.2]

3.9

1.3

1.2

1.3

1.3

1.5

1.4

1.4

1.4

Standard error of the mean

0.03

0.02

0.06

0.02

0.03

0.03

0.05

0.02

% <1.0 mmol/l Pakistani 2004 Mean

15.2

20.5

20.6

18.7

3.6

10.3

17.1

8.9

1.2

1.2

[1.1]

1.2

1.3

1.4

b

1.4

Standard error of the mean

0.03

0.05

[0.05]

0.03

0.04

0.06

b

0.03

% <1.0 mmol/l 1999 Mean

20.7

15.4

[26.2]

19.8

4.8

8.5

b

5.6

1.2

1.1

[1.1]

1.1

1.4

1.3

b

1.4

Standard error of the mean

0.03

0.02

[0.04]

0.02

0.03

0.03

b

0.02

% <1.0 mmol/l Bangladeshi 2004 Mean

24.5

34.5

[21.5]

27.9

13.1

14.0

b

13.1

[1.1]

[1.1]

b

1.1

1.2

[1.2]

b

1.2

Standard error of the mean

[0.04]

[0.04]

b

0.03

0.04

[0.03]

b

0.02

[20.3]

[18.1]

b

19.5

7.4

[4.8]

b

8.1

% <1.0 mmol/l 1999 Mean

Copyright © 2006, The Information Centre. All rights reserved

2004, 1999

Age group

1.1

1.0

[1.0]

1.1

1.4

[1.1]

b

1.3

Standard error of the mean

0.03

0.03

[0.04]

0.02

0.04

[0.05]

b

0.03

% <1.0 mmol/l Chinese 2004 Mean

28.8

57.0

[58.0]

43.4

14.3

[31.2]

b

18.5

[1.3]

[1.4]

b

1.3

[1.7]

1.7

b

1.7

Standard error of the mean

[0.03]

[0.05]

b

0.03

[0.07]

0.05

b

0.04

% <1.0 mmol/l 1999 Mean

[1.9]

[4.9]

b

7.7

[-]

2.9

b

1.3

b Results are not shown because of

[1.3]

1.4

[1.2]

1.3

[1.6]

1.6

b

1.6

c Comparative data for the general

Standard error of the mean

[0.05]

0.04

[0.06]

0.03

[0.06]

0.04

b

0.03

[11.2]

14.4

[20.4]

14.6

[4.3]

5.2

b

4.9

% <1.0 mmol/l

a Black Africans were included in the

2004 survey but not in 1999, and are therefore excluded from this comparative table. small bases.

Continued…

population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which was weighted for nonresponse. The 2004 survey is weighted for differential selection probabilities and for non-response. d Comparative data for the general

population are not available on this topic from the 1999 survey, so data have been taken from the 1998 survey, in which no weighting was involved.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES

321

Table 10.5 continued

Aged 16 and over with valid HDL-cholesterol measurement

Men 16-34

Irish 2004 Mean Standard error of the mean

% <1.0 mmol/l 1999 Mean

2004, 1999

Age group

Women 35-54

55+

All men

16-34

35-54

55+

All women

1.3

1.4

1.4

1.4

[1.4]

1.6

1.7

1.6

0.04

0.04

0.04

0.02

[0.06]

0.04

0.04

0.03

4.8

1.0

9.5

5.1

[4.2]

1.7

0.9

1.8

1.3

1.3

1.4

1.3

1.6

1.6

1.6

1.6

Standard error of the mean

0.05

0.03

0.04

0.02

0.04

0.03

0.04

0.02

% <1.0 mmol/l General population 2003c Mean

19.7

18.1

19.0

18.7

5.4

4.7

3.6

4.6

1.4

1.4

1.4

1.4

1.6

1.6

1.7

1.6

Standard error of the mean

0.01

0.01

0.01

0.01

0.01

0.01

0.01

0.01

6.7

5.7

6.6

6.3

2.6

2.0

1.3

1.9

% <1.0 mmol/l 1998d Mean Standard error of the mean

% <1.0 mmol/l

1.3

1.3

1.3

1.3

1.5

1.6

1.6

1.6

0.01

0.01

0.01

0.01

0.01

0.01

0.01

0.01

4.3

6.5

6.1

16.9

1.4

2.1

1.8

5.4

52 54 119 173 45 67 18 15 13 24 191 454 1463 d

41 68 62 61 25 22 6 12 5 9 189 282 1268 d

139 201 267 357 123 177 44 53 39 47 510 947 4020 d

66 88 116 132 79 96 39 29 23 13 125 302 1289 d

86 113 147 162 52 54 18 11 22 35 277 597 1469 d

48 50 41 59 17 13 6 3 3 7 273 365 1491 d

199 252 304 353 148 162 64 43 48 56 675 1264 4249 d

59 79 117 185 51 115 38 56 41 73 100 151 1478 1897

40 96 52 65 27 37 12 39 16 31 87 104 1488 1644

137 285 234 379 137 301 87 198 101 149 244 326 3814 4874

47 131 82 136 70 164 56 114 43 41 49 107 942 1417

99 167 133 176 55 94 32 49 57 110 126 197 1716 2147

49 70 41 64 18 23 10 13 8 24 125 135 1802 1894

195 368 256 376 143 281 98 176 108 175 300 439 4460 5458

Bases (weighted) Black Caribbean 2004 46 Black Caribbean 1999 80 Indian 2004 85 Indian 1999 123 Pakistani 2004 53 Pakistani 1999 88 Bangladeshi 2004 21 Bangladeshi 1999 26 Chinese 2004 20 Chinese 1999 14 Irish 2004 130 Irish 1999 211 General population (2003)c 1288 General population (1998) d Bases (unweighted) Black Caribbean 2004 38 Black Caribbean 1999 110 Indian 2004 65 Indian 1999 129 Pakistani 2004 59 Pakistani 1999 149 Bangladeshi 2004 37 Bangladeshi 1999 103 Chinese 2004 44 Chinese 1999 45 Irish 2004 57 Irish 1999 71 General population (2003)c 848 General population (1998)d 1333

322

a Black Africans were included in the

2004 survey but not in 1999, and are therefore excluded from this comparative table. b Results are not shown because of

small bases. c Comparative data for the general

population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which was weighted for nonresponse. The 2004 survey is weighted for differential selection probabilities and for non-response. d Comparative data for the general

population are not available on this topic from the 1999 survey, so data have been taken from the 1998 survey, in which no weighting was involved.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES

Copyright © 2006, The Information Centre. All rights reserved

HDL-cholesterol (mmol/l)

Table 10.6 C-reactive protein, by minority ethnic group and sex Aged 16 and over with valid C-reactive protein measurement C-reactive protein (mg/l)

2004

Minority ethnic group Black Caribbean

Black African

General population (2003)a Indian

Pakistani Bangladeshi

Chinese

Irish

Men Observed Mean (mg/l) Standard error of the mean

2.2

2.9

2.8

4.7

3.8

1.3

2.9

3.1

0.38

1.00

0.41

1.09

1.26

0.25

0.40

0.12

% ≤0.5b % 0.6-0.9 % 1.0-1.7 % 1.8-3.6 % >3.6 Standardised risk ratios Mean CRP: ratio of means

27 23 14 22 14

37 18 16 13 16

23 17 21 20 19

18 13 22 17 30

26 19 11 25 19

51 12 20 11 7

22 16 14 31 18

23 17 20 20 20

0.68

0.98

0.89

1.66

1.15

0.59

0.85

1

Standard error of the ratio

0.10

0.26

0.11

0.38

0.33

0.15

0.12

% >3.6mg/l (risk ratio)c

0.79

0.89

1.00

1.64

1.00

0.67

0.76

Standard error of the ratio

0.23

0.25

0.13

0.26

0.24

0.37

0.16

1

Women Observed Mean (mg/l) Standard error of the mean

2.7

3.5

3.3

4.0

4.2

1.2

3.1

3.8

0.34

0.67

0.34

0.37

0.69

0.21

0.32

0.11

% ≤0.5b % 0.6-1.2 % 1.3-2.6 % 2.7-5.2 % >5.2 Standardised risk ratios Mean CRP: ratio of means

30 24 13 18 15

31 17 21 10 20

25 21 21 16 16

13 17 20 26 24

13 11 28 30 18

56 22 10 9 3

18 23 24 19 16

20 20 21 20 20

0.73

0.97

0.99

1.24

1.10

0.54

0.76

1

Standard error of the ratio

0.09

0.17

0.13

0.12

0.15

0.21

0.08

% >5.2mg/l (risk ratio)c

0.79

1.08

0.93

1.50

0.98

0.33

0.87

Standard error of the ratio

0.19

0.29

0.14

0.24

0.23

0.21

0.21

139 200

109 142

266 301

123 148

44 64

39 48

506 675

3999 4230

137 195

103 118

233 255

137 143

87 98

101 108

243 300

3789 4442

Bases (weighted) Men Women Bases (unweighted) Men Women

1

a Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey. b These values correspond to the thresholds for the sex-specific quintiles in the general population in the 2003 survey.

Copyright © 2006, The Information Centre. All rights reserved

c These values correspond to the top quintile in the general population in the 2003 survey.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES

323

Table 10.7 Comparison of C-reactive protein in 2004 and 1999, by age within minority ethnic group and sexa Aged 16 and over with valid C-reactive protein measurement

2004, 1999

Age group

Men 16-34

Women 35-54

55+

All men

16-34

35-54

All 55+ women

Black Caribbean 2004 Mean

[1.5]

2.4

[2.7]

2.2

[1.8]

2.5

[4.5]

2.7

Standard error of the mean

[0.43]

0.49

[0.97]

0.38

[0.38]

0.36

[0.92]

0.34

[9]

16

[17]

14

[15]

11

[28]

16

% >3.7 (men), > 4.9 (women)b 1999 Mean Standard error of the mean

% >3.7 (men), > 4.9 (women)b Indian 2004 Mean Standard error of the mean

% >3.7 (men), > 4.9 (women)b 1999 Mean Standard error of the mean

% >3.7 (men), > 4.9 (women)b Pakistani 2004 Mean Standard error of the mean

% >3.7 (men), > 4.9 (women)b 1999 Mean Standard error of the mean

1.4

1.8

4.2

2.5

1.9

2.6

4.8

2.8

0.18

0.22

0.77

0.29

0.25

0.33

0.71

0.24

6

13

25

15

9

11

30

15

1.9

2.6

4.4

2.8

3.0

3.1

[4.7]

3.3

0.39

0.43

1.45

0.41

0.67

0.35

[1.38]

0.34

11

18

24

17

13

18

[21]

17

1.9

3.7

4.2

3.2

2.5

3.4

5.2

3.4

0.29

0.75

0.82

0.41

0.38

0.31

1.07

0.27

10

21

29

19

13

19

28

19

4.9

4.1

c

4.7

3.4

3.9

c

4.0

2.25

0.84

c

1.09

0.51

0.55

c

0.37

27

28

c

29

25

25

c

28

2.7

2.3

[3.0]

2.6

2.8

5.3

c

4.0

0.72

0.21

[0.49]

0.36

0.34

0.59

c

0.31

10

16

[24]

14

16

44

c

29

% >3.7 (men), > 4.9 (women)b Bangladeshi 2004 Mean

[4.9]

[2.6]

c

3.8

4.7

[3.8]

c

4.2

Standard error of the mean

[2.37]

[0.55]

c

1.26

1.08

[0.62]

c

0.69

% >3.7 (men), > 4.9 (women)b 1999 Mean

[14]

[22]

c

19

25

[27]

c

23

1.4

3.2

[3.8]

2.5

2.1

4.4

c

3.1

Standard error of the mean

0.24

0.61

[0.68]

0.27

0.31

0.75

c

0.33

% >3.7 (men), > 4.9 (women)b Chinese 2004 Mean

7

21

[23]

15

11

21

c

16

[0.9]

[1.0]

c

1.3

[1.0]

1.0

c

1.2

Standard error of the mean

[0.15]

[0.21]

c

0.25

[0.21]

0.19

c

0.21

[4]

[2]

c

7

[2]

3

c

3

% >3.7 (men), > 4.9 (women)b 1999 Mean

[1.4]

1.4

[4.2]

1.9

[5.2]

1.5

c

2.4

Standard error of the mean

[0.48]

0.44

[2.11]

0.49

[1.93]

0.16

c

0.47

[9]

2

[18]

7

[17]

3

c

7

% >3.7 (men), > 4.9 (women)b

Continued…

a Black Africans were included in the 2004 survey but not in 1999, and are therefore excluded from this comparative table. b These values correspond to the top quintile in the general population 1998 for comparison with 1999 data. c Results are not shown because of small bases. d Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and for nonresponse. e Comparative data for the general population are not available on this topic from the 1999 survey, so data have been taken from the 1998 survey, in which no weighting was involved.

324

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES

Copyright © 2006, The Information Centre. All rights reserved

C-reactive protein (mg/l)

Table 10.7 continued

Aged 16 and over with valid C-reactive protein measurement C-reactive protein (mg/l)

2004, 1999

Age group

Men 16-34 Irish 2004 Mean Standard error of the mean

% >3.7 (men), > 4.9 (women)b 1999 Mean Standard error of the mean

% >3.7 (men), > 4.9 (women)b General population 2003c Mean Standard error of the mean

% >3.7 (men), > 4.9 (women)b 1998d Mean Standard error of the mean

Copyright © 2006, The Information Centre. All rights reserved

% >3.7 (men), > 4.9 (women)b Bases (weighted) Black Caribbean 2004 Black Caribbean 1999 Indian 2004 Indian 1999 Pakistani 2004 Pakistani 1999 Bangladeshi 2004 Bangladeshi 1999 Chinese 2004 Chinese 1999 Irish 2004 Irish 1999 General population (2003)d General population (1998) Bases (unweighted) Black Caribbean 2004 Black Caribbean 1999 Indian 2004 Indian 1999 Pakistani 2004 Pakistani 1999 Bangladeshi 2004 Bangladeshi 1999 Chinese 2004 Chinese 1999 Irish 2004 Irish 1999 General population (2003)d General population (1998)e

Women 35-54

55+

All men

16-34

35-54

All 55+ women

1.7

2.3

4.2

2.9

[2.6]

2.5

4.0

3.1

0.24

0.54

0.85

0.40

[0.58]

0.37

0.59

0.32

5

11

32

17

[20]

10

26

18

1.8

2.8

4.1

3.0

2.8

3.7

4.9

3.9

0.23

0.43

0.51

0.27

0.75

0.42

0.59

0.32

12

17

31

20

18

20

22

20

2.3

2.7

4.2

3.1

3.2

3.4

4.8

3.8

0.30

0.14

0.22

0.12

0.19

0.16

0.21

0.11

12

17

29

19

18

19

27

21

1.9

2.2

4.8

3.0

3.0

3.0

4.6

3.6

0.12

0.08

0.21

0.09

0.14

0.12

0.16

0.08

10

15

33

20

15

16

27

20

46 79 85 120 53 86 21 25 20 13 130 208 1287 e

52 53 118 178 45 67 18 15 13 23 188 466 1453 e

41 69 62 67 25 25 6 14 5 9 189 292 1259 e

139 201 266 365 123 178 44 53 39 45 506 965 3999 e

67 86 112 128 79 97 39 28 23 13 125 291 1283 e

86 111 148 165 52 53 18 13 22 35 277 597 1463 e

48 56 41 59 17 14 6 3 3 7 273 376 1484 e

200 252 301 353 148 164 64 44 48 54 675 1264 4230 e

38 110 65 125 59 146 37 101 44 42 57 71

59 78 116 190 51 116 38 54 41 69 99 154

40 97 52 72 27 42 12 44 16 30 87 107

137 285 233 387 137 304 87 199 101 141 243 332

47 128 80 134 70 164 56 110 43 38 49 104

99 163 134 176 55 93 32 52 57 108 126 197

49 77 41 64 18 25 10 14 8 24 125 139

195 368 255 374 143 282 98 176 108 170 300 440

845 1310

1468 1912

1476 1716

3789 4938

939 1397

1709 2140

1794 1965

4442 5502

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES

a Black Africans were included

in the 2004 survey but not in 1999, and are therefore excluded from this comparative table. b These values correspond to

the top quintile in the general population 1998 for comparison with 1999 data. c Results are not shown

because of small bases. d Comparative data for the

general population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and for nonresponse. e Comparative data for the

general population are not available on this topic from the 1999 survey, so data have been taken from the 1998 survey, in which no weighting was involved.

325

Table 10.8 Fibrinogen, by minority ethnic group and sex Aged 16 and over with valid fibrinogen measurement Fibrinogen (g/l)

2004

Minority ethnic group Black Caribbean

Black African

General population (2003)a Indian

Pakistani Bangladeshi

Chinese

Irish

Men Observed (g/l) Mean Standard error of the mean

2.6

2.6

2.8

2.9

2.8

2.6

2.9

2.8

0.06

0.07

0.04

0.08

0.10

0.07

0.06

0.01

Median 10th percentile 90th percentile Standardised risk ratios Mean fibrinogen: ratio of means

2.6 1.9 3.4

2.5 1.9 3.5

2.7 2.1 3.6

2.8 2.0 3.8

2.8 2.0 3.9

2.4 1.8 3.4

2.8 2.1 3.9

2.7 2.0 3.7

0.95

0.96

1.01

1.06

1.07

0.95

1.04

1

Standard error of the ratio

0.02

0.03

0.02

0.03

0.04

0.03

0.02

Women Observed (g/l) Mean Standard error of the mean

3.0

3.0

3.0

3.2

3.2

2.7

3.0

3.1

0.07

0.08

0.05

0.07

0.10

0.07

0.05

0.01

Median 10th percentile 90th percentile Standardised risk ratios Mean fibrinogen: ratio of means

3.0 2.2 4.0

3.0 2.2 3.9

2.9 2.2 3.8

3.2 2.4 4.2

3.1 2.3 4.3

2.6 2.0 3.6

3.0 2.2 3.9

3.0 2.2 4.0

1.01

1.02

1.01

1.12

1.07

0.91

1.00

1

Standard error of the ratio

0.03

0.03

0.02

0.04

0.03

0.02

0.02

114 180

98 133

220 279

105 124

37 55

34 44

431 582

3435 3629

115 170

98 109

194 231

119 120

73 83

89 99

210 266

3194 3779

Bases (weighted) Men Women Bases (unweighted) Men Women

326

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES

Copyright © 2006, The Information Centre. All rights reserved

a Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey.

Table 10.9 Comparison of fibrinogen in 2004 and 1999, by age within minority ethnic group and sexa Aged 16 and over with valid fibrinogen measurement Fibrinogen (g/l)

2004, 1999

Age group

Men 16-34

35-54

55+

16-34

35-54

55+

All women

Black Caribbean 2004 Mean

[2.4]

2.8

b

2.6

[2.8]

3.1

b

3.0

Standard error of the mean

[0.07]

0.10

b

0.06

[0.12]

0.09

b

0.07

Median 1999 Mean

[2.3]

2.8

b

2.6

[2.7]

3.0

b

3.0

2.3

2.4

2.9

2.5

2.6

2.7

3.0

2.7

Standard error of the mean

0.05

0.06

0.08

0.04

0.06

0.05

0.09

0.04

2.2

2.4

2.9

2.4

2.5

2.6

2.9

2.6

Median Indian 2004 Mean Standard error of the mean

Median 1999 Mean Standard error of the mean

Median Pakistani 2004 Mean Standard error of the mean

Median 1999 Mean Standard error of the mean

Copyright © 2006, The Information Centre. All rights reserved

Women All men

2.6

2.7

b

2.8

2.9

2.9

[3.4]

3.0

0.06

0.05

b

0.04

0.08

0.06

[0.15]

0.05

2.5

2.7

b

2.7

2.8

2.9

[3.3]

2.9

2.3

2.5

2.8

2.5

2.5

2.7

3.3

2.7

0.06

0.06

0.10

0.04

0.06

0.04

0.16

0.04

2.1

2.4

2.6

2.4

2.4

2.7

3.0

2.7

2.8

[2.9]

b

2.9

3.1

[3.2]

b

3.2

0.12

[0.11]

b

0.08

0.10

[0.09]

b

0.07

2.6

[2.9]

b

2.8

3.1

[3.2]

b

3.2

2.4

2.6

[3.0]

2.5

2.7

2.8

b

2.8

0.04

0.05

[0.16]

0.04

0.05

0.08

b

0.04

2.4

2.7

2.8

b

2.7

Median Bangladeshi 2004 Mean

2.3

2.5

[3.0]

[2.7]

b

b

2.8

3.2

b

b

3.2

Standard error of the mean

[0.11]

b

b

0.10

0.11

b

b

0.10

Median 1999 Mean

[2.7]

b

b

2.8

3.0

b

b

3.1

2.3

2.7

[3.0]

2.6

2.5

[3.0]

b

2.8

Standard error of the mean

0.05

0.08

[0.15]

0.05

0.06

[0.08]

b

0.06

Median Chinese 2004 Mean

2.2

2.6

[2.7]

2.5

2.5

[2.9]

b

2.7

[2.4]

[2.7]

b

2.6

[2.6]

2.7

b

2.7

Standard error of the mean

[0.08]

[0.07]

b

0.07

[0.11]

0.11

b

0.07

Median 1999 Mean

[2.3]

[2.7]

b

2.4

[2.5]

2.7

b

2.6

b Results are not shown because of

[2.4]

2.6

b

2.6

[2.8]

2.6

b

2.7

c Comparative data for the general

Standard error of the mean

[0.12]

0.09

b

0.06

[0.10]

0.06

b

0.05

Median

[2.3]

2.4

b

2.4

[2.7]

2.5

b

2.6

a Black Africans were included in the

2004 survey but not in 1999, and are therefore excluded from this comparative table. small bases.

Continued…

population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which was weighted for nonresponse. The 2004 survey is weighted for differential selection probabilities and for non-response. d Comparative data for the general

population are not available on this topic from the 1999 survey, so data have been taken from the 1998 survey, in which no weighting was involved.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES

327

Table 10.9 continued

Aged 16 and over with valid fibrinogen measurement

2004, 1999

Age group

Men 16-34 Irish 2004 Mean Standard error of the mean

Median 1999 Mean Standard error of the mean

Median General population 2003c Mean Standard error of the mean

Median 1998d Mean Standard error of the mean

Median

35-54

55+

16-34

35-54

55+

All women

2.7

2.8

3.2

2.9

2.9

3.0

3.3

3.0

0.08

0.08

0.13

0.06

0.09

0.08

0.08

0.05

2.6

2.7

3.2

2.8

2.8

3.0

3.1

3.0

2.3

2.6

3.0

2.7

2.6

2.8

3.0

2.8

0.07

0.05

0.08

0.04

0.07

0.05

0.06

0.04

2.3

2.5

3.0

2.5

2.5

2.7

3.0

2.7

2.5

2.8

3.2

2.8

2.9

3.0

3.4

3.1

0.02

0.02

0.03

0.01

0.03

0.02

0.02

0.01

2.4

2.7

3.1

2.7

2.8

2.9

3.3

3.0

2.3

2.5

3.0

2.6

2.6

2.7

3.0

2.8

0.02

0.01

0.02

0.01

0.02

0.01

0.02

0.01

2.2

2.4

2.9

2.5

2.5

2.6

3.0

2.7

50 49 101 152 41 65 13 15 13 21 168 447 1330 d

23 54 34 53 14 20 4 10 3 7 136 255 876 d

114 177 220 319 105 167 37 48 34 42 431 903 3435 d

65 80 112 121 72 88 39 26 22 11 115 274 1207 d

84 102 137 146 46 46 14 11 21 30 270 543 1348 d

31 42 30 47 6 10 3 3 2 6 196 330 1074 d

180 223 279 315 124 145 55 41 44 47 582 1147 3629 d

56 72 102 163 46 113 29 52 38 63 90 146 1345 1795

25 77 29 57 15 33 7 32 10 25 63 91 1047 1430

115 251 194 341 119 285 73 180 89 131 210 304 3194 4480

45 115 80 127 67 151 55 104 40 33 48 98 888 1325

96 150 121 159 47 82 24 44 54 94 125 176 1570 1979

29 58 30 51 6 18 4 13 5 20 93 117 1321 1622

170 323 231 337 120 251 83 161 99 147 266 391 3779 4926

Bases (weighted) Black Caribbean 2004 41 Black Caribbean 1999 74 Indian 2004 85 Indian 1999 114 Pakistani 2004 50 Pakistani 1999 82 Bangladeshi 2004 21 Bangladeshi 1999 24 Chinese 2004 18 Chinese 1999 13 Irish 2004 127 Irish 1999 201 General population (2003)c 1229 General population (1998) d Bases (unweighted) Black Caribbean 2004 34 Black Caribbean 1999 102 Indian 2004 63 Indian 1999 121 Pakistani 2004 58 Pakistani 1999 139 Bangladeshi 2004 37 Bangladeshi 1999 96 Chinese 2004 41 Chinese 1999 43 Irish 2004 57 Irish 1999 67 General population (2003)c 802 General population (1998)d 1255

328

Women All men

a Black Africans were included in the

2004 survey but not in 1999, and are therefore excluded from this comparative table. b Results are not shown because of

small bases. c Comparative data for the general

population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which was weighted for nonresponse. The 2004 survey is weighted for differential selection probabilities and for non-response. d Comparative data for the general

population are not available on this topic from the 1999 survey, so data have been taken from the 1998 survey, in which no weighting was involved.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES

Copyright © 2006, The Information Centre. All rights reserved

Fibrinogen (g/l)

Table 10.10 Haemoglobin, by minority ethnic group and sexa Aged 16 and over with valid haemoglobin measurement Haemoglobin (g/dl)

2004

Minority ethnic group Black Caribbean

Black African

Indian

Mean (g/dl)

14.5

14.8

14.8

15.2

Standard error of the mean

0.23

0.13

0.10

0.13

4.4

2.1

1.9

Mean (g/dl)

12.9

12.5

Standard error of the mean

0.09

0.14

% <12.0 g/dl (low)

16.4

Pakistani Bangladeshi

Chinese

Irish

15.2

15.1

14.9

0.16

0.09

0.12

2.3

1.5

-

-

12.6

13.0

12.7

13.2

13.5

0.10

0.15

0.17

0.11

0.09

25.8

29.0

20.5

22.5

7.3

5.7

138 199

107 136

266 289

120 140

42 59

40 47

494 669

134 194

102 113

233 241

136 136

84 92

103 105

239 301

Men

% <12.0 g/dl (low)

Women

Bases (weighted) Men Women Bases (unweighted) Men Women

Copyright © 2006, The Information Centre. All rights reserved

a Haemoglobin was not measured in 2003 so general population data are not presented in this table.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES

329

Table 10.11 Comparison of haemoglobin in 2004 and 1999, by age within minority ethnic group and sexa Aged 16 and over with valid haemoglobin measurement

2004, 1999

Age group

Men

Black Caribbean 2004 Mean

Women

16-34

35-54

55+

All men

16-34

35-54

55+

All women

12.9

[14.6]

14.6

[14.2]

14.5

[12.9]

12.8

12.9

Standard error of the mean

[0.57]

0.24

[0.29]

0.23

[0.16]

0.13

0.17

0.09

% <12.0 g/dl (low) 1999 Mean

[9.0]

-

[4.7]

4.4

[11.2]

19.3

18.3

16.4

14.6

14.5

14.0

14.4

12.5

12.5

12.7

12.5

Standard error of the mean

0.10

0.12

0.14

0.07

0.09

0.11

0.09

0.06

% <12.0 g/dl (low) Indian 2004 Mean

-

-

5.6

1.9

29.8

25.7

18.3

25.5

15.3

14.8

14.1

14.8

12.6

12.6

[12.7]

12.6

Standard error of the mean

0.16

0.13

0.21

0.10

0.16

0.11

[0.18]

0.10

% <12.0 g/dl (low) 1999 Mean

1.8

2.3

1.2

1.9

25.4

30.0

[36.8]

29.0

15.0

14.8

14.3

14.8

12.4

12.4

13.1

12.5

Standard error of the mean

0.09

0.07

0.15

0.05

0.09

0.10

0.15

0.06

% <12.0 g/dl (low) Pakistani 2004 Mean

-

0.4

4.1

0.9

36.2

32.9

12.1

30.7

15.4

[15.4]

b

15.2

13.1

12.9

b

13.0

Standard error of the mean

0.16

[0.18]

b

0.13

0.18

0.23

b

0.15

% <12.0 g/dl (low) 1999 Mean

-

-

b

2.3

18.2

23.9

b

20.5

15.1

15.2

[14.0]

15.0

12.4

12.3

b

12.4

Standard error of the mean

0.10

0.09

[0.27]

0.07

0.10

0.14

b

0.08

3.0

-

[10.7]

2.9

31.6

29.6

b

30.3

[15.7]

[15.2]

b

15.2

12.6

b

b

12.7

[0.17]

[0.23]

b

0.16

0.22

b

b

0.17

% <12.0 g/dl (low) Bangladeshi 2004 Mean Standard error of the mean

% <12.0 g/dl (low) 1999 Mean

-

-

b

1.5

21.3

b

b

22.5

15.4

14.9

[14.3]

15.0

12.7

[12.1]

b

12.5

Standard error of the mean

0.10

0.14

[0.21]

0.08

0.09

[0.21]

b

0.09

-

-

[1.4]

0.3

21.0

[54.0]

b

28.3

[15.2]

[15.2]

b

15.1

[13.2]

13.1

b

13.2

[0.13]

[0.17]

b

0.09

[0.15]

0.18

b

0.11

-

-

b

-

[2.3]

13.1

b

7.3

[15.4]

15.0

[14.7]

15.1

[13.3]

12.9

b

13.1

[0.15]

0.12

[0.25]

0.09

[0.17]

0.12

b

0.09

[-]

0.9

[2.5]

0.9

[14.5]

16.1

b

13.5

% <12.0 g/dl (low) Chinese 2004 Mean Standard error of the mean

% <12.0 g/dl (low) 1999 Mean Standard error of the mean

% <12.0 g/dl (low)

a Black Africans were included in the 2004 survey but not in 1999, and are therefore excluded from this

comparative table. Haemoglobin was not measured in 2003, so the general population is also excluded from this table. b Results are not shown because of small bases.

330

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES

Copyright © 2006, The Information Centre. All rights reserved

Haemoglobin (g/dl)

Table 10.11 continued

Aged 16 and over with valid haemoglobin measurement Haemoglobin (g/dl)

2004, 1999

Age group

Men

Women

16-34

35-54

55+

All men

16-34

35-54

55+

All women

Irish 2004 Mean

15.3

15.0

14.6

14.9

[13.4]

13.3

13.7

13.5

Standard error of the mean

0.14

0.14

0.27

0.12

[0.13]

0.13

0.15

0.09

% <12.0 g/dl (low) 1999 Mean

-

-

-

-

[8.5]

5.7

4.4

5.7

15.2

14.9

14.7

14.9

13.1

13.2

13.3

13.2

Standard error of the mean

0.10

0.08

0.12

0.06

0.11

0.08

0.09

0.05

-

0.2

0.6

0.3

7.4

11.2

8.2

9.4

47 80 88 123 54 88 26 19 14 21 213 130

52 54 117 179 44 68 15 17 25 13 480 189

39 68 61 66 23 25 13 6 9 5 284 175

138 203 266 368 120 181 55 42 48 40 977 494

65 86 113 125 74 95 27 37 13 23 310 127

86 109 140 160 50 51 11 16 34 22 605 275

48 55 36 56 15 13 3 6 8 2 390 268

199 251 289 341 140 159 41 59 54 47 1305 669

39 110 66 129 61 150 36 102 46 46 57 72

59 80 116 192 49 117 37 57 41 73 100 158

36 96 51 72 26 40 11 43 16 31 82 104

134 286 233 393 136 307 84 202 103 150 239 334

46 128 79 129 67 161 55 107 42 39 49 109

99 160 125 172 52 88 28 41 57 106 128 200

49 76 37 60 17 23 9 13 6 26 124 142

194 364 241 361 136 272 92 161 105 171 301 451

% <12.0 g/dl (low) Bases (weighted) Black Caribbean 2004 Black Caribbean 1999 Indian 2004 Indian 1999 Pakistani 2004 Pakistani 1999 Bangladeshi 2004 Bangladeshi 1999 Chinese 2004 Chinese 1999 Irish 2004 Irish 1999 Bases (unweighted) Black Caribbean 2004 Black Caribbean 1999 Indian 2004 Indian 1999 Pakistani 2004 Pakistani 1999 Bangladeshi 2004 Bangladeshi 1999 Chinese 2004 Chinese 1999 Irish 2004 Irish 1999

a Black Africans were included in the 2004 survey but not in 1999, and are therefore excluded from this

comparative table. Haemoglobin was not measured in 2003, so the general population is also excluded from this table.

Copyright © 2006, The Information Centre. All rights reserved

b Results are not shown because of small bases.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES

331

Table 10.12 Ferritin, by minority ethnic group and sexa Aged 16 and over with valid ferritin measurement Ferritin (ng/ml)

2004

Minority ethnic group Black Caribbean

Black African

Indian

134.0

137.1

91.3

124.5

8.89

10.91

7.12

9.81

Median 109.3 %
109.4 15

65.0 33

101.1 16

Pakistani Bangladeshi

Chinese

Irish

100.0

220.7

159.9

6.85

13.95

10.22

90.0 19

195.8 3

126.4 16

75.0

Men Mean Standard error of the mean

Women Mean

64.0

53.6

33.8

43.5

56.9

79.3

Standard error of the mean

4.72

5.79

2.55

5.96

10.20

8.60

8.41

Median 46.0 %
35.9 24

22.0 48

27.0 38

36.4 29

49.3 14

52.0 14

136 197

107 139

266 292

122 141

44 58

39 47

502 675

134 193

103 115

233 245

136 136

86 90

101 105

243 299

Bases (weighted) Men Women Bases (unweighted) Men Women

332

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES

Copyright © 2006, The Information Centre. All rights reserved

a Ferritin was not measured in 2003 so comparisons with the general population are not presented in this table.

Table 10.13 Comparison of ferritin in 2004 and 1999, by age within minority ethnic group and sexa Aged 16 and over with valid ferritin measurement Ferritin (ng/ml)

2004, 1999

Age group

Men 16-34

35-54

55+

[133.9]

152.2

[111.5]

134.0

[44.6]

61.9

[93.5]

[19.77]

13.80

[11.49]

8.89

[6.50]

6.61

[8.60]

4.72

Median [102.0] %
136.0 12

[85.0] [21]

109.3 17

[32.6] [29]

43.0 19

[78.0] [5]

46.0 19 53.2

Black Caribbean 2004 Mean Standard error of the mean

16-34

35-54

55+

All women

64.0

117.7

140.7

114.3

33.4

46.2

98.4

Standard error of the mean

5.18

10.18

12.31

5.52

2.36

2.94

9.09

2.80

Median %
77.4 31

85.6 23

117.0 19

90.1 25

28.4 34

34.3 26

76.0 3

37.0 24

89.2

105.3

67.3

91.3

21.9

36.1

[60.2]

33.8

Standard error of the mean

10.92

10.76

7.53

7.12

2.14

2.97

[14.79]

2.55

Median %
65.0 31

66.0 27

50.0 48

65.0 33

17.0 64

25.0 39

[28.6] [32]

22.0 48

81.3

90.7

71.7

84.2

24.8

31.4

58.9

33.5

Standard error of the mean

4.77

6.76

5.43

3.82

1.52

5.08

6.83

2.75

Median %
66.0 32

67.7 37

61.3 33

65.5 34

21.0 48

22.0 47

48.1 30

23.0 45

96.7

150.2

b

124.5

35.2

38.7

b

43.5

Standard error of the mean

6.80

19.28

b

9.81

4.93

6.43

b

5.96

Median %
87.0 16

135.5 12

b b

101.1 16

23.0 41

27.0 38

b b

27.0 38

71.1

104.7

[86.6]

86.0

31.9

38.3

b

36.9

Standard error of the mean

3.90

5.71

[8.77]

3.22

4.54

4.06

b

3.26

Median 62.0 %
91.4 20

[70.1] [27]

69.8 28

21.0 49

23.0 47

b b

22.0 46

[108.1]

b

100.0

35.8

b

b

56.9

[10.45]

[8.16]

b

6.85

3.99

b

b

10.20

Median [104.6] %
[104.2] [16]

b b

90.0 19

29.6 34

b b

b b

36.4 29 34.0

Standard error of the mean

Copyright © 2006, The Information Centre. All rights reserved

Women All men

118.8

[85.0]

94.8

32.5

[35.1]

b

Standard error of the mean

5.84

8.29

[7.51]

4.16

3.06

[5.53]

b

2.57

Median %
67.6 25

99.0 7

[87.5] [33]

78.1 22

22.0 44

[23.2] [46]

b b

23.0 42

a Black Africans were included in the 2004 survey but not in 1999, and are therefore excluded from this

comparative table. Ferritin was not measured in 2003 so comparison with the general population is not presented in this table. b Results are not shown because of small bases.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES

Continued…

333

Table 10.13 continued

Aged 16 and over with valid ferritin measurement

2004, 1999

Age group

Men

Women

16-34

35-54

55+

All men

[176.1]

[266.9]

b

220.7

[17.33]

[23.96]

b

13.95

Median [164.8] %
[252.2] [2]

b b

Chinese 2004 Mean Standard error of the mean

35-54

55+

All women

[64.3]

90.1

113.3

79.3

[7.22]

16.05

27.78

8.60

195.8 3

[49.3] [9]

40.8 21

112.7

49.3 14 74.7

16-34

214.4

[207.5]

193.4

[53.8]

68.0

b

[21.93]

14.68

[29.12]

11.55

[6.00]

8.78

b

6.76

Median [101.7] %
185.5 6

[184.6] [11]

157.8 9

[49.5] [19]

46.0 19

b b

52.0 16

75.0

Standard error of the mean

151.7

182.8

159.9

[43.3]

51.3

113.8

15.87

14.78

17.26

10.22

[4.24]

3.38

18.62

8.41

Median 129.0 %
110.3 14

157.0 19

126.4 16

[35.0] [10]

43.2 19

78.0 11

52.0 14 61.8

Standard error of the mean

138.3

127.0

131.6

37.7

56.8

89.8

Standard error of the mean

13.07

10.41

9.36

6.42

2.95

3.35

10.93

3.74

Median %
95.0 12

107.1 16

104.0 21

103.0 16

29.2 30

44.8 20

60.4 9

43.0 19

46 79 85 121 53 86 21 25 20 13 130 213

50 53 119 180 45 67 18 15 13 25 189 459

40 68 61 63 23 25 6 13 5 9 183 279

136 199 266 365 122 178 44 53 39 47 502 951

64 85 113 125 76 93 36 25 23 13 125 309

86 108 142 159 50 49 16 11 21 33 277 588

48 54 38 55 15 13 6 2 3 7 273 372

197 247 292 339 141 155 58 38 47 54 675 1269

38 109 65 127 59 147 37 103 44 44 57 72

58 78 117 191 51 116 38 53 41 73 101 151

38 96 51 69 26 41 11 43 16 31 85 103

134 283 233 387 136 304 86 199 101 148 243 326

45 127 79 129 67 158 53 100 42 41 48 108

99 157 128 171 52 83 28 43 55 104 126 193

49 75 38 58 17 24 9 10 8 25 125 137

193 359 245 358 136 265 90 153 105 170 299 438

Bases (weighted) Black Caribbean 2004 Black Caribbean 1999 Indian 2004 Indian 1999 Pakistani 2004 Pakistani 1999 Bangladeshi 2004 Bangladeshi 1999 Chinese 2004 Chinese 1999 Irish 2004 Irish 1999 Bases (unweighted) Black Caribbean 2004 Black Caribbean 1999 Indian 2004 Indian 1999 Pakistani 2004 Pakistani 1999 Bangladeshi 2004 Bangladeshi 1999 Chinese 2004 Chinese 1999 Irish 2004 Irish 1999

a Black Africans were included in the 2004 survey but not in 1999, and are therefore excluded from this

comparative table. Ferritin was not measured in 2003 so comparison with the general population is not presented in this table. b Results are not shown because of small bases.

334

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Copyright © 2006, The Information Centre. All rights reserved

Ferritin (ng/ml)

Table 10.14 Glycated haemoglobin, by minority ethnic group and sex Aged 16 and over with valid glycated haemoglobin measurement Glycated haemoglobin (%)

2004

Minority ethnic group Black Caribbean

Black African

General population (2003)a Indian

Pakistani Bangladeshi

Chinese

Irish

Men Observed Mean Standard error of the mean

5.5

5.5

5.5

5.7

5.8

5.3

5.3

5.3

0.10

0.10

0.05

0.10

0.13

0.06

0.03

0.01

% ≥7% Standardised risk ratios Mean haemoglobin: ratio of means

3.4

4.7

6.4

6.5

10.7

2.9

1.9

2.8

1.04

1.06

1.05

1.09

1.12

1.04

0.99

1

Standard error of the ratio

0.02

0.03

0.01

0.02

0.03

0.02

0.01

% ≥7% (risk ratio)

1.49

2.99

2.38

3.12

5.16

1.45

0.44

Standard error of the ratio

0.99

1.65

0.81

1.18

1.89

0.71

0.20

1

Women Observed Mean Standard error of the mean

5.5

5.3

5.5

5.6

5.5

5.3

5.2

5.3

0.08

0.10

0.05

0.09

0.09

0.07

0.03

0.01

% ≥7% Standardised risk ratios Mean haemoglobin: ratio of means

4.9

2.7

2.6

7.0

6.9

1.5

0.9

2.4

1.05

1.03

1.05

1.12

1.10

1.01

0.99

1

Standard error of the ratio

0.01

0.01

0.01

0.03

0.03

0.01

0.01

% ≥7% (risk ratio)

2.33

0.76

1.27

6.39

6.20

0.64

0.36

Standard error of the ratio

0.80

0.60

0.61

2.15

2.57

0.45

0.18

127 180

87 117

262 296

117 144

42 64

40 49

506 664

3985 4199

122 177

82 100

229 249

129 140

84 99

103 109

242 301

3782 4417

Bases (weighted) Men Women Bases (unweighted) Men Women

1

Copyright © 2006, The Information Centre. All rights reserved

a Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES

335

Table 10.15 Comparison of glycated haemoglobin in 2004 and 1999, by age within minority ethnic group and sexa Aged 16 and over with valid glycated haemoglobin measurement

2004, 1999

Age group

Men 16-34

Women 35-54

55+

All men

16-34

35-54

55+

All women

Black Caribbean 2004 Mean

[5.1]

5.4

[6.1]

5.5

[5.2]

5.2

[6.3]

5.5

Standard error of the mean

[0.08]

0.12

[0.25]

0.10

[0.16]

0.07

[0.21]

0.08

1999 Mean Standard error of the mean

Indian 2004 Mean Standard error of the mean

1999 Mean Standard error of the mean

Pakistani 2004 Mean Standard error of the mean

1999 Mean Standard error of the mean

5.3

5.7

6.8

5.9

5.2

5.6

6.8

5.7

0.08

0.16

0.28

0.12

0.04

0.10

0.21

0.07

5.2

5.6

[6.0]

5.5

5.2

5.6

[5.8]

5.5

0.04

0.09

[0.09]

0.05

0.03

0.09

[0.08]

0.05

5.3

6.0

6.5

5.9

5.3

5.7

6.6

5.7

0.05

0.14

0.19

0.08

0.04

0.07

0.23

0.06

5.3

[5.8]

b

5.7

5.2

5.6

b

5.6

0.05

[0.21]

b

0.10

0.05

0.11

b

0.09

5.3

5.9

[7.2]

5.8

5.3

6.0

b

5.7

0.06

0.12

[0.37]

0.08

0.07

0.16

b

0.09

Bangladeshi 2004 Mean

[5.3]

[5.8]

b

5.8

5.3

[5.7]

b

5.5

Standard error of the mean

[0.10]

[0.19]

b

0.13

0.09

[0.13]

b

0.09

1999 Mean Standard error of the mean

5.4

6.4

[7.4]

6.2

5.5

[6.1]

b

5.8

0.08

0.20

[0.32]

0.12

0.08

[0.24]

b

0.09

Chinese 2004 Mean

[5.1]

[5.5]

b

5.3

[5.1]

5.4

b

5.3

Standard error of the mean

[0.05]

[0.14]

b

0.06

[0.04]

0.12

b

0.07

1999 Mean

[5.4]

5.7

[6.7]

5.8

[5.5]

5.6

b

5.8

Standard error of the mean

[0.08]

0.11

[0.47]

0.11

[0.10]

0.06

b

0.09

Irish 2004 Mean Standard error of the mean

1999 Mean Standard error of the mean

General population 2003c Mean Standard error of the mean

5.1

5.2

5.5

5.3

[5.0]

5.2

5.4

5.2

0.04

0.04

0.07

0.03

[0.06]

0.05

0.04

0.03

5.1

5.3

5.9

5.5

4.9

5.1

5.5

5.2

0.05

0.06

0.14

0.06

0.04

0.04

0.05

0.03

a Black Africans were included in the

2004 survey but not in 1999, and are therefore excluded from this comparative table. b Results are not shown because of

5.0

5.3

5.6

5.3

5.0

5.2

5.6

5.3

0.01

0.02

0.02

0.01

0.02

0.02

0.02

0.01

1999 Mean

d

5.3

5.8

5.6

d

5.3

5.9

5.6

Standard error of the mean

d

0.10

0.16

0.10

d

0.05

0.16

0.09

Continued…

small bases. c Comparative data for the general

population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey, which was weighted for nonresponse. The 2004 survey is weighted for differential selection probabilities and for non-response. d Blood sample not collected under age

35 in the general population 1999.

336

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES

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Glycated haemoglobin (%)

Table 10.15 continued

Aged 16 and over with valid glycated haemoglobin measurement

2004, 1999

Age group

Men 16-34 Black Caribbean 2004 Black Caribbean 1999 Indian 2004 Indian 1999 Pakistani 2004 Pakistani 1999 Bangladeshi 2004 Bangladeshi 1999 Chinese 2004 Chinese 1999 Irish 2004 Irish 1999 General population (2003)c General population (1999)

36 109 66 125 56 149 36 101 46 47 57 71 838 d

Women 35-54

55+

All men

53 80 113 193 47 119 37 56 41 72 99 157 1470 128

33 99 50 77 26 41 11 42 16 31 86 108 1474 111

122 288 229 395 129 309 84 199 103 150 242 336 3782 239

16-34

35-54

55+

All women

40 127 81 134 69 165 57 111 43 39 49 107 927 d

91 161 128 181 54 92 32 49 59 109 127 200 1703 179

46 78 40 65 17 24 10 14 7 26 125 143 1787 133

177 366 249 380 140 281 99 174 109 174 301 450 4417 312

a Black Africans were included in the 2004 survey but not in 1999, and are therefore excluded from this

comparative table. b Results are not shown because of small bases. c Comparative data for the general population are not available on this topic from the 2004 survey, so data have

been taken from the 2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and for non-response.

Copyright © 2006, The Information Centre. All rights reserved

d Blood sample not collected under age 35 in the general population 1999.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES

337

Table 10.16 LDL-cholesterol, by minority ethnic group and sex Aged 16 and over with valid LDL-cholesterol measurement LDL-cholesterol (mmol/l)

2004

Minority ethnic group Black Caribbean

Black African

General population (2003)a Indian

Pakistani Bangladeshi

Chinese

Irish

Men Observed Age 16+ Mean Standard error of the mean

% ≥3 mmol/l Age 35+ Mean Standard error of the mean

3.2

3.1

3.6

3.3

[3.3]

3.1

3.4

0.13

0.16

0.10

0.11

[0.15]

0.10

0.12

c c

57

56

68

59

[72]

63

68

c

3.3

[3.4]

3.7

[3.5]

b

[3.5]

3.4

3.6

0.17

[0.15]

0.1

[0.16]

b

[0.13]

0.13

0.05

% ≥3 mmol/l Standardised risk ratios Age 35+ Mean LDL-cholesterol: ratio of means

61

[75]

76

[77]

b

[84]

73

77

0.96

[0.91]

1.05

[1.00]

b

[0.96]

0.94

1

Standard error of the ratio

0.05

[0.05]

0.05

[0.04]

b

[0.04]

0.04

% ≥3 mmol/l (risk ratio)

0.91

[0.87]

1.01

[1.03]

b

[1.09]

0.94

Standard error of the ratio

0.11

[0.13]

0.09

[0.11]

b

[0.09]

0.09

1

Women

Standard error of the mean

% ≥3 mmol/l Age 35+ Mean Standard error of the mean

3.2

2.9

3.1

3.0

[3.2]

2.7

3.5

0.10

0.11

0.07

0.11

[0.08]

0.11

0.11

c c

60

48

55

50

[72]

30

67

c

3.4

[3.1]

3.3

b

b

[3.0]

3.6

3.6

0.12

[0.19]

0.1

b

b

[0.12]

0.12

0.05

% ≥3 mmol/l Standardised risk ratios Age 35+ Mean LDL-cholesterol: ratio of means

68

[52]

68

b

b

[46]

73

74

1.00

[0.89]

0.96

b

b

[0.89]

0.98

1

Standard error of the ratio

0.04

[0.06]

0.03

b

b

[0.04]

0.03

% ≥3 mmol/l (risk ratio)

0.99

[0.62]

1.05

b

b

[0.69]

0.98

Standard error of the ratio

0.10

[0.21]

0.08

b

b

[0.13]

0.07

75 116

65 87

120 179

61 50

14 20

26 33

275 401

c c

55 77

39 42

80 105

33 23

7 7

11 19

215 328

290 351

78 109

60 67

112 145

69 53

31 33

63 71

137 172

c c

57 82

42 36

80 94

36 25

15 12

32 46

112 144

332 429

Bases (weighted) Age 16+ Men Women Age 35+ Men Women Bases (unweighted) Age 16+ Men Women Age 35+ Men Women

a Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey. b Results are not shown because of small bases. c Fasting bloods were not taken from people <35 before 2004.

338

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1

Copyright © 2006, The Information

Observed Age 16+ Mean

Table 10.17 Comparison of LDL-cholesterol in 2004 and 1999, by minority ethnic group and sexa Aged 35 and over with valid LDL-cholesterol measurementb LDL-cholesterol (mmol/l)

2004

Minority ethnic group Black Caribbean

Indian

General population (2003)c Pakistani Bangladeshi

Chinese

Irish

Men 2004 Mean Standard error of the mean

% ≥3 mmol/l 1999 Mean Standard error of the mean

% ≥3 mmol/l

3.3

3.7

[3.5]

d

[3.5]

3.4

3.6

0.17

0.10

[0.16]

d

[0.13]

0.13

0.05

61

76

[77]

d

[84]

73

77

3.3

3.5

3.2

[3.3]

3.4

3.5

3.5

0.09

0.07

0.08

[0.11]

0.10

0.07

0.09

67

66

63

[61]

75

70

71

Women Observed 2004 Mean Standard error of the mean

% ≥3 mmol/l 1999 Mean Standard error of the mean

% ≥3 mmol/l Bases (weighted) Men 2004 Men 1999 Women 2004 Women 1999 Bases (unweighted) Men 2004 Men 1999 Women 2004 Women 1999

3.4

3.3

d

d

[3.0]

3.6

3.6

0.12

0.10

d

d

[0.12]

0.12

0.05

68

68

d

d

[46]

73

74

3.1

3.1

3.0

d

2.9

3.4

3.5

0.08

0.06

0.08

d

0.09

0.06

0.11

49

57

47

d

45

65

61

55 79 77 111

80 147 105 151

33 57 23 40

7 14 7 7

11 24 19 30

215 469 328 639

290 13635 351 18761

57 108 82 159

80 157 94 162

36 95 25 72

15 47 12 28

32 73 46 92

112 167 144 222

332 161 429 215

a Black Africans were included in the 2004 survey but not in 1999, and are therefore excluded from this comparative table. b Fasting bloods were not taken from people <35 before 2004. c Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the

2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and for nonresponse.

Copyright © 2006, The Information Centre. All rights reserved

d Results are not shown because of small bases.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES

339

Table 10.18 Triglycerides, by minority ethnic group and sex Aged 16 and over with valid triglycerides measurement Triglycerides (mmol/l)

2004

Minority ethnic group Black Caribbean

Black African

General population (2003)a Indian

Pakistani Bangladeshi

Chinese

Irish

Men Observed Age 16+ Mean Standard error of the mean

% ≥1.6 mmol/l Age 35+ Mean Standard error of the mean

1.1

1.1

1.7

1.8

[2.0]

1.3

1.6

0.07

0.08

0.12

0.14

[0.22]

0.10

0.09

c c

14

18

36

52

[53]

25

37

c

1.2

[1.2]

1.7

[2.1]

b

[1.6]

1.5

1.8

0.06

[0.10]

0.12

[0.21]

b

[0.15]

0.10

0.08

% ≥1.6 mmol/l Standardised risk ratios Age 35+ Mean triglyceride: ratio of means

14

[18]

42

[62]

b

[40]

36

41

0.67

[0.70]

0.99

[1.20]

b

[0.87]

0.84

1

Standard error of the ratio

0.05

[0.07]

0.08

[0.15]

b

[0.10]

0.07

% ≥1.6 mmol/l (risk ratio)

0.32

[0.45]

1.05

[1.47]

b

[0.98]

0.82

Standard error of the ratio

0.10

[0.16]

0.17

[0.24]

b

[0.24]

0.14

Observed Age 16+ Mean Standard error of the mean % ≥1.6 mmol/l Age 35+ Mean

1.0 0.05 9

0.8 0.04 3

1.2 0.07 23

1.3 0.11 26

[1.5] [0.13] [43]

1.1 0.09 15

1.2 0.06 24

1.1

[0.9]

1.4

b

b

[1.1]

1.3

1.4

Standard error of the mean

0.06

[0.06]

0.09

b

b

[0.07]

0.07

0.04

1

Women

c c c

% ≥1.6 mmol/l Standardised risk ratios Age 35+ Mean triglyceride: ratio of means

14

[4]

29

b

b

[16]

25

31

0.84

[0.78]

1.06

b

b

[0.86]

0.91

1

Standard error of the ratio

0.05

[0.08]

0.07

b

b

[0.07]

0.06

% ≥1.6 mmol/l (risk ratio)

0.59

[0.11]

1.28

b

b

[0.70]

0.73

Standard error of the ratio

0.21

[0.09]

0.33

b

b

[0.23]

0.15

75 116

65 87

125 180

62 50

15 20

26 33

277 402

c c

55 77

39 42

84 106

35 23

8 7

11 19

216 329

304 352

79 109

60 67

117 146

71 53

33 34

63 71

139 173

c c

57 82

42 36

84 95

38 25

17 13

32 46

113 145

347 431

a Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey. b Results are not shown because of small bases. c Fasting bloods were not taken from people <35 before 2004.

340

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES

Copyright © 2006, The Information

Bases (weighted) Age 16+ Men Women Age 35+ Men Women Bases (unweighted) Age 16+ Men Women Age 35+ Men Women

1

Table 10.19 Comparison of triglycerides in 2004 and 1999, by minority ethnic group and sexa Aged 35 and over with valid triglycerides measurementb Triglycerides (mmol/l)

2004

Minority ethnic group Black Caribbean

Indian

General population (2003)c Pakistani Bangladeshi

Chinese

Irish

Men 2004 Mean Standard error of the mean

% ≥1.6 mmol/l 1999 Mean Standard error of the mean

% ≥1.6 mmol/l

1.2

1.7

[2.1]

d

[1.6]

1.5

1.8

0.06

0.12

[0.21]

d

[0.15]

0.10

0.08

14

42

[62]

d

[40]

36

41

1.5

2.3

2.1

2.5

1.6

2.1

1.7

0.08

0.2

0.11

0.2

0.15

0.15

0.12

28

53

61

64

33

51

35

Women Observed 2004 Mean Standard error of the mean

% ≥1.6 mmol/l 1999 Mean Standard error of the mean

% ≥1.6 mmol/l Bases (weighted) Men 2004 Men 1999 Women 2004 Women 1999 Bases (unweighted) Men 2004 Men 1999 Women 2004 Women 1999

1.1

1.4

d

d

[1.1]

1.3

1.4

0.06

0.09

d

d

[0.07]

0.07

0.04

14

29

d

d

[16]

25

31

1.1

1.5

1.6

[2.0]

1.5

1.5

1.4

0.04

0.06

0.11

[0.25]

0.12

0.06

0.06

18

34

45

[64]

28

30

31

55 89 77 121

84 176 106 166

35 63 23 42

8 17 7 9

11 25 19 33

216 544 329 740

304 15557 352 20527

57 124 82 174

84 187 95 179

38 108 25 77

17 60 13 35

32 77 46 101

113 191 145 258

347 181 431 237

a Black Africans were included in the 2004 survey but not in 1999, and are therefore excluded from this comparative table. b Fasting bloods were not taken from people <35 before 2004. c Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the

2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and for nonresponse.

Copyright © 2006, The Information Centre. All rights reserved

d Results are not shown because of small bases.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES

341

Table 10.20 Glucose, by minority ethnic group and sex Aged 16 and over with valid glucose measurement Glucose (mmol/l)

2004

Minority ethnic group

General population (2003)a

Black Caribbean

Black African

Indian

%

%

%

Pakistani Bangladeshi %

%

Chinese

Irish

%

%

%

b

Men Observed Age 16+ Mean Standard error of the mean

% ≥7 mmol/l Age 35+ Mean Standard error of the mean

5.0

5.6

5.3

5.5

[5.2]

4.8

5.0

0.14

0.38

0.13

0.27

[0.28]

0.12

0.07

b

2.7

9.7

8.2

5.7

[4.2]

2.3

2.9

b

5.1

[6.3]

5.5

[6.0]

c

[5.2]

5.1

5.3

0.17

[0.59]

0.17

[0.43]

c

[0.22]

0.08

0.06

% ≥7 mmol/l Standardised risk ratios Age 35+ Mean glucose: ratio of means

3.7

[16.2]

12.0

[9.5]

c

[5.3]

3.6

5.1

0.98

[1.21]

1.05

[1.13]

c

[1.00]

0.98

1

Standard error of the ratio

0.03

[0.11]

0.03

[0.07]

c

[0.04]

0.02

% ≥7 mmol/l (risk ratio)

0.81

[4.60]

3.08

[2.11]

c

[1.27]

0.64

Standard error of the ratio

0.60

[2.16]

1.21

[1.19]

c

[0.88]

0.44

1

Women Observed Age 16+ Mean Standard error of the mean

% ≥7 mmol/l Age 35+ Mean

5.0

4.9

5.0

6.0

[5.2]

4.8

5.0

0.12

0.22

0.09

0.62

[0.39]

0.05

0.07

b b

3.5

2.9

2.5

9.9

[10.2]

-

1.8

b

5.2

[5.2]

5.2

[5.9]

c

[5.0]

5.0

5.1

0.16

[0.42]

0.14

[0.41]

c

[0.06]

0.08

0.05

5.3

[6.0]

4.1

[14.7]

c

[-]

2.2

2.4

Age 35+ Mean glucose: ratio of means

1.05

[1.00]

1.04

[1.21]

c

[0.99]

1.00

1

Standard error of the ratio

0.03

[0.04]

0.03

[0.09]

c

[0.01]

0.02

% ≥7 mmol/l (risk ratio)

3.51

[1.35]

2.15

[11.80]

c

[0.00]

1.40

Standard error of the ratio

2.08

[1.48]

1.23

[6.75]

c

[0.00]

0.85

80 128

66 91

139 191

68 61

16 22

27 32

298 424

b b

59 84

40 44

95 115

41 32

9 7

12 19

240 350

349 384

84 123

61 72

129 157

78 63

36 37

68 70

151 183

b b

62 93

43 39

94 104

45 35

20 15

36 46

125 154

389 465

Standard error of the mean

% ≥7 mmol/l Standardised risk ratios

a Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the 2003 survey. b Fasting bloods were not taken from people <35 in the general population before 2004. c Results are not shown because of small bases.

342

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Bases (weighted) Age 16+ Men Women Age 35+ Men Women Bases (unweighted) Age 16+ Men Women Age 35+ Men Women

1

Table 10.21 Comparison of glucose in 2004 and 1999, by minority ethnic group and sexa Aged 35 and over with valid glucose measurementb Glucose (mmol/l)

2004

Minority ethnic group Black Caribbean

Indian

General population (2003)c Pakistani Bangladeshi

Chinese

Irish

Men 2004 Mean Standard error of the mean

% ≥7 mmol/l 1999 Mean

5.1

5.5

[6.0]

d

[5.2]

5.1

5.3

0.17

0.17

[0.43]

d

[0.22]

0.08

0.06

3.7

12.0

[9.5]

d

[5.3]

3.6

5.1

6.2

6.3

6.3

6.9

6.3

5.9

5.8

Standard error of the mean

0.23

0.16

0.23

0.33

0.24

0.13

0.18

% ≥7 mmol/l

16.6

19.0

18.7

41.7

17.2

10.9

11.3

Women Observed 2004 Mean Standard error of the mean

% ≥7 mmol/l 1999 Mean Standard error of the mean

% ≥7 mmol/l Bases (weighted) Men 2004 Men 1999 Women 2004 Women 1999 Bases (unweighted) Men 2004 Men 1999 Women 2004 Women 1999

5.2

5.2

[5.9]

d

[5.0]

5.0

5.1

0.16

0.14

[0.41]

d

[0.06]

0.08

0.05

5.3

4.1

[14.7]

d

[-]

2.2

2.4

5.7

5.9

6.2

[6.0]

5.7

5.3

5.3

0.13

0.16

0.26

[0.27]

0.21

0.08

0.08

9.2

10.5

17.3

[10.4]

9.1

6.0

3.0

59 92 84 126

95 186 115 168

41 67 32 43

9 19 7 10

12 25 19 33

240 569 350 763

349 15718 384 21323

62 127 93 182

94 197 104 178

45 115 35 80

20 62 15 38

36 76 46 102

125 199 154 261

389 184 465 241

a Black Africans were included in the 2004 survey but not in 1999, and are therefore excluded from this comparative table. b Fasting bloods were not taken from people <35 before 2004. c Comparative data for the general population are not available on this topic from the 2004 survey, so data have been taken from the

2003 survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and for nonresponse.

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d Results are not shown because of small bases.

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343

Complementary and alternative medicines and therapies (CAM)

11

Richard Boreham

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Summary ●

Among the general population, 33% of women had used any of the 24 listed complementary or alternative medicines (CAM) in the last 12 months, compared with 21% of men.

●

Women were also more likely than men to have used a CAM practitioner in the last 12 months (23% compared with 14%).

●

The most popular CAM used in the last 12 months among the general population were massage therapy (10% of women and 6% of men) and aromatherapy (11% of women, 3% of men).

●

The Chinese were the ethnic group most likely to use CAM, and Bangladeshi's were the least likely. In total, 47% of Chinese women had used any CAM in the last 12 months compared with 4% of Bangladeshi women, and 33% of women in the general population. Equivalent figures for men were Chinese (30%), general population (21%) and Bangladeshi (6%). These differences were mostly due to higher use of Chinese medicine among Chinese people.

●

Younger people in the general population were more likely to use CAM - 22% of men aged 16-34 and 23% of men aged 35-54 had done so in the last 12 months compared with 16% of men aged 55 and over. Equivalent figures for women were 34%, 40% and 25%.

●

Prevalence of having used CAM in the last 12 months was higher among men and women in the general population with higher incomes. Among men, those in the highest income tertile had a risk ratio of 1.61 compared with a risk ratio of 0.57 for those in the lowest income tertile. Among women the equivalent risk ratios were 1.16 and 0.61 respectively.

●

There were no relationships between age or income and using CAM among the different minority ethnic groups, although small sample sizes in older age groups and higher income groups make it difficult to determine whether such relationships exist.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

345

11.1 Introduction and measures Complementary and alternative medicines and therapies (CAM) were introduced as a core module in 2004 in order to measure national prevalence of use of CAMs for the first time on HSE. The CAM module was interviewer administered via CAPI and was asked of adults aged 16 and over. For each of 24 different medicines or therapies, participants were asked whether they had ever used it, whether they had used it in the last year and whether they had consulted a practitioner about it in the last year. The CAM module was introduced in April 2004, and therefore bases are smaller in this chapter than elsewhere in the report.

11.2 Ever used CAM Among the general population, women were more likely than men to have ever used any of the 24 listed complementary or alternative medicines (51% of women compared with 40% of men). The most popular CAM ever used were massage therapy (17% of women and 10% of men), aromatherapy (18% of women, 6% of men), acupuncture (13% of women, 9% of men) and osteopathy (11% of women, 11% of men). Women in the general population were significantly more likely than men to have ever used each individual CAM (for CAM with prevalence greater than 0.5%), with the exception of osteopathy, chiropractic and Chinese medicine. Chinese men and women were the most likely ethnic group to have ever used CAM – 64% of Chinese women and 55% of Chinese men had ever used CAM, compared with 51% of women and 40% of men in the general population. These differences were mostly due to higher use of Chinese medicine and acupuncture among Chinese people. Among women, 52% of Chinese informants had ever used Chinese medicine (compared with 4% of the general population), and 22% of Chinese women had ever used acupuncture (compared with 13% of women in the general population). A similar pattern was found among men – Chinese men were more likely than men in the general population to have ever used Chinese medicine (44% compared with 3% respectively) and acupuncture (15% and 9% respectively). Although levels of use were much lower, Chinese women (7%) and men (3%) were also more likely to have ever used Shiatsu than their counterparts in the general population (2% and 1% respectively). The same patterns for Chinese Medicine and acupuncture were seen for age-standardised risk ratios. Bangladeshi men and women were the least likely ethnic group to have ever used CAM – 15% of Bangladeshi women and 14% of Bangladeshi men had ever used any of the 24 listed CAM, compared with 51% and 40% among women and men in the general population, respectively. The only CAM where rates of use among Bangladeshi men and women were similar to the general population was homeopathy – 8% of Bangladeshi men and women had ever used homeopathy, compared with 6% of men and 11% of women in the general population. The same pattern was seen for age-standardised risk ratios.

Ayurvedic medicine was much more prevalent among Indian women and men than among any other ethnic group – 7% of Indian women and 10% of Indian men had ever used Ayurvedic medicine compared with less than 0.5% of men and of women in the general population. Table 11.1

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Table 11.1, Figure 11A

Among women, those from Black Caribbean (40%), Indian (36%), Black African (32%), Pakistani (25%) and Bangladeshi (15%) groups were less likely than those in the general population to have ever used CAM (51%) and these differences were still significant after age standardisation. Indian men (29%), Pakistani men (22%) and Bangladeshi men (14%) were less likely than men in the general population (40%) to have ever used CAM, and these differences were still significant after age standardisation. Although Black Caribbean men and Black African men also appeared to be less likely than men in the general population to have ever used CAM, these differences were not significant once the data were agestandardised. The prevalence of ever using CAM among Irish men and women was similar to that of the general population. Table 11.1, Figure 11A

Figure 11A Ever used any CAM, by minority ethnic group Women

Risk ratio, logarithmic scale

Men 10.0

10.0

2.0

2.0

1.0

1.0

0.5

0.5

0.1

0.1

ar C

ar C

sh Iri se i ne hi sh C de la ng Ba n i a st ki Pa an an di In ric n Af a be ib k

ac

k

ac

Bl

Bl

sh Iri se i ne hi sh C de la ng Ba n i a st ki Pa an an di In ric n Af a be ib k

ac

k

ac

Bl

Bl

General population = 1.0. Error bars indicate 95% confidence limits.

11.3 Used CAM in last 12 months 11.3.1

Used CAM in last 12 months, by sex and age Among the general population, women were more likely than men to have used any of the 24 listed complementary or alternative medicines (CAM) in the last 12 months (33% of women compared with 21% of men). The most popular CAM used in the last 12 months were massage therapy (10% of women and 6% of men) and aromatherapy (11% of women, 3% of men) – these were also the CAM with the highest prevalence of having ever been used. The next most popular CAM used in the last 12 months were relaxation techniques (8% of women, 3% of men) and herbal medicine (8% of women, 3% of men). This was in contrast to the prevalence of having ever used CAM, where acupuncture and osteopathy were the next most popular.

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As with the measure of ever having used CAM, Chinese men and women were the most likely ethnic group to have used CAM in the last 12 months. Overall 47% of Chinese women and 30% of Chinese men had used CAM in the last 12 months, compared with 33% of women and 21% of men in the general population. These differences were mostly due to higher use of Chinese medicine and acupuncture among Chinese people. Among women, 31% of Chinese informants had used Chinese medicine in the last 12 months compared with 2% of the general population, and 13% of Chinese women had used acupuncture in the last 12 months, compared with 3% of women in the general population. The only difference in prevalence of use of specific CAM in the last 12 months among men was Chinese medicine (19% of Chinese men compared with 1% of men in the general population). Bangladeshi men and women were the least likely ethnic group to have used CAM in the last 12 months, and they were also the least likely group to have ever used CAM. In total, 4% of Bangladeshi women and 6% of Bangladeshi men had used any of the 24 listed CAM in the last 12 months, compared with 33% and 21% among the general population, respectively. Table 11.2, Figure 11B Among women, those from Black Caribbean (26%), Indian (24%), Black African (19%), Pakistani (17%) and Bangladeshi (4%) groups were less likely than those in the general population to have used CAM in the last 12 months (33%), and these differences were still significant after age standardisation. The differences between these minority ethnic groups and women in the general population were smaller for use of CAM in the last 12 months, than for having ever used CAM. Bangladeshi men (6%) were the only group who were less HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

347

Figure 11B Used any CAM in last 12 months, by minority ethnic group Women

Men 10.0

2.0

2.0

1.0

1.0

0.5

0.5

0.1

0.1

0.01

0.01

Risk ratio, logarithmic scale

10.0

se i

sh

de

la

ne

sh

Iri

hi C

ni

a st

ng

ki

Ba

be

i

an

ric

ib

sh

ar

Af

C

n

a di

Pa

In k

k

ac

ac

Bl

Bl

se

de

la

ne

sh

Iri

hi C

ni

a st

ng

ki

Ba

an

an

be

an

ric

ib

ar

Af

C

n

a di

Pa

In k

k

ac

ac

Bl

Bl

General population = 1.0. Error bars indicate 95% confidence limits.

likely than men in the general population (21%) to have used CAM in the last 12 months where the difference was still significant after age standardisation. Table 11.2, Figure 11B Ayurvedic medicine was more prevalent among Indian women and men than among any other ethnic group – 4% of Indian women and men had used Ayurvedic medicine in the last 12 months, compared with less than 0.5% of men and of women in the general population. Table 11.2

Among the general population prevalence of using CAM in the last 12 months was lower among older respondents. Among men in the general population, 16% of those aged 55 and over had used CAM in the last 12 months, compared with 23% of those aged 35-54 and 22% of those aged 16-34. Among women the equivalent percentages were 25%, 40% and 34%. Table 11.3, Figure 11C Figure 11C Whether used CAM in last 12 months, by sex and age

Men Women

Base: General population aged 16 and over 40

20

10

0 16-34

35-54

55+

Age group

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Percent

30

It is difficult to determine whether the same age differences existed among minority ethnic groups because the sample of men and women aged 55 and over in Black African, Pakistani, Bangladeshi and Chinese groups was too small to allow conclusions about the relationship between use of CAM and age. Among women, there was no relationship between age and prevalence of taking CAM in the last 12 months for Black Caribbean, Indian or Irish groups. Among Indian men, prevalence of taking CAM was lowest among those aged 16-34, whereas among Black Caribbean and Irish men prevalence was lowest among those aged 55 and over. Table 11.3 11.3.2

Used CAM in last 12 months, by household income Among the general population, prevalence of having used CAM in the last 12 months was higher among men and women with higher incomes. Among men in the general population, those in the highest income tertile had a risk ratio of 1.16 compared with a risk ratio of 0.57 for those in the lowest income tertile. Among women in the general population the equivalent risk ratios were 1.16 and 0.61 respectively. Table 11.4, Figure 11D Figure 11D Used CAM in last 12 months, by equivalised household income tertile Base: General population aged 16 and over

Women

Men Risk ratio, logarithmic scale

10.0

2.0 1.0 0.5

0.1 w e

til

er

le

le

rti

rti

te

te

tt

e

es

dl

e

til

er

le

le

rti

rti

te

te

tt

st

es

e

st

he

id

Lo

M

ig

H

w

dl

he

id

Lo

M

ig

H

General population = 1.0. Error bars indicate 95% confidence limits.

There were no significant relationships between income and using CAM in the last 12 months among either men or women from any of the minority ethnic groups. However, it should be borne in mind that the sample sizes for comparing income tertiles within sex and ethnic group were small, and only a very strong relationship between income and CAM would be identifiable. Table 11.4

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11.4 Consulted a CAM practitioner in last 12 months As with the other measures of use of CAM, among the general population, women were more likely than men to have consulted a practitioner for any of the 24 listed CAM in the last 12 months (23% of women compared with 14% of men). Prevalence levels for having consulted a practitioner for individual CAMs were relatively low, with the most popular being massage therapy (8% of women, 5% of men) and osteopathy (4% of women, 3% of men). This is in contrast to prevalence levels of ever using CAM, and using CAM in the last 12 months, where massage therapy and aromatherapy were the most popular. Bangladeshi men and women were the least likely ethnic group to have consulted a CAM practitioner in the last 12 months. In total 3% of Bangladeshi women and 3% of Bangladeshi men had consulted a CAM practitioner in the last 12 months, compared with

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

349

23% and 14% among women and men in the general population, respectively. This relationship was still significant after age standardisation. Table 11.5, Figure 11E Figure 11E Consulted any CAM practitioner in last 12 months, by minority ethnic group Women

Men 10.0

2.0

2.0

1.0

1.0

0.5

0.5

0.1

0.1

0.01

0.01

Risk ratio, logarithmic scale

10.0

sh

i

i

sh

de

se

ne

hi

Iri

C la

an

st

ng

an

be

an

ric

ib

i

sh

ar

Af

C

an

ki

Ba

Pa

k

k

ac

di

In

Bl

ac

Bl

sh

i

de

se

ne

hi

Iri

C la

an

st

ng

an

be

an

ric

ib

ar

Af

C

an

ki

Ba

Pa

di

In k

k

ac

ac

Bl

Bl

General population = 1.0. Error bars indicate 95% confidence limits.

Black African men and women were also less likely than men and women in the general population to have consulted a CAM practitioner in the last 12 months. In total, 9% of Black African women and 8% of Black African men had consulted a CAM practitioner in the last 12 months, compared with 23% of women and 14% of men in the general population.

For men and women in Black Caribbean, Indian and Pakistani ethnic groups, it was less clear whether there were significant differences in having consulted a CAM practitioner in the last 12 months compared with their counterparts in the general population. Before age standardisation men and women in all these groups (except Indian and Pakistani men) appeared to be less likely than those in the general population to have consulted a CAM practitioner in the last 12 months. However, after age standardisation, differences were still significant for women in all these groups, but only Indian men were significantly different from men in the general population. Table 11.5

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Unlike differences in the use of CAM between Chinese informants and the general population, there was no difference between Chinese men and women and their counterparts in the general population in prevalence of having consulted any CAM practitioner in the last 12 months. However, Chinese women were more likely than women in the general population to have consulted a practitioner of Chinese medicine in the last 12 months (12% and 1% respectively) and there was a similar pattern among men (7% and 1% respectively).

11.5 Relationship between ever using CAM, use of CAM in the last 12 months, and consulting a CAM practitioner in the last 12 months This chapter has presented analysis of three CAM measures: ever used, used in the last 12 months and consulted a practitioner in the last 12 months. These three measures are obviously inter-related, and thus patterns by minority ethnic groups seen for one measure were usually present in the other measures. Where there were differences in patterns between the different measure, this can mostly be explained by relationships between ever used, used in the last 12 months, and consulted a practitioner for individual CAM. Among the general population, the proportion of those who had ever used individual CAM that had used it in the last 12 months varied considerably for different CAM. Among those who had ever used meditation/visualisation, 65% had done so in the last 12 months and the equivalent figure for massage therapy was 62%. In contrast, 19% of those who had ever used hypnotherapy had used it in the last year, and equivalent figures for acupuncture and shiatsu were 27% and 28% respectively. Table 11.6, Figure 11F Figure 11F Whether used individual CAM in the last 12 months Base: General population aged 16 and over who had ever used individual CAM Meditation/visualisation Massage therapy Aromatherapy Crystal therapy Relaxation techniques Nutritional therapy Herbal medicine Reiki Spiritual healing Reflexology Chinese medicine Homeopathy Kinesiology Osteopathy Chiropractic Shiatsu Acupuncture Hypnotherapy 0

10

20

30

40

50

60

70

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Percent

There was also substantial variation by CAM in the proportion that had seen a practitioner among those who had used each CAM in the last 12 months. The CAM where people were most likely to have seen a practitioner were chiropractic, osteopathy and acupuncture – 99% of those who had used chiropractic in the last 12 months had seen a chiropractor in the last 12 months and equivalent figures were 97% for osteopathy and 94% for acupuncture. The CAM where people were least likely to have seen a practitioner were herbal medicine (37% of those who had used herbal medicine in the last 12 months had seen a practitioner in the last 12 months), aromatherapy (45%) and meditation/visualisation (46%). Table 11.7, Figure 11G

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

351

Figure 11G Whether consulted individual CAM practitioner in the last 12 months Base: General population aged 16 and over who had ever used individual CAM Chiropractic Osteopathy Acupuncture Reflexology Reiki Massage therapy Spiritual healing Chinese medicine Homeopathy Relaxation techniques Meditation/visualisation Aromatherapy Herbal medicine 0

10 20 30 40 50 60 70 80 90 100

352

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Percent

Tables

11.1 Whether ever used CAM, by minority ethnic group and sex 11.2 Whether used CAM in the last 12 months, by minority ethnic group and sex 11.3 Whether used CAM in the last 12 months, by age within minority ethnic group and sex 11.4 Whether used CAM in the last 12 months, by equivalised household income tertile within minority ethnic group and sex 11.5 Whether used CAM practitioner in the last 12 months, by minority ethnic group and sex 11.6 Whether used individual CAM in the last 12 months, among those who had ever used individual CAM

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11.7 Whether consulted individual CAM practitioner in the last 12 months, among those who had used individual CAM practitioner in the last 12 months

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

353

Table 11.1 Whether ever used CAM, by minority ethnic group and sex Aged 16 and over

2004

Ever used CAM

Minority ethnic group

General population

Black Caribbean

Black African

Indian

Observed % Massage therapy Aromatherapy Acupuncture Osteopathy Herbal medicine Relaxation techniques Chiropractic Homeopathy Reflexology Meditation/visualisation Healing / spiritual healing Hypnotherapy Chinese medicine Reiki Shiatsu Crystal therapy Nutritional therapy Kinesiology Dowsing Naturopathy Ayurvedic medicine Iridology Unani medicine MegaVit Used any CAM

9 4 7 3 8 5 1 5 3 4 4 1 4 0 0 1 1 0 29

7 4 5 1 14 5 2 3 1 2 4 4 1 1 1 1 1 29

8 2 7 3 8 3 2 8 4 4 2 2 4 3 0 1 1 1 10 1 29

6 2 4 2 4 2 2 9 1 0 1 0 3 1 1 0 1 22

Standardised risk ratios Massage therapy

0.87

0.55

0.65

Standard error

0.22

0.15

0.20

Aromatherapy

0.78

0.52

Standard error

0.31

0.21

Herbal medicine

1.33

Standard error

0.34

Acupuncture Standard error

Pakistani Bangladeshi

Chinese

Irish

0 0 2 3 8 1 2 0 14

10 4 15 7 5 5 5 5 7 5 1 1 44 3 3 1 1 0 55

13 7 8 12 6 5 2 5 5 3 2 2 1 1 2 2 0 0 0 0 36

10 6 9 11 7 7 8 6 4 3 3 3 3 2 1 1 1 1 0 0 0 0 0 40

0.52

0.03

0.94

1.41

1

0.16

0.03

0.25

0.28

0.37

0.46

0.05

0.65

1.24

0.17

0.32

0.05

0.25

0.34

2.17

1.20

0.45

0.92

0.79

0.88

0.59

0.31

0.17

0.42

0.27

0.32

1.01

0.49

0.72

0.40

0.36

1.78

0.83

0.30

0.17

0.18

0.15

0.25

0.38

0.20

Chinese medicine

1.29

1.04

0.82

1.43

0.82

12.40

0.48

Standard error

0.53

0.39

0.30

0.70

0.59

2.26

0.22

Any CAM

0.83

0.79

0.69

0.61

0.47

1.36

0.93

Standard error

0.09

0.11

0.10

0.11

0.09

0.12

0.11

Bases (weighted) Bases (unweighted)

331 284

245 252

548 321

228 213

107 245

78 182

1187 325

Men

1 1 1 1

31588 1981 Continued…

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1

Table 11.1 continued Aged 16 and over

2004

Ever used CAM

Minority ethnic group

General population

Black Caribbean

Black African

Indian

Observed % Massage therapy Aromatherapy Acupuncture Osteopathy Herbal medicine Relaxation techniques Chiropractic Homeopathy Reflexology Meditation/visualisation Healing / spiritual healing Hypnotherapy Chinese medicine Reiki Shiatsu Crystal therapy Nutritional therapy Kinesiology Dowsing Naturopathy Ayurvedic medicine Iridology Unani medicine MegaVit Used any CAM

15 13 8 6 13 6 6 6 10 4 3 2 9 1 2 0 1 0 1 1 0 40

9 7 3 2 15 7 0 3 4 4 4 0 3 2 1 0 1 1 0 1 32

11 6 8 2 6 4 3 11 8 5 3 3 3 6 1 2 3 1 1 2 7 1 36

10 5 6 1 7 3 1 8 3 1 2 0 4 1 0 0 1 0 25

Standardised risk ratios Massage therapy

0.86

0.55

0.55

Standard error

0.14

0.14

0.10

Aromatherapy

0.68

0.32

Standard error

0.12

0.10

Herbal medicine

1.01

Standard error

0.19

Acupuncture Standard error

Pakistani Bangladeshi

Chinese

Irish

2 0 3 3 8 0 0 0 2 0 0 15

16 11 22 5 11 6 5 6 10 5 2 1 52 2 7 3 2 2 1 0 0 1 64

16 21 15 13 12 13 7 11 16 7 6 6 6 5 4 2 1 1 0 0 0 52

17 18 13 11 12 12 9 11 12 5 5 5 4 5 2 2 2 1 1 1 0 1 51

0.64

0.06

0.78

0.88

1

0.14

0.04

0.14

0.18

0.29

0.24

0.01

0.52

1.14

0.07

0.07

0.01

0.12

0.19

1.14

0.41

0.53

0.35

0.89

1.05

0.23

0.13

0.14

0.13

0.20

0.25

0.62

0.32

0.63

0.64

0.39

1.72

1.14

0.13

0.11

0.12

0.19

0.16

0.27

0.21

Chinese medicine

2.09

0.71

0.70

2.00

0.59

12.34

1.40

Standard error

0.51

0.27

0.25

0.87

0.35

1.84

0.43

Any CAM

0.79

0.62

0.68

0.53

0.36

1.26

0.98

Standard error

0.06

0.07

0.07

0.07

0.05

0.07

0.08

Bases (weighted) Bases (unweighted)

439 433

308 303

647 369

285 271

121 276

94 220

1497 408

Copyright © 2006, The Information Centre. All rights reserved

Women

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

1 1 1 1 1

33736 2649

355

Table 11.2 Whether used CAM in the last 12 months, by minority ethnic group and sex Aged 16 and over

2004

Used CAM in last 12 months

Minority ethnic group

General population

Black Caribbean

Black African

Indian

5 2 3 4 1 1 2 3 2 0 3 0 1 0 0 0 17

5 3 3 3 1 0 0 2 1 2 4 1 2 1 0 16

4 2 3 4 3 1 4 4 2 1 1 2 1 1 1 0 4 19

4 1 1 2 2 5 0 2 0 0 1 0 14

Standardised risk ratios Massage therapy

0.78

0.65

0.54

Standard error

0.24

0.22

0.20

Aromatherapy

0.73

0.68

Standard error

0.45

0.34

Herbal medicine

1.41

Standard error

0.48

Acupuncture Standard error

Pakistani Bangladeshi

Chinese

Irish

0 0 2 0 2 1 0 6

5 1 3 2 2 1 2 4 3 1 19 0 2 0 30

8 4 3 3 2 1 1 1 3 0 1 1 1 1 1 1 0 20

6 3 3 3 2 3 2 2 2 2 1 1 1 0 1 0 0 0 0 0 0 0 21

0.55

0.05

0.74

1.33

1

0.20

0.05

0.26

0.33

0.52

0.58

0.09

0.33

1.34

0.28

0.56

0.10

0.18

0.49

1.67

1.16

0.64

0.68

0.44

1.24

0.92

0.36

0.31

0.27

0.26

0.64

1.21

0.29

0.78

0.67

0.43

1.25

1.24

0.70

0.21

0.33

0.32

0.26

0.61

0.52

Chinese medicine

0.88

1.61

1.20

0.24

0.24

14.00

0.74

Standard error

0.54

0.86

0.69

0.25

0.24

4.34

0.48

Any CAM

0.92

0.81

0.77

0.73

0.27

1.35

1.11

Standard error

0.15

0.18

0.15

0.17

0.07

0.20

0.19

Bases (weighted) Bases (unweighted)

331 284

245 252

548 321

228 213

107 245

78 182

1187 325

Men

1 1 1 1 1

31588 1981 Continued…

356

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

Copyright © 2006, The Information Centre. All rights reserved

Observed % Massage therapy Aromatherapy Relaxation techniques Herbal medicine Reflexology Osteopathy Homeopathy Meditation/visualisation Acupuncture Chiropractic Spiritual healing Reiki Chinese medicine Crystal therapy Hypnotherapy Nutritional therapy Shiatsu Kinesiology Dowsing Naturopathy Iridology Ayurvedic medicine Unani medicine Megavit Used any CAM

Table 11.2 continued Aged 16 and over

2004

Used CAM in last 12 months

Minority ethnic group

General population

Black Caribbean

Black African

Indian

10 8 4 8 5 1 2 3 1 2 1 0 2 0 1 1 1 26

7 5 6 7 1 1 1 1 3 1 1 0 1 0 1 0 0 19

8 4 3 4 4 1 5 3 3 1 2 4 1 1 1 2 1 4 24

9 5 2 4 2 0 4 1 2 1 2 1 2 0 0 1 0 17

Standardised risk ratios Massage therapy

0.94

0.69

0.68

Standard error

0.18

0.20

0.14

Aromatherapy

0.63

0.42

Standard error

0.13

0.15

Herbal medicine

1.03

Standard error

0.27

Acupuncture Standard error

Pakistani Bangladeshi

Chinese

Irish

1 0 1 0 2 0 0 0 0 4

11 8 4 6 5 3 2 3 13 2 1 0 31 2 1 1 3 2 0 1 0 47

11 13 8 8 6 5 4 6 4 1 4 3 2 1 1 0 3 30

10 11 8 8 5 4 4 3 3 3 2 2 2 1 1 1 1 1 0 0 0 0 33

0.84

0.07

0.91

0.99

1

0.21

0.05

0.20

0.27

0.32

0.32

0.01

0.63

1.20

0.09

0.11

0.01

0.16

0.27

0.93

0.44

0.48

0.06

0.75

1.26

0.27

0.15

0.17

0.04

0.23

0.40

0.26

0.56

0.82

1.34

0.06

3.13

1.03

0.16

0.30

0.29

0.64

0.06

0.75

0.46

Chinese medicine

1.24

0.55

0.42

3.06

0.13

16.12

1.05

Standard error

0.54

0.27

0.26

1.87

0.13

3.59

0.53

Any CAM

0.78

0.59

0.68

0.58

0.10

1.27

0.87

Standard error

0.08

0.10

0.08

0.10

0.04

0.13

0.12

Bases (weighted) Bases (unweighted)

439 433

308 303

647 369

285 271

121 276

94 220

1497 408

Women

Copyright © 2006, The Information Centre. All rights reserved

Observed % Massage therapy Aromatherapy Relaxation techniques Herbal medicine Reflexology Osteopathy Homeopathy Meditation/visualisation Acupuncture Chiropractic Spiritual healing Reiki Chinese medicine Crystal therapy Hypnotherapy Nutritional therapy Shiatsu Kinesiology Dowsing Naturopathy Iridology Ayurvedic medicine Unani medicine Megavit Used any CAM

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

1 1 1 1 1

33736 2649

357

Table 11.3 Whether used CAM in the last 12 months, by age within minority ethnic group and sex Aged 16 and over

2004 Age group

Men

Women

16-34

35-54

55+

Total

16-34

35-54

55+

Total

%

%

%

%

%

%

%

%

Black Caribbean Massage therapy Aromatherapy Relaxation techniques Herbal medicine Reflexology Osteopathy Homeopathy Meditation/visualisation Acupuncture Chiropractic Spiritual healing Reiki Chinese medicine Crystal therapy Hypnotherapy Nutritional therapy Shiatsu Kinesiology Dowsing Naturopathy Iridology Ayurvedic medicine Unani medicine Megavit Used any CAM

5 3 5 5 2 2 6 7 6 4 26

6 3 3 2 1 0 0 2 1 0 4 1 3 1 17

3 2 6 1 1 1 1 1 1 9

5 2 3 4 1 1 2 3 2 0 3 0 1 0 0 0 17

9 6 4 4 4 0 4 0 0 2 1 1 23

15 13 7 8 6 2 5 2 3 2 1 2 0 0 1 2 32

4 2 1 13 3 2 0 3 3 2 3 1 23

10 8 4 8 5 1 2 3 1 2 1 0 2 0 1 1 1 26

Bases (weighted) Bases (unweighted)

93 83

139 115

98 86

331 284

148 133

168 180

123 120

439 433

a Results are not shown because of small bases.

358

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

Copyright © 2006, The Information Centre. All rights reserved

Used CAM in last 12 months

Table 11.3 continued

Aged 16 and over Used CAM in last 12 months

Black African Massage therapy Aromatherapy Relaxation techniques Herbal medicine Reflexology Osteopathy Homeopathy Meditation/visualisation Acupuncture Chiropractic Spiritual healing Reiki Chinese medicine Crystal therapy Hypnotherapy Nutritional therapy Shiatsu Kinesiology Dowsing Naturopathy Iridology Ayurvedic medicine Unani medicine Megavit Used any CAM Bases (weighted) Bases (unweighted)

2004 Age group

Men

Women

16-34

35-54

55+

Total

16-34

35-54

55+

Total

%

%

%

%

%

%

%

%

3 6 2 3 1 1 2 4 0 1 1 14

7 1 3 4 1 1 0 4 2 1 4 1 5 17

a a a a a a a a a a a a a a a a a a a a a a a a a

5 3 3 3 1 0 0 2 1 2 4 1 2 1 0 16

5 1 4 5 1 0 0 0 2 0 1 0 2 0 1 12

8 11 9 10 2 2 2 3 6 2 2 1 1 29

[10] [-] [3] [2] [3] [-] [-] [5] [2] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [16]

7 5 6 7 1 1 1 1 3 1 1 0 1 0 1 0 0 19

120 122

105 111

20 19

245 252

153 148

127 121

27 34

308 303

Copyright © 2006, The Information Centre. All rights reserved

a Results are not shown because of small bases.

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

359

Table 11.3 continued

Aged 16 and over

2004 Age group

Men

Indian Massage therapy Aromatherapy Relaxation techniques Herbal medicine Reflexology Osteopathy Homeopathy Meditation/visualisation Acupuncture Chiropractic Spiritual healing Reiki Chinese medicine Crystal therapy Hypnotherapy Nutritional therapy Shiatsu Kinesiology Dowsing Naturopathy Iridology Ayurvedic medicine Unani medicine Megavit Used any CAM Bases (weighted) Bases (unweighted)

Women

16-34

35-54

55+

Total

16-34

35-54

55+

Total

%

%

%

%

%

%

%

%

2 3 4 2 1 2 3 5 2 6 2 1 1 12

5 2 2 5 3 6 4 2 1 2 1 1 1 1 1 7 22

7 2 5 4 3 2 2 1 1 5 24

4 2 3 4 3 1 4 4 2 1 1 2 1 1 1 0 4 19

8 4 2 2 2 1 5 2 2 2 1 3 1 1 5 23

9 5 4 5 6 1 5 4 4 1 3 4 1 2 2 1 4 23

8 4 2 2 1 5 4 1 2 9 1 1 2 4 4 26

8 4 3 4 4 1 5 3 3 1 2 4 1 1 1 2 1 4 24

192

247

236

296

146

109 65

548

110

321

135

168

116 66

369

a Results are not shown because of small bases.

360

647

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

Copyright © 2006, The Information Centre. All rights reserved

Used CAM in last 12 months

Table 11.3 continued

Aged 16 and over Used CAM in last 12 months

Pakistani Massage therapy Aromatherapy Relaxation techniques Herbal medicine Reflexology Osteopathy Homeopathy Meditation/visualisation Acupuncture Chiropractic Spiritual healing Reiki Chinese medicine Crystal therapy Hypnotherapy Nutritional therapy Shiatsu Kinesiology Dowsing Naturopathy Iridology Ayurvedic medicine Unani medicine Megavit Used any CAM Bases (weighted) Bases (unweighted)

2004 Age group

Men

Women

16-34

35-54

55+

Total

16-34

35-54

55+

Total

%

%

%

%

%

%

%

%

1 0 2 4 1 2 1 0 1 1 0 10

7 1 2 8 4 1 17

a a a a a a a a a a a a a a a a a a a a a a a a a

4 1 1 2 2 5 0 2 0 0 1 0 14

6 5 3 5 3 1 3 1 1 1 0 0 1 0 13

15 5 1 5 1 6 1 4 4 1 1 2 1 24

a a a a a a a a a a a a a a a a a a a a a a a a a

9 5 2 4 2 0 4 1 2 1 2 1 2 0 0 1 0 17

114 110

91 81

23 22

228 213

177 166

89 86

19 19

285 271

Copyright © 2006, The Information Centre. All rights reserved

a Results are not shown because of small bases.

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

361

Table 11.3 continued

Aged 16 and over

2004 Age group

Men

Bangladeshi Massage therapy Aromatherapy Relaxation techniques Herbal medicine Reflexology Osteopathy Homeopathy Meditation/visualisation Acupuncture Chiropractic Spiritual healing Reiki Chinese medicine Crystal therapy Hypnotherapy Nutritional therapy Shiatsu Kinesiology Dowsing Naturopathy Iridology Ayurvedic medicine Unani medicine Megavit Used any CAM Bases (weighted) Bases (unweighted)

Women

16-34

35-54

55+

Total

16-34

35-54

55+

Total

%

%

%

%

%

%

%

%

1 1 1 2 1 1 6

5 1 3 1 9

[-] [-] [-] [-] [-] [-] [2] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [2]

0 0 2 0 2 1 0 6

1 0 1 2 1 1 1 5

1 1

[3] [-] [-] [-] [2] [-] [3] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [5]

1 0 1 0 2 0 0 0 0 4

59

34

14

107

80

29

13

121

135

80

30

245

181

65

30

276

a Results are not shown because of small bases.

362

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

Copyright © 2006, The Information Centre. All rights reserved

Used CAM in last 12 months

Table 11.3 continued

Aged 16 and over Used CAM in last 12 months

2004 Age group

Men

Women

16-34

35-54

55+

Total

16-34

35-54

55+

Total

%

%

%

%

%

%

%

%

Chinese Massage therapy Aromatherapy Relaxation techniques Herbal medicine Reflexology Osteopathy Homeopathy Meditation/visualisation Acupuncture Chiropractic Spiritual healing Reiki Chinese medicine Crystal therapy Hypnotherapy Nutritional therapy Shiatsu Kinesiology Dowsing Naturopathy Iridology Ayurvedic medicine Unani medicine Megavit Used any CAM

5 2 3 1 4 1 2 5 2 20 1 3 1 28

6 1 4 3 1 1 1 4 4 1 20 0 33

[3] [-] [-] [-] [3] [-] [3] [-] [6] [3] [-] [-] [19] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [27]

5 1 3 2 2 1 2 4 3 1 19 0 2 0 30

15 13 3 7 10 2 4 4 7 1 2 26 3 2 1 2 2 2 1 47

12 6 5 7 3 3 2 3 19 1 2 1 37 1 2 5 2 1 51

a a a a a a a a a a a a a a a a a a a a a a a a a

11 8 4 6 5 3 2 3 13 2 1 0 31 2 1 1 3 2 0 1 0 47

Bases (weighted) Bases (unweighted)

32 76

31 72

15 34

78

34 81

49

182

111

11 28

220

Copyright © 2006, The Information Centre. All rights reserved

a Results are not shown because of small bases.

94

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

363

Table 11.3 continued

Aged 16 and over

2004 Age group

Men

Irish Massage therapy Aromatherapy Relaxation techniques Herbal medicine Reflexology Osteopathy Homeopathy Meditation/visualisation Acupuncture Chiropractic Spiritual healing Reiki Chinese medicine Crystal therapy Hypnotherapy Nutritional therapy Shiatsu Kinesiology Dowsing Naturopathy Iridology Ayurvedic medicine Unani medicine Megavit Used any CAM Bases (weighted) Bases (unweighted)

Women

16-34

35-54

55+

Total

16-34

35-54

55+

Total

%

%

%

%

%

%

%

%

6 4 8 5 2 4 2 2 4 1 2 2 2 1 1 26

17 8 4 4 3 1 1 0 1 0 2 1 1 2 1 2 29

1 1 1 1 1 1 1 3 1 1 1 0 6

8 4 3 3 2 1 1 1 3 0 1 1 1 1 1 1 0 20

6 13 5 11 4 6 7 2 2 5 5 1 2 0 3 27

18 20 14 11 8 8 5 8 6 1 5 3 3 2 2 2 38

6 5 3 3 4 5 3 2 2 1 1 2 1 3 22

11 13 8 8 6 5 4 6 4 1 4 3 2 1 1 0 3 30

278 78

448 124

462 123

1187 325

292 82

672 177

533 149

1497 408

a Results are not shown because of small bases.

364

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

Copyright © 2006, The Information Centre. All rights reserved

Used CAM in last 12 months

Table 11.3 continued

Aged 16 and over Used CAM in last 12 months

General population Massage therapy Aromatherapy Relaxation techniques Herbal medicine Reflexology Osteopathy Homeopathy Meditation/visualisation Acupuncture Chiropractic Spiritual healing Reiki Chinese medicine Crystal therapy Hypnotherapy Nutritional therapy Shiatsu Kinesiology Dowsing Naturopathy Iridology Ayurvedic medicine Unani medicine Megavit Used any CAM Bases (weighted) Bases (unweighted)

2004 Age group

Men

Women

16-34

35-54

55+

Total

16-34

35-54

55+

Total

%

%

%

%

%

%

%

%

7 4 3 3 2 2 1 2 2 1 0 1 2 1 1 0 1 0 0 22

8 4 4 2 3 5 3 2 3 3 2 1 1 0 0 0 0 0 0 0 23

3 2 2 4 1 2 2 2 2 2 1 0 1 0 0 0 0 0 0 0 16

6 3 3 3 2 3 2 2 2 2 1 1 1 0 1 0 0 0 0 0 0 0 21

12 12 9 6 6 3 4 4 2 1 3 3 2 1 1 0 0 0 0 0 34

13 14 10 9 6 4 6 4 5 4 3 3 2 2 1 1 1 1 0 0 0 0 40

7 6 4 7 3 3 3 3 3 3 2 2 1 0 1 1 0 1 1 0 0 25

10 11 8 8 5 4 4 3 3 3 2 2 2 1 1 1 1 1 0 0 0 0 33

9968 501

11428 672

10191 808

31588 1981

10183 637

11706 945

11848 1067

33736 2649

Copyright © 2006, The Information Centre. All rights reserved

a Results are not shown because of small bases.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

365

Table 11.4 Whether used CAM in the last 12 months, by equivalised household income tertile within minority ethnic group and sex Aged 16 and over

2004 Equivalised household income tertile

Men Highest

Women Middle Lowest

Highest

Middle

Lowest

%

%

%

%

%

%

Black Caribbean Observed % Massage therapy Aromatherapy Relaxation techniques Herbal medicine Reflexology Osteopathy Homeopathy Meditation/visualisation Acupuncture Chiropractic Spiritual healing Reiki Chinese medicine Crystal therapy Hypnotherapy Nutritional therapy Shiatsu Kinesiology Dowsing Naturopathy Iridology Ayurvedic medicine Unani medicine Megavit Used any CAM Standardised risk ratios Massage therapy

8 6 5 5 1 2 6 3 5 0 3 0 2 73

2 2 1 2 2 1 93

6 1 5 9 2 1 2 1 1 84

15 10 5 13 10 3 7 5 1 1 4 1 1 3 62

11 8 5 10 5 1 3 2 2 1 1 74

8 9 3 5 3 1 4 1 3 0 77

1.12

0.17

1.26

1.04

1.01

0.78

Standard error

0.47

0.17

0.74

0.35

0.36

0.27

Aromatherapy

1.76

0.00

0.43

0.69

0.66

0.80

Standard error

1.17

0.00

0.44

0.25

0.29

0.28

Herbal medicine

1.55

0.33

1.38

1.85

1.41

0.65

Standard error

0.77

0.33

0.77

0.70

0.55

0.28

Acupuncture

3.18

0.00

0.00

0.00

0.37

0.22

Standard error

1.92

0.00

0.00

0.00

0.37

0.22

Chinese medicine

0.89

1.33

0.00

2.38

0.73

1.77

Standard error

0.74

1.37

0.00

1.97

0.58

1.37

Any CAM

1.31

0.32

0.77

1.03

0.77

0.67

Standard error

0.29

0.14

0.28

0.20

0.16

0.12

Bases (weighted) Bases (unweighted)

110 85

82 67

61 61

103 94

112 105

111 118

Continued…

366

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

Copyright © 2006, The Information Centre. All rights reserved

Used CAM in last 12 months

Table 11.4 continued

Aged 16 and over

2004

Used CAM in last 12 months

Equivalised household income tertile

Men

Copyright © 2006, The Information Centre. All rights reserved

Highest

Women Middle Lowest

Highest

Middle

Lowest

%

%

%

%

%

%

Black African Observed % Massage therapy Aromatherapy Relaxation techniques Herbal medicine Reflexology Osteopathy Homeopathy Meditation/visualisation Acupuncture Chiropractic Spiritual healing Reiki Chinese medicine Crystal therapy Hypnotherapy Nutritional therapy Shiatsu Kinesiology Dowsing Naturopathy Iridology Ayurvedic medicine Unani medicine Megavit Used any CAM Standardised risk ratios Massage therapy

6 1 2 1 2 2 4 4 1 88

4 1 4 1 1 1 3 3 3 3 89

4 4 7 3 0 7 1 5 0 3 83

4 4 7 9 1 2 3 4 2 1 2 1 79

11 13 8 6 3 3 1 2 2 2 1 79

3 1 2 6 1 0 1 1 3 1 2 1 2 1 86

1.76

0.57

0.47

0.27

1.05

0.45

Standard error

1.10

0.42

0.37

0.18

0.43

0.28

Aromatherapy

0.00

0.00

1.04

0.24

0.94

0.04

Standard error

0.00

0.00

0.82

0.17

0.38

0.04

Herbal medicine

0.48

1.08

0.92

0.97

0.73

0.68

Standard error

0.37

0.87

0.74

0.48

0.35

0.28

Acupuncture

0.64

0.00

0.56

0.83

0.00

1.13

Standard error

0.60

0.00

0.57

0.56

0.00

0.90

Chinese medicine

1.92

2.01

0.70

0.44

1.18

0.91

Standard error

1.36

2.07

0.73

0.45

0.85

0.73

Any CAM

0.75

0.49

0.72

0.49

0.57

0.48

Standard error

0.35

0.22

0.26

0.16

0.17

0.15

74 69

59 70

57 59

85 72

72 76

96 94

Bases (weighted) Bases (unweighted)

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

367

Table 11.4 continued

Aged 16 and over

2004 Equivalised household income tertile

Men Highest

Women Middle Lowest

Highest

Middle

Lowest

%

%

%

%

%

%

Indian Observed % Massage therapy Aromatherapy Relaxation techniques Herbal medicine Reflexology Osteopathy Homeopathy Meditation/visualisation Acupuncture Chiropractic Spiritual healing Reiki Chinese medicine Crystal therapy Hypnotherapy Nutritional therapy Shiatsu Kinesiology Dowsing Naturopathy Iridology Ayurvedic medicine Unani medicine Megavit Used any CAM Standardised risk ratios Massage therapy

4 2 5 1 0 2 3 2 1 2 6 82

1 1 2 7 2 4 3 3 1 1 1 1 1 1 5 86

2 2 2 6 2 4 2 2 7 79

10 6 3 3 7 5 4 4 1 2 3 1 1 1 6 72

4 2 2 3 2 4 1 1 3 2 1 2 82

8 3 3 2 3 1 4 1 1 3 8 3 79

0.39

0.09

0.29

0.80

0.39

0.72

Standard error

0.23

0.09

0.28

0.24

0.19

0.31

Aromatherapy

0.45

0.18

0.00

0.45

0.18

0.25

Standard error

0.29

0.19

0.00

0.19

0.11

0.17

Herbal medicine

0.24

1.69

0.48

0.37

0.35

0.30

Standard error

0.19

0.74

0.49

0.23

0.21

0.29

Acupuncture

0.60

1.19

0.63

1.05

0.00

0.49

Standard error

0.43

0.77

0.66

0.59

0.00

0.49

Chinese medicine

0.00

0.44

0.00

0.52

0.00

0.00

Standard error

0.00

0.46

0.00

0.53

0.00

0.00

Any CAM

0.66

0.58

0.95

0.71

0.54

0.53

Standard error

0.20

0.17

0.31

0.13

0.15

0.16

Bases (weighted) Bases (unweighted)

141 87

150 92

88 54

196 115

176 97

100 58

Continued…

368

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

Copyright © 2006, The Information Centre. All rights reserved

Used CAM in last 12 months

Table 11.4 continued

Aged 16 and over

2004

Used CAM in last 12 months

Equivalised household income tertile

Men Highest

Pakistani Observed % Massage therapy Aromatherapy Relaxation techniques Herbal medicine Reflexology Osteopathy Homeopathy Meditation/visualisation Acupuncture Chiropractic Spiritual healing Reiki Chinese medicine Crystal therapy Hypnotherapy Nutritional therapy Shiatsu Kinesiology Dowsing Naturopathy Iridology Ayurvedic medicine Unani medicine Megavit Used any CAM Standardised risk ratios Massage therapy Standard error

Aromatherapy Standard error

Herbal medicine

Highest

Middle

Lowest

%

%

%

%

%

%

[8] [-] [-] [1] [-] [4] [4] [-] [1] [-] [-] [-] [-] [-] [-] [-] [3] [-] [-] [-] [-] [1] [-] [-] [87]

[2] [0] [5] [7] [-] [-] [6] [2] [2] [-] [2] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [84]

5 2 2 2 3 3 1 0 84

[14] [7] [10] [7] [7] [-] [3] [3] [3] [3] [-] [3] [-] [3] [-] [4] [-] [-] [-] [-] [-] [-] [-] [-] [80]

5 4 2 8 2 8 2 6 1 0 5 0 79

11 5 4 2 2 1 0 85

[1.04]

[0.18]

0.74

[1.36]

1.33

0.85

[0.72]

[0.12]

0.36

[0.64]

0.73

0.32

[0.00]

[0.07]

0.88

[0.63]

0.34

0.31

[0.00]

[0.08]

0.88

[0.44]

0.24

0.22

[0.28]

[1.70]

0.47

[0.95]

0.61

0.42

Standard error

[0.30]

[1.04]

0.46

[0.66]

0.31

0.30

Acupuncture

[0.46]

[1.18]

1.36

[1.51]

4.98

0.00

Standard error

Chinese medicine Standard error

Any CAM Standard error Copyright © 2006, The Information Centre. All rights reserved

Women Middle Lowest

Bases (weighted) Bases (unweighted)

[0.48]

[1.20]

0.83

[1.43]

2.79

0.00

[0.00]

[0.00]

0.67

[0.00]

7.77

0.00

[0.00]

[0.00]

0.68

[0.00]

4.83

0.00

[0.50]

[0.70]

0.83

[0.65]

0.87

0.37

[0.27]

[0.24]

0.25

[0.26]

0.22

0.12

37 30

54 49

79 84

40 31

66 66

100 99

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

369

Table 11.4 continued

Aged 16 and over

2004 Equivalised household income tertile

Men

Women

Highest

Middle Lowest

Highest

Middle

Lowest

%

%

%

%

%

%

Bangladeshi Observed % Massage therapy Aromatherapy Relaxation techniques Herbal medicine Reflexology Osteopathy Homeopathy Meditation/visualisation Acupuncture Chiropractic Spiritual healing Reiki Chinese medicine Crystal therapy Hypnotherapy Nutritional therapy Shiatsu Kinesiology Dowsing Naturopathy Iridology Ayurvedic medicine Unani medicine Megavit Used any CAM Standardised risk ratios Massage therapy

a a a a a a a a a a a a a a a a a a a a a a a a a

6 6 1 1 90

1 99

a a a a a a a a a a a a a a a a a a a a a a a a a

4 1 1 95

1 1 1 1 1 97

a

0.00

0.00

a

0.00

0.03

Standard error

a

0.00

0.00

a

0.00

0.03

Aromatherapy

a

0.00

0.00

a

0.00

0.03

Standard error

a

0.00

0.00

a

0.00

0.03

Herbal medicine

a

1.99

0.00

a

0.00

0.07

Standard error

a

0.98

0.00

a

0.00

0.07

Acupuncture

a

0.49

0.00

a

0.00

0.00

Standard error

a

0.51

0.00

a

0.00

0.00

Chinese medicine

a

0.74

0.00

a

0.47

0.00

Standard error

a

0.78

0.00

a

0.50

0.00

Any CAM

a

0.52

0.05

a

0.13

0.05

Standard error

a

0.20

0.05

a

0.08

0.03

5 12

29 65

43 99

7 17

31 71

50 113

Bases (weighted) Bases (unweighted)

a Results are not shown because of small bases.

Continued…

370

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

Copyright © 2006, The Information Centre. All rights reserved

Used CAM in last 12 months

Table 11.4 continued

Aged 16 and over

2004

Used CAM in last 12 months

Equivalised household income tertile

Men Highest

Highest

Middle

Lowest

%

%

%

%

%

%

Chinese Observed % Massage therapy Aromatherapy Relaxation techniques Herbal medicine Reflexology Osteopathy Homeopathy Meditation/visualisation Acupuncture Chiropractic Spiritual healing Reiki Chinese medicine Crystal therapy Hypnotherapy Nutritional therapy Shiatsu Kinesiology Dowsing Naturopathy Iridology Ayurvedic medicine Unani medicine Megavit Used any CAM Standardised risk ratios Massage therapy

3 1 3 2 3 2 5 5 6 2 29 3 56

[6] [3] [8] [1] [6] [-] [1] [8] [6] [-] [-] [-] [6] [-] [1] [-] [1] [-] [-] [-] [-] [1] [-] [-] [77]

a a a a a a a a a a a a a a a a a a a a a a a a a

17 10 8 9 10 3 1 5 14 4 3 1 39 3 2 2 4 3 1 2 1 46

[6] [5] [-] [8] [3] [4] [1] [3] [14] [-] [2] [-] [31] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [-] [50]

a a a a a a a a a a a a a a a a a a a a a a a a a

0.34

[0.42]

a

1.31

[0.25]

a

Standard error

0.23

[1.10]

a

0.35

[0.35]

a

Aromatherapy

0.22

[0.75]

a

0.86

[0.26]

a

Standard error

0.23

[0.41]

a

0.31

[0.92]

a

Herbal medicine

0.33

[0.42]

a

0.85

[0.48]

a

Standard error

0.34

[2.92]

a

0.32

[3.95]

a

Acupuncture

3.40

[1.83]

a

3.68

[1.68]

a

Standard error

Chinese medicine

Copyright © 2006, The Information Centre. All rights reserved

Women Middle Lowest

1.85

[4.18]

a

1.24

[17.17]

a

21.36

[2.53]

a

21.76

[5.18]

a

Standard error

8.84

[1.06]

a

5.69

[1.36]

a

Any CAM

2.13

[0.29]

a

1.64

[0.22]

a

Standard error

0.42

[0.00]

a

0.20

[0.00]

a

25 59

20 44

7 17

35 82

19 44

11 25

Bases (weighted) Bases (unweighted)

a Results are not shown because of small bases.

Continued…

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

371

Table 11.4 continued

Aged 16 and over

2004 Equivalised household income tertile

Men Highest

Women Middle Lowest

Highest

Middle

Lowest

%

%

%

%

%

%

Irish Observed % Massage therapy Aromatherapy Relaxation techniques Herbal medicine Reflexology Osteopathy Homeopathy Meditation/visualisation Acupuncture Chiropractic Spiritual healing Reiki Chinese medicine Crystal therapy Hypnotherapy Nutritional therapy Shiatsu Kinesiology Dowsing Naturopathy Iridology Ayurvedic medicine Unani medicine Megavit Used any CAM Standardised risk ratios Massage therapy

12 5 3 5 2 2 0 0 1 1 2 1 2 1 1 76

6 4 4 2 1 3 7 1 2 1 1 0 82

1 2 2 3 2 1 1 2 93

16 20 11 14 10 6 5 9 7 2 4 4 4 2 0 0 6 57

13 12 6 4 5 7 7 7 2 0 4 4 0 3 76

4 3 8 3 3 3 3 1 4 1 84

1.71

1.12

0.23

1.21

0.97

0.22

Standard error

0.50

0.67

0.24

0.36

0.38

0.15

Aromatherapy

1.46

1.13

0.96

1.75

1.12

0.27

Standard error

0.75

0.57

0.92

0.43

0.46

0.18

Herbal medicine

1.73

0.00

0.92

1.96

0.70

0.23

Standard error

1.09

0.00

0.94

0.58

0.45

0.18

Acupuncture

0.39

3.23

2.27

1.96

0.55

0.63

Standard error

0.28

1.88

2.29

0.84

0.45

0.51

Chinese medicine

0.96

1.59

0.00

2.18

0.24

0.00

Standard error

0.77

1.60

0.00

1.17

0.24

0.00

Any CAM

1.18

0.92

0.60

1.25

0.60

0.34

Standard error

0.23

0.29

0.31

0.18

0.16

0.12

Bases (weighted) Bases (unweighted)

571 142

271 84

160 50

645 159

381 106

214 74

Continued…

372

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

Copyright © 2006, The Information Centre. All rights reserved

Used CAM in last 12 months

Table 11.4 continued

Aged 16 and over

2004

Used CAM in last 12 months

Equivalised household income tertile

Men

Copyright © 2006, The Information Centre. All rights reserved

Highest

Women Middle Lowest

Highest

Middle

Lowest

%

%

%

%

%

%

General population Observed % Massage therapy Aromatherapy Relaxation techniques Herbal medicine Reflexology Osteopathy Homeopathy Meditation/visualisation Acupuncture Chiropractic Spiritual healing Reiki Chinese medicine Crystal therapy Hypnotherapy Nutritional therapy Shiatsu Kinesiology Dowsing Naturopathy Iridology Ayurvedic medicine Unani medicine Megavit Used any CAM Standardised risk ratios Massage therapy

8 4 3 3 2 4 3 2 2 3 1 1 2 1 0 1 0 0 0 0 0 76

5 2 3 4 1 3 1 2 1 2 1 1 0 0 0 0 0 0 82

3 2 3 2 1 0 3 3 0 1 2 1 0 88

15 16 9 10 7 4 6 4 4 3 3 4 2 2 1 1 1 1 1 1 0 0 59

7 7 8 6 3 2 3 4 2 2 3 1 1 1 1 0 0 0 0 0 0 0 71

6 7 6 5 1 1 2 2 3 1 1 2 1 1 0 1 79

1.21

0.88

0.39

1.32

0.78

0.49

Standard error

0.18

0.21

0.19

0.14

0.11

0.14

Aromatherapy

1.24

0.71

0.64

1.32

0.71

0.66

Standard error

0.30

0.26

0.36

0.14

0.12

0.15

Herbal medicine

1.03

1.18

0.50

1.24

0.78

0.77

Standard error

0.24

0.35

0.28

0.17

0.15

0.20

Acupuncture

1.07

0.68

1.41

1.38

0.60

0.73

Standard error

0.32

0.35

0.64

0.28

0.18

0.28

Chinese medicine

1.23

0.35

1.48

1.29

0.80

0.57

Standard error

0.49

0.31

1.20

0.35

0.33

0.35

Any CAM

1.16

0.90

0.57

1.16

0.95

0.61

Standard error

0.09

0.11

0.13

0.07

0.07

0.08

15166 941

7980 517

3579 227

13698 1037

9955 820

4485 365

Bases (weighted) Bases (unweighted)

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

373

Table 11.5 Whether used CAM practitioner in the last 12 months, by minority ethnic group and sex Aged 16 and over

2004

Used CAM practitioner in last 12 months

Minority ethnic group

General population

Black Caribbean

Black African

Indian

Observed % Massage therapy Osteopathy Aromatherapy Reflexology Relaxation techniques Acupuncture Chiropractic Herbal medicine Homeopathy Healing / spiritual healing Reiki Meditation/visualisation Chinese medicine Hypnotherapy Nutritional therapy Crystal therapy Kinesiology Shiatsu Iridology Dowsing Naturopathy Ayurvedic medicine Unani medicine MegaVit Used any CAM

4 1 1 1 2 1 0 1 2 1 0 1 1 0 10

4 0 1 0 1 2 1 0 1 1 1 1 8

3 1 1 2 1 1 1 1 3 1 1 1 1 1 1 11

3 2 1 0 2 1 2 0 1 11

Standardised risk ratios Massage therapy

0.74

0.73

0.42

Standard error

0.28

0.26

0.21

Aromatherapy

0.81

0.00

Standard error

0.63

0.00

Herbal medicine

1.46

Standard error

0.87

Acupuncture Standard error

Pakistani Bangladeshi

Chinese

Irish

0 0 1 1 2 0 3

4 1 1 2 1 3 1 1 1 1 7 0 1 16

6 1 1 2 2 3 0 1 0 1 1 0 0 1 1 1 0 15

5 3 1 2 2 2 2 1 1 1 0 1 1 0 0 0 0 0 0 0 0 14

0.43

0.00

0.80

1.24

1

0.20

0.00

0.28

0.38

0.70

1.88

0.30

0.72

0.79

0.72

1.85

0.31

0.52

0.56

0.14

0.35

0.04

0.00

0.79

1.55

0.15

0.26

0.04

0.00

0.53

0.90

0.89

1.34

1.18

1.11

0.82

0.91

0.74

0.53

0.99

0.70

0.83

0.59

0.64

0.47

Chinese medicine

1.61

2.12

0.95

0.55

0.54

11.31

0.64

Standard error

1.17

1.53

0.76

0.58

0.56

4.85

0.67

Any CAM

0.79

0.46

0.62

0.81

0.18

1.02

1.17

Standard error

0.19

0.12

0.16

0.23

0.07

0.19

0.24

Bases (weighted) Bases (unweighted)

331 284

245 252

548 321

228 213

107 245

78 182

1187 325

Men

1 1 1 1

31588 1981 Continued…

374

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

Copyright © 2006, The Information Centre. All rights reserved

1

Table 11.5 continued Aged 16 and over

2004

Used CAM practitioner in last 12 months

Minority ethnic group

General population

Black Caribbean

Black African

Indian

Observed % Massage therapy Osteopathy Aromatherapy Reflexology Relaxation techniques Acupuncture Chiropractic Herbal medicine Homeopathy Healing / spiritual healing Reiki Meditation/visualisation Chinese medicine Hypnotherapy Nutritional therapy Crystal therapy Kinesiology Shiatsu Iridology Dowsing Naturopathy Ayurvedic medicine Unani medicine MegaVit Used any CAM

6 1 4 3 2 1 2 2 1 0 0 1 2 0 1 1 1 15

5 2 1 2 1 2 1 1 0 1 1 0 0 9

6 1 2 2 1 2 1 1 4 0 3 1 1 1 1 0 2 17

5 0 2 2 1 2 1 3 4 0 1 0 2 0 12

Standardised risk ratios Massage therapy

0.76

0.63

0.61

Standard error

0.18

0.20

0.15

Aromatherapy

0.66

0.38

Standard error

0.19

0.20

Herbal medicine

0.56

Standard error

0.22

Acupuncture Standard error

Pakistani Bangladeshi

Chinese

Irish

1 0 0 0 0 2 0 0 3

11 3 4 4 2 12 1 3 2 1 1 12 1 1 2 2 3 1 0 0 30

9 5 7 5 3 4 1 3 3 2 3 2 2 1 0 3 22

8 4 5 4 4 3 3 3 3 2 2 2 1 1 0 1 0 0 0 0 0 0 23

0.67

0.07

1.10

1.09

1

0.25

0.04

0.25

0.34

0.31

0.33

0.02

0.72

1.27

0.13

0.16

0.02

0.27

0.49

0.32

0.22

0.26

0.00

0.29

1.17

0.18

0.12

0.16

0.00

0.18

0.59

0.65

0.61

0.36

0.63

0.07

0.88

1.46

0.28

0.31

0.18

0.26

0.07

0.37

0.83

Chinese medicine

1.51

0.57

0.36

4.17

0.19

9.51

1.45

Standard error

0.77

0.32

0.28

2.73

0.19

2.97

0.77

Any CAM

0.66

0.41

0.69

0.64

0.10

1.15

0.90

Standard error

0.09

0.09

0.11

0.14

0.05

0.17

0.14

Bases (weighted) Bases (unweighted)

439 433

308 303

647 369

285 271

121 276

94 220

1497 408

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Women

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

1 1 1 1 1

33736 2649

375

Table 11.6 Whether used individual CAM in the last 12 months, among those who had ever used individual CAM General population aged 16 and over who had ever used individual CAM CAMa

2004 Used in last 12 months

Weighted bases

Unweighted bases

Meditation/visualisation

%

65

Massage therapy Aromatherapy Crystal therapy Relaxation techniques Nutritional therapy Herbal medicine Reiki Spiritual healing Reflexology Chinese medicine Homeopathy Kinesiology Osteopathy

% % % % % % % % % % % % %

62 58 58 58 57 55 48 45 42 40 39 37 31

2792 8743 7974 948 6230 715 6417 2207 2589 5352 2252 5466 699 7067

204 627 600 74 454 54 474 160 188 399 151 402 55 513

Chiropractic Shiatsu Acupuncture Hypnotherapy

% % % %

30 28 27 19

5477 965 7127 2464

411 71 540 185

a Only CAM where 50 or more participants had ever used them are shown in the table.

Table 11.7 Whether consulted individual CAM practitioner in the last 12 months, among those who had used individual CAM in the last 12 months General population aged 16 and over who had ever used individual CAM in last 12 months

2004

Consulted practitioner in last 12 months

Weighted bases

Unweighted bases

1622 2205 1942 2269 1042 5445 1171 894 2150 3591 1826 4643 3513

119 155 144 162 75 388 86 60 162 265 137 343 267

Chiropractic

%

99

Osteopathy Acupuncture Reflexology Reiki Massage therapy Spiritual healing Chinese medicine Homeopathy Relaxation techniques Meditation/visualisation Aromatherapy Herbal medicine

% % % % % % % % % % % %

97 94 86 80 78 72 61 54 54 46 45 37

a Only CAM where 50 or more participants had used them in the last 12 months are

shown in the table.

376

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES

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CAMa

Children’s health

12

Elizabeth Fuller

Summary General health (ages 0 to 15) ●

Irish and Black Caribbean boys and girls and Chinese boys reported similar levels of longstanding illness to children in the general population. Children in all other minority ethnic groups were less likely than the general population to report a longstanding illness. The prevalence of limiting longstanding illness differed less between groups.

●

Children in most minority ethnic groups were less likely than were children in the general population to report acute sickness within the past two weeks. The prevalence of acute sickness among Irish boys and girls and Pakistani boys was similar to the prevalence in the general population.

●

Children in all groups were very likely to rate their general health as ‘good’ or ‘very good’. In most minority ethnic groups the proportions who reported this were similar to the proportions in the general population (93% of boys and girls). Smaller proportions of Bangladeshi boys (86%) and Black Caribbean girls (89%) reported ‘good’ or ‘very good’ general health.

Psychosocial health (ages 4 to 15) ●

The prevalence of emotional, behavioural or relationship difficulties, as indicated by a high total deviance score on the Strengths and Difficulties Questionnaire, was not significantly different among children in most minority ethnic groups and the general population. The exceptions were Chinese boys and Black African girls, who were less likely to obtain a score above the ‘problem’ threshold.

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Respiratory symptoms (ages 0 to 15) and lung function (ages 7 to 15) ●

The prevalence of having experienced respiratory symptoms (wheezing or whistling) among Black Caribbean, Irish and Chinese boys and Black Caribbean and Irish girls was similar to the prevalence within the general population. Experience of wheezing was less prevalent among children in other minority ethnic groups. In all groups, boys were more likely than girls to have ever wheezed, although the difference was not significant for Black Caribbean, Indian and Irish children.

●

After controlling for age and height, mean FEV1 (forced expiratory volume in the first second) was similar among Black Caribbean and Irish boys and boys in the general population. The mean FEV1 for boys in other minority ethnic groups, and for girls in all minority ethnic groups, was lower than the mean for the general population.

Cigarette smoking (ages 8 to 15) ●

Among minority ethnic groups, Black Caribbean, Black African, Bangladeshi and Irish boys, and Black Caribbean and Irish girls were as likely to have smoked cigarettes as children in the general population. Children in other minority groups were less likely to have smoked.

Drinking alcohol (ages 8 to 15) ●

45% of boys and 40% of girls in the general population had drunk alcohol at least

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

377

once. Children in most minority ethnic groups were less likely than the general population to have ever had an alcoholic drink. This was particularly so for Pakistani and Bangladeshi boys, only 1% of whom reported ever having had an alcoholic drink. The proportions of Black Caribbean and Irish boys and Black Caribbean girls who had tried alcohol were similar to the proportions in the general population, and Irish girls were more likely than girls in the general population to have ever drunk alcohol. Blood pressure (ages 5 to 15) ●

After controlling for age and height, mean systolic blood pressure (SBP) was similar for children in minority ethnic groups and the general population. Mean diastolic blood pressure (DBP) did not differ significantly between groups, except for Indian, Pakistani and Bangladeshi boys and Black African girls. Children in these groups had higher mean DBP than children in the general population.

Anthropometric measures (ages 2 to 15) ●

For each minority ethnic group, mean heights were compared after controlling for age. Most groups had a mean height that was similar to the general population. Compared with boys in the general population, Black Caribbean boys were taller on average and Chinese boys were shorter on average. Black Caribbean and Black African girls were taller on average than girls in the general population, and Bangladeshi girls were shorter on average.

●

For most minority ethnic groups, the average weight was similar to children in the general population, once age had been controlled for. Black Caribbean, Black African and Pakistani boys were heavier on average than boys in the general population. Black Caribbean and Black African girls were heavier on average than girls in the general population.

●

Black African boys were more likely to be obese than boys in the 2004 general population. Otherwise the prevalence of obesity was similar among all groups.

Physical activity (ages 2 to 15) ●

Pakistani boys and Irish boys and girls were as likely as children in the general population to have exercised at the levels recommended by government (at least one hour every day). Children in other minority ethnic groups were less likely than children in the general population to have been active at the recommended levels.

Fruit and vegetable consumption (ages 5 to 15)

378

Children in most minority ethnic groups were more likely than the general population to eat the recommended five or more portions a day of fruit and vegetables. The proportions of Chinese boys, Bangladeshi girls and Irish boys and girls who ate five or more portions were not significantly different from the general population. The average consumption of fruit and vegetables among children in minority ethnic groups ranged from 2.8 portions for Irish boys to 3.6 portions for Chinese girls. Children in the general population ate fewer portions: boys ate an average of 2.5 portions, girls ate an average of 2.6 portions.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

Copyright © 2006, The Information Centre. All rights reserved

●

12.1 Introduction 12.1.1

Background This chapter focuses on the health of children aged 15 and under from seven minority ethnic groups: Black Caribbean, Black African, Indian, Pakistani, Bangladeshi, Chinese and Irish, along with a comparison sample of children in the general population. The Health Survey for England (HSE) has covered children aged 2 to 15 since 1995, and in 2001 the age range was broadened to include children aged under 2. As elsewhere in this report, comparisons are made in this chapter with HSE 1999, the first nationally representative survey in England to include children from minority ethnic groups.1

12.1.2

The sample In most years, the sample of children in the Health Survey is not large enough for any detailed analysis of children’s health. Surveys in 1997 and 2002 used boosted samples of children, and the reports from those years presented aggregated data from more than one survey year, to enable a full analysis of children’s health. However, these boosted samples of children were not large enough to provide separate results on the health of minority ethnic children. The Health Surveys of 1999 and 2004 boosted samples of people from minority ethnic groups, and included up to three randomly selected children per household, compared with the usual Health Survey limit of two children per household. The 2004 general population sample was half the usual size and did not receive a nurse visit; consequently it did not include sufficient numbers of children for comparisons to be drawn with those from minority ethnic groups. Within this chapter, findings for minority ethnic groups are compared with the general population sample used in the 2002 report, which included the 2001 sample and the boosted 2002 sample.2 For minority ethnic groups, comparisons are also drawn with the results from the 1999 survey, with two important exceptions. The 1999 survey did not include children aged under 2, so the comparisons are limited to those aged 2 to 15. Also, Black Africans were not included in the boosted sample in 1999, so no comparisons can be made. Further information about the sample, including response rates among children for the stages of the survey, is shown in volume 2 of HSE 2004, Health Survey for England 2004: Methodology and Documentation.

12.1.3

Coverage and methods The following topics are covered in this chapter: 12.2 Longstanding illness, acute sickness, self-assessed general health and prescribed medicines (ages 0 to 15); 12.3 Psychosocial health (General Health Questionnaire ages 13 to 15, Strengths and Difficulties Questionnaire ages 4 to 15); 12.4 Respiratory symptoms (ages 0 to 15) and lung function (ages 7 to 15);

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12.5 Smoking cigarettes (ages 8 to 15); 12.6 Drinking alcohol (ages 8 to 15); 12.7 Blood pressure (ages 5 to 15); 12.8 Anthropometric measures (height, weight and BMI, ages 2 to 15); 12.9 Physical activity (ages 2 to 15); and 12.10 Fruit and vegetable consumption (ages 5 to 15). Information was collected from children in the same way as from adults, by personal interview, self-completion questionnaires and measurements carried out by interviewers and nurses. For children aged 0 to 12, a parent or guardian answered on behalf of the child,

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though interviews were carried out in the child’s presence. Children aged 13 to 15 answered directly. There were some exceptions to this. The Strengths and Difficulties Questionnaire (SDQ) was completed by parents about their children aged 4 to 15. Questions about smoking cigarettes and drinking alcohol were answered directly by all children aged 8 to 15; these questions were presented in self-completion format to allow privacy. The Health Survey mostly collects similar data from children and adults, and details of most measurements can be found in the relevant chapters covering adults’ health. Exceptions to this are the measurement of lung function, which was not carried out on adults, and questions covering cigarette smoking, drinking alcohol and physical activity where the questions are worded differently. Details of the measures used are given in the relevant sections below. Results are presented separately for boys and girls within each minority ethnic group. Despite the boosting of the sample, this approach means that some analyses in this chapter are based on small subsamples, especially when analyses are broken down by age, or where measurements were not carried out on all children. Differences commented on in this chapter are statistically significant at the 95% level unless otherwise stated. As in 1999, the data for children have not been standardised by age, and differences between groups may be influenced by differences in their age profiles. The tables show key comparisons with the general population in the form of risk ratios; again these are not generally age-standardised. Where measures are strongly related to age, data are presented within age categories (smoking and drinking behaviour, obesity and overweight) or age-adjusted regression coefficients are shown (lung function, blood pressure, height and weight). The latter are derived using linear regression models; the regression coefficients are equivalent to age-standardised absolute differences in the means for each minority ethnic group compared with the general population. The regression models for lung function and blood pressure also incorporate height, and these regression coefficients are standardised for height as well as age. For further information about risk ratios and linear regression models, see the Glossary in volume 2 of HSE 2004, Health Survey for England 2004: Methodology and Documentation.

12.2 General health Longstanding illness and limiting longstanding illness All informants were asked whether they had any longstanding illness, disability or infirmity that had troubled them over a period of time, or was likely to trouble them over a period of time. Those who said they had were asked about the nature of the illness and also whether it limited their activities in any way. Within minority ethnic groups, the proportion of children aged 15 or under who reported a longstanding illness ranged from 11% of Black African boys to 23% of Irish boys, and from 7% of Black African girls to 22% of Black Caribbean girls. In the general population 24% of boys and 20% of girls reported such an illness. Black Caribbean and Irish boys and girls and Chinese boys were as likely as children in the general population to report longstanding illness; otherwise children in minority ethnic groups were less likely to report this. Table 12.1 In all groups apart from Chinese boys, less than half of those who reported a longstanding illness said that it limited their activities. Within minority ethnic groups, the proportions reporting a limiting longstanding illness ranged from 5% of Black African and Bangladeshi boys to 10% of Chinese boys, and from 2% of Black African girls to 8% of Black Caribbean girls. 8% of boys and 7% of girls in the general population reported a limiting longstanding illness. In most minority ethnic groups boys had similar levels of limiting longstanding illness as boys in the general population; only Bangladeshi boys were less likely to report this. In contrast, only Black Caribbean and Pakistani girls reported similar levels of limiting longstanding illness to girls in the general population; girls in most minority ethnic groups were less likely to report this. Table 12.1

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The sample in 1999 did not include children aged under 2, and so the comparison between 1999 and 2004 shown in Table 12.2 shows children aged 2 to 15 for both years. Levels of longstanding illness and limiting longstanding illness observed in 1999 were similar to those recorded in 2004 for most minority ethnic groups. Among Indian and Irish girls, the prevalence of longstanding illness in 2004 was lower than in 1999, and the prevalence of limiting longstanding illness had fallen in the same period among Bangladeshi and Irish girls. Other differences between the two years were not significant. Table 12.2 12.2.2

Types of longstanding illness Longstanding illnesses reported by informants were coded and grouped into broad categories corresponding as far as possible to the chapter headings of the Tenth Revision of the International Classification of Disease 3 (see Chapter 2, Section 2.3.5 in this report). The table below shows three categories with high prevalence rates: diseases of the respiratory system, skin complaints and mental disorders. Rate per thousand of most commonly reported types of illness, by minority ethnic group and sex Black Caribbean

Black African

Indian

%

%

%

%

69 20 20

101 45 7

38 18 2

71 16 -

Boys Respiratory system 157 Skin complaints 9 Mental disorders 13 Girls Respiratory system 118 Skin complaints 71 Mental disorders 11

Chinese

Irish

General population (2001-2002)

%

%

%

%

96 22 8

60 29 10

127 32 8

136 38 43

123 45 27

55 51 11

41 22 3

63 19 -

91 36 23

99 43 10

Pakistani Bangladeshi

Diseases of the respiratory system were the most common among all groups of children. The prevalence in minority ethnic groups ranged from 60 per 1000 among Bangladeshi boys to 157 per 1000 among Black Caribbean boys; the corresponding figure for boys in the general population was 123 per 1000. Among girls in minority ethnic groups the prevalence was lower, ranging from 38 per 1000 among Black African girls to 118 per 1000 among Black Caribbean girls. Among girls in the general population it was 99 per 1000. Skin complaints were the next most common category of disease. Prevalence ranged from 9 per 1000 among Black Caribbean boys to 45 per 1000 among Indian boys, and from 16 per 1000 among Indian girls to 71 per 1000 among Black Caribbean girls. In the general population, the prevalence of skin complaints was 45 per 1000 for boys and 43 per 1000 for girls.

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The prevalence of mental disorders among boys in minority ethnic groups ranged from 7 per 1000 among Indian boys to 43 per 1000 among Irish boys. The prevalence was much lower among girls, and no Indian or Chinese girls reported mental disorders. Among girls in other minority ethnic groups, the prevalence ranged from 2 per 1000 among Black African girls to 23 per 1000 among Irish girls. Within the general population the prevalence of mental disorders was 27 per 1000 for boys, 10 per 1000 for girls. Table 12.3 12.2.3

Acute sickness Acute sickness was defined as illness or injury within the last two weeks that had caused the child to cut down on anything usually done about the house, at school or during free time. Severity was measured by the number of days on which activities were affected by illness or injury in this way. The proportions of children aged 15 or under who had suffered from acute sickness in the last two weeks ranged from 4% of Chinese boys to 12% of Irish boys, and from 4% of Bangladeshi girls to 11% of Irish girls. Apart from Irish boys and girls and Pakistani boys, children in minority ethnic groups were less likely to have suffered acute sickness than were HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

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children in the general population (13% of both boys and girls). Most children who reported acute sickness had been affected for a short period, from 1 to 3 days. Table 12.4 Similar levels of acute sickness among children were reported in 1999, and – as in 2004 – children aged 2 to 15 from most minority ethnic groups were less likely than children in the general population to have suffered acute sickness in the last two weeks (general population data not shown). Table 12.5 12.2.4

Self-assessed general health Informants were asked to rate their own general health on a five-point scale ranging from ‘very good’ to ‘very bad’, with ‘fair’ as the mid-point. In all groups, most children were inclined to rate their health as ‘good’ or ‘very good’, ranging from 86% of Bangladeshi boys to 94% of Black African, Indian and Irish boys, and from 89% of Black Caribbean girls to 97% of Chinese girls. Children in most minority ethnic groups were as likely to report ‘good’ or ‘very good’ health as were children in the general population (93% of both boys and girls). The exceptions were Bangladeshi boys and Black Caribbean girls, who were less likely to report this than children in the general population. Very few children in any group reported ‘bad’ or ‘very bad’ health.

Table 12.6

The patterns of self-assessed general health among boys and girls aged 2 to 15 in minority ethnic groups in 1999 were broadly similar to those recorded in 2004. Table 12.7 12.2.5

Prescribed medicines Informants were asked whether they were taking any medication – defined as medicines, pills, syrups, ointments, puffers or injections – prescribed by a doctor. The proportions of children in minority ethnic groups who were taking prescribed medicines ranged from 9% of Chinese boys to 24% of Pakistani boys, and from 10% of Black African girls to 22% of Bangladeshi girls. Chinese boys and Black African girls were less likely than children in the general population to be taking prescribed medicines; for other groups the proportions taking prescribed medicines were similar to the proportion doing so in the general population (20% of boys and 19% of girls). Table 12.8 The prevalence of taking prescribed medicine among children aged 2 to 15 in minority ethnic groups was broadly similar in 1999 and 2004. The proportion of Chinese boys taking prescribed medicines was lower in 2004 than in 1999; other differences between the two years were not significant. Table 12.9

12.3 Psychosocial health General Health Questionnaire (GHQ12) The General Health Questionnaire (GHQ12), a 12-question scale designed to assess psychological health, was included in the self-completion questionnaire for children aged 13 to 15.4 The GHQ12 has been used successfully with young people aged 13 or over, but is not recommended for use with younger children. A high score (4 or more) is used as the threshold to identify informants with possible psychiatric disorder. However, too few children in any of the minority ethnic groups completed the GHQ12 for reliable comparisons to be made between groups. Among the general population, girls were more likely than boys to have a high score (13% compared with 7%). Among minority ethnic groups in 1999, girls were also more likely than boys to have a high score (data not shown).1 Table 12.10 12.3.2

Strength and Difficulties Questionnaire (SDQ) The Strengths and Difficulties Questionnaire (SDQ) is designed to detect emotional, behavioural or relationship difficulties in children aged 4 to 15.5 It includes 25 questions, divided into five items in each of the following domains: hyperactivity, emotional symptoms, conduct problems, peer problems and prosocial behaviour. A total deviance score, or total

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12.3.1

score is derived from the sum of scores on the first four scales. Threshold scores reported here are as recommended by the author of the SDQ, and the scoring system is outlined in a note at the end of this chapter.6 The SDQ correlates highly with other measures of behavioural and emotional problems in childhood such as the Rutter questionnaire5 and the Child Behaviour Checklist.7 It has the advantages of being shorter and including some focus on positive behaviour (the prosocial behaviour scale).5,7 The SDQ is currently available in more than 40 languages, but, as with the GHQ, its validity for cross-cultural comparisons is uncertain, particularly when these are based on different language versions of the questionnaire. The SDQ was administered in a self-completion booklet to parents, who responded about their children aged 4 to 15. The prevalence of emotional and behavioural problems, as measured by a high total deviance score (17+), is shown in the table below and ranged from 3% of Chinese boys to 21% of Black Caribbean boys, and from 3% of Black African girls to 12% of Pakistani girls. Compared with children in the general population, Chinese boys and Black African girls were less likely to score above the problem threshold (17+) on the total deviance score. The prevalence rates of problem scores among other groups were not significantly different from the general population. Proportion of children with high SDQ total scores, by minority ethnic group and sex

Boys Girls a

Black Caribbean

Black African

Indian

%

%

%

%

%

%

%

%

21 6

9 3

9 6

11 12

17 9

[3] [6]

13 10

12 8

Pakistani Bangladeshi

a

Chinese

Irish

General population (2001-2002)

Percentages shown in square brackets are based on fewer than 50 cases.

In the general population higher proportions of boys than girls had a high SDQ score. This was also true for Black Caribbean children. Differences between boys and girls among Bangladeshi, Black African, Indian and Irish children were not statistically significant. Table 12.11

The likelihood of ‘problem’ scores on the SDQ subscales was, on the whole, not significantly different among minority groups compared with the general population. The small samples of Chinese boys and girls showed comparatively low risks of problem scores for emotional symptoms and conduct problems. Black African and Indian boys were less likely than boys in the general population to have problem scores for hyperactivity. Among girls, Black African and Indian girls were also less likely than girls in the general population to score in the high (problem) range for hyperactivity. Only one group, Pakistani girls, was more likely than the general population to have problems in any of the subscales, with a relatively high risk of peer problems.

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As noted, apparent differences in the prevalence of problem scores should be treated with caution. This is underlined by comparisons of SDQ scores from 2004 with those recorded in 1999. Taking the two years together, there are no indications of significant differences between children in different minority ethnic groups when analysing the prevalence of emotional and behavioural problems indicated by the SDQ and its subscales. Table 12.12

12.4 Respiratory symptoms and lung function 12.4.1

Coverage and methods Asthma is one of the most common chronic childhood diseases, and its prevalence in Britain is amongst the highest in the world.8,9 Like other industrialised nations, the UK saw a rise in the prevalence of asthma among children over several decades, levelling off in the mid-1990s. The causes of this rise are still largely unexplained; a range of epidemiological studies in the 1970s and 1980s failed to provide a satisfactory account of the demographic, perinatal or environmental factors behind it. It is probable that the increase in documented HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

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prevalence was due in some part to changes in diagnostic practice.8,10 Since the mid-1990s prevalence trends have been less clear.8,9,11,12 There is evidence that the prevalence of asthma and associated respiratory symptoms among children in Britain differs between ethnic groups.1,13 All children aged under 16 (or their parents) were asked about any respiratory symptoms they had experienced: wheezing or whistling in the chest at any time, wheezing when they didn’t have a cold, breathlessness when wheezing, and wheezing in the last 12 months. These symptoms are generally taken to indicate asthma, independent of a medical diagnosis.8 Informants were also asked whether they had ever had asthma diagnosed by a doctor. The nurse visit included a measure of lung function for children aged 7 to 15 (uniquely among HSE survey measurements in 2004, this was carried out on children but not adults). Research elsewhere has shown that there are differences in lung function related to ethnicity for both adults and children, but validated algorithms to correct for these differences are not currently available.14,15,16,17 FEV1 (forced expiratory volume in the first second), FVC (forced vital capacity) and PEF (peak expiratory flow) were measured using a Vitalograph ‘Escort Spirometer’. For this instrument, the manufacturer reports the accuracy of volume measurement as +/-3% or +/0.5 litres, whichever is greater, and of flow measurement as +/-5%. The measurement technique involves a maximum inspiration followed by a forced expiration for as long as possible into the instrument. After a demonstration by the nurse, children were asked to carry out the test up to five times, to allow for practice and with the aim of achieving at least three technically satisfactory measures. The data here are based on the highest values from any technically successful test for each of the three parameters, FEV1, FVC and PEF, and the values for each informant may not come from the same test. Full details of the methods used can be found in volume 2 of HSE 2004, Health Survey for England 2004: Methodology & Documentation. Respiratory symptoms and doctor-diagnosed asthma Among children in minority ethnic groups, the proportions who had ever experienced wheezing or whistling in the chest ranged from 16% of Bangladeshi boys to 39% of Black Caribbean boys, and from 8% of Bangladeshi girls to 33% of Black Caribbean girls. In most minority ethnic groups, children were less likely than those in the general population to have ever wheezed. The exceptions were Black Caribbean, Irish and Chinese boys and Black Caribbean and Irish girls, among whom the proportions who had ever wheezed were similar to children in the general population (36% of boys and 29% of girls). Among all groups, boys were more likely than girls to have ever wheezed, although the difference was not significant for Black Caribbean, Indian and Irish children. The patterns were similar for the lifetime experience of any other respiratory symptoms. Among boys, Black Caribbean boys were the most likely to have wheezed (when they didn’t have a cold) and to have been breathless when wheezing (26% experienced each symptom), and Bangladeshi boys were the least likely to have experienced these symptoms (7% experienced each symptom). Among girls, Black Caribbean girls were most likely to have experienced these symptoms (15% had wheezed without a cold, 16% had been breathless when wheezing). Bangladeshi and Black African girls were least likely to have wheezed when they didn’t have a cold (3% and 4% respectively) and to have been breathless when wheezing (4% of girls in both groups). The proportions of children who had wheezed in the last 12 months ranged from 11% of Bangladeshi boys to 27% of Black Caribbean boys, and from 6% of Bangladeshi girls to 21% of Black Caribbean and Irish girls. Bangladeshi boys and Black African, Bangladeshi and Chinese girls were less likely than children in the general population to have wheezed within the last 12 months. Table 12.13 Black Caribbean boys were more likely than boys in the general population to have had asthma diagnosed by a doctor (30% compared with 23%). Doctor-diagnosed asthma was 384

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12.4.2

less prevalent among Black African, Pakistani and Bangladeshi boys (17%, 13% and 12% respectively) than among boys in the general population (23%). As with boys, the proportion of Black African, Pakistani and Bangladeshi girls with doctor-diagnosed asthma (9%, 8% and 7% respectively) was lower than among girls in the general population (18%). Among girls in other minority ethnic groups the prevalence of doctor-diagnosed asthma was similar to that found among girls in the general population. Among the general population and most minority ethnic groups, boys were more likely than girls to be diagnosed with asthma. The exceptions to this were Indian, Irish and Chinese children, where the differences between the sexes were not statistically significant. Table 12.13, Figure 12A

Figure 12A Prevalence of having wheezed in the last 12 months, by sex and minority ethnic group

Boys Girls

30 25

Percent

20

15 10 5 0 se i

sh

de

al er on en ti G ula p po

ne

sh

hi

Iri

C la

i

an

st

ng

ki

Ba

Pa

an

di

In

k ac Bl can ri

Af

k n ac ea Bl ibb ar

C

In 1999, the pattern of prevalence of respiratory symptoms was broadly similar to that found in 2004. Table 12.14 12.4.3

Severity of respiratory symptoms This section is based on the relatively small number of children in each group who reported having wheezed in the last 12 months. In the case of Black African and Chinese boys and Black African, Indian, Bangladeshi and Chinese girls, the subsamples are too small to report the findings. Where figures are shown, any apparent differences are not statistically significant.

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In all groups, the majority of children who had experienced wheezing in the last 12 months had no more than three attacks in the year (on average one or less every three months). A minority had 12 or more attacks over the last year, or one or more each month on average (from 3% of Black Caribbean boys to 29% of Irish boys, though these figures should be treated with caution). A minority in each group reported adverse effects from wheezing attacks, such disturbed sleep at least once a week, difficulty in speaking during attacks or interference with daily activities. Table 12.15 12.4.4

Lung function Lung function is strongly related to height and age among children, and the analysis includes regression coefficients adjusted for age and height, allowing comparisons to be made between mean values measured for each group regardless of age profile. (The regression coefficient shows the difference between the mean for that group and the mean for the general population once age and height have been controlled for.) For further information about age and height standardisation using linear regression models, see the Glossary in volume 2 of HSE 2004, Health Survey for England 2004: Methodology and Documentation.

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The sample of Chinese boys from whom valid lung function measures were obtained was too small to analyse. Otherwise, among minority ethnic groups, mean FEV1 (forced expiratory volume in the first second) ranged from 1.85 litres for Bangladeshi boys to 2.53 litres for Irish boys, and from 1.80 litres for Bangladeshi girls to 2.23 for Black Caribbean girls. Mean values in the general population were 2.46 litres for boys and 2.29 litres for girls. The regression coefficients showed that, once age and height had been taken into account, only Black Caribbean and Irish boys had an average FEV1 that was similar to boys in the general population. For boys in other minority ethnic groups, and girls in all minority ethnic groups, mean FEV1 was lower than for boys and girls in the general population. Table 12.16 Among children in minority ethnic groups, mean FVC (forced vital capacity) ranged from 2.26 litres for Bangladeshi boys to 3.11 litres for Black Caribbean boys, and from 2.04 litres for Bangladeshi girls to 2.66 litres for Black Caribbean girls. In the general population mean FVC was 2.88 litres for boys and 2.61 litres for girls. As with FEV1, once age and height had been taken into account, Black African, Indian, Pakistani and Bangladeshi boys had lower average FVC measures than boys in the general population. Among girls, Black African, Pakistani and Bangladeshi girls had average FVC lower than girls in the general population, but the same was not true for girls in other minority ethnic groups. Table 12.17 Mean PEF (peak expiratory flow) among children in minority ethnic groups ranged from 254 l/min for Bangladeshi boys to 327 l/min for Pakistani and Irish boys, and from 251 l/min among Bangladeshi girls to 313 l/min for Black Caribbean girls. Among the general population mean peak flow was 322 l/min for boys and 303 l/min for girls. After adjustment for age and height, mean peak flow was lower than for the general population among Indian and Bangladeshi boys and Black Africa, Indian, Pakistani, Bangladeshi and Irish girls. Table 12.18

12.5 Cigarette smoking 12.5.1

Coverage and methods Questions about smoking were included in the self-completion questionnaires for children aged 8 to 15, a mode designed to allow a measure of privacy to encourage children to be honest about behaviour of which their parents might disapprove. Children were asked whether they had ever smoked a cigarette ‘even if it was only a puff or two’. Those who had smoked were asked when they first tried smoking, whether they still smoked and, if they did smoke, how often they did so and how many cigarettes they had smoked in the last week.

12.5.2

Self-reported cigarette smoking Among children in minority ethnic groups aged 8 to 15, the proportion who had ever smoked ranged from 1% of Indian boys to 16% of Black Caribbean boys, and from 5% of Bangladeshi and Pakistani girls to 23% of Irish girls. In the general population, 18% of boys and 19% of girls had ever smoked. Compared with children in the general population, Indian, Chinese and Pakistani boys were less likely to have smoked, and the same was true for girls in all groups except for Irish and Black Caribbean girls. Table 12.19

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HSE has asked about children’s smoking behaviour since 1995. Similar questions are asked in the survey of smoking, drinking and drug use among young people in England (SDD), carried out annually among children aged 11 to 15 in secondary schools.18 The latter survey collects data using a self-completion questionnaire administered in schools. Comparison of the two surveys suggests that children under-report their smoking behaviour in HSE and other surveys completed within the family home, compared with SDD and other surveys carried out at school.19 Because SDD includes relatively small samples of children from minority ethnic groups, and categorises ethnicity differently from HSE, it is not possible to compare smoking prevalence rates measured by these two surveys in 2004. However SDD and other surveys indicate that children’s smoking patterns vary between different ethnic groups.20,21

The patterns of smoking were generally similar to those reported by minority ethnic children in 1999, when Black Caribbean and Irish boys and girls were also most likely to report having ever smoked cigarettes. Table 12.23 No Indian or Chinese children and no Bangladeshi girls reported that they currently smoked, and the samples were too small for reliable conclusions to be drawn about the relative proportions of children within other different minority ethnic groups who currently smoked. Tables 12.19, 12.20, Figure 12B Figure 12B Prevalence of ever having smoked a cigarette, by sex and minority ethnic group

Boys Girls

25

Percent

20

15

10

5

0 se i

sh

de

al er on en ti G ula p po

ne

sh

hi

Iri

C la

i

an

st

ng

ki

Ba

Pa

an

di

In

k ac Bl can ri

Af

k n ac ea Bl ibb ar

C

Smoking behaviour among children is strongly linked to age. The bases for individual minority ethnic groups are too small for reliable comparisons between age groups, but overall experience of smoking tended to be lower among children aged 8 to 10 than among those aged 11 to 15 in all groups. Among children in minority ethnic groups, none aged 8 to 10 reported being a current smoker, and the proportions who had ever tried smoking were generally very small. Consequently, reliable conclusions cannot be drawn about the relative prevalence rates of smoking within different minority ethnic groups, since the data have not been age-standardised (see Section 12.1.3). Since smoking behaviour among children aged 8 to 15 is highly related to age, apparent differences between groups may be the product of different age profiles. Tables 12.21, 12.22

12.6 Drinking alcohol

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12.6.1

Coverage and methods Questions about drinking alcohol were included in the self-completion questionnaire for children aged 8 to 15. As with questions about smoking, this was to allow children to respond to these questions privately, with the aim of encouraging frankness in reporting behaviour which parents might not know about and might disapprove of. Children were asked two initial questions (see below) about whether they had ever drunk alcohol. Those who answered yes to either of these questions were asked how old they were when they first had an alcoholic drink, how often they usually drank alcohol and when they had last drunk alcohol. Older children (aged 13 to 15) who had drunk alcohol in the last week were asked about their consumption of different types of drink during the last seven days. The current questions about children’s alcohol consumption were first included in HSE 1998. Similar questions are asked in the survey of smoking, drinking and drug use among young people in England (SDD), carried out annually among children aged 11 to 15 in secondary schools.22 The latter survey collects data using a self-completion questionnaire administered in schools. As with smoking, comparison of the two surveys suggests that children under-report their drinking behaviour in HSE and other surveys completed within HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

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the family home, compared with SDD and other surveys carried out at school. To attempt to compensate for this under-reporting, HSE uses a different approach to measure how many children have ever drunk alcohol. SDD asks: ‘Have you ever had a proper alcoholic drink, not just a sip? Please don’t count drinks labelled low alcohol’. In HSE, children who answer no to this are also asked ‘Have you ever drunk alcopops (such as Bacardi Breezer, Smirnoff Ice, WKD, Hooch etc)?’. The use of this follow-up question in 2002 increased the proportion of children who reported that they had drunk alcohol so that it was closer to the proportion recorded by SDD.23 Because SDD includes relatively small samples of children from minority ethnic groups, and categorises ethnicity differently from HSE, it is not possible to carry out a comparison of drinking prevalence rates measured by these two surveys in 2004. However, evidence from these and other surveys suggest that there are differences between ethnic groups in children’s experience of alcohol. 20,21 The analysis below is restricted to whether children had ever drunk alcohol. Given the small sizes of the subsamples of children in minority ethnic groups, it is not possible to analyse their drinking behaviour in more detail. As noted above (Section 12.1.3), the data have not been agestandardised and – since drinking behaviour among children is highly related to age – apparent differences between groups may be the product of different age profiles. The prevalence of drinking alcohol The proportions of children aged 8 to 15 in minority ethnic groups who had ever drunk alcohol varied widely. Bangladeshi and Pakistani children were much less likely than children in other groups to have drunk alcohol. Among boys, the prevalence of having ever drunk alcohol ranged from 1% of Pakistani and Bangladeshi boys to 43% of Irish boys; among girls, the prevalence ranged from 3% of Bangladeshi girls to 54% of Irish girls. For most groups, the proportion of boys or girls who had drunk alcohol was lower than the proportion who had done so in the general population (45% of boys, 40% of girls). The exceptions were Black Caribbean and Irish boys and Black Caribbean girls, among whom the prevalence of having drunk alcohol was similar to that in the general population; and Irish girls, among whom the prevalence of ever having drunk alcohol was higher than the general population. Within the general population, boys were more likely than girls to have drunk alcohol. None of the minority groups showed significant differences between the sexes. Table 12.24, Figure 12C

Figure 12C Prevalence of ever having drunk alcohol, by sex and minority ethnic group

Boys Girls

60 50 40 Percent

30 20 10 0 se

al er on en ti G ula p po

sh

ne

hi

Iri

C hi

es

ad

i

an

st

gl

ki

n Ba

Pa

an

di

In

k ac Bl can ri

Af

k n ac ea Bl ibb ar

C

Among children, the likelihood of having tried alcohol is strongly related to age. It is not possible to make reliable comparisons between older and younger children within minority ethnic groups because of the small subsample sizes. Among older children (aged 11 to 15), the proportion who had drunk alcohol ranged from 1% of Bangladeshi boys to 75% of Irish

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12.6.2

girls, with no Bangladeshi girls of this age reporting that they had drunk alcohol. (In the general population 60% of boys and 56% of girls of this age had drunk alcohol.) Table 12.25 As already noted, these prevalence rates are based on children’s responses to two questions: ‘Have you ever had a proper alcoholic drink, not just a sip? Please don’t count drinks labelled low alcohol.’ and ‘Have you ever drunk alcopops (such as Bacardi Breezer, Smirnoff Ice, WKD, Hooch etc)?’ The table below compares the prevalence of drinking alcohol among children based on the first question with the prevalence based on both questions. Among Pakistani and Bangladeshi children there is very little difference. Among other groups, including the alcopops responses increases the prevalence rates by up to 16 percentage points. This matched the findings of HSE 2002, where the use of both questions also produced higher prevalence rates, which were closer to the findings of other surveys, such as smoking, drinking and drug use among young people in schools in England.23 Reported experience of drinking in response to alcohol questions, by minority ethnic group and sex (aged 8 to 15) Black Caribbean

Black African

Indian

%

%

%

%

%

33 38

17 24

5 13

1 1

26 35

15 23

8 17

3 4

Boys One question Two questions Girls One question Two questions a

Irish

General population (2001-2002)

%

%

%

1 1

19 29

35 43

37 45

3 3

[6] [21]

38 54

31 40

Pakistani Bangladeshi

a

Chinese

Percentages shown in square brackets are based on fewer than 50 cases.

The 1999 results have been recalculated to include responses to the alcopops question. The proportions of children who had ever drunk alcohol in 1999 and 2004 followed similar patterns: Irish and Black Caribbean children were most likely to have drunk alcohol, and very few Pakistani or Bangladeshi children said that they had ever had an alcoholic drink. In 2004 the proportion of Irish girls who had drunk alcohol was higher than in 1999 (54% compared with 40%). Other differences between prevalence rates in the two years were not significant. Table 12.26

12.7 Blood pressure

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12.7.1

Coverage and methods The blood pressure of children aged 5 to 15 has been measured every year for HSE since 1995. For a discussion of the methods used, see Chapter 7, Section 7.2.1 in this report, which also describes the change in 2003 in the equipment used to measure blood pressure in HSE. Previously, measurements had been taken using the Dinamap 8100. In HSE 2003 a new oscillometric automated device, the Omron HEM 907, replaced the Dinamap, which had become obsolete. A calibration study for HSE 2003 provided suitable regression equations to derive predicted Omron readings from Dinamap readings and vice versa. For this report, the Dinamap values obtained in 1999, 2001 and 2002 were converted into Omron values when comparing blood pressure measurements over time. For children aged 5 to 15 the conversion algorithms were as follows: Systolic blood pressure for boys: Systolic blood pressure for girls: Diastolic blood pressure for boys: Diastolic blood pressure for girls:

Dinamap = 1.025*Omron Dinamap = 1.040*Omron Dinamap = 0.934*Omron Dinamap = 0.915*Omron.

Blood pressure is known to have a stronger relationship with age, height and weight in children than in adults, and the reference guidelines on high blood pressure in children, published by the National High Blood Pressure Education Program Working Group are sex,

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age and height specific.24,25 The analysis below shows regression coefficients adjusted for age and height, allowing comparisons to be made between mean values for each group, regardless of age profiles. (The regression coefficient shows the difference between the mean for that group and the mean for the general population once age and height have been controlled for.) 12.7.2

Systolic blood pressure Among children in minority ethnic groups, mean systolic blood pressure (SBP) ranged from 105.2mmHg for Chinese boys to 112.2mmHg for Pakistani boys, and from 102.9mmHg for Bangladeshi girls to 110.7mmHg for Black Caribbean girls. Mean SBP among children in the general population was 108.7mmHg for boys and 106.7mmHg for girls. Regression coefficients, controlling for age and height, have been calculated to allow comparison with the general population. For mean SBP, there were no significant differences between children in minority ethnic groups and the general population. Table 12.27

12.7.3

Diastolic blood pressure Mean diastolic blood pressure (DBP) ranged from 61.3mmHg for Irish boys to 65.9mmHg for Bangladeshi boys, and from 62.7mmHg for Irish girls to 68.2mmHg for Black African girls. In the general population mean DBP was 61.5mmHg for boys and 63.5mmHg for girls. Once age and height had been taken into account, mean DBP was higher among Indian, Pakistani and Bangladeshi boys and Black African girls compared with boys and girls in the general population. Table 12.28

12.8 Anthropometric measures Coverage and methods The heights and weights of children aged 2 to 15 were measured, and body mass index (BMI) was derived in the standard way: weight in kilograms was divided by the square of height in metres (kg/m2). For a description of the methods used to measure heights and weights see Chapter 6, Section 6.1.2. Both height and weight are strongly age-related among children, and comparisons between groups have been made using age-adjusted regression coefficients, which control for differences in their age profiles. (The regression coefficient shows the difference between the mean for that group and the mean for the general population once age has been controlled for.) The proportion of children who were overweight or obese has been calculated using the UK national BMI percentiles classification. Using 1990 reference data compiled from a number of sources as the baseline, and adjusted for age and sex, the threshold for overweight was defined as the 85th percentile and the threshold for obesity is the 95th percentile.26 This classification was used in the analysis of HSE data published in 2005 on trends in obesity among children under 11 in England, and has the advantage of showing trends over time.27 These national percentiles were also used (alongside international classification standards) in the 2002 HSE report.28 As the national percentiles are based on data collected from the general population, they may not be appropriate measures to use in assessing obesity and overweight among children in minority ethnic groups. There is considerable debate about the applicability of definitions of overweight and obesity across ethnic groups for adults and children (see Chapter 6, Section 6.1.1). Evidence suggests that, for a given BMI, the average proportion of body fat differs between ethnic groups, and that thresholds for overweight and obesity may be lower among Asian populations and higher among those of African descent. The issue is further complicated among children by differences between groups in the rate of maturation during adolescence.29,30 In the tables, the general population data used for comparison are taken from HSE 2002. Given that mean BMI and the proportions of children who are overweight and obese have been increasing since 1990, the comparison with an earlier year may overestimate the differences in 2004 between minority ethnic groups with higher mean BMIs and the general 390

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12.8.1

population (and underestimate those with lower mean BMIs). This issue is discussed in Section 12.8.4. 12.8.2

Height Mean height among children in minority ethnic groups ranged from 128.7cm for Black African boys to 140.6cm for Black Caribbean boys, and from 127.5cm for Bangladeshi girls to 134.0cm for Black Caribbean girls. However, as noted above, height is strongly related to age among children, so age-adjusted regression coefficients have been calculated to allow comparison with the general population, controlling for the different age profiles of the minority ethnic groups. The age-adjusted regression coefficients show that, on average, the mean height of Black Caribbean boys was 3.9cm more than the mean height of boys in the general population and the mean height of Chinese boys was 1.7cm less. Compared with the mean height of girls in the general population, the mean heights of Black Caribbean and Black African girls were greater (by 1.8cm and 3.8cm respectively) and the mean height of Bangladeshi girls was less (by 2.1cm). Table 12.29 A similar pattern of difference was seen in 1999. However, in 1999, the mean heights of Bangladeshi boys and Indian and Chinese girls were less than the average for the general population, whereas in 2004 they were not significantly different (data not shown).1

12.8.3

Weight Mean weight among children in minority ethnic groups ranged from 32.2kg for Indian boys to 39.6kg for Black Caribbean boys, and from 30.9kg for Bangladeshi girls to 38.9kg for Black Caribbean girls. As with height, weight is strongly related to age, so age-adjusted regression coefficients have been calculated for each group. These show that, having controlled for age, the mean weights of Black Caribbean, Black African and Pakistani boys were greater than the mean weight of boys in the general population (by 3.7kg, 2.0kg and 1.6kg respectively). Among girls, the mean weights of Black Caribbean and Black African girls were greater than the mean weight of girls in the general population (by 3.9kg and 4.0kg respectively). Table 12.30 In 1999, after controlling for age, Black Caribbean girls, but not boys, were also heavier on average than girls in the general population. Children in several minority ethnic groups were lighter on average than boys or girls in the general population: Bangladeshi boys and Indian, Bangladeshi and Chinese girls (data not shown).1

12.8.4

Body mass index (BMI)

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Among children in minority ethnic groups, mean BMI ranged from 17.7 for Indian boys to 19.3 for Black Caribbean boys, and from 18.1 for Pakistani girls to 20.0 for Black Caribbean girls. As noted above, the definitions of overweight and obesity used here are based on the agespecific national BMI percentiles. Among minority ethnic groups, the prevalence of overweight (including obesity) ranged from 22% of Chinese boys to 42% of Black African boys, and from 25% of Pakistani girls to 42% of Black Caribbean girls. 30% of boys and 31% of girls in the 2002 general population were overweight or obese. Black African and Pakistani boys and Black Caribbean and Black African girls had an increased risk of being overweight or obese compared with the 2002 general population. Chinese boys were less likely than boys in the general population to be overweight or obese. The remainder of this section focuses on the prevalence of obesity. Among children in minority ethnic groups, the proportions who were obese ranged from 14% of Indian and Chinese boys to 31% of Black African boys, and from 12% of Chinese girls to 27% of Black Caribbean and Black African girls. In the 2002 general population, 16% of boys and 16% of girls were obese. Black Caribbean and Black African boys and girls and Pakistani boys were more likely than boys and girls in the general population to be obese. Table 12.31, Figure 12D

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Figure 12D Prevalence of overweight and obesity among children aged 2 to 15, by minority ethnic group

Overweight Obese

Boys 45 40 35

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Because the proportions of overweight and obese children in the general population have risen in recent years, comparisons with the 2002 general population will tend to overestimate differences between the general population and groups with higher levels of overweight and obesity. The table below compares the proportions of obese children in minority ethnic groups with the 2004 general population.

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Obesity among younger children has become a focus of government concern. The 2004 Public Service Agreements (PSAs) include the objective, shared by the Department of Health, the Department for Education and Skills and the Department of Culture, Media and Sport, of ‘halting the year-on-year rise in obesity among children under 11 by 2010 in the context of a broader strategy to tackle obesity in the population as a whole’.31 In the 2002 general population sample, 15% of boys and 15% of girls aged 2 to 10 were obese. Among minority ethnic groups the proportions of obese children aged 2 to 10 in 2004 ranged from 13% of Indian boys to 32% of Black African boys, and from 11% of Pakistani girls to 28% of Black African girls. The pattern of obesity was slightly different among older children (aged 11 to 15) in minority ethnic groups in 2004. The proportion of minority ethnic children in this age group who were obese ranged from 13% of Chinese boys to 31% of Pakistani boys, and from 15% of Bangladeshi girls to 37% of Black Caribbean girls. Although it seems likely that – as with the general population – the proportion of obese children is higher in the older age group, the minority ethnic group subsamples were too small for reliable comparisons to be made. Table 12.32

Obesity among children in 2004, by minority ethnic group, sex and age

Boys Aged 2 to 10 Aged 11 to 15 Aged 2 to 15 Girls Aged 2 to 10 Aged 11 to 15 Aged 2 to 15 a

Black Caribbean

Black African

Indian

Irish

General population

%

%

%

%

%

%

%

%

27 29 28

32 [27] 31

13 16 14

21 31 25

24 19 22

[15] [13] 14

20 28 22

16 24 19

21 37 27

28 [24] 27

16 28 21

11 22 15

21 [15] 20

13 a 12

13 21 16

13 27 18

a

Pakistani Bangladeshi

Chinese

a

The sample base for Chinese girls aged 11-15 was too small for results to be shown. Percentages in square brackets are based on fewer than 50 cases.

In 2004, 19% of boys and 18% of girls in the general population were obese. The prevalence of obesity in most minority ethnic groups was not significantly different; only Black African boys were more likely to be obese than boys in the 2004 general population. The patterns of overweight and obesity among children in minority ethnic groups in 1999 (not shown in the 1999 report) were broadly similar to those in 2004. The prevalence of obesity among Black Caribbean and Bangladeshi boys increased between 1999 and 2004. Other differences between the two years were not statistically significant. Table 12.33

12.9 Physical activity 12.9.1

Coverage and methods HSE has collected information on children’s physical activity since 1997, using different questions from those used for adults. Although there have been some changes in the questions in successive surveys, those used in 2004 are consistent with those used in 1999 and 2002, the years used for comparison in this chapter.

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In 2004 this information was collected in the face-to-face interview with parents of children aged 2 to 12, and directly from children aged 13 to 15. Questions referred to the previous seven days and asked for details of specific activities, although not those done as part of the school curriculum. ‘Sports and exercise’ included organised sports and activities such as swimming, gymnastics, football or athletics. ‘Active play’ was less formal, defined as having done ‘active things like ride a bike, kick a ball around, run about, play active games, jump around’. Continuous walking of at least five minutes’ duration was also asked about. For children aged 8 to 15 there were questions about housework and gardening lasting for 15 minutes or more. Weekdays and weekends were asked about separately, including the number of days on which each type of activity was done and the amount of time spent. These data are based on self-reported information, and are therefore vulnerable to recall error, particularly when parents are answering on behalf of children aged 12 or under. Although parents answered in the presence of the child, they might not always been able to construct an accurate account of their child’s activities. In any case, children’s activity may be difficult to quantify, given that it is typically made up of short and sporadic bouts rather than sustained episodes. Finally parents and older children might have been influenced by social desirability in their responses. For further discussion of the methodology of this section, including the limitations of selfreport as a means of measuring physical activity, see Chapter 4, Section 4.2.1 in the 2002 HSE report.32 12.9.2

Participation in different activities in the last week Participation in different types of physical activity varied between groups. Overall, walking and active play were the most common forms of exercise. In some minority ethnic groups – Black Caribbean, Black African, Pakistani and Irish boys, and Pakistani, Chinese and Irish HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

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girls – participation was at similar levels for walking and active play. Children in other groups – Indian, Bangladeshi and Chinese boys, and Black Caribbean, Black African, Indian and Bangladeshi girls – were more likely to have walked than to have taken part in active play. Children in all groups were less likely to have taken part in the other activities asked about: sport and other organised exercise, and housework or gardening. In all groups, children were active, on average, on at least six days in the preceding week. For boys, the average amount of time spent in all forms of activity ranged from a mean of 8.0 hours for Chinese boys to 12.9 hours for Irish boys, compared with 14.2 hours for boys in the general population. The average amount of time spent in physical activity among girls in minority ethnic groups ranged from 6.9 hours for Pakistani girls to 10.2 for Irish girls. The mean time spent by girls in the general population was 12.2 hours. Walking The proportion of boys who had walked for five minutes or more ranged from 86% of Pakistani boys to 94% of Irish boys, and from 83% of Pakistani girls to 93% of Irish girls. These levels were similar to those in the general population (89% of boys, 90% of girls), apart from Irish boys (who were more likely to have walked) and Pakistani girls (who were less likely to have walked for at least five minutes). On average, children in all groups walked on four or five days of the week (from a mean of 4.1 days for Chinese girls to 5.4 days for Bangladeshi boys). The average time in a week spent walking ranged from 2.1 hours for Pakistani girls to 3.5 hours for Bangladeshi boys. Boys and girls in the general population walked for an average of 3.5 hours. Active play The proportion of children in minority ethnic groups who had done some kind of active play ranged from 77% of Chinese boys to 91% of Irish boys, and from 74% of Bangladeshi girls to 88% of Irish girls. Indian, Bangladeshi and Chinese boys and Black Caribbean, Black African, Indian and Bangladeshi girls were less likely to have done any active play than children in the general population (93% of boys, 87% of girls). Boys in most groups were likely to have done some active play on most days of the week (from a mean of 4.6 days for Indian boys to 5.0 days for Pakistani and Irish boys). Chinese boys played, on average, on fewer days (3.1) than boys in other groups. In most minority ethnic groups, the mean number of days on which girls had taken part in active play was lower than for boys, and ranged from a mean of 3.4 days (Indian girls) to 4.2 days (Bangladeshi and Irish girls). The average time spent in active play ranged from 3.1 hours (Bangladeshi girls) to 7.0 hours (Irish boys). Among the general population, boys spent an average of 7.8 hours, girls 6.4 hours in active play.

The questions on exercise excluded activities undertaken as part of the school curriculum and thus participation in sports and types of organised exercise is likely to be underrepresented for many of these children, most of whom are of school age. The Government’s 2004 target for sporting activity was for 75% of school children to be spending a minimum of two hours per week on high quality physical exercise and school sport within and beyond the curriculum by 2006. At the time they estimated that this was provided by about a quarter of schools at Key Stage 1, two-fifths at Key Stage 2 and a third at Key Stages 3 and 4. However, it should be noted that these estimates were for school provision, not for the take-up by pupils.33,34 There were considerable differences between minority ethnic groups in the proportion of boys and girls who had taken part in sport or organised exercise in the last week, ranging from 48% of Pakistani boys to 71% of Black Caribbean boys, and from 23% of Pakistani girls to 61% of Chinese and Irish girls. Among the general population 59% of boys and 55% of girls had done some sport or exercise. In the general population and in most minority ethnic groups, boys were more likely than girls to have taken part in sport or exercise. Levels of participation for boys and girls were similar among Black African, Chinese and Irish children. 394

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Sports and exercise

The average number of days on which children participated in sport and exercise ranged from 2.0 days for Pakistani boys to 2.7 days for Black Caribbean boys, and from 1.0 days for Pakistani girls to 1.7 days for Black African girls. The time spent on these activities ranged from a mean of 0.7 hours (Pakistani girls) to 3.2 hours (Black Caribbean boys). In the general population, the average time spent by boys was 2.4 hours, by girls 1.7 hours. Housework and gardening The proportions of children aged 8 to 15 who had done housework or gardening for at least 15 minutes ranged from 23% of Bangladeshi boys to 37% of Indian boys, and from 24% of Chinese girls to 58% of Indian girls. Among children of this age in the general population, 30% of boys and 37% of girls had done some housework or gardening. Unlike sport and exercise, girls in the general population and in most minority ethnic groups were more likely than boys to have done housework or gardening in the last week, but this was not so among Chinese children. The mean number of days on which children did housework or gardening ranged from 0.4 days for Chinese boys to 0.9 days for Indian boys, and from 0.4 days for Chinese girls to 1.9 days for Indian girls. The mean number of hours ranged from 0.2 hours (Chinese boys and girls) to 1.1 hours (Indian, Pakistani, Bangladeshi and Irish girls). Boys in the general population did an average of 0.5 hours housework and gardening, girls an average of 0.6 hours. Table 12.34 12.9.3

Levels of activity The government has recommended that young people aged between 5 and 18 should do some physical activity of at least moderate intensity for at least one hour every day; and that inactive young people should do some activity of at least moderate intensity for at least half an hour (30 minutes) a day. In line with these guidelines, the amount of activity children had done in the last week was summarised into three categories. The recommendation of at least an hour’s activity on all seven days in the week was defined as a ‘high’ level of activity. The level of activity recommended for less active children, for at least 30 minutes on each day of the week, was classified as ‘medium’ level activity. Activity for less time, or on fewer than seven days a week, was classified as ‘low’ level activity.

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With the exception of Pakistani boys and Irish boys and girls, children in minority ethnic groups were less likely than the general population to have done the recommended level of activity. Additionally, in most groups, girls were less likely than boys to have done a high level of activity, though the proportions of boys and girls who did a high level of activity were similar among Black Caribbean, Chinese and Irish children. Chinese boys (38%) were much less likely than boys in other groups to have done the recommended level of activity. Otherwise, the proportions of boys exercising at recommended levels ranged from 53% of Indian boys to 68% of Irish boys, compared with 69% of boys in the general population. Among girls, the proportions who had done this level of exercise ranged from 36% of Pakistani girls to 60% of Irish girls, and 61% of girls in the general population. Irish and Black Caribbean girls were more likely than girls in other minority ethnic groups to have done a high level of exercise. Table 12.35, Figure 12E These patterns were reflected in the proportions of children whose level of activity was low (below the government’s lower recommendation) or who had recorded no exercise in the preceding week. Among minority ethnic groups, the proportion whose activities were low, or who reported no activity, ranged from 14% of Irish boys to 43% of Chinese boys and from 24% of Irish girls to 46% of Indian girls. Among the general population the corresponding proportions were 17% of boys and 23% of girls. Table 12.35 Questions about exercise were asked in 1999, although the summary exercise levels were not presented in the report. Although the questionnaires were comparable, apparent differences between the findings should be treated with caution, given the small sample sizes. In each minority ethnic group the proportions of children who reported high levels of activity

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Figure 12E Proportion doing recommended amount of exercise, by minority ethnic group Girls

Boys 10.0

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2.0

1.0

1.0

0.5

0.5

0.10

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Risk ratio, logarithmic scale

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in 1999 and 2004 were not significantly different, except for Black Caribbean boys, among whom the proportion decreased from 72% in 1999 to 59% in 2004, and Bangladeshi girls, among whom the proportion increased from 24% in 1999 to 41% in 2004. Table 12.36

12.10 Fruit and vegetable consumption 12.10.1 Coverage and methods Information about fruit and vegetable consumption was collected during the face-to-face interview, from parents of children aged 5 to 12 and from children aged 13 to 15 directly. Questions were asked about a range of food items consumed in a single day (defined as the 24 hours ending at midnight before the interview). For details of the methodology see Chapter 9, Section 9.2.1.

The analysis below reflects the government recommendation that everyone should eat at least five portions of fruit and vegetables a day, a level of consumption which is known to significantly reduce the risks of cardiovascular disease and many cancers. The NHS ‘5 a day’ campaign was launched in 2000, and during 2004 the School Fruit and Vegetable Scheme was extended to all children aged 4 to 6 in English primary schools. Since autumn 2004 all children of this age have been entitled to a free daily piece of fruit or vegetable (apples, pears, bananas, easy-peel citrus, carrots or tomatoes). 12.10.2 Fruit and vegetable consumption The proportion of children in minority ethnic groups who ate five or more portions ranged from 15% of Chinese boys to 22% of Indian and Bangladeshi boys, and from 12% of Irish girls to 24% of Chinese girls. In most minority ethnic groups, the proportion of children eating five or more portions a day was higher than among children in the general population (11% of boys, 12% of girls), though the difference was not significant for Chinese and Irish boys or for Bangladeshi and Irish girls. Table 12.37, Figure 12F 396

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As the data are based on self-reported information, there may be some variation in the way informants interpreted the definitions. Additionally responses may have been subject to recall error or influenced by the social desirability of responses. Informants may have found it difficult to assess accurately the amount of fruit or vegetables consumed in composite items, such as fruit pies or vegetable chilli. Finally, parents might not always have an accurate knowledge of what their child had eaten, for example during the school day, or when visiting friends.

Figure 12F Proportion eating 5+ portions of fruit and vegetables, by minority ethnic group Girls

Risk ratio, logarithmic scale

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Mean consumption among minority ethnic groups ranged from 2.8 portions by Irish boys to 3.4 portions by Indian boys, and from 2.9 portions by Irish and Black Caribbean girls to 3.6 portions by Chinese girls. Again, these levels were generally higher than the average consumption by children in the general population (2.5 portions for boys, 2.6 by girls). The proportions of children who reported no fruit and vegetable consumption ranged from 2% of Black African boys to 11% of Irish boys, and from 1% of Chinese girls to 9% of Black Caribbean and Bangladeshi girls. Compared with boys (12%) and girls (8%) in the general population, Black Caribbean, Indian and Chinese boys (8%, 5% and 4% respectively), and Chinese and Pakistani girls (1% and 2%) were less likely to have eaten no fruit or vegetables. Table 12.37 References and notes 1 Nazroo J, Becher H, Kelly Y et al, Chapter 13: Children’s health in Erens B, Primatesta P, Prior G (eds). Health Survey for England 1999: The Health of Minority Ethnic Groups. Volume 1: Findings. The Stationery Office, London, 2001. 2 Sproston K, Primatesta P (eds). Health Survey for England 2002: The Health of Children and Young People. Volume 3: Methodology and Documentation. The Stationery Office, London 2003. 3 The International Classification of Diseases and Related Health Problems (Tenth Revision). World Health Organisation, Geneva, 1992. 4 Goldberg D, Williams OA. Users’ guide to the General Health Questionnaire. NFER-Nelson, London, 1988.

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5 Goodman R. The Strengths and Difficulties Questionnaire: a research note. Journal of Child Psychology and Psychiatry 1997; 38:581-6. 6 The SDQ measures 25 attributes: ten strengths, fourteen difficulties and one neutral item. The 25 SDQ items are divided into five scales each made up of five items: hyperactivity, emotional symptoms, conduct problems, peer problems and prosocial behaviour. Each question has three possible answers, ‘not true’ (assigned a value of 0), ‘somewhat true’ (1) or ‘certainly true’ (2). The score for each scale is the sum of the scores on the five relevant items, ranging from 0 to 10. The total deviance score derived from the sum of four scales, excluding the prosocial behaviour scale, and ranges from 0 to 40. Each score has been split into three categories, corresponding to ‘low’, ‘medium’ and ‘high’ problems in that domain, shown in Tables 12.12 and 12.13. In general, the higher scores indicate a higher level of problems, although the reverse is true for Prosocial Behaviour, where lower scores indicate more problems. For more information about the SDQ see Goodman (1997) or refer to the website http://www.sdqinfo.com 7 Goodman R, Scott S. Comparing the Strengths and Difficulties Questionnaire and the Child Behaviour Checklist: is small beautiful? Journal of Abnormal Child Psychology 1999; 27(1):17-24. 8 Gupta R, Strachan D, Chapter 7: Asthma and allergic diseases in The health of children and young people. Office for National Statistics, London 2004. www.statistics.gov.uk/children.

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9 Anderson HR, Ruggles R, Strachan DP et al. Trends in the prevalence of symptoms of asthma, hay fever, and eczema in 12-14 year olds in the British Isles, 1995-2002: questionnaire survey. British Medical Journal 2004; 328:1052-3. 10 Magnus P, Jaakkola JJK. Secular trend in the occurrence of asthma among children and young adults: critical appraisal of repeated cross-sectional surveys. British Medical Journal 1997;314:1795 11 Von Hertzen L, Haahtela T. Signs of reversing trends in prevalence of asthma. Allergy 2005; 60:283-292. 12 Primatesta P, Chapter 5: Respiratory health in Sproston K, Primatesta P (eds). Health Survey for England 2002: The Health of Children and Young People. Volume 1: Findings. The Stationery Office, London 2003. 13 Netuveli G, Hurwitz B, Levy M et al. Ethnic variations in UK asthma frequency, morbidity, and healthservice use: a systematic review and meta-analysis. Lancet 2005; 365(9465):312-7. 14 Rossiter CE, Weill H. Ethnic differences in lung function: evidence for proportional differences. International Journal of Epidemiology 1974; 3(1):55-61. 15 Patrick JM, Patel A. Ethnic differences in the growth of lung function in children: a cross-sectional study in inner-city Nottingham. Annals of Human Biology 1986; 13(4):307-15. 16 Johnston ID, Bland JM, Anderson HR. Ethnic variation in respiratory morbidity and lung function in childhood. Thorax 1987; 42:542-8. 17 Whittaker AL, Sutton AJ, Beardsmore CS. Are ethnic differences in lung function explained by chest size? Archives of Disease in Childhood: Fetal and Neonatal Edition 2005;90(5):F423-8. 18 The survey of Smoking, drinking and drug use among young people in England began in 1982 as the survey of Smoking among secondary school children. 19 Wardle H, Hedges B, Chapter 1: Cigarette smoking in Sproston K, Primatesta P (eds). Health Survey for England 2002: The Health of Children and Young People. Volume 1: Findings. The Stationery Office, London 2003. 20 Fuller E (ed). Smoking, drinking and drug use among young people in England 2004. Health and Social Care Information Centre, Leeds 2005. http://www.dh.gov.uk/assetRoot/04/12/34/32/04123432.pdf . 21 Best D, Rawaf S, Rowley J et al. Ethnic and gender differences in drinking and smoking among London adolescents. Ethnicity and Health 2001; 6(1):51-7. 22 Questions about drinking alcohol were first included in the survey of smoking, drinking and drug use among young people in England in 1988. 23 Erens B, Chapter 2: Alcohol consumption in Sproston K, Primatesta P (eds). Health Survey for England 2002: The Health of Children and Young People. Volume 1: Findings. The Stationery Office, London 2003. 24 Voors AW, Webber LS, Frerichs RR, Berenson GS. Body height and body mass as determinants of basal blood pressure in children – the Bogalusa Heart Study. American Journal of Epidemiology 1977; 106(2):101-8. 25 Rosner B, Prineas RJ, Loggie JMH, Daniels SR. Blood pressure nomogram for children and adolescents, by height, sex and age, in the United States. Journal of Pediatrics, 1993; 123:871-86. 26 Cole T, Freeman JV, Preece MA. Body mass index reference curves for the UK, 1990. Archives of Disease in Childhood 1995; 73:25-9 27 Wardle H (ed). Obesity among children under 11. 2004 http://www.dh.gov.uk/assetRoot/04/10/94/10/04109410.pdf. 28 Stamatakis E, Chapter 9: Anthropometric measurements, overweight and obesity in Sproston K, Primatesta P (eds). Health Survey for England 2002: The Health of Children and Young People. Volume 1: Findings. The Stationery Office, London 2003. 29 Gulliford MC, Mahabir D, Rocke B et al. Overweight, obesity and skinfold thicknesses of children of African or Indian descent in Trinidad and Tobago. International Journal of Epidemiology 2001; 30:989-98.

31 This and other departmental Public Service Agreements can be found at http://www.hmtreasury.gov.uk/media//70320/sr04_psa_ch3.pdf . 32 Stamatakis E, Chapter 4: Physical activity in Sproston K, Primatesta P (eds). Health Survey for England 2002: The Health of Children and Young People. Volume 1: Findings. The Stationery Office, London 2003. 33 Department for Education and Skills/Department for Culture, Media and Sport. Learning through PE and Sport. A Guide to the Physical Education, School Sport and Club Link Strategy. London, 2003. http://www.sportdevelopment.org.uk/learningthruPE2002.pdf . 34 As part of the strategy, the government aims to create at least 400 School Sport Partnerships, networks of primary and secondary schools and specialist colleges. A survey of schools within 312 networks, covering 54% of English primary and secondary schools, concluded that 69% of children in partnership schools met the target of at least two hours sport a day (http://www.teachernet.gov.uk/_doc/9045/2004-

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30 Daniels SR, Khoury PR, Morrison JA. The utility of Body Mass Index as a measure of body fatness in children and adolescents: differences by race and gender. Pediatrics 1997; 99(6):804-7.

05SchholSportSurveyReport.doc). However it is unlikely that these schools are typical of all schools in England, and the level of activity among all school children may well be much less. 35 Department of Health. At least five a week: evidence on the impact of physical activity and its relationship to health. 2004. http://www.dh.gov.uk/assetRoot/04/08/09/81/04080981.pdf .

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36 See http://www.5aday.nhs.uk/sfvs/default.aspx.

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399

Tables

12.1 Self-reported longstanding illness and limiting longstanding illness among children, by minority ethnic group and sex

12.15 Severity of childen’s respiratory symptoms and impact on everyday life in the last twelve months, by minority ethnic group and sex

12.2 Comparison of self-reported longstanding illness and limiting longstanding illness among children in 2004 and 1999, by minority ethnic group and sex

12.16 Forced expiratory volume in the first second (FEV1), by minority ethnic group and sex

12.4 Self-reported acute sickness in last two weeks among children, by minority ethnic group and sex 12.5 Comparison of self-reported acute sickness in the last two weeks among children in 2004 and 1999, by minority ethnic group and sex 12.6 Self-assessed general health among children, by minority ethnic group and sex 12.7 Comparison of self-assessed general health among children in 2004 and 1999, by minority ethnic group and sex 12.8 Children’s use of prescribed medicines, by minority ethnic group and sex 12.9 Comparison of children’s use of prescribed medicines in 2004 and 1999, by minority ethnic group and sex 12.10 General Health Questionnaire (GHQ12) score among children, by minority ethnic group and sex

12.18 Peak expiratory flow (PEF), by minority ethnic group and sex 12.19 Children’s self-reported experience of smoking cigarettes, by minority ethnic group and sex 12.20 Children’s self-reported frequency of smoking cigarettes, by minority ethnic group and sex 12.21 Children’s self-reported experience of smoking cigarettes, by age within minority ethnic group and sex 12.22 Children’s self-reported frequency of smoking cigarettes, by age within minority ethnic group and sex 12.23 Comparison of children’s self-reported experience of smoking cigarettes in 2004 and 1999, by age within minority ethnic group and sex 12.24 Children’s self-reported experience of drinking alcohol, by minority ethnic group and sex 12.25 Children’s self-reported experience of drinking alcohol, by age within minority ethnic group and sex

12.11 Strengths and Difficulties Questionnaire (SDQ) score, by minority ethnic group and sex

12.26 Children’s self-reported experience of drinking alcohol in 2004 and 1999, by age within minority ethnic group and sex

12.12 Comparison of Strengths and Difficulties Questionnaire (SDQ) scores in 2004 and 1999, by minority ethnic group and sex

12.27 Children’s systolic blood pressure (SBP), by minority ethnic group and sex

12.13 Children’s respiratory symptoms and doctordiagnosed asthma, by minority ethnic group and sex 12.14 Comparison of children’s respiratory symptoms and doctor-diagnosed asthma in 2004 and 1999, by minority ethnic group and sex 400

12.28 Children’s diastolic blood pressure (DBP), by minority ethnic group and sex 12.29 Children’s height, by minority ethnic group and sex 12.30 Children’s weight, by minority ethnic group and sex

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

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12.3 Type of longstanding illness (rate per 1000) among children, by minority ethnic group and sex

12.17 Forced vital capacity (FVC), by minority ethnic group and sex

12.31 Children’s body mass index (BMI) and the prevalence of overweight and obesity, by minority ethnic group and sex 12.32 Children’s body mass index (BMI) and the prevalence of overweight and obesity, by age within minority ethnic group and sex 12.33 Comparison of children’s body mass index (BMI) and the prevalence of overweight and obesity in 2004 and 1999, by minority ethnic group and sex 12.34 Summary of children’s participation in different activities in the last week, by minority ethnic group and sex 12.35 Summary of children’s activity levels, by minority ethnic group and sex 12.36 Comparison of children’s activity levels in 2004 and 1999, by minority ethnic group and sex

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12.37 Children’s consumption of fruit and vegetables, by minority ethnic group and sex

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401

Table 12.1 Self-reported longstanding illness and limiting longstanding illness among children, by minority ethnic group and sex Aged 0-15 Longstanding illness and limiting longstanding illness

2004 Minority ethnic group

General population (2001-2002)

Black Caribbean

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Boys Observed % Limiting longstanding illness Any longstanding illness Risk ratios Limiting longstanding illness

7 21

5 11

6 18

7 18

5 14

10 17

7 23

8 24

0.90

0.60

0.74

0.83

0.59

1.24

0.81

1

Standard error of the ratio

0.28

0.23

0.20

0.18

0.17

0.42

0.27

Any longstanding illness

0.89

0.46

0.73

0.76

0.56

0.72

0.94

Standard error of the ratio

0.14

0.11

0.12

0.11

0.10

0.18

0.18

1

Girls Observed % Limiting longstanding illness Any longstanding illness Risk ratios Limiting longstanding illness

8 22

2 7

3 9

6 13

3 10

3 13

4 17

7 20

1.14

0.28

0.38

0.90

0.45

0.48

0.50

1

Standard error of the ratio

0.36

0.15

0.17

0.20

0.14

0.23

0.20

Any longstanding illness

1.14

0.35

0.46

0.67

0.50

0.65

0.86

Standard error of the ratio

0.17

0.10

0.13

0.12

0.11

0.15

0.15

322 264

269 283

391 319

354 319

133 136

53 52

935 979

6936 6863

262 223

253 266

241 185

313 287

290 277

123 112

225 241

6066 5992

402

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

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Bases (weighted) Boys Girls Bases (unweighted) Boys Girls

1

Table 12.2 Comparison of self-reported longstanding illness and limiting longstanding illness among children in 2004 and 1999, by minority ethnic groupa and sex Aged 2-15b

2004, 1999

Longstanding illness and limiting longstanding illness

Minority ethnic group Black Caribbean

Indian

%

%

%

9 23

7 20

9 27

Pakistani Bangladeshi

Chinese

Irish

%

%

%

8 18

5 14

12 20

6 24

10 21

10 19

7 17

8 21

6 25

9 24

3 10

6 13

3 11

4 14

4 18

9 23

6 17

7 11

7 11

4 14

9 27

275 207 234 217

340 275 290 209

312 243 280 245

114 106 114 98

47 43 46 42

803 852 857 894

226 300 203 312

209 268 170 203

272 397 249 393

244 385 229 357

110 138 99 126

195 270 204 265

Boys 2004 Limiting longstanding illness Any longstanding illness 1999 Limiting longstanding illness Any longstanding illness

Girls 2004 Limiting longstanding illness Any longstanding illness 1999 Limiting longstanding illness Any longstanding illness Bases (weighted) Boys 2004 Boys 1999 Girls 2004 Girls1999 Bases (unweighted) Boys 2004 Boys 1999 Girls 2004 Girls 1999

a Black Africans were included in the 2004 survey but not in the 1999 survey, so therefore are excluded from this

comparative table. b The sample in 1999 included children aged between 2 and 15. In 2004 the sample included all children from birth. For the

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purposes of comparison, the 2004 figures in this table are based on children aged 2-15 and may differ from those shown elsewhere in this report.

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403

Table 12.3 Type of longstanding illness (rate per 1000) among children, by minority ethnic group and sex Aged 0-15 Condition group (ICD categories)a

2004 Minority ethnic group Black Caribbean

General population (2001-2002)

Black African

Indian

2 9 14 13 25 17 5 157 4 5 9 4 -

2 20 6 3 8 8 69 8 20 15 -

10 9 7 11 11 20 11 101 19 45 -

4 1 12 8 14 6 4 96 15 10 22 7 4

12 11 5 18 8 118 21 7 71 18 -

3 6 2 2 5 38 18 -

4 7 3 7 71 3 4 16 9 -

322 264

269 283

262 223

253 266

Pakistani Bangladeshi

Chinese

Irish

3 4 10 13 8 3 4 60 7 14 29 4 -

5 8 16 8 8 127 32 16 -

1 3 43 8 29 6 1 136 3 6 38 2 -

1 1 5 3 27 16 10 18 5 123 18 9 45 16 3

7 11 9 5 55 10 51 17 4

3 10 3 7 2 41 12 22 9

8 63 19 30 8

3 3 3 23 4 9 7 6 91 20 3 36 10 3

1 1 6 5 10 10 8 14 5 99 14 6 43 13 1

391 319

354 319

133 136

53 52

935 979

6936 6863

241 185

313 287

290 277

123 112

225 241

6066 5992

Boys I Infectious disease II Neoplasms & benign growths III Endocrine & metabolic IV Blood & related organs V Mental disorders VI Nervous system VI Eye complaints VI Ear complaints VII Heart & circulatory system VIII Respiratory system IX Digestive system X Genito-urinary system XII Skin complaints XIII Musculoskeletal system Other complaints

Girls I Infectious disease II Neoplasms & benign growths III Endocrine & metabolic IV Blood & related organs V Mental disorders VI Nervous system VI Eye complaints VI Ear complaints VII Heart & circulatory system VIII Respiratory system IX Digestive system X Genito-urinary system XII Skin complaints XIII Musculoskeletal system Other complaints Bases (weighted) Boys Girls Bases (unweighted) Boys Girls

404

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a ICD categories as in The International Classification of Diseases and Related Health problems (Tenth Revision). World Health Organisation, Geneva, 1992.

Table 12.4 Self-reported acute sickness in last two weeks among children, by minority ethnic group and sex Aged 0-15 Acute sickness in last two weeks

2004 Minority ethnic group Black Caribbean

General population (2001-2002)

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Boys Observed % Had acute sickness 1-3 days 4-6 days 7-13 days 2 weeks Risk ratios Acute sickness in last 2 weeks

7 5 0 1 1

5 2 2 1

7 3 2 1 0

11 5 2 2 2

6 3 1 1 1

4 2 2 -

12 6 2 3 1

13 7 3 2 1

0.53

0.36

0.53

0.86

0.46

0.33

0.90

1

Standard error of the ratio

0.14

0.16

0.14

0.16

0.11

0.14

0.23

6 3 1 2

5 2 2 1 -

7 5 1 1 -

7 3 2 1 0

4 2 1 0

5 3 1 -

11 6 4 1 0

13 8 2 2 1

Risk ratios Acute sickness in last 2 weeks

0.45

0.35

0.57

0.53

0.29

0.37

0.89

1

Standard error of the ratio

0.14

0.13

0.17

0.14

0.11

0.15

0.24

322 264

269 283

391 319

354 319

133 136

53 52

935 979

6937 6861

262 223

253 266

241 185

313 287

290 277

123 112

225 241

6067 5990

Girls Observed % Had acute sickness 1-3 days 4-6 days 7-13 days 2 weeks

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Bases (weighted) Boys Girls Bases (unweighted) Boys Girls

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

405

Table 12.5 Comparison of self-reported acute sickness in the last two weeks among children in 2004 and 1999, by minority ethnic groupa and sex Aged 2-15b Acute sickness in the last two weeks

2004, 1999 Minority ethnic group Black Caribbean

Indian

%

%

%

7

7

10

Pakistani Bangladeshi

Chinese

Irish

%

%

%

12

5

4

12

9

10

5

6

12

5

8

6

4

4

13

11

6

7

6

5

14

275 207 234 217

340 275 290 209

312 243 280 244

114 106 114 98

47 43 46 42

803 852 857 894

226 300 203 312

209 268 170 203

272 397 249 392

244 385 229 357

110 138 99 126

195 270 204 265

Boys 2004 Had acute sickness in last 2 weeks 1999 Had acute sickness in last 2 weeks

Girls 2004 Had acute sickness in last 2 weeks 1999 Had acute sickness in last 2 weeks Bases (weighted) Boys 2004 Boys 1999 Girls 2004 Girls1999 Bases (unweighted) Boys 2004 Boys 1999 Girls 2004 Girls 1999

a Black Africans were included in the 2004 survey but not in the 1999 survey, so therefore are excluded from this

comparative table. b The sample in 1999 included children aged between 2 and 15. In 2004 the sample included all children from birth. For the

406

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

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purposes of comparison, the 2004 figures in this table are based on children aged 2-15 and may differ from those shown elsewhere in this report.

Table 12.6 Self-assessed general health among children, by minority ethnic group and sex Aged 0-15 Self-assessed general health

2004 Minority ethnic group

General population (2001-2002)

Black Caribbean

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Boys Observed % Very good Good Very good/good Fair Bad Very bad Bad/very bad Risk ratios Good/very good

52 39 91 9 -

58 36 94 5 1 0 1

55 39 94 6 0 0

47 46 92 7 0 0 1

39 47 86 10 4 4

49 43 92 7 1 1

64 29 94 6 0 0 1

57 36 93 7 1 0 1

0.98

1.02

1.01

1.00

0.93

0.99

1.01

1

Standard error of the ratio

0.03

0.02

0.02

0.02

0.03

0.03

0.03

Bad/very bad

-

1.03

0.45

0.62

4.39

1.68

0.93

Standard error of the ratio

-

0.77

0.46

0.47

1.57

1.23

0.56

1

Girls Observed % Very good Good Very good/good Fair Bad Very bad Bad/very bad Risk ratios Good/very good

46 43 89 10 1 1

53 41 95 5 0 0

55 41 96 4 0 0

50 41 91 8 0 0 1

37 56 94 5 1 1

47 49 97 3 -

67 28 95 5 0 0

57 35 93 6 1 0 1

0.96

1.02

1.03

0.98

1.01

1.04

1.02

1

Standard error of the ratio

0.03

0.02

0.02

0.02

0.02

0.02

0.03

Bad/very bad

1.26

0.17

0.41

0.70

0.75

-

0.29

Standard error of the ratio

0.72

0.17

0.40

0.48

0.44

-

0.26

321 264

269 283

391 319

354 316

133 136

53 52

935 979

6937 6862

261 223

253 266

241 185

313 285

290 277

123 112

225 241

6067 5991

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Bases (weighted) Boys Girls Bases (unweighted) Boys Girls

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

1

407

Table 12.7 Comparison of self-assessed general health among children in 2004 and 1999, by minority ethnic groupa and sex Aged 2-15b Self-assessed general health

2004,1999 Minority ethnic group Black Caribbean

Indian

%

%

%

91 9 -

93 7 0

88 11 1

Pakistani Bangladeshi

Chinese

Irish

%

%

%

93 7 0

86 10 4

91 7 2

95 5 1

89 10 1

87 11 2

84 14 2

91 7 2

94 6 0

90 9 1

95 4 0

91 8 1

94 6 1

97 3 -

94 6 0

90 9 1

87 12 1

92 6 2

89 9 2

91 9 0

91 7 2

274 207 234 217

228 275 226 209

340 243 290 244

312 106 277 98

114 43 114 42

47 852 46 894

225 300 203 312

212 268 211 203

209 397 170 392

272 385 247 357

244 138 229 126

110 270 99 265

Boys 2004 Good/very good Fair Bad/very bad 1999 Good/very good Fair Bad/very bad

Girls 2004 Good/very good Fair Bad/very bad 1999 Good/very good Fair Bad/very bad Bases (weighted) Boys 2004 Boys 1999 Girls 2004 Girls1999 Bases (unweighted) Boys 2004 Boys 1999 Girls 2004 Girls 1999

a Black Africans were included in the 2004 survey but not in the 1999 survey, so therefore are excluded from this

comparative table. b The sample in 1999 included children aged between 2 and 15. In 2004 the sample included all children from birth.

408

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

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For the purposes of comparison, the 2004 figures in this table are based on children aged 2-15 and may differ from hose shown elsewhere in this report.

Table 12.8 Children’s use of prescribed medicines, by minority ethnic group and sex Aged 0-15

2004

Use of prescribed medicines

Minority ethnic group

General population (2001-2002)

Black Caribbean

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Boys Observed % Taking any prescribed medicine 1 prescribed medicine 2 prescribed medicines 3 prescribed medicines 4 or more prescribed medicines Risk ratios Any prescribed medicine

21 6 9 1 5

14 10 3 0 0

20 7 11 1

24 14 8 2 1

16 7 5 1 3

9 6 2 2 -

19 11 6 1

20 10 7 2 1

1.08

0.73

1.00

1.22

0.84

0.46

0.96

1

Standard error of the ratio

0.25

0.25

0.18

0.22

0.17

0.17

0.24

Girls Observed % Taking any prescribed medicine 1 prescribed medicine 2 prescribed medicines 3 prescribed medicines 4 or more prescribed medicines Risk ratios Any prescribed medicine

18 8 8 1 1

10 7 2 2 --

16 8 8 1

12 6 4 0 1

22 13 7 2

20 14 4 3 -

18 11 5 2 -

19 9 7 2 1

0.97

0.56

0.85

0.65

1.18

1.08

0.95

1

Standard error of the ratio

0.23

0.19

0.22

0.15

0.18

0.32

0.21

159 139

142 141

209 150

171 168

69 65

26 27

447 468

5769 5715

120 119

121 123

155 108

175 169

115 104

67 68

140 159

5033 4989

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Bases (weighted) Boys Girls Bases (unweighted) Boys Girls

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

409

Table 12.9 Comparison of children’s use of prescribed medicines in 2004 and 1999, by minority ethnic groupa and sex Aged 2-15b Use of prescribed medicines

2004, 1999 Minority ethnic group Black Caribbean

Indian

%

%

%

19

21

27

Pakistani Bangladeshi

Chinese

Irish

%

%

%

22

14

11

17

14

15

23

24

17

16

16

13

25

19

17

17

14

13

21

23

19

135 148 121 161

181 208 137 160

145 170 147 169

58 58 50 52

22 35 24 31

397 690 418 755

106 216 106 236

134 199 100 157

147 279 146 268

95 219 79 194

59 113 59 92

122 206 137 208

Boys 2004 Taking any prescribed medicine 1999 Taking any prescribed medicine

Girls 2004 Taking any prescribed medicine 1999 Taking any prescribed medicine Bases (weighted) Boys 2004 Boys 1999 Girls 2004 Girls1999 Bases (unweighted) Boys 2004 Boys 1999 Girls 2004 Girls 1999

a Black Africans were included in the 2004 survey but not in the 1999 survey, so therefore are excluded from this

comparative table. b The sample in 1999 included children aged between 2 and 15. In 2004 the sample included all children from birth. For the

410

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

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purposes of comparison, the 2004 figures in this table are based on children aged 2-15 and may differ from those shown elsewhere in this report.

Table 12.10 General Health Questionnaire (GHQ12) score among children, by minority ethnic group and sex Aged 13-15 GHQ12 score

2004 Minority ethnic group

General population (2001-2002)

Black Caribbean

Black African

Indian

[64] [30] [7]

a a a

[67] [22] [11]

[66] [30] [4]

[0.89]

a

[1.48]

[0.63]

a

[0.74]

[42] [37] [20]

[59] [38] [4]

[1.59] [0.69]

Pakistani Bangladeshi

Chinese

Irish

[69] [20] [10]

a a a

[77] [18] [5]

62 30 7

[0.52]

[1.41]

a

[0.71]

1

[0.40]

[0.78]

a

[0.45]

[60] [32] [8]

[62] [31] [7]

[69] [23] [8]

a a a

[62] [33] [5]

56 31 13

[0.30]

[0.62]

[0.53]

[0.66]

a

[0.41]

1

[0.21]

[0.44]

[0.30]

[0.50]

a

[0.23]

45 42

24 32

52 48

50 34

16 17

10 8

128 137

1189 1187

35 31

23 31

36 30

40 32

33 31

25 17

34 36

1070 1071

Boys Observed % 0 1-3 4+ Risk ratios High score (4+) Standard error of the ratio

Girls Observed % 0 1-3 4+ Risk ratios High score (4+) Standard error of the ratio

Bases (weighted) Boys Girls Bases (unweighted) Boys Girls

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a Results are not shown because of small bases.

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411

Table 12.11 Strengths and Difficulties Questionnaire (SDQ) score, by minority ethnic group and sex Aged 4-15 SDQ score

2004 Minority ethnic group

General population (2001-2002)

Black Caribbean

Black African

Indian

68 11 21

85 6 9

81 9 9

69 20 11

76 16 7

83 10 7

81 9 10

65 10 26

67 19 14

67 5 28

Pakistani Bangladeshi

Chinese

Irish

73 10 17

[86] [10] [3]

76 11 13

80 9 12

77 9 14

76 5 19

[94] [2] [4]

76 9 15

84 7 10

72 13 15

67 13 20

71 12 17

[89] [6] [5]

73 16 10

72 13 15

81 10 9

79 11 10

68 14 17

74 10 16

[79] [7] [14]

77 12 11

72 10 18

62 16 22

75 16 10

64 20 16

59 20 21

65 16 19

[74] [11] [16]

81 7 12

75 11 14

85 8 7

83 5 12

85 9 6

86 9 5

89 4 7

[81] [7] [12]

93 6 1

89 6 5

Boys

Total deviance scorea Mean

11.2

9.4

9.1

10.4

10.7

[8.2]

8.9

9.2

Standard error of the mean

0.79

0.68

0.53

0.57

0.81

[0.79]

0.71

0.10

Median

10.0

9.0

8.0

10.6

10.2

[8.6]

7.0

8.0

Risk ratios Total deviance score 17-40a

1.65

0.75

0.80

0.92

1.51

[0.29]

1.04

1

Standard error of the ratio

0.45

0.36

0.21

0.33

0.56

[0.20]

0.35

Emotional symptoms score 5-10

0.78

0.77

1.07

1.48

2.02

[0.42]

1.52

Standard error of the ratio

0.32

0.40

0.30

0.45

0.69

[0.28]

0.45

Conduct problems score 4-10

1.71

0.94

0.97

1.35

1.12

[0.36]

0.70

Standard error of the ratio

0.39

0.31

0.25

0.30

0.36

[0.18]

0.24

Hyperactivity score 7-10

1.53

0.49

0.55

0.97

0.85

[0.76]

0.61

Standard error of the ratio

0.35

0.21

0.17

0.24

0.20

[0.27]

0.24

Peer problems score 4-10

1.59

0.69

1.17

1.57

1.35

[1.13]

0.87

Standard error of the ratio

0.39

0.29

0.25

0.36

0.34

[0.35]

0.26

Prosocial behaviour score 0-4

1.44

2.49

1.20

0.97

1.44

[2.46]

0.16

Standard error of the ratio

0.62

0.98

0.71

0.45

0.77

[0.96]

0.12

Bases Boys (weighted) Boys (unweighted)

119 87

78 71

167 109

118 95

29 62

21 48

444 100

1 1 1 1 1

3461 3004

a The total deviance score is the sum of the scores from four of the subscales: emotional symptoms, conduct problems, hyperactivity and peer problems

(see note 6).

Continued …

.

412

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Observed % Total deviance scorea 0-13 14-16 17-40 Emotional symptoms score 0-3 4 5-10 Conduct problems score 0-2 3 4-10 Hyperactivity score 0-5 6 7-10 Peer problems score 0-2 3 4-10 Prosocial behaviour score 6-10 5 0-4

Table 12.11 continued Aged 4-15

2004

SDQ score

Minority ethnic group

General population (2001-2002)

Black Caribbean

Black African

Indian

81 12 6

92 5 3

84 10 6

74 15 12

72 9 19

87 6 7

74 12 14

74 15 11

88 5 8

81 8 10

Pakistani Bangladeshi

Chinese

Irish

80 11 9

[85] [10] [6]

88 1 10

84 9 8

61 13 27

68 13 19

[77] [12] [11]

75 6 18

79 9 12

81 12 7

68 9 23

67 24 9

[75] [21] [4]

74 13 12

76 12 12

92 6 2

90 6 4

83 4 13

89 3 8

[85] [12] [4]

86 9 5

85 6 9

78 11 11

76 18 7

72 12 16

55 24 21

69 17 13

[70] [18] [12]

83 7 10

78 11 11

94 4 2

95 2 2

95 2 2

90 6 3

94 4 2

[90] [8] [2]

91 1 7

93 4 3

Girls Observed % Total deviance scorea 0-13 14-16 17-40 Emotional symptoms score 0-3 4 5-10 Conduct problems score 0-2 3 4-10 Hyperactivity score 0-5 6 7-10 Peer problems score 0-2 3 4-10 Prosocial behaviour score 6-10 5 0-4 Total deviance scorea Mean

8.6

6.8

8.4

10.3

9.3

7.8

7.7

8.1

Standard error of the mean

0.83

0.54

0.60

1.00

0.83

0.87

0.69

0.09

8.0

7.0

7.0

11.0

8.0

8.0

6.0

7.0

Risk ratios Total deviance score 17-40a

0.83

0.37

0.80

1.51

1.12

0.73

1.33

1

Standard error of the ratio

0.40

0.19

0.31

0.63

0.67

0.68

0.55

Emotional symptoms score 5-10

1.56

0.61

1.25

2.14

1.54

0.93

1.53

Standard error of the ratio

0.42

0.28

0.36

0.60

0.56

0.45

0.42

Conduct problems score 4-10

0.98

0.67

0.60

1.93

0.79

0.34

1.05

Standard error of the ratio

0.42

0.25

0.25

0.54

0.34

0.22

0.45

Hyperactivity score 7-10

1.16

0.25

0.45

1.42

0.89

0.42

0.56

Standard error of the ratio

0.46

0.20

0.22

0.53

0.41

0.27

0.27

Peer problems score 4-10

1.00

0.60

1.52

1.88

1.21

1.07

0.93

Standard error of the ratio

0.36

0.29

0.33

0.41

0.48

0.46

0.38

Prosocial behaviour score 0-4

0.73

0.81

0.88

1.23

0.62

0.84

2.78

Standard error of the ratio

0.72

0.58

0.61

0.71

0.62

0.83

1.92

Bases Girls (weighted) Girls (unweighted)

104 81

93 77

140 85

115 90

29 54

23 49

489 112

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Median

1 1 1 1 1

3339 2878

a The total deviance score is the sum of the scores from four of the subscales: emotional symptoms, conduct problems, hyperactivity and peer problems

(see note 6).

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

413

Table 12.12 Comparison of Strengths and Difficulties Questionnaire (SDQ) scores in 2004 and 1999, by minority ethnic groupa and sex Aged 4-15 SDQ score

2004, 1999 Minority ethnic group Black Caribbean

Indian

%

%

%

21 7 26 28 22 7

9 10 15 10 16 6

14 13 20 21 13 2

Pakistani Bangladeshi

Chinese

Irish

%

%

%

11 14 20 17 21 5

17 19 17 16 19 7

[3] [4] [5] [14] [16] [12]

13 15 10 11 12 1

15 15 16 19 24 4

22 22 21 11 26 5

13 11 15 15 24 16

11 14 17 17 15 8

8 5 17 24 10 2

6 19 11 10 11 2

6 14 7 4 16 2

12 27 23 13 21 3

9 19 9 8 13 2

[6] [11] [4] [4] [12] [2]

10 18 12 5 10 7

12 18 12 11 16 2

16 21 15 11 16 5

17 26 16 7 20 3

12 20 16 6 27 13

8 15 18 4 11 6

14 15 18 8 9 2

119 121 104 129

167 173 140 136

118 128 115 135

29 45 29 41

21 30 23 29

444 588 489 630

87 174 81 189

109 163 85 133

95 204 90 208

62 171 54 148

48 98 49 84

100 168 112 174

Boys 2004 Total deviance score 17-40b Emotional symptoms score 5-10 Conduct problems score 4-10 Hyperactivity score 7-10 Peer problems score 4-10 Prosocial behaviour score 0-4 1999 Total deviance score 17-40b Emotional symptoms score 5-10 Conduct problems score 4-10 Hyperactivity score 7-10 Peer problems score 4-10 Prosocial behaviour score 0-4

2004 Total deviance score 17-40b Emotional symptoms score 5-10 Conduct problems score 4-10 Hyperactivity score 7-10 Peer problems score 4-10 Prosocial behaviour score 0-4 1999 Total deviance score 17-40b Emotional symptoms score 5-10 Conduct problems score 4-10 Hyperactivity score 7-10 Peer problems score 4-10 Prosocial behaviour score 0-4 Bases (weighted) Boys 2004 Boys 1999 Girls 2004 Girls1999 Bases (unweighted) Boys 2004 Boys 1999 Girls 2004 Girls 1999

a Black Africans were included in the 2004 survey but not in the 1999 survey, so therefore are excluded from this

comparative table. b The total deviance score is the sum of the scores from four of the subscales: emotional symptoms, conduct problems,

hyperactivity and peer problems (see note 6).

414

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Girls

Table 12.13 Children’s respiratory symptoms and doctor-diagnosed asthma, by minority ethnic group and sex Aged 0-15

2004

Respiratory symptoms and asthma

Minority ethnic group

General population (2001-2002)

Black Caribbean

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Boys Observed % Ever wheezed Wheezed without a cold Breathless when wheezing Wheezed in last 12 months Doctor-diagnosed asthma Risk ratios Wheezed in last 12 months

39 26 26 27 30

20 10 8 13 17

23 11 10 15 18

22 12 9 15 13

16 7 7 11 12

30 16 14 15 21

29 14 15 13 20

36 22 16 20 23

1.37

0.67

0.76

0.79

0.54

0.76

0.67

1

Standard error of the ratio

0.20

0.18

0.14

0.13

0.11

0.17

0.18

Doctor-diagnosed asthma

1.33

0.74

0.81

0.56

0.52

0.92

0.90

Standard error of the ratio

0.18

0.15

0.12

0.09

0.09

0.16

0.17

1

Girls Observed % Ever wheezed Wheezed without a cold Breathless when wheezing Wheezed in last 12 months Doctor-diagnosed asthma Risk ratios Wheezed in last 12 months

33 15 16 21 21

12 4 4 8 9

19 8 10 13 16

15 8 5 13 8

8 3 4 6 7

14 9 10 9 15

27 10 13 21 14

29 16 13 17 18

1.27

0.47

0.80

0.77

0.36

0.53

1.27

1

Standard error of the ratio

0.20

0.15

0.18

0.14

0.12

0.17

0.23

Doctor-diagnosed asthma

1.21

0.50

0.90

0.44

0.37

0.85

0.82

Standard error of the ratio

0.19

0.14

0.21

0.09

0.11

0.21

0.15

321 262

269 282

384 316

354 318

133 136

53 52

935 979

6937 6864

260 220

253 265

238 184

313 285

290 277

123 112

225 241

6067 5993

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Bases (weighted) Boys Girls Bases (unweighted) Boys Girls

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

1

415

Table 12.14 Comparison of children’s respiratory symptoms and doctor-diagnosed asthma in 2004 and 1999, by minority ethnic groupa and sex Aged 2-15b Respiratory symptoms and asthma

2004, 1999 Minority ethnic group Black Caribbean

Indian

%

%

%

40 28 28 27 33

25 12 11 15 21

41 25 23 20 30

Pakistani Bangladeshi

Chinese

Irish

%

%

%

21 11 10 13 14

16 7 8 10 13

34 18 16 17 24

31 14 17 12 22

25 15 15 15 17

24 14 13 15 18

18 10 10 12 17

26 11 14 15 22

37 25 22 18 28

33 17 17 21 24

20 9 10 14 17

13 8 6 11 8

9 4 5 7 7

15 10 11 9 16

26 10 14 20 15

32 18 20 16 24

23 13 16 13 13

15 8 5 8 10

11 5 5 5 8

17 10 11 11 18

34 20 18 19 21

273 206 233 217

335 275 287 209

312 243 278 245

114 105 114 98

47 43 46 42

803 827 857 888

224 298 200 312

207 268 169 203

272 397 247 393

244 384 229 358

110 138 99 126

195 267 204 264

Boys 2004 Ever wheezed Wheezed without a cold Breathless when wheezing Wheezed in last 12 months Doctor-diagnosed asthma 1999 Ever wheezed Wheezed without a cold Breathless when wheezing Wheezed in last 12 months Doctor-diagnosed asthma

Girls 2004 Ever wheezed Wheezed without a cold Breathless when wheezing Wheezed in last 12 months Doctor-diagnosed asthma 1999 Ever wheezed Wheezed without a cold Breathless when wheezing Wheezed in last 12 months Doctor-diagnosed asthma Bases (weighted) Boys 2004 Boys 1999 Girls 2004 Girls1999 Bases (unweighted) Boys 2004 Boys 1999 Girls 2004 Girls 1999

a Black Africans were included in the 2004 survey but not in the 1999 survey, so therefore are excluded from this

purposes of comparison, the 2004 figures in this table are based on children aged 2-15 and may differ from those shown elsewhere in this report.

416

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Copyright © 2006, The Information Centre. All rights reserved

comparative table. b The sample in 1999 included children aged between 2 and 15. In 2004 the sample included all children from birth. For the

Table 12.15 Severity of children’s respiratory symptoms and impact on everyday life in the last twelve months, by minority ethnic group and sex Aged 2-15 who had wheezing/whistling in the chest in the last 12 months Respiratory symptoms

2004

Minority ethnic group Black Caribbean

General population (2001-2002)

Black African

Indian

57 40 3 9 22 28

a a a a a a

[63] [37] [-] [-] a [32]

63 24 13 24 [20] 34

[67] [18] [15] [34] [8] [43]

a a a a a a

a a a a a a

86 55

35 22

62 45

28 18

Pakistani Bangladeshi

Chinese

Irish

[76] [12] [12] [32] a [30]

a a a a a a

[51] [20] [29] [35] a [41]

68 23 8 20 15 57

[65] [19] [16] [19] [24] [31]

a a a a a a

a a a a a a

[67] [27] [6] [11] [29] [54]

69 23 8 20 15 57

57 42

55 41

14 8

8 5

122 206

1360 1140

32 26

50 37

33 16

18 10

32 45

1197 993

Boys Number of wheezing attacks in the last twelve months 1-3 4-12 More than 12 Sleep disturbed once or more a week Speech limitedb,c Interfered with daily activitiesd

Girls Number of wheezing attacks in the last twelve months 1-3 4-12 More than 12 Sleep disturbed once or more a week Speech limitedb,c Interfered with daily activitiesd Bases (weighted) Boys Girls Bases (unweighted) Boys Girls

a Results are not shown because of small bases. b ‘Speech limited’ defined as ‘wheezing/whistling severe enough to limit speech to one or two words only between breaths’.

Copyright © 2006, The Information Centre. All rights reserved

c Not asked about those aged under 2. d Interfered ‘a little’, ‘quite a bit’ or ‘a lot’.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

417

Table 12.16 Forced expiratory volume in the first second (FEV1), by minority ethnic group and sex Aged 7-15 with valid lung function and height measurement FEV1 (litres)

2004

Minority ethnic group

General population (2001-2002)

Black Caribbean

Black African

Indian

Observed Mean

2.41

[2.24]

2.20

2.37

Standard error of the mean

0.25

[0.14]

0.09

0.11

Median Age and height adjusted Regression coefficientb

2.02

[2.13]

2.03

-0.22

[-0.34]

0.21

[0.09]

[2.23] [0.14]

Pakistani Bangladeshi

Chinese

Irish

[1.85]

a

2.53

[0.12]

a

0.17

0.02

2.43

[1.69]

a

2.20

2.23

-0.24

-0.26

[-0.29]

a

0.05

0

0.06

0.07

[0.05]

a

0.07

[2.11]

1.98

2.07

[1.80]

[2.17]

2.21

[0.12]

0.11

0.13

[0.08]

[0.11]

0.10

0.02

[2.15]

[2.19]

1.98

2.00

[1.83]

[2.13]

2.14

2.19

[-0.26]

[-0.39]

-0.26

-0.17

[-0.34]

[0.00]

-0.11

0

[0.06]

[0.05]

0.04

0.05

[0.10]

[0.05]

0.05

72 60

42 48

92 79

63 53

23 24

11 13

206 202

3020 2948

51 49

40 38

69 57

60 53

38 34

29 30

61 67

2638 2556

Boys

Standard error of the coefficient

2.46

Girls Observed Mean Standard error of the mean

Median Age and height adjusted Regression coefficientb Standard error of the coefficient

Bases (weighted) Boys Girls Bases (unweighted) Boys Girls

2.29

a Results are not shown because of small bases. b Equivalent to absolute difference in mean FEV , adjusted for height and age, compared with the general population. The reference value for the general 1

418

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

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population is consequently 0.

Table 12.17 Forced vital capacity (FVC), by minority ethnic group and sex Aged 7-15 with valid lung function and height measurement FVC (litres)

2004

Minority ethnic group

General population (2001-2002)

Black Caribbean

Black African

Indian

Observed Mean

3.11

[2.91]

2.63

2.75

Standard error of the mean

0.29

[0.27]

0.13

0.14

Median Age and height adjusted Regression coefficientb

2.68

[2.49]

2.36

0.04

[-0.12]

Standard error of the coefficient

0.22

[0.23]

[2.66] [0.17]

Pakistani Bangladeshi

Chinese

Irish

[2.26]

a

2.96

[0.14]

a

0.19

0.02

2.75

[2.08]

a

2.63

2.65

-0.23

-0.32

[-0.25]

a

0.05

0

0.10

0.10

[0.11]

a

0.08

[2.58]

2.58

2.37

[2.04]

[2.54]

2.61

[0.13]

0.17

0.14

[0.09]

[0.13]

0.14

0.02

[2.57]

[2.59]

2.45

2.35

[1.99]

[2.53]

2.43

2.52

[-0.17]

[-0.26]

0.03

-0.18

[-0.40]

[0.07]

-0.03

0

[0.10]

[0.10]

0.11

0.07

[0.14]

[0.08]

0.07

72 60

42 48

92 79

63 53

23 24

11 13

206 202

3020 2948

51 49

40 38

69 57

60 53

38 34

29 30

61 67

2638 2556

Boys 2.88

Girls Observed Mean Standard error of the mean

Median Age and height adjusted Regression coefficientb Standard error of the coefficient

Bases (weighted) Boys Girls Bases (unweighted) Boys Girls

2.61

a Results are not shown because of small bases. b Equivalent to absolute difference in mean FVC , adjusted for height and age, compared with the general population. The reference value for the general 1

Copyright © 2006, The Information Centre. All rights reserved

population is consequently 0.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

419

Table 12.18 Peak expiratory flow (PEF), by minority ethnic group and sex Aged 7-15 with valid lung function and height measurement PEF (l.min-1)

2004

Minority ethnic group

General population (2001-2002)

Black Caribbean

Black African

Observed Mean

321

[309]

301

327

[254]

a

327

Standard error of the mean

28.7

[20.3]

10.4

15.3

[18.5]

a

23.5

2.2

Median Age and height adjusted Regression coefficientb

300

[285]

292

329

[242]

a

290

298

-18.57

[-27.05]

-18.71

-15.40

[-28.59]

a

0.40

0

25.70

[15.25]

6.68

10.27

[7.54]

a

11.01

Observed Mean

[313]

[282]

260

267

[251]

[286]

266

Standard error of the mean

[16.6]

[16.5]

15.1

19.9

[14.0]

[13.8]

11.6

1.8

Median Age and height adjusted Regression coefficientb

[302]

[268]

263

249

[240]

[285]

256

295

[-13.52]

[-43.67]

-37.64

-30.92

[-36.51]

[-2.60]

-39.10

0

[9.92]

[12.52]

7.80

12.27

[12.46]

[8.28]

8.91

72 60

42 48

92 79

63 53

23 24

11 13

206 202

3020 2948

51 49

40 38

69 57

60 53

38 34

29 30

61 67

2638 2556

Indian

Pakistani Bangladeshi

Chinese

Irish

Boys

Standard error of the coefficient

322

Girls

Standard error of the coefficient

Bases (weighted) Boys Girls Bases (unweighted) Boys Girls

303

a Results are not shown because of small bases. b Equivalent to absolute difference in mean PEF, adjusted for height and age, compared with the general population. The reference value for the general

420

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population is consequently 0.

Table 12.19 Children’s self-reported experience of smoking cigarettes, by minority ethnic group and sex Aged 8-15

2004

Experience of smoking cigarettes

Minority ethnic group Black Caribbean

General population (2001-2002)

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Boys Observed % Has never smoked cigarettes Has ever smoked Has smoked, but does not do so now Current smoker Risk ratios Has ever smoked

84 16 15 2

88 12 7 5

99 1 1 -

89 11 8 3

90 10 7 3

94 6 6 -

87 13 8 5

82 18 14 4

0.89

0.65

0.08

0.59

0.53

0.32

0.73

1

Standard error of the ratio

0.25

0.33

0.06

0.18

0.24

0.16

0.23

Current smoker

0.45

1.35

-

0.81

0.69

-

1.30

Standard error of the ratio

0.34

1.31

-

0.58

0.47

-

0.76

1

Girls Observed % Has never smoked cigarettes Has ever smoked Has smoked, but does not do so now Current smoker Risk ratios Has ever smoked

83 17 11 6

91 9 8 1

93 7 7 -

95 5 3 2

95 5 5 -

[98] [2] [2] [-]

77 23 15 8

81 19 15 4

0.90

0.49

0.38

0.25

0.27

[0.11]

1.25

1

Standard error of the ratio

0.30

0.20

0.19

0.11

0.15

[0.11]

0.42

Current smoker

1.47

0.21

-

0.50

-

-

2.03

Standard error of the ratio

1.03

0.21

-

0.36

-

-

1.00

117 111

71 81

168 147

142 120

46 41

24 21

391 372

3298 3282

91 89

68 76

109 86

121 103

96 76

57 46

93 89

2887 2859

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Bases (weighted) Boys Girls Bases (unweighted) Boys Girls

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

1

421

Table 12.20 Children’s self-reported frequency of smoking cigarettes, by minority ethnic group and sex Aged 8-15 Frequency of smoking cigarettes

2004 Minority ethnic group

General population (2001-2002)

Black Caribbean

Black African

Indian

%

%

%

%

98 0 1

95 5

100 -

94 2 4

99 1 -

117 111 91 89

Pakistani Bangladeshi

Chinese

Irish

%

%

%

%

97 2 1

97 3

100 -

95 2 3

96 1 2

100 -

98 2

100 -

[100] [-] [-]

92 1 8

96 1 3

71 81

168 147

142 120

46 41

24 21

391 372

3298 3282

68 76

109 86

121 103

96 76

57 46

93 89

2887 2859

Boys Doesn’t smoke Smokes less than once a week Smokes once a week or more

Doesn’t smoke Smokes less than once a week Smokes once a week or more Bases (weighted) Boys Girls Bases (unweighted) Boys Girls

422

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

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Girls

Table 12.21 Children’s self-reported experience of smoking cigarettes, by age within minority ethnic group and sex Aged 8-15

2004

Experience of smoking cigarettes

Black Caribbean Ever smoked Currently smokes Black African Ever smoked Currently smokes Indian Ever smoked Currently smokes Pakistani Ever smoked Currently smokes

Copyright © 2006, The Information Centre. All rights reserved

Bangladeshi Ever smoked Currently smokes Chinese Ever smoked Currently smokes Irish Ever smoked Currently smokes General population (2001-2002) Ever smoked Currently smokes

Age group

Boys

Girls

8-10

11-15

All boys

%

%

%

%

%

%

[10] [-]

20 3

16 2

[-] [-]

26 9

17 6

a a

[15] [9]

12 5

a a

14 1

9 1

-

3 -

1 -

a a

9 -

7 -

[3] [-]

15 5

11 3

[3] [-]

6 3

5 2

[-] [-]

16 4

10 3

[-] [-]

[8] [-]

5 -

a a

[8] [-]

6 -

a a

a a

[2] [-]

[1] [-]

24 9

13 5

a a

33 12

23 8

5 0

26 6

18 4

4 -

27 6

19 4

72 41 89 89 28 19 215 2072

117 71 168 142 46 24 391 3298

40 29 49 47 17 9 111 1234

72 52 98 73 24 12 261 2047

111 81 147 120 41 21 372 3282

57 39 59 73 60 45 57 1836

91 68 109 121 96 57 93 2887

34 26 28 41 31 18 21 1041

55 50 58 62 45 28 68 1818

89 76 86 103 76 46 89 2859

Bases (weighted) Black Caribbean 44 Black African 30 Indian 78 Pakistani 53 Bangladeshi 18 Chinese 6 Irish 176 General population (2001-2002) 1227 Bases (unweighted) Black Caribbean 34 Black African 29 Indian 50 Pakistani 48 Bangladeshi 36 Chinese 12 Irish 36 General population (2001-2002) 1051

8-10

11-15

All girls

a Results are not shown because of small bases.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

423

Table 12.22 Children’s self-reported frequency of smoking cigarettes, by age within minority ethnic group and sex Aged 8-15

2004 Age group

Boys 8-10

11-15

%

%

%

%

%

%

97 1 2

98 0 1

[100] [-] [-]

91 3 6

94 2 4

[91] [-] [9]

95 5

a a a

99 1 -

99 1 -

100 -

100 -

a a a

100 -

100 -

95 3 2

97 2 1

[100] [-] [-]

97 3

98 2

96 4

97 3

[100] [-] [-]

[100] [-] [-]

100

[91] [3] [6]

95 2 3

a a a

a a a

[100] [-] [-]

96 1 2

98 1 1

a a a

88 1 11

92 1 8

94 2 4

96 1 2

100 -

94 2 5

96 1 3

44 30 78 53 18 6 176 1227

72 41 89 89 28 19 215 2072

117 71 168 142 46 24 391 3298

40 29 49 47 17 9 111 1234

72 52 98 73 24 12 261 2047

111 81 147 120 41 21 372 3282

34 29 50 48 36 12 36 1051

57 39 59 73 60 45 57 1836

91 68 109 121 96 57 93 2887

34 26 28 41 31 18 21 1041

55 50 58 62 45 28 68 1818

89 76 86 103 76 46 89 2859

Black Caribbean Doesn't smoke cigarettes [100] Smokes less than once a week [-] Smokes once a week or more often [-] Black African Doesn't smoke cigarettes a Smokes less than once a week a Smokes once a week or more often a Indian Doesn't smoke cigarettes 100 Smokes less than once a week Smokes once a week or more often Pakistani Doesn't smoke cigarettes [100] Smokes less than once a week [-] Smokes once a week or more often [-] Bangladeshi Doesn't smoke cigarettes 100 Smokes less than once a week [-] Smokes once a week or more often [-] Chinese Doesn't smoke cigarettes a Smokes less than once a week a Smokes once a week or more often a Irish Doesn't smoke cigarettes [100] Smokes less than once a week [-] Smokes once a week or more often [-] General population (2001-2002) Doesn't smoke cigarettes 100 Smokes less than once a week 0 Smokes once a week or more often Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2001-2002) Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2001-2002)

Girls All boys

8-10

11-15

All girls

a Results are not shown because of small bases.

424

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

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Frequency of smoking cigarettes

Table 12.23 Comparison of children’s self-reported experience of smoking in 2004 and 1999, by age within minority ethnic groupa and sex Aged 8-15 Experience of smoking cigarettes

Copyright © 2006, The Information Centre. All rights reserved

2004 Black Caribbean Ever smoked Current smoker Indian Ever smoked Current smoker Pakistani Ever smoked Current smoker Bangladeshi Ever smoked Current smoker Chinese Ever smoked Current smoker Irish Ever smoked Current smoker 1999 Black Caribbean Ever smoked Current smoker Indian Ever smoked Current smoker Pakistani Ever smoked Current smoker Bangladeshi Ever smoked Current smoker Chinese Ever smoked Current smoker Irish Ever smoked Current smoker

2004, 1999 Age group

Boys

Girls

8-10

11-15

All boys

8-10

11-15

All girls

%

%

%

%

%

%

[10] [-]

20 3

16 2

[-] [-]

26 9

17 6

-

3 -

1 -

b b

9 -

7 -

[3] [-]

15 5

11 3

[3] [-]

6 3

5 2

[-] [-]

16 4

10 3

[-] [-]

[8] [-]

5 -

b b

[8] [-]

6 -

b b

b b

[2] [-]

[1] [-]

24 9

13 5

b b

33 12

23 8

9 1

31 4

21 2

5 0

34 7

21 4

[1] [0]

15 5

10 3

[0] [0]

12 0

7 0

2 0

16 1

10 1

0 0

8 1

5 0

0 0

13 1

8 0

[0] [0]

1 0

1 0

b b

7 [4]

6 3

b b

[4] [0]

3 0

15 0

31 9

25 6

2 0

46 7

30 4

a Black Africans were included in the 2004 survey but not in the 1999 survey, so

therefore are excluded from this comparative table. b Results are not shown because of small bases.

Continued …

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

425

Table 12.23 continued

Aged 8-15

2004, 1999 Age group

Bases (weighted) 2004 Black Caribbean Indian Pakistani Bangladeshi Chinese Irish 1999 Black Caribbean Indian Pakistani Bangladeshi Chinese Irish Bases (unweighted) 2004 Black Caribbean Indian Pakistani Bangladeshi Chinese Irish 1999 Black Caribbean Indian Pakistani Bangladeshi Chinese Irish

426

Girls

8-10

11-15

All boys

8-10

11-15

All girls

44 78 53 18 6 176

72 89 89 28 19 215

117 168 142 46 24 391

40 49 47 17 9 111

72 98 73 24 12 261

111 147 120 41 21 372

49 48 36 15 8 172

65 96 53 28 15 278

114 144 89 43 23 450

54 44 40 13 6 165

65 72 80 28 17 281

119 116 119 41 23 445

34 50 48 36 12 36

57 59 73 60 45 57

91 109 121 96 57 93

34 28 41 31 18 21

55 58 62 45 28 68

89 86 103 76 46 89

70 45 58 51 26 52

89 93 87 110 50 84

159 138 145 161 76 136

72 48 62 46 17 54

98 60 128 98 49 76

170 108 190 144 66 130

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

Copyright © 2006, The Information Centre. All rights reserved

Boys

Table 12.24 Children’s self-reported experience of drinking alcohol, by minority ethnic group and sex Aged 8-15 Experience of drinking alcohola

2004 Minority ethnic group Black Caribbean

General population (2001-2002)

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Boys Observed % Has had an alcoholic drink Has not had an alcoholic drink Risk ratios Has had an alcoholic drink

38 62

24 76

13 87

1 99

1 99

29 71

43 57

45 55

0.87

0.53

0.29

0.02

0.02

0.66

0.97

1

Standard error of the ratio

0.15

0.15

0.07

0.02

0.02

0.17

0.17

Girls Observed % Has had an alcoholic drink Has not had an alcoholic drink Risk ratios Has had an alcoholic drink

35 65

23 77

17 83

4 96

3 97

[21] [79]

54 46

40 60

0.89

0.58

0.44

0.09

0.07

[0.53]

1.37

1

Standard error of the ratio

0.15

0.15

0.16

0.05

0.05

[0.15]

0.19

121 112

72 83

172 152

146 121

46 41

24 21

393 378

3327 3313

94 90

68 78

112 87

124 103

97 76

57 46

93 92

2910 2883

Bases (weighted) Boys Girls Bases (unweighted) Boys Girls

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a Includes children who say that they have not had an alcoholic drink but that they have drunk alcopops.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

427

Table 12.25 Children’s self-reported experience of drinking alcohol, by age within minority ethnic group and sex Aged 8-15 Ever drunk alcoholb

2004 Age group

Boys

Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2001-2002) Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2001-2002) Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2001-2002)

Girls

8-10

11-15

All boys

8-10

11-15

All girls

%

%

%

%

%

%

[10] [11] 1 [-] [-] a [25] 18

55 [34] 23 1 2 [35] 58 60

38 24 13 1 1 29 43 45

[5] a a [6] [7] a a 13

52 35 20 2 [-] a 75 56

35 23 17 4 3 [21] 54 40

44 32 80 53 18 6 177 1227

76 41 92 93 28 19 215 2072

121 72 172 146 46 24 393 3298

40 29 54 48 17 9 117 1234

72 55 98 73 24 12 261 2047

112 83 152 121 41 21 378 3282

34 30 51 48 37 12 36 1051

60 38 61 76 60 45 57 1836

94 68 112 124 97 57 93 2887

35 26 29 41 30 18 24 1041

55 52 58 62 46 28 68 1818

90 78 87 103 76 46 92 2859

428

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

Copyright © 2006, The Information Centre. All rights reserved

a Results are not shown because of small bases. b Includes children who say that they have not had an alcoholic drink but that they have drunk alcopops.

Table 12.26 Children’s self-reported experience of drinking alcohol in 2004 and 1999, by age within minority ethnic groupa and sex Aged 8-15 Ever drunk alcoholb

2004, 1999 Age group

Boys

Girls

8-10

11-15

All boys

8-10

11-15

All girls

%

%

%

%

%

%

[10] 1 [-] [-] b [25]

55 23 1 2 [35] 58

38 13 1 1 29 43

[5] a [6] [7] b b

52 20 2 [-] b 75

35 17 4 3 [21] 54

22 [6] b 20

51 18 1 2 25 49

39 14 1 1 19 38

9 [1] 2 [3] 6 9

42 14 2 1 [17] 58

27 9 2 1 14 40

44 80 53 18 6 177

76 92 93 28 19 215

121 172 146 46 24 393

40 54 48 17 9 117

72 98 73 24 12 261

112 152 121 41 21 378

49 47 37 15 8 172

64 96 53 28 15 278

112 143 89 42 23 450

54 44 39 13 6 165

65 72 79 27 17 281

119 116 118 41 23 445

34 51 48 37 12 36

60 61 76 60 45 57

94 112 124 97 57 93

35 29 41 30 18 24

55 58 62 46 28 68

90 87 103 76 46 92

69 44 59 51 26 52

88 93 86 108 50 84

157 137 145 159 76 136

72 48 61 45 17 54

98 60 128 97 49 76

170 108 189 142 66 130

2004c

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Black Caribbean Indian Pakistani Bangladeshi Chinese Irish 1999d Black Caribbean Indian Pakistani Bangladeshi Chinese Irish Bases (weighted) 2004 Black Caribbean Indian Pakistani Bangladeshi Chinese Irish 1999 Black Caribbean Indian Pakistani Bangladeshi Chinese Irish Bases (unweighted) 2004 Black Caribbean Indian Pakistani Bangladeshi Chinese Irish 1999 Black Caribbean Indian Pakistani Bangladeshi Chinese Irish

a Black Africans were included in the 2004 survey but not in the

1999 survey, so therefore are excluded from this comparative table. b Results are not shown because of small bases. c Includes children who say that they have not had an alcoholic

drink but that they have drunk alcopops. d 1999 figures differ from previously published figures since they

include children who say that they have not had an alcoholic drink but that they have drunk alcopops.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

429

Table 12.27 Children’s systolic blood pressure (SBP), by minority ethnic group and sex Aged 5-15 with valid BP and height measurements Systolic blood pressure (mmHg)

2004

Minority ethnic group

General population (2001a Irish 2002)

Black Caribbean

Black African

Indian

108.9

[109.6]

109.2

112.2

[109.6]

[105.2]

108.4

1.86

[1.48]

1.30

1.15

[1.83]

[2.15]

1.64

0.21

124.8

[123.5]

121.7

123.5

[129.6]

[122.2]

121.5

122.0

-1.24

[1.54]

-0.11

1.29

[2.23]

[-2.58]

-0.79

0

1.64

[1.50]

1.40

1.04

[1.80]

[1.85]

1.63

110.7

[108.1]

107.8

106.2

[102.9]

[106.0]

105.8

1.97

[1.49]

1.29

1.75

[2.71]

[1.61]

1.19

0.21

128.7

[120.5]

120.0

122.3

[118.9]

[123.9]

115.0

120.13

2.45

[1.12]

0.60

-0.04

[-2.92]

[-0.64]

-0.81

0

1.75

[1.62]

1.23

1.56

[3.23]

[1.59]

1.12

83 63

59 52

97 85

70 85

18 22

13 13

181 189

3347 3366

58 50

45 37

75 64

66 77

30 32

34 32

56 63

2911 2915

Pakistani Bangladeshi

Chinese

Boys Observed Mean SBP Standard error of the mean

90th percentile Age and height standardised Regression coefficientb Standard error of the coefficient

108.7

Girls Observed Mean SBP Standard error of the mean

90th percentile Age and height standardised Regression coefficientb Standard error of the coefficient

Bases (weighted) Boys Girls Bases (unweighted) Boys Girls

106.7

a Measurements in 2001 and 2002 were made using a Dinamap 8100 monitor. In this table they have been converted to their Omron equivalents (see Section

12.7.1 for further information). b Equivalent to an absolute difference in mean SBP standardised for age and height, compared with the general population. The reference value for the

430

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

Copyright © 2006, The Information Centre. All rights reserved

general population is consequently 0.

Table 12.28 Children’s diastolic blood pressure (DBP), by minority ethnic group and sex Aged 5-15 with valid BP and height measurements Diastolic blood pressure (mmHg)

2004

Minority ethnic group

General population (2001a Irish 2002)

Black Caribbean

Black African

Indian

Observed Mean DBP

62.2

[63.1]

64.9

64.9

[65.9]

[62.1]

61.3

Standard error of the mean

1.57

[1.94]

1.01

1.18

[1.84]

[1.90]

1.28

0.19

90th percentile Age and height standardised Regression coefficientb

77.5

[84.0]

76.5

75.3

[79.1]

[77.1]

73.0

73.3

0.63

[1.63]

3.42

3.38

[4.42]

[0.65]

-0.18

0

Standard error of the coefficient

1.57

[1.95]

1.03

1.20

[1.85]

[1.91]

1.30

Observed Mean DBP

64.3

[68.2]

65.2

65.1

[65.1]

[64.4]

62.7

Standard error of the mean

1.60

[1.82]

1.29

1.29

[1.54]

[1.28]

0.91

0.20

90th percentile Age and height standardised Regression coefficientb

80.0

[80.0]

78.4

78.0

[78.8]

[76.1]

71.0

76.0

0.71

[4.74]

1.71

1.73

[1.82]

[0.99]

-0.69

0

Standard error of the coefficient

1.61

[1.84]

1.32

1.29

[1.57]

[1.30]

0.96

83 63

59 52

97 85

70 85

18 22

13 13

181 189

3347 3366

58 50

45 37

75 64

66 77

30 32

34 32

56 63

2911 2915

Pakistani Bangladeshi

Chinese

Boys 61.5

Girls

Bases (weighted) Boys Girls Bases (unweighted) Boys Girls

63.5

a Measurements in 2001 and 2002 were made using a Dinamap 8100 monitor. In this table they have been converted to their Omron equivalents (see Section

12.7.1 for further information). b Equivalent to an absolute difference in mean SBP standardised for age and height, compared with the general population. The reference value for the

Copyright © 2006, The Information Centre. All rights reserved

general population is consequently 0.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

431

Table 12.29 Children’s height, by minority ethnic group and sex Aged 2-15 with a valid height measurement Height (cm)

2004

Minority ethnic group

General population (2001-2002)

Black Caribbean

Black African

Indian

140.6

128.7

131.8

132.9

2.12

2.01

1.93

2.06

Pakistani Bangladeshi

Chinese

Irish

131.5

136.0

132.2

134.7

1.67

2.64

2.70

0.33

0

Boys Observed Mean Standard error of the mean

Age adjusted Regression coefficient Standard error of the coefficient

3.9

0.1

-0.5

0.1

-1.2

-1.7

-1.0

0.70

0.91

0.58

0.61

0.72

0.75

0.82

134.0

131.8

132.7

128.4

127.5

128.7

132.7

133.0

2.40

2.43

2.28

1.71

1.88

2.72

2.70

0.31

0

Observed Mean Standard error of the mean

Age adjusted Regression coefficient Standard error of the coefficient

Bases (weighted) Boys Girls Bases (unweighted) Boys Girls

432

1.8

3.8

-0.3

-1.1

-2.1

-1.1

0.9

0.85

0.92

0.63

0.71

0.93

0.75

0.62

199 181

181 172

292 256

257 239

87 85

40 41

701 694

5556 5510

156 146

167 150

179 149

214 202

186 168

93 85

168 168

4838 4786

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

Copyright © 2006, The Information Centre. All rights reserved

Girls

Table 12.30 Children’s weight, by minority ethnic group and sex Aged 2-15 with a valid weight measurement Weight (kg)

2004

Minority ethnic group

General population (2001-2002)

Black Caribbean

Black African

Indian

Observed Mean

39.6

33.0

32.2

35.5

Standard error of the mean

1.84

1.43

1.29

1.51

Pakistani Bangladeshi

Chinese

Irish

32.9

36.0

33.9

35.0

1.08

1.93

1.81

0.23

0

Boys

Age adjusted Regression coefficient

3.7

2.0

-1.1

1.6

-0.7

-1.1

-0.2

1.02

0.94

0.70

0.81

0.90

1.04

0.88

Observed Mean

38.9

35.2

35.5

31.7

30.9

32.2

35.8

34.9

Standard error of the mean

2.08

1.68

1.79

1.31

1.29

1.72

2.23

0.23

0

Standard error of the coefficient

Girls

Age adjusted Regression coefficient Standard error of the coefficient

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Bases (weighted) Boys Girls Bases (unweighted) Boys Girls

3.9

4.0

0.4

-1.2

-1.3

-1.2

1.1

1.11

0.91

0.92

0.76

0.90

0.75

0.88

196 178

180 176

294 260

260 242

87 88

40 41

705 681

5568 5511

150 143

168 158

180 151

217 206

185 175

91 85

164 164

4847 4785

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433

Table 12.31 Children’s body mass index (BMI) and the prevalence of overweight and obesity, by minority ethnic group and sex Aged 2-15 with valid height and weight measurements BMI (kg/m2) and BMI

2004

Minority ethnic group

General population (2001-2002)

status Black Caribbean

Black African

Indian

Observed % Mean

19.3

19.0

17.7

18.8

Standard error of the mean

0.39

0.47

0.27

0.37

Median % overweighta,b % obesea,b % overweight including obese Risk ratios Obese

18.4 11 28 39

17.8 11 31 42

16.9 12 14 26

17.6 14 25 39

1.7

1.9

0.8

1.5

1.3

Standard error of the ratio

0.29

0.31

0.19

0.24

0.23

Pakistani Bangladeshi

Chinese

Irish

18.2

18.4

18.3

0.31

0.41

0.38

0.05

17.5 12 22 34

17.5 8 14 22

17.2 10 22 32

17.4 14 16 30

0.8

1.4

1

0.24

0.27

Boys 18.3

Overweight and obese

1.3

1.4

0.8

1.3

1.1

0.7

1.1

Standard error of the ratio

0.17

0.17

0.12

0.14

0.12

0.15

0.18

1

Observed % Mean

20.0

19.6

18.9

18.1

18.5

18.2

18.9

Standard error of the mean

0.52

0.42

0.47

0.34

0.35

0.34

0.47

0.05

Median % overweighta,b % obesea,b % overweight including obese Risk ratios Obese

18.6 15 27 42

18.6 13 27 40

17.7 11 21 31

16.9 10 15 25

17.6 14 20 33

17.8 22 12 34

17.9 16 16 32

17.6 15 16 31

1.7

1.7

1.3

0.9

1.2

0.8

1.0

1

Standard error of the ratio

0.31

0.30

0.21

0.18

0.23

0.29

0.26

Girls 18.7

Overweight and obese

1.4

1.3

1.0

0.8

1.1

1.1

1.0

Standard error of the ratio

0.16

0.15

0.15

0.11

0.18

0.19

0.19

190 173

173 168

285 256

255 239

85 84

39 41

694 681

5442 5381

147 139

161 147

176 149

213 202

182 165

90 85

162 163

4740 4672

Bases (weighted) Boys Girls Bases (unweighted) Boys Girls

1

a Overweight and obesity were defined using national BMI percentiles, adjusted for age. Overweight was defined as >=85th<95th BMI percentile; obese was

defined as >=95th BMI percentile.

434

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

Copyright © 2006, The Information Centre. All rights reserved

b Categories are independent, i.e. overweight does not include those who are obese.

Table 12.32 Children’s body mass index (BMI) and the prevalence of overweight and obesity among children, by age within minority ethnic group and sex Aged 2-15 with valid height and weight measurements BMI (kg/m2) and BMI status

2004

Age group

Boys 2-10

11-15

Black Caribbean Mean

17.8

21.7

19.3

18.2

23.0

20.0

Standard error of the mean

0.42

0.53

0.39

0.47

0.94

2-10

11-15

All girls

0.52

% overweightb,c % obeseb,c % overweight including obese Black African Mean

6 27 33

19 29 48

11 28 39

11 21 32

22 37 59

15 27 42

18.4

[20.8 ]

19.0

18.6

[21.9]

19.6

Standard error of the mean

0.56

[0.73]

0.47

0.46

[0.78]

0.42

% overweightb,c % obeseb,c % overweight including obese Indian Mean

14 32 46

[4] [27] [31]

11 31 42

15 28 43

[9] [24] [33]

13 27 40

16.9

19.4

17.7

17.1

21.7

18.9

Standard error of the mean

0.22

0.56

0.27

0.45

0.69

0.47

Overweightb,c Obeseb,c Overweight including obese Pakistani Mean

13 13 26

9 16 26

12 14 26

13 16 29

7 28 35

11 21 31

17.5

21. 1

18.8

16.6

21.3

18.1

Standard error of the mean

0.37

0.57

0.37

0.22

0.62

0.34

% overweightb,c % obeseb,c % overweight including obese Bangladeshi Mean

14 21 36

14 31 45

14 25 39

10 11 21

11 22 33

10 15 25

17.1

20.4

18.2

17.6

[21.1]

18.5

Standard error of the mean

0.32

0.76

0.31

0.37

[0.69]

0.35

9 24 33

18 19 37

12 22 34

11 21 33

[20] [15] [35]

14 20 33

[17.0]

[19.8]

18.4

17.0

a

18.2

[0.28]

[0.73]

0.41

0.31

a

0.34

Overweightb,c Obeseb,c Overweight including obese Chinese Mean Standard error of the mean

Copyright © 2006, The Information Centre. All rights reserved

Girls All boys

% overweightb,c % obeseb,c % overweight including obese Irish Mean

[4] [15] [19]

[12] [13] [25]

8 14 22

21 13 34

a a a

22 12 34

17.2

20.8

18.3

17.1

21.8

18.9

Standard error of the mean

0.37

0.63

0.38

0.25

0.77

0.47

% overweightb,c % obeseb,c % overweight including obese General population (2001-2002) Mean

9 20 29

12 28 40

10 22 32

12 13 25

21 21 43

16 16 32

17.1

20.3

18.3

17.3

21.2

18.7

Standard error of the mean

0.05

0.09

0.05

0.05

0.11

0.06

14 15 29

14 19 34

14 16 31

13 15 28

16 19 35

14 16 31

% overweightb,c % obeseb,c % overweight including obese

a Results are not shown because of small bases. b Overweight and obesity were defined using national BMI percentiles, adjusted for age. Overweight

was defined as >=85th<95th BMI percentile; obese was defined as >=95th BMI percentile. c Categories are independent, i.e. overweight does not include those who are obese.

Continued …

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

435

Table 12.32 continued

Aged 2-15 with valid height and weight measurements

2004

Age group

Boys

Bases (weighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2001-2002) Bases (unweighted) Black Caribbean Black African Indian Pakistani Bangladeshi Chinese Irish General population (2001-2002)

Girls

2-10

11-15

All boys

2-10

11-15

All girls

118 128 200 163 57 20 475 3427

72 45 85 93 28 19 219 2015

190 173 285 255 85 39 694 5442

109 117 155 165 62 27 423 3413

63 51 101 74 22 13 258 1967

173 168 256 239 84 41 681 5381

93 117 119 139 123 45 106 2949

54 44 57 74 59 45 56 1791

147 161 176 213 182 90 162 4740

89 100 90 141 125 56 97 2928

50 47 59 61 40 29 66 1744

139 147 149 202 165 85 163 4672

a Results are not shown because of small bases. b Overweight and obesity were defined using national BMI percentiles, adjusted for age. Overweight

was defined as >=85th<95th BMI percentile; obese was defined as >=95th BMI percentile.

436

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

Copyright © 2006, The Information Centre. All rights reserved

c Categories are independent, i.e. overweight does not include those who are obese.

Table 12.33 Comparison of children’s body mass index (BMI) and the prevalence of overweight and obesity in 2004 and 1999, by minority ethnic groupa and sex Aged 2-15 with valid height and weight measurements BMI (kg/m2) and BMI status

2004, 1999

Minority ethnic group Black Caribbean

Indian

2004 Mean

19.3

17.7

18.8

Standard error of the mean

0.39

0.27

0.37

Pakistani Bangladeshi

Chinese

Irish

18.2

18.4

18.3

0.31

0.41

0.38

Boys

% overweightb,c % obeseb,c % overweight including obese 1999 Mean

11 28 39

12 14 26

14 25 39

12 22 34

8 14 22

10 22 32

18.2

18.4

17.8

17.1

17.8

17.9

Standard error of the mean

0.21

0.28

0.19

0.18

0.27

0.19

14 16 30

11 21 32

14 19 33

11 12 24

5 13 18

13 15 28

2004 Mean

20.0

18.9

18.1

18.5

18.2

18.9

Standard error of the mean

0.52

0.47

0.34

0.35

0.34

0.47

% overweightb,c % obeseb,c % overweight including obese

Girls

% overweightb,c % obeseb,c % overweight including obese 1999 Mean

15 27 42

11 21 31

10 15 25

14 20 33

22 12 34

16 16 32

19.1

18.1

18.4

17.8

17.7

18.2

Standard error of the mean

0.29

0.24

0.23

0.23

0.27

0.22

13 21 34

10 16 25

11 18 29

9 13 22

11 7 19

16 14 30

190 173 173 194

285 226 256 192

255 204 239 210

85 77 84 68

39 39 41 38

694 719 681 805

147 247 139 275

176 221 149 183

213 327 202 333

182 286 165 244

90 124 85 115

162 230 163 235

% overweightb,c % obeseb,c % overweight including obese Bases (weighted) Boys 2004 Boys 1999 Girls 2004 Girls1999 Bases (unweighted) Boys 2004 Boys 1999 Girls 2004 Girls 1999

a Black Africans were included in the 2004 survey but not in the 1999 survey, so therefore are excluded from this

comparative table. Copyright © 2006, The Information Centre. All rights reserved

b Overweight and obesity were defined using national BMI percentiles, adjusted for age. Overweight was defined as

>=85th<95th BMI percentile; obese was defined as >=95th BMI percentile. c Categories are independent, i.e. overweight does not include those who are obese.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

437

Table 12.34 Summary of children’s participation in different activities in the last week, by minority ethnic group and sex Aged 2-15 Summary of participationa in different activities in the last week

2004 Minority ethnic group

General population (2002)b

Black Caribbean

Black African

Indian

Sports and exercise % who participated Risk ratios

71 1.21

54 0.93

60 1.02

48 0.82

Standard error of the ratio

0.07

0.07

0.08

Mean number of days

2.7

2.1

2.5

0.23

0.21

0.23

Pakistani Bangladeshi

Chinese

Irish

49 0.84

63 1.07

68 1.16

0.08

0.07

0.10

0.08

2.0

2.1

1.7

2.3

1.9

0.25

0.28

0.23

0.24

0.03

Boys

Mean number of hours

3.2

2.4

2.4

2.5

1.7

1.8

2.5

2.4

Standard error of the mean

0.34

0.39

0.24

0.42

0.24

0.37

0.26

0.06

Active play % who participated Risk ratios

86 0.93

88 0.95

83 0.90

88 0.96

82 0.88

77 0.83

91 0.99

93 1

Standard error of the ratio

0.04

0.04

0.04

0.03

0.05

0.05

0.03

Mean number of days

4.8

4.7

4.6

5.0

4.7

3.1

5.0

5.2

0.25

0.26

0.24

0.23

0.36

0.30

0.27

0.04

Standard error of the mean

Mean number of hours

5.7

5.3

4.4

6.2

4.1

3.4

7.0

7.8

Standard error of the mean

0.56

0.48

0.42

0.66

0.45

0.52

0.84

0.11

Walkingc % who participated Risk ratios

89 1.01

88 1.00

92 1.04

86 0.97

92 1.03

88 0.99

94 1.06

89 1

Standard error of the ratio

0.03

0.03

0.03

0.03

0.02

0.05

0.02

Mean number of days

5.1

4.9

4.6

4.9

5.4

4.3

4.6

4.5

0.20

0.25

0.19

0.19

0.19

0.34

0.27

0.04

Standard error of the mean

Mean number of hours

3.2

3.0

2.4

2.8

3.5

2.7

3.1

3.5

Standard error of the mean

0.31

0.40

0.20

0.32

0.36

0.58

0.36

0.08

Housework and gardeningd,e % who participated Risk ratios

28 0.92

27 0.91

37 1.23

30 1.00

23 0.78

24 0.79

33 1.11

30 1

Standard error of the ratio

0.16

0.19

0.17

0.17

0.15

0.19

0.23

Mean number of days

0.8

0.7

0.9

0.7

0.6

0.4

0.7

0.6

0.19

0.17

0.15

0.16

0.15

0.12

0.20

0.02

Standard error of the mean

Mean number of hours

0.6

0.7

0.5

0.5

0.3

0.2

0.5

0.5

Standard error of the mean

0.29

0.26

0.10

0.14

0.10

0.05

0.19

0.01

Any physical activity % who participated Risk ratios

99 1.00

99 1.00

98 0.99

99 1.00

96 0.97

99 1.00

100 1.01

99 1

Standard error of the ratio

0.01

0.01

0.01

0.01

0.01

0.01

0.00

Mean number of days

6.6

6.5

6.5

6.6

6.4

6.1

6.8

6.6

Standard error of the mean

0.10

0.16

0.11

0.10

0.15

0.20

0.06

0.02

Mean number of hours

12.4

10.9

9.5

11.7

9.4

8.0

12.9

14.2

Standard error of the mean

0.82

0.87

0.61

1.01

0.81

1.01

0.86

0.16

a Informants who reported participation in physical activities but failed to provide valid information about frequency and duration were excluded. b Exercise questions were not asked in 2001, and the general population figures are based on 2002 only. c At least 5 minutes. d At least 15 minutes. e Questions about housework and gardening were not asked of children aged 2-7. f Bases for individual activities may vary.

438

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

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Standard error of the mean

59 1

Continued….

Table 12.34 continued

Aged 2-15

2004 Minority ethnic group Black Caribbean

Bases (weighted)f Boys (all activities except housework) Boys (housework/gardening) Bases (unweighted)f Boys (all activities except housework) Boys (housework/gardening)

General population (2002)b

Black African

Indian

272 156

227 97

340 190

311 173

223 131

211 95

209 123

269 146

Pakistani Bangladeshi

Chinese

Irish

113 61

47 29

802 438

4201 2440

242 128

109 67

194 105

3629 2113

a Informants who reported participation in physical activities but failed to provide valid information about frequency and duration were excluded. b Exercise questions were not asked in 2001, and the general population figures are based on 2002 only. c At least 5 minutes. d At least 15 minutes.

Copyright © 2006, The Information Centre. All rights reserved

e Questions about housework and gardening were not asked of children aged 2-7. f Bases for individual activities may vary.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

Continued….

439

Table 12.34 continued

Aged 2-15 Summary of participationa in different activities in the last week

2004 Minority ethnic group

General population (2002)b

Black Caribbean

Black African

Indian

Sports and exercise % who participated Risk ratios

48 0.86

51 0.91

46 0.82

23 0.41

Standard error of the ratio

0.08

0.09

0.09

Mean number of days

1.6

1.7

1.5

0.20

0.20

0.22

Pakistani Bangladeshi

Chinese

Irish

33 0.59

61 1.10

61 1.11

0.06

0.07

0.11

0.09

1.0

1.3

1.6

1.6

1.4

0.18

0.21

0.23

0.19

0.03

Girls

Mean number of hours

1.6

1.3

1.2

0.7

0.9

1.6

1.6

1.7

Standard error of the mean

0.29

0.20

0.20

0.20

0.16

0.26

0.20

0.05

Active play % who participated Risk ratios

78 0.90

79 0.91

75 0.86

79 0.92

74 0.86

85 0.98

88 1.02

87 1

Standard error of the ratio

0.05

0.04

0.05

0.05

0.06

0.05

0.04

Mean number of days

4.1

3.8

3.4

4.0

4.2

3.9

4.2

4.6

0.26

0.26

0.27

0.25

0.35

0.32

0.26

0.04

Standard error of the mean

Mean number of hours

5.0

3.5

3.3

3.6

3.1

3.4

4.7

6.4

Standard error of the mean

0.55

0.49

0.54

0.45

0.39

0.55

0.54

0.10

Walkingc % who participated Risk ratios

91 1.00

92 1.01

91 1.01

83 0.92

89 0.98

87 0.97

93 1.03

90 1

Standard error of ratio

0.03

0.03

0.03

0.04

0.03

0.04

0.03

4.6

4.9

4.4

4.4

5.2

4.1

4.4

4.6

0.22

0.21

0.20

0.21

0.22

0.32

0.26

0.04

Mean number of days Standard error of the mean

Mean number of hours

2.6

2.5

2.4

2.1

3.1

2.7

3.3

3.5

Standard error of the mean

0.29

0.28

0.35

0.23

0.27

0.48

0.39

0.07

Housework and gardeningd,e % who participated Risk ratios

46 1.23

39 1.05

58 1.58

44 1.17

38 1.02

24 0.64

53 1.43

37 1

Standard error of ratio

0.16

0.16

0.16

0.17

0.15

0.16

0.20

1.2

0.9

1.9

1.5

1.2

0.4

1.7

0.9

0.22

0.16

0.31

0.27

0.21

0.14

0.36

0.02

Mean number of days Standard error of the mean

Mean number of hours

0.6

0.6

1.1

1.1

1.1

0.2

1.1

0.6

Standard error of the mean

0.13

0.11

0.22

0.28

0.30

0.07

0.26

0.02

Any physical activity % who participated Risk ratios

97 0.98

97 0.98

95 0.96

98 0.99

94 0.95

100 1.01

98 0.99

99 1

Standard error of ratio

0.02

0.02

0.02

0.01

0.02

0.00

0.01

6.4

6.4

6.3

6.3

6.2

6.3

6.5

6.5

0.17

0.15

0.13

0.13

0.20

0.15

0.13

0.02

Mean number of days Standard error of the mean

Mean number of hours

9.5

7.5

7.5

6.9

7.5

7.8

10.2

12.2

Standard error of the mean

0.72

0.65

0.67

0.72

0.58

0.86

0.78

0.15

a Informants who reported participation in physical activities but failed to provide valid information about frequency and duration were excluded. b Exercise questions were not asked in 2001, and the general population figures are based on 2002 only. c At least 5 minutes. d At least 15 minutes. e Questions about housework and gardening were not asked of children aged 2-7. f Bases for individual activities may vary.

440

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

Copyright © 2006, The Information Centre. All rights reserved

Standard error of the mean

55 1

Continued….

Table 12.34 continued

Aged 2-15

2004 Minority ethnic group Black Caribbean

Bases (weighted)f Girls (all activities except housework) Girls (housework/gardening) Bases (unweighted)f Girls (all activities except housework) Girls (housework/gardening)

General population (2002)b

Black African

Indian

233 137

225 103

288 171

277 141

200 118

209 98

169 98

246 121

Pakistani Bangladeshi

Chinese

Irish

114 58

45 24

856 465

4058 2341

229 109

97 54

203 111

3504 2016

a Informants who reported participation in physical activities but failed to provide valid information about frequency and duration were excluded. b Exercise questions were not asked in 2001, and the general population figures are based on 2002 only. c At least 5 minutes. d At least 15 minutes.

Copyright © 2006, The Information Centre. All rights reserved

e Questions about housework and gardening were not asked of children aged 2-7. f Bases for individual activities may vary.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

441

Table 12.35 Summary of children’s activity levels, by minority ethnic group and sex Aged 2-15 Activity levels in the last weeka

2004 Minority ethnic group Black Caribbean

General population (2002)b

Black African

Indian

Pakistani Bangladeshi

Chinese

Irish

Boys Observed % High Medium Low No activity recorded in last week Risk ratios High level of physical activity

59 19 21 1

55 13 30 1

53 18 27 2

60 16 22 1

57 16 24 4

38 19 42 1

68 17 14 0

69 13 16 1

0.85

0.79

0.77

0.87

0.82

0.55

0.99

1

Standard error of the ratios

0.06

0.07

0.06

0.07

0.07

0.07

0.07

Girls Observed % High Medium Low No activity recorded in last week Risk ratios High level of physical activity

52 16 29 3

38 25 35 3

40 14 41 5

36 21 40 2

41 24 30 6

38 19 43 -

60 16 23 2

61 16 22 1

0.86

0.62

0.65

0.59

0.67

0.63

0.98

1

Standard error of the ratios

0.07

0.07

0.08

0.08

0.08

0.10

0.10

272 233

227 225

340 288

311 277

113 114

47 45

802 856

4186 4043

223 200

211 209

209 169

269 246

242 229

109 97

194 203

3618 3491

Bases (weighted) Boys Girls Bases (unweighted) Boys Girls

a Activity levels are defined as follows: high = active on all seven days for an average of 60+ minutes per day; medium = active on all seven days for an

average of 30-59 minutes per day; low = not active on all seven days or active for an average of less than 30 minutes per day.

442

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

Copyright © 2006, The Information Centre. All rights reserved

b Exercise questions were not asked in 2001, and the general population figures are based on 2002 only.

Table 12.36 Comparison of children’s activity levels in 2004 and 1999, by minority ethnic groupa and sex Aged 2-15

2004, 1999

Activity levels in the last two weeksb

Minority ethnic group Black Caribbean

Indian

Pakistani Bangladeshi

Chinese

Irish

Boys 2004 High Medium Low No activity recorded in last week 1999 High Medium Low No activity recorded in last week

59 19 21 1

53 18 27 2

60 16 22 1

57 16 24 4

38 19 42 1

68 17 14 0

72 12 13 3

61 14 23 2

55 19 20 6

46 19 33 2

50 21 26 2

67 15 15 4

52 16 29 3

40 14 41 5

36 21 40 2

41 24 30 6

38 19 43 -

60 16 23 2

52 19 27 1

42 23 31 4

42 23 31 3

24 28 44 4

31 26 42 2

63 16 19 2

272 207 233 217

340 275 288 209

311 243 277 245

113 106 114 98

47 43 45 42

802 852 856 894

223 300 200 312

209 268 209 203

269 397 269 393

242 385 242 358

109 138 109 126

194 270 194 265

Girls 2004 High Medium Low No activity recorded in last week 1999 High Medium Low No activity recorded in last week Bases (weighted) Boys 2004 Boys 1999 Girls 2004 Girls1999 Bases (unweighted) Boys 2004 Boys 1999 Girls 2004 Girls 1999

a Black Africans were included in the 2004 survey but not in the 1999 survey, so therefore are excluded from this

comparative table. b Activity levels are defined as follows: high = active on all seven days for an average of 60+ minutes per day; medium = active

Copyright © 2006, The Information Centre. All rights reserved

on all seven days for an average of 30-59 minutes per day; low = not active on all seven days or active for an average of less than 30 minutes per day.

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

443

Table 12.37 Children’s consumption of fruit and vegetables, by minority ethnic group and sex Aged 5-15 Fruit and vegetable consumption (portions per day)

2004 Minority ethnic group Black Caribbean

General population (2001-2002)

Black African

Indian

8 4 21 21 14 12 10 4 5 1 19 3.0

2 3 17 27 20 12 7 6 2 3 18 3.3

5 9 18 17 14 15 5 7 4 6 22 3.4

10 3 20 20 16 12 9 3 3 3 19 3.0

0.20

Pakistani Bangladeshi

Chinese

Irish

10 3 23 18 14 10 12 7 1 2 22 3.1

4 2 15 28 17 19 6 3 6 15 3.3

11 7 17 20 18 12 6 6 3 1 16 2.8

12 5 25 23 15 9 6 3 1 2 11 2.5

Boys Observed % None Less than 1 portion 1 portion or more but less than 2 2 portions or more but less than 3 3 portions or more but less than 4 4 portions or more but less than 5 5 portions or more but less than 6 6 portions or more but less than 7 7 portions or more but less than 8 8 or more portions 5 portions or more Mean Standard error of the mean

0.21

0.32

0.21

0.24

0.22

0.25

0.03

Median Risk ratios Eats 5 or more portions a day

2.7

2.9

3.0

2.7

2.7

2.9

2.3

2.0

1.68

1.54

1.96

1.62

1.88

1.28

1.38

1

Standard error of the ratio

0.35

0.35

0.39

0.31

0.37

0.34

0.39

9 2 25 15 19 11 11 5 1 2 19 2.9

7 3 19 22 17 12 10 2 6 2 20 3.2

6 8 17 22 16 14 6 6 2 4 18 3.1

2 3 28 19 20 13 8 2 4 3 16 3.0

9 2 16 14 18 20 10 6 3 3 21 3.3

1 4 13 21 21 14 10 7 5 3 24 3.6

7 4 15 29 16 17 5 0 5 2 12 2.9

8 5 25 22 18 10 5 3 1 2 12 2.6

0.19

Observed % None Less than 1 portion 1 portion or more but less than 2 2 portions or more but less than 3 3 portions or more but less than 4 4 portions or more but less than 5 5 portions or more but less than 6 6 portions or more but less than 7 7 portions or more but less than 8 8 or more portions 5 portions or more Mean Standard error of the mean

0.22

0.28

0.22

0.26

0.27

0.20

0.03

Median Risk ratios Eats 5 or more portions a day

2.7

2.8

2.7

2.7

3.3

3.2

2.7

2.3

1.64

1.74

1.55

1.39

1.84

2.12

1.02

1

Standard error of the ratio

0.33

0.36

0.36

0.35

0.44

0.50

0.28

212 186

159 164

262 228

229 205

85 82

39 33

617 654

4905 4839

178 160

154 148

166 132

196 177

184 156

91 74

147 157

4260 4178

Bases (weighted) Boys Girls Bases (unweighted) Boys Girls

444

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

Copyright © 2006, The Information Centre. All rights reserved

Girls