health survey for 2004 - lemosandcrane.co.uk statistics - health... · 5 alcohol consumption...

Volume 1

The health ofminority 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

Health Survey for England

2004

National Centre for Social ResearchThe National Centre for Social Research is the largest independent social research institute inBritain, specialising in social survey and qualitative research for the development and evaluation ofpolicy. 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 computerassisted interviewing. NatCen has approximately 300 staff, a national panel of over 1,000interviewers and 200 nurses who work on health-related surveys.

Department of Epidemiology and Public Health at the Royal Free and University College Medical SchoolThe Department houses over 160 staff, in 13 main research groups, including: the Joint HealthSurveys Unit, part of the Health and Social Surveys Research Group; Cancer Research UK HealthBehaviour Unit (including Weight Concern); Central and Eastern Europe Research Group; DentalPublic Health; Healthcare Evaluation Group; Life Course Modelling Research Group (including theESRC Priority Network: Capability and Resilience Research); MRC National Survey of Health andDevelopment Unit; Psychobiology Group; Public Health Research Group; Social Epidemiology; andthe Whitehall II Group. The Department also includes a Medical Statistics Unit. Joint posts link theDepartment to the Departments of Statistical Science and Economics and The Wolfson Institute forBiomedical Research at UCL, whilst a great deal of collaborative research is conducted through theInternational Centre for Health and Society, housed within the Department. Its research programmeis concerned particularly with social factors in health and illness, including longitudinal studies ofcardiovascular 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.

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Health Survey for England 2004

Volume 1


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Volume 1


Edited byKerry Sproston and Jennifer Mindell

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 UnitNational Centre for Social Research

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

THE INFORMATION CENTRE

A survey carried out on behalf of The Information Centre

Health Survey for England

2004

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Published by The Information Centre

Summary booklet available from:

Onlinewww.ic.nhs.uk

Mail, Telephone & E-mailThe Information Centre1 Trevelyan Square, Boar Lane, Leeds LS1 6AETelephone orders/General enquiries: 0845 300 6016E-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 bereproduced 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.

First published 2006

Designed by Davenport Associates

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Foreword 9

Editors’ acknowledgements 10

Notes 11

1 Introduction 13

1.1 The Health Survey for England 13

1.2 The 2004 Health Survey for England 14

1.3 Ethical clearance 14

1.4 This report 15

1.5 2004 survey design 15

1.6 Data analysis 19

1.7 Content of this report 23

2 Self-reported health and psychosocial wellbeing Lucy Natarajan 25

2.1 Introduction 26

2.2 Self-reported general health 26

2.3 Self-reported longstanding illness and limiting longstanding illness 27

2.4 Self-reported acute sickness 29

2.5 Self-reported psychosocial health 30

2.6 Prescribed medications 33

Tables 34

3 Cardiovascular disease and diabetes Jennifer Mindell & Paola Zaninotto 63

3.1 Cardiovascular disease 65

3.2 Diabetes 71

Tables 77

4 Use of tobacco products Heather Wardle 95

4.1 Introduction 97

4.2 Cigarette smoking 98

4.3 Number of cigarettes smoked 100

4.4 Self-reported use of chewing tobacco and other tobacco products 101

4.5 Cotinine 102

4.6 Prevalence and cotinine-adjusted prevalence of use of tobacco products 103

Tables 105

Contents

Volume 1: The health of minority ethnic groups

5 Alcohol consumption Elizabeth Becker, Amy Hills & Bob Erens 131

5.1 Introduction 132

5.2 Measures 132

5.3 Usual drinking frequency 133

5.4 Frequency of drinking in the past week 134

5.5 Amount consumed on the heaviest drinking day in the past week 136

Tables 140

6 Anthropometric measures, overweight and obesity Vasant Hirani & Emmanuel Stamatakis 163


6.2 Anthropometric measures by minority ethnic groups 167

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

6.4 Comparisons between 1999 and 2004 174

Tables 177

7 Blood pressure Moushumi Chaudhury & Paola Zaninotto 205


7.2 Methods and definitions 206

7.3 Response rates 207

7.4 Blood pressure measurements 208

7.5 Hypertension 210

7.6 Urinary sodium and potassium and their relationship with blood pressure 212

7.7 Blood pressure levels by equivalised household income 212

7.8 Comparison of systolic and diastolic blood pressure in 2004 and 1999 213

7.9 Comparison of prevalence of hypertension (140/90 mmHg) in 2004 and 1999 213

Tables 215

8 Physical Activity Emmanuel Stamatakis 237


8.2 Methods 238

8.3 Participation in different types of physical activity, and summary activity levels 239

8.4 Physical activity comparisons between 1999 and 2004 245

Tables 248

9 Eating habits Rachel Craig, Melanie Doyle and Dhriti Jotangia 263


9.2 Methodology 266

9.3 Fruit and vegetable consumption 267

9.4 Fat intake 271

9.5 Use of salt in cooking and at the table 272

Tables 276

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10 Blood analytes Emanuela Falaschetti & Moushumi Chaudhury 301


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 303

10.4 C-reactive protein 306

10.5 Fibrinogen 306

10.6 Haemoglobin 307

10.7 Ferritin 308

10.8 Glycated haemoglobin 309

10.9 Fasting blood samples 309

10.10 LDL-cholesterol 310

10.11 Triglycerides 311

10.12 Glucose 312

Tables 315

11 Complementary and alternative medicines and therapies (CAM) Richard Boreham 345

11.1 Introduction and measures 346

11.2 Ever used CAM 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 Elizabeth Fuller 377


12.2 General health 380

12.3 Psychosocial health 382

12.4 Respiratory symptoms and lung function 383

12.5 Cigarette smoking 386

12.6 Drinking alcohol 387

12.7 Blood pressure 389

12.8 Anthropometric measures 390

12.9 Physical activity 393

12.10 Fruit and vegetable consumption 396

Tables 400

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HSE 2004 | VOL 1: THE HEALTH OF MINORITY ETHNIC GROUPS 9

This report presents the findings of the fourteenth annual survey of health in England. I ampleased to present this important research which has been undertaken on behalf of TheInformation Centre for health and social care.

The Health Survey for England is conducted annually and collects information about arepresentative sample of the general population. It is vital to our understanding of the healthsituation and behaviours of the public in England and helps to ensure that policies areinformed 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, suchas blood pressure measurements, and analyses of blood samples. Thus we can study theinter-relationship of the characteristics and circumstances of adults and their children, withtheir health situation. It is an important source of information on health equity, and thesurvey from 2004 is especially valuable in this regard since there is a focus on the health ofethnic minorities (Black Caribbean, Black African, Pakistani, Indian, Bangladeshi, Chineseand 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 theInformation 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 forceis especially noteworthy. May I also thank the anonymous respondents across England whogave up their time to take part in the survey and who were willing to submit to various healthtests. Without their help we would lose a public tool of enormous potential to benefit andprotect the health of every one of us.

Professor Denise Lievesley

Chief Executive

The Information Centre for health and social care

Foreword

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

Editors’ acknowledgements

We wish to thank, first of all, all those who gave up their time to be interviewed and whowelcomed interviewers and nurses into their homes. We would also like to acknowledge thedebt the survey’s success owes to the commitment and professionalism of the interviewersand 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. Inparticular we would like to thank:

● The authors of all the chapters: Elizabeth Becker, Richard Boreham, MoushoumiChaudhury, Rachel Craig, Claire Deverill, Melanie Doyle, Bob Erens, EmanuelaFalaschetti, 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 inputting this report together.

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

● Operations staff, especially Lesley Mullender, Sue Roche and the Area Managers atNatCen 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 ClinicalBiochemistry at the Royal Victoria Infirmary in Newcastle upon Tyne for their helpfulnessand efficiency.

Last, but certainly not least, we wish to express our appreciation of the work of the Healthand Social Care Information Centre staff at all stages of the project, and in particular thecontribution made by Patrick Tucker and Richard Bond.

Kerry Sproston and Jennifer Mindell

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HSE 2004 | VOL 1: THE HEALTH OF MINORITY ETHNIC GROUPS 11

1. The data used in the report have been weighted. The weighting is described in Chapter7, in Volume 2 of this report. Both unweighted and weighted sample sizes are shown atthe foot of each table. The weighted numbers reflect the relative size of each group inthe population, not numbers of interviews made, which are shown by the unweightedbases.

2. Three different non-response weights have been used: one for non-response at theinterview stage, one for non-response to the nurse visit, and one for non-response tothe 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 ormore 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 inthe table.

6. Values for means, medians, percentiles and standard errors are shown to anappropriate number of decimal places. Standard Error may sometimes be abbreviatedto SE for space reasons.

7. ‘Missing values’ occur for several reasons, including refusal or inability to answer aparticular question; refusal to co-operate in an entire section of the survey (such as thenurse visit or a self-completion questionnaire); and cases where the question is notapplicable to the informant. In general, missing values have been omitted from all tablesand analyses.

8. All minority ethnic date related to 2004 (except for comparisons with results from HSE1999 which also focused on the health of minority ethnic groups). General populationdata normally related to 2004, but because the general population sample in 2004 didnot have a nurse visit, comparative data about the general population have, in somecases, been taken from the previous year (2003). Where this has been the case, it isindicated.

9. Some tables and charts who data in the form of risk ratios, or ratios of means. In allchapters, 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 isnormally from 0.1 to 10.0 (the general population being set at 1.0). The lower and upper95% confidence limits are also plotted, as a vertical line with markers at the lower andupper 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 notintended to imply substantive importance.

Notes

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HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 1: INTRODUCTION 13

Introduction 11.1 The Health Survey for England

This is the fourteenth annual survey of health in England. Each survey has covered adultsaged 16 and over living in private households in England. Since 1995, the surveys haveincluded children aged two to 15, and since 2001, infants under two years old, who live inhouseholds selected for the survey. Results for adults and children from previous surveysare 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 ethnicgroups in England. Additional households were included in the survey to increase thenumber of Black Caribbean, Indian, Pakistani, Bangladeshi, Chinese and Irishparticipants, as in 1999. For 2004, the representation of Black African informants was alsoincreased. This report compares results for each of these groups with the generalpopulation in England.

The Health Survey for England (HSE) is part of a programme of surveys commissioned bythe Department of Health, and provides regular information that cannot be obtained fromother sources on a range of aspects concerning the public’s health, and many of thefactors that affect health. Since April 2005 this function has been taken over by the newHealth and Social Care Information Centre. More details about the Information Centre areavailable from its website (www.ic.nhs.uk). Results for adults and children from the generalpopulation 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 thenation’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 orethnicity) in their likelihood of having specified conditions or risk factors;

5. Assess the frequency with which particular combinations of risk factors are found, andin 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 NationalStudy 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 bloodpressure and anthropometric measurements and analysis of blood, saliva and urinesamples), as well as modules of questions on specific issues that vary from year to year. Inrecent years, the core sample has also been augmented by an additional boosted samplefrom a specific population subgroup, such as children, older people or, as this year, thosefrom the largest minority ethnic groups in England.

The Health Survey for England has been carried out since 1994 by the Joint Health SurveysUnit of the National Centre for Social Research (NatCen) and the Department ofEpidemiology 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 arewell established, less is known about why they occur and the extent to which ethnicity isrelated 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 carebetween different groups. This is the second health survey in the series to consider thehealth of minority ethnic groups in this country. It was designed to build on the informationobtained in the 1999 survey. A large-scale representative sample of adults and childrenfrom minority ethnic groups across England was interviewed; information obtained wascomplemented by objective physical measurements and analysis of blood, urine and salivasamples.

The general household sampling method does not yield sufficient numbers of householdsfrom minority ethnic groups to analyse their responses separately. Therefore, only half of theusual sample number of adults and children was selected in the usual way. This provided arepresentative sample of the whole population (including members of minority ethnicgroups who happened to be included in this general sample), with whom the specificminority 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 twochildren in each household were interviewed, and a nurse visit arranged for thoseparticipants in minority ethnic groups who consented.

The other part of the sample for the 2004 survey was a ‘boost’ sample designed to includeadditional interviews with members of the seven largest minority ethnic groups in England:Black Caribbean, Black African, Indian, Pakistani, Bangladeshi, Chinese and Irish. 41,436addresses 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 minorityethnic groups were eligible for inclusion: up to four adults and three children were includedfrom each eligible household in the boost sample, with a random selection of participants ifthere was more than this number in an eligible household.

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

1.3 Ethical clearance

Ethical approval for the 2004 survey was obtained from the London Multi-centre ResearchEthics Committee (MREC).

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1.4 This report

The 2004 Health Survey for England was designed primarily to provide information aboutthe seven largest minority ethnic groups in England. Comparisons are made between thesegroups and the results from the general population sample where these exist. Comparisonsfor information from the nurse visit are made with the results from the 2003 survey foradults, and the 2001/2002 survey for children, as there was no nurse visit for the generalpopulation sample in 2004.

When reading this report, it should be noted that the ‘general population’ refers to the wholepopulation 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 onwhom 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 anyage living in private households, plus a similar sample of the seven most populous minorityethnic groups in England. More detailed information about survey design is presented inVolume 2 of this report.

Those living in institutions were excluded from the survey: this should be considered wheninterpreting 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 Englishaverage, and more families in minority ethnic groups may care for elders within privatehouseholds. Thus excluding people living in institutions may affect assessment of theoverall health of minority ethnic groups to a lesser extent than that of the generalpopulation.

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 thathouseholds were sampled proportionately across the nine Government Office regions ofEngland. 312 wards were selected, and 21 addresses selected within each ward. Where anaddress was found to have multiple households, up to three households were included, andif there were more than three, a random selection was made.

Each individual within a selected household was eligible for inclusion. Where there weremore than two children, two were randomly selected for inclusion, to limit the burden on anyhousehold. A maximum limit of ten adults per household was also imposed, although therewere no cases where there were more than ten adults in a selected household.

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 theminority ethnic boost sample, 408 wards were selected after stratification into 13 groupsbased on 2001 Census estimates of the proportion of residents in the required minorityethnic 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 theremaining twelve, the number of addresses within each selected ward varied from 40 to 115depending on the density of minority ethnic groups recorded in Census estimates. Sampledaddresses were visited to ascertain whether they contained residents from any of the sevenspecified minority ethnic groups. In order to control achieved sample sizes, not all those

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identified as being Black Caribbean or Indian were included in some sample groups, and inone group only Irish informants were included (see table below).

A different procedure, focused enumeration, was followed in 40 of the selected wards withthe lowest density of people from Black and Asian backgrounds (at least 2% but less than10% of the total resident population). In each of these wards, 80 ‘seed’ addresses wereselected, and as well as establishing eligibility at these addresses, interviewers asked aboutpeople from minority ethnic backgrounds at the two addresses on either side of the address(‘adjacent addresses’). This technique is only appropriate for identifying ‘visible’ minorityethnic groups, and therefore was not used to identify people of Irish origin. If thehouseholder at the seed address stated that there was no-one from one of the minorityethnic groups at any of the adjacent addresses, then they were screened out and theinterviewer made no attempt to make contact. Otherwise, the interviewer attempted tomake 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 Total Proportion of wards screened:wards addresses number of

selected per ward addresses Black Caribbean Indian Others

Stratum 1 70 45 3150 all half all


Stratum 3 60 40 2400 half all all

Stratum 4 31 115 3565 16/31 half all

Stratum 5 30 60 1800 half half all



Stratum 8 13 50 650 7/13 all all




Stratum 12 40 80+3201 16000 all all all2

Stratum 13 26 35 910 none none Irish only

Total 408 37535

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

Special Chinese boost sample

In addition, a special Chinese boost sample was used, which involved screening theElectoral Register for people with ‘Chinese sounding’ surnames. 75 wards, identified fromthe 2001 Census as containing 15 or more Chinese people, were selected. For eachselected ward, all households on the restricted Electoral Register (i.e. where people hadagreed to have their names included in the public listing of the register) with at least oneresident with a Chinese sounding surname were identified for screening. This samplingapproach followed methodology devised by the Office for National Statistics (ONS), basedon a list of the 1,300 most common Chinese surnames appearing in the English version ofthe 1991 Hong Kong telephone directory. A total of 3,901 addresses were issued, andinterviewers visited the selected addresses to establish whether any Chinese informantswere resident.

It should be noted that the sampling methodology for the Chinese differed in 2004 and1999. The 2004 survey identified Chinese informants from the core general populationsample, the minority ethnic boost sample and the special Chinese boost sample, asdescribed above. In 1999, apart from Chinese informants identified in the generalpopulation sample, the sample of Chinese informants was not selected independently. Itwas obtained by following up addresses with Chinese residents in a survey carried out bythe National Centre on behalf of the Health Education Authority (HEA) in 1998. This studylooked at the health and lifestyles of Chinese residents aged 16-74 in England; it was


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restricted to areas of the country identified in the 1991 Census as having the highestproportions of Chinese residents, and involved screening the Electoral Register for ‘Chinesesounding’ names.3 The different methodologies adopted for the two surveys may affectcomparability of results for the Chinese population, and should be taken into account wheninterpreting the findings.

Selecting individuals in the minority ethnic sample

Each individual in a selected household with one or more residents from the target minorityethnic groups was eligible to participate. As minority ethnic groups more commonly live inlarger households than the general population, the rules for selecting individuals weredifferent from those in the core general population sample. Up to four minority ethnic adultswere included in the survey, to limit the survey burden for these households (rather than upto ten adults in the core sample). However, up to three children were included (rather thantwo in the core sample) to ensure that sufficient numbers of interviews with children fromminority ethnic backgrounds were achieved. Where there were more than these numbers ofeligible 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 eligibleminority ethnic groups were identified in the general population sample. To obtain the totalminority ethnic group sample that is reported here, informants from eligible groups whowere identified in the general population sample were included with those from the boostsample. Thus, minority ethnic informants identified in the general population sample areincluded in both the general population sample and the minority ethnic sample in thisreport.

1.5.5 Establishing ethnicity

Ethnicity was established during the screening process by the interviewer reading a list ofminority ethnic groups and asking, for each one, whether anyone in the household was ofthat 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 wereborn in Ireland, or their father or mother was born there. Informants of mixed originincluding one of the target minority ethnic groups were included as eligible. At the screeningstage, an adult member of the household provided information, including ethnic origin,about all household members. Each individual selected for interview was later asked toconfirm their ethnic origin, and his/ her own classification was definitive.

If informants were not able to speak English, language cards were used to indicate thelanguages for which translations were available (Urdu, Punjabi, Gujarati, Hindi, Bengali,Mandarin, Cantonese). Informants who were able to read one of the translated languageswere given a card in that language with the appropriate screening questions to establishwhether they and other household members belonged to an eligible group.

All adults and children in any of the target minority ethnic groups were identified in ahousehold, and if there were more than four adults and three children, the CAPI (computerassisted 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 theinterviewer visiting; the only exception was for adjacent addresses in the wards in theminority ethnic boost sample where focused enumeration was carried out. Letters toaddresses for the minority ethnic boost sample also explained that the survey’s focus wasthe health of people from different ethnic and cultural groups, so the interviewer wouldcheck if any household members were eligible to participate. The interviewer sought thepermission 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.


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Computer-assisted interviews were conducted. The content of the interview is detailed inVolume 2; full documentation is provided in the Appendices to Volume 2. Interview topicsincluded general health, fractures, physical activity (aged 2+), fruit and vegetableconsumption (aged 5+), smoking and alcohol use (aged 8+), and psychosocial health (aged13+). Adults (aged 16+) were also asked about use of complementary and alternativemedicine, social support, and use of hormone replacement therapy and the contraceptivepill. Adults aged 16 and 17 were given a self-completion questionnaire to provideinformation about smoking and alcohol use, to respect their privacy and avoid potentialembarrassment or unwillingness to answer if parents were present.

For children under 13, one of the child’s parents or guardians was interviewed about thechild, with the child present during the interview. Additional questions about childrenincluded 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 aboutsmoking and alcohol consumption. Children aged 13-15 were interviewed in person, afterpermission was obtained from a parent or guardian. Parents of children aged four to 15were also given a self-completion questionnaire to complete about strengths and difficultiestheir child experienced.

The ethnic boost sample was asked additional questions about fungus, damp and pets inthe household; cardiovascular disease, country of birth, religion, languages, and culturalidentity (adults aged 16+); and asthma and wheezing (children).

At the end of the interview, the interviewer measured the participants’ height (aged 2+) andweight.

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 beinterviewed in English were visited by an interviewer who could speak the relevantlanguage, and this interviewer accompanied the nurse for her visit if the nurse did not speakthe relevant language.

Nurse visit

All participants from any of the seven minority ethnic groups, whether in the core or boostsamples, were eligible for a nurse visit. The nurse obtained information on currentmedication and gave participants aged 16+ a self-completion booklet on their eatinghabits. 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 fastingblood 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 bloodsamples were obtained from adults (aged 16+) to be analysed for triglycerides, LDLcholesterol and glucose. A urine sample was also requested from adults to assess dietarysodium and a saliva sample from children aged 4-15 for cotinine, to assess smoking andexposure to tobacco smoke.

1.5.7 Survey response

Interviews were held in 4,119 households with 6,704 adults aged 16 or over, and 1,650children from the general population, including 876 adults and 393 children from minorityethnic groups. The minority ethnic boost sample resulted in an additional 5,940 adults and2,905 children being interviewed. Among minority ethnic informants, 3,540 adults and1,743 children agreed to a nurse visit, with 2,325 adults and 174 older children (11+) giving ablood sample.

Response to the survey can be calculated in two ways: at a household level and at anindividual level. A summary of responses obtained to each component of the survey is givenbelow for the general population as well as for each minority ethnic group.


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Interviews were carried out at 72% of households in the general population, at 69% ofknown eligible boost sample households (66% of estimated eligible households).

Within the general population sample, interviews were obtained with 90% of adults and94% of (sampled) children in interviewed households. The equivalent figures for the totalminority ethnic sample were 88% of adults and 92% of children.

1.6 Data analysis

1.6.1 Introduction

As a cross-sectional survey, the Health Survey for England gives information on theproportions of the population with certain characteristics. It also examines associationsbetween various health states, personal characteristics and behaviours, but cannotcomment on whether these are causal. It should be noted that current health status oftenreflects previous rather than current behaviour. For example, a cross-sectional survey mayfind that ex-smokers are more likely to have heart disease than current smokers. This isprobably because smokers who develop heart disease are more likely to stop smoking, so


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Table 1.2: Adult response rate in co-operating households

Black Black General Caribbean African Indian Pakistani Bangladeshi Chinese Irish population

% % % % % % % %

Interviewed 88 89 87 84 89 84 92 90

Height measured 70 71 78 69 73 74 81 79

Weight measured 67 69 77 66 69 72 79 77

Saw nurse 45 40 51 42 33 44 59 n/a

Waist-hip measured 43 37 49 38 31 43 57 n/a

Blood pressure measured 44 38 50 39 31 43 58 n/a

Non fasting blood sample obtained 28 24 37 25 19 26 45 n/a

Fasting blood sample obtained 18 14 21 13 8 17 28 n/a

Saliva sample obtained 38 34 45 33 28 37 54 n/a

Urine sample obtained 36 33 43 30 25 35 51 n/a

Table 1.3: Child response rate in co-operating households


% % % % % % % %

Interviewed 92 92 93 92 91 95 94 94

Height measured 65 72 81 74 68 81 79 80

Weight measured 62 69 80 74 67 79 75 78

Saw nurse 45 43 57 53 35 54 60 n/a

Waist-hip measured (aged 11and over) 41 40 55 43 20 35 55 n/a

Blood pressure measured (aged 5 and over) 43 38 55 45 30 47 58 n/a

Lung function measured (aged 7 and over) 34 35 48 34 26 41 51 n/a

Non fasting blood sample obtained (aged 11 and over) 15 22 24 10 10 10 26 n/a

Saliva sample obtained (aged 4 and over) 36 36 51 38 27 36 51 n/a

ex-smokers include a disproportionate number of people who already had heart disease. Inaddition current smokers include many individuals who will not develop heart disease orwho have not yet done so, and those smokers whose heart disease is most closely relatedto smoking may have died prematurely.

1.6.2 Weighting the samples

The general population sample

For the general population sample, weights were calculated at the household level and atthe individual informant level. The household weights corrected for the probability ofselection where additional households were identified at a selected address. Calibrationweighting was also used for adults to reduce non-response bias resulting from differentialnon-response at the household level, based on the age and sex profile of the residents andthe region in which the household was situated. Weights were also calculated at anindividual level for adults to correct for non-response within participating households.

For children, selection weights were calculated so that children in larger households werenot under-represented in the sample, since a maximum of two children were interviewed ina household. Adjustment weights were also calculated for children at the individual level byage 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 froma 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 inthe general population core sample; the boost sample for minority ethnic groups; and theChinese special boost sample for Chinese informants.

The household selection weights for the boost were calculated in the same way for the coresample, with the exception of sample points where focused enumeration was carried out. Inthese sample points the household selection weight was set to be 1 for all households inthe sample. Selection weights were calculated for adults and children to adjust for theprobability of being included, since a maximum of four adults and three children wereselected. Selection weights for addresses were also calculated for each informantseparately, because each informant from a minority ethnic group had a chance of beingselected either from the general population or the boost sample, with the probability ofbeing interviewed for the boost sample depending on their ethnic group. Therefore theprobability of selection for an informant would be the same whether they were selected forthe core sample or the boost sample.

The weighted distribution of the minority ethnic groups using the combination of theseselection weights was treated as the best estimate of the population distribution, and thisdistribution 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 boostsamples were re-scaled so that they summed to the number of Chinese informants fromthose samples. The weights for the informants from the Chinese special boost were all setto be equal to 1, so that they summed to the number of informants in the Chinese specialsample. The Chinese special sample was then added to the minority ethnic sample and theweights for the Chinese informants in the combined minority ethnic sample re-scaled to beequal to the best estimate of the proportion of Chinese people in the population, derivedfrom 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 furtherweights were calculated to adjust for non-response to the nurse visit, and for obtaining ablood sample.


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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 ineach table. The unweighted bases show the number of participants involved. The weightedbases show the relative sizes of the various sample elements after weighting, reflecting theirproportions in the English population, so that data from different columns can be combinedin their correct proportions.

Where data from 2002 or 2003 have been used as a general population comparator, theweightings from those years were applied: selection weights only in 2002, and selectionand 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 Surveyfor 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 age-standardised for comparisons between different ethnic groups for factors that vary by age,to examine whether differences observed reflect ethnic differences and not merelydifferences in the age profiles of participants.

It should be noted that all analyses in the report are presented separately for men andwomen. All age standardisation has been undertaken separately within each sex,expressing male data to the overall male population and female data to the overall femalepopulation. When comparing data for the two sexes, it should be remembered that no agestandardisation has been introduced to remove the effects of the sexes’ different agedistributions.

The direct standardisation method has been used. Instead of showing the age-standardised figures themselves, the results are presented in the form of risk ratios thatcompare the prevalence or mean for a given minority ethnic group with the prevalence ormean in the general population, after adjusting for age in each group. For example, a riskratio of 2.0 means that group is twice as likely as the general population to have thatcondition, allowing for age differences; a risk ratio of 0.5 means that group is half as likely asthe general population to have that condition, allowing for age differences. Risk ratios werecalculated separately for men and women. Standard errors of the ratios are also given in thetables.

The age distribution to which each minority ethnic group and the general population arestandardised was the same distribution used in analysis of the 1999 survey. This is anartificial distribution that was designed to minimise the percentage increase in standarderrors that the standardised weights introduced.


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Table 1.4: Adult response in co-operating households


% % % % % % % %

Men

16-34 29 47 36 49 51 49 23 32

35-54 41 42 43 36 37 33 38 36

55 and over 30 11 21 15 12 18 39 32

Women

16-34 32 50 38 55 65 39 21 30

35-54 43 42 44 32 25 48 44 35

55 and over 24 8 18 12 10 14 35 35

1.6.6 Equivalised income

Household income was established by means of a card shown to informants (see AppendixA, Volume 2) on which banded incomes were presented. Information was obtained from thehousehold reference person (HRP) or their partner. Initially they were asked to state theirown (HRP and partner combined) aggregate gross income, and were then asked toestimate 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 increasinginterest recently in using measures of equivalised income that adjust income to takeaccount of the number of persons in the household. Thus equivalised annual income scoreswere calculated, and the equivalised annual household income was attributed to allmembers of the household, including children. Data in the report are presented inequivalised 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 thegeneral population. This is because household income amongst minority ethnic groups is,on average, considerably lower than that for the general population. The general populationtertiles have been used for analysis of the Irish group. Categorising minority ethnic groupsto tertiles based on the general population income distribution would give only very smallsample sizes in the highest income tertile for most minority ethnic groups. This wouldreduce the likelihood of observing associations between ethnicity, income and health. Itshould be noted that even when tertiles for Black, Asian and Chinese households werecalculated, 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. Theresults shown for 1999 may differ from those presented in the published report for 1999 dueto weighting or use of different thresholds. When comparisons are made between data for2004 and 1999, it should also be noted that the age profiles of minority ethnic groups maydiffer between the two years. This should be taken into account when interpretingdifferences in results over time. Comparisons over time will be more valid within specificage groups, therefore, and where base sizes allow, results are presented broken down byage.

1.6.8 Presentation of results

There are four main types of table in this report:

● 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 agestandardisation;

● 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 substantiveimportance.

1.6.9 Availability of unpublished data

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


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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.

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


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HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING 25

Self-reported healthand psychosocial well-being

Lucy Natarajan

Self-reported general health

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

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

● Among the general population, there was no change in the prevalence of bad or verybad self-reported general health between 1999 and 2004. The same was true for allminority ethnic groups, with the exception of Indian women, where the prevalence ofbad 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 longstandingillness, 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 morelikely than those in the general population to report a limiting longstanding illness.

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

Acute sickness

● Among the general population, 14% of men and 19% of women reported that they hadhad an acute sickness in the past two weeks. Pakistani men and women were morelikely to report acute sickness than the general population, with risk ratios of 1.42 and1.39 respectively.

GHQ12

● The prevalence of high GHQ12 scores among the general population was lower in2004 (11% for men and 15% for women) than in 1999 (15% for men and 19% forwomen), this was also true for Irish and Bangladeshi men and women, and BlackCaribbean and Indian women.

Social support

● A minority (16% of men and 11% of women) of the general population reported asevere lack of support. Prevalence of severe lack of social support was much higheramong 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%) andBangladeshi men (35%) and women (33%).

2Summary

2.1 Introduction

This chapter covers self-reported general health, acute sickness, longstanding illness,limiting longstanding illnesses, psychosocial measures (GHQ12 and perceived socialsupport), and prescribed medicines.

These are subjective measures, and the survey included people with a variety of firstlanguages. Therefore, it should be noted that issues of culture and interpretation mayinfluence the survey results. The meanings and values that each minority ethnic group andthe general population give to the question terms are not necessarily identical. Moreover,subjective health assessments do not necessarily correspond with medical diagnoses, orprescriptions.

2.2 Self-reported general health

2.2.1 Self-reported general health, by minority ethnic group

Informants were asked to rate their general health selecting one of five categories: verygood, good, fair, bad, or very bad. Results are presented for the best two categoriescombined (‘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 womenwere 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 and7% of women reported bad or very bad health. Table 2.1

Overall the minority ethnic groups followed this pattern, with the majority of peoplereporting good or very good general health, and a much lower proportion reporting bad orvery bad health.

Age-standardised risk ratios were analysed in order to control for differences in the ageprofiles 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 andwomen and Black Caribbean women were more likely to report bad or very bad health thanthe general population. In relation to the general population the risk ratios for bad or verybad health were 3.77 for Bangladeshi men, 4.02 for Bangladeshi women, 2.33 for Pakistanimen, 3.54 for Pakistani women, and 1.90 for Black Caribbean women. Chinese womenwere the only group less likely to report bad or very bad health (with a risk ratio of 0.55) thanthe general population. Figure 2A

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

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Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

Self-reported bad or very bad general health, by minority ethnic group

Men Women

Ris

k ra

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Figure 2A

2.0

0.5

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

0.10

1.0

10.0

Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

2.0

0.5

0.10

1.0

10.0

2.2.2 Self-reported general health by age

As with previous HSE reports, levels of bad or very bad self-reported health increased withage. In the general population, 2% of men and women aged 16-34 reported bad or verybad health, and this proportion rose to 6% for men and women aged 35-54, and 12% ofmen and women aged 55 and older. Table 2.2

As with the general population, the prevalence of bad or very bad health increased with ageamong minority ethnic groups. As in 1999, the association of bad or very bad self-reportedhealth with older age was strongest in the Bangladeshi and Pakistani groups. Theproportion reporting bad or very bad health in the oldest age group was 34% for Pakistanimen, 45% for Pakistani women, 53% for Bangladeshi men and 44% for Bangladeshiwomen, 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 badself-reported general health between 1999 and 2004. The same was true for all minorityethnic groups, with the exception of Indian women, where the prevalence of bad or verybad health decreased to 8% in 2004 compared with 12% in 1999. Table 2.3, Figure 2B

2.2.4 Self-reported general health, by household income

Equivalised household income is a measure of household income that takes account of thenumber of persons in a household. The same strong association found in previous yearsbetween income and self-reported health was seen in 2004. Those in the lowest incometertile were more likely to report bad or very bad health than those in the middle and highesttertile. 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. Asimilar relationship was seen in most of the minority ethnic groups for both men andwomen, 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 longstandingillnesses, have been measured. Longstanding illnesses are illnesses, disabilities and

HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING 27Cop

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Black

Caribbean

Indian

Pakistani

Bangladeshi

IrishChinese

Black

Caribbean

Indian

Pakistani

Bangladeshi

IrishChinese

Comparison of self-reported bad or very bad general health in 1999 and 2004

Men Women

Per

cent

Figure 2B

0

2

4

6

8

10

12

14

16

18

20

0

2

4

6

8

10

12

14

16

18

20

19992004

General

population

General

population

infirmities that have affected or are likely to affect a person over a period of time. Peoplewho said they had a longstanding illness were asked if their activities were limited in anyway by the longstanding illness, and such illnesses are classified as ‘limiting longstandingillness’.

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 werearound the same prevalences as found in previous years.

Pakistani women were more likely than the general population to report a longstandingillness, with a risk ratio of 1.17. Black African and Chinese men and women and Indianwomen were less likely than the general population to report a longstanding illness. Theirrisk ratios as compared with the general population were 0.67 for Black African men, 0.66for Black African women, 0.61 for Chinese men and women, and 0.73 Indian women. Forthe other minority ethnic groups, the levels reporting a longstanding illness were around thesame as in the general population. Table 2.5, Figure 2C

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

Pakistani women (risk ratio of 1.60) and Bangladeshi men (risk ratio of 1.52) were more likelythan 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 generalpopulation to report having a limiting longstanding illness. The risk ratios for having limitinglongstanding illnesses were 0.63 for Black African men, 0.57 for Chinese men and 0.46 forChinese women. Table 2.5

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 allgroups. Among the general population, the prevalence of longstanding illness increasedfrom 23% of men and 28% of women aged 16-34, to 67% of men and women aged 55 andolder. For limiting longstanding illnesses, the rise was steeper, from 9% of men and 15% ofwomen aged 16-34, to 40% of men and 43% of women aged 55 and older. The samerelationship was found for all minority ethnic groups, although the base sizes for the BlackAfrican and Bangladeshi groups are small. Table 2.6


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Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

Longstanding illness, by minority ethnic group

Men Women

Ris

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Figure 2C

2.0

0.5


0.10

1.0

10.0

Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

2.0

0.5

0.10

1.0

10.0

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 andwomen in the general population was around the same as in 1999. For Indian women, thelevels of longstanding illness and limiting longstanding illness reported were significantlylower in 2004 than they were in 1999. For that group, the prevalence of longstanding illnessfell 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 illnesswere significantly higher in 2004 than they were in 1999. For that group, the prevalence oflongstanding 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. Thisinformation was used to categorise the types of illnesses according to the ICD10 codingsystem, by rates per thousand reporting. As in the 1999 report the three most commontypes of condition for men and women in the general population were disorders of themusculoskeletal system (173 and 208 per thousand), the heart and circulatory system (123and 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 amongthe three most common types of condition for all the minority ethnic groups. The other mostcommon type of condition was endocrine and metabolic disorders for Black Caribbean,Bangladeshi and Indian men and women, Black African men, and Chinese women, anddisorders of the musculoskeletal system for the rest. Musculoskeletal disorders were themost common condition for all groups except Chinese men.

For most minority ethnic groups the levels of the four most common conditions werearound 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) andBlack Caribbean women (1.48) were more likely to report disorders of the heart andcirculatory 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 theendocrine and metabolic system than the general population. Chinese men (risk ratio of0.48) and women (risk ratio of 0.45) and Black African men (0.46) were less likely to reportdisorders 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 toreport disorders of the respiratory system than the general population. Table 2.7

2.3.6 Self-reported longstanding illness, by household income

As in previous years there was an inverse association between longstanding illness andequivalised household income for both men and women in the general population. For menin the highest income tertile, the prevalence of longstanding illness was 38%, comparedwith around 50% in the other two categories. For women in the highest income tertile theprevalence of longstanding illness was 39%, compared with 56% in the middle and 54% inthe lowest category. The same pattern could be seen for Black Caribbean, Indian and Irishgroups. 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, work-related or other activities due to sickness in the two weeks prior to the interview. Thenumber of days on which activities were affected was recorded as an indicator of theseverity of the acute sickness.


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Among the general population, 14% of men and 19% of women reported that they had hadany acute sickness in the past two weeks. Chinese men and women were significantly lesslikely than the general population (with risk ratios of 0.64 for men and 0.56 for women) toreport acute sickness. The only other groups significantly different from the generalpopulation 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

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

2.4.2 Self-reported acute sickness, by age

The prevalence of acute sickness increased with age. In the general population, 11% ofmen and 13% of women aged 16-34 reported acute sickness, and this proportion rose to17% of men and 22% of women aged 55 and older. The same pattern was seen among allminority ethnic groups. Table 2.10

2.4.3 Self-reported acute sickness, by household income

As in previous years, an inverse association was found between equivalised householdincome 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 tertilereported acute sickness. These proportions rose to 17% of men and 26% of women in thelowest income tertile. The same pattern was also seen in the Black Caribbean, and Irishminority ethnic groups, and for Black African and Indian women. The base sizes in sometertiles for the Pakistani, Bangladeshi and Chinese groups were too low for reliableconclusions 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 ofhappiness, depression, anxiety, sleep disturbance and ability to cope during the four weeks


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Black African

Indian

Pakistani

Bangladeshi

IrishChinese

Acute sickness, by minority ethnic group

Men Women

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Figure 2D

2.0

0.5


0.10

1.0

10.0

Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

2.0

0.5

0.10

1.0

10.0

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 beenvalidated for a general population but not for specific minority ethnic groups. Subjectivity inindividual interviews where informants’ interpretations of the questions are informed bycultural factors may affect comparability between minority ethnic groups. This should benoted particularly for the analysis of psychosocial health, since cultural norms surroundingthe 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 scoresthan men in the general population and in the Black Caribbean, Indian, Pakistani andChinese groups. By contrast, in 2004 there was little variation by gender among theminority ethnic groups, with the exception of Black Africans. 19% of Black African womenscored 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 highGHQ12 score than the general population. Differences for these groups were replicated inthe 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 havelower rates of high GHQ12 scores than the general population, but this difference was notreplicated in the 2004 data. Table 2.13, Figure 2E

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 2004than in 1999. A similar decrease in rates of high GHQ12 score was also seen for some ofthe minority ethnic groups: Irish and Bangladeshi men and women, and Black Caribbeanand Indian women. For Chinese men, in contrast, the prevalence was higher in 2004 than ithad 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 highGHQ12 scores. Those in the highest income tertile were least likely to have a high GHQ12score. Risk ratios for men in the general population were 0.75 in the highest tertile, this rose


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Black African

Indian

Pakistani

Bangladeshi

IrishChinese

High GHQ12 scores, by minority ethnic group

Men Women

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Figure 2E

2.0

0.5


0.10

1.0

10.0

Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

2.0

0.5

0.10

1.0

10.0

to 1.17 in the middle tertile and 1.72 in the lowest tertile. For women in the highest tertile therisk 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 prevalenceof high GHQ12 scores was found in the highest income tertile amongst Irish (risk ratio of0.62) and Indian (risk ratio of 0.58) men, and Black Caribbean (risk ratio of 0.83) women. Therisk ratios rose significantly in the middle and lowest tertiles for those groups (with riskratios in the lowest tertiles of 2.52 for Irish men, 2.22 for Indian men, and 1.55 for BlackCaribbean 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 beenincluded in most HSE years. The questions ask informants to rate the physical andemotional aspects of support they receive from family and friends, by comparing them topositive scenarios. The ratings are given on a three point scale (not true for me, partly truefor 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 ofsupport’, and 21 ‘no lack of support’.

In 2004 most people in the general population (57% of men and 67% of women) reportedno lack of support, and only a minority (16% of men and 11% of women) a severe lack ofsupport. Prevalence of severe lack of social support was much higher among men andwomen in all minority ethnic groups, except Irish men and women. This was particularlymarked 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 supportthan 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 thegeneral population, were higher for men and women in all minority ethnic groups exceptIrish. Figure 2F

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 thegeneral population were the same in 1999 and 2004. Both Chinese men and women andIndian women reported lower levels of prevalence in 2004 than in 1999. By contrast, the


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Black African

Indian

Pakistani

Bangladeshi

IrishChinese

Severe lack of social support, by minority ethnic group

Men Women

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Figure 2F

2.0

0.5


0.10

1.0

10.0

Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

2.0

0.5

0.10

1.0

10.0

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HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 2: SELF-REPORTED HEALTH & PSYCHOSOCIAL WELL-BEING 33

prevalence of severe lack of social support was higher in 2004 than 1999 for BlackCaribbean 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 socialsupport for men and women in the general population, and Black African, Indian and Irishminority ethnic groups. Those in the lowest tertile were more likely to report a severe lack ofsupport. 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 weretaking any medicines, pills, syrups, ointments, puffers or injections which a doctor or nursehad prescribed for them.

The prevalence of taking prescribed medication was unchanged for men and women in thegeneral 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 medicinesamong men and women (3.0 for both in 2004) in the general population who were taking anyprescribed medication was also unchanged from 2003. This was also true for the averagenumber of prescribed medicines amongst all men (1.2) and women (1.5) in the generalpopulation.

Comparing the risk ratios of taking four or more prescribed medicines across minorityethnic groups, most groups were around the same level as men and women in the generalpopulation. 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 prescribedmedications than the general population: 2.35 for Pakistani women, 2.50 for Bangladeshiwomen, and 1.78 for Indian men. Table 2.18


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

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

2.16 Comparison of perceived social support in2004 and 1999, by minority ethnic group andsex

2.17 Perceived social support, by equivalisedhousehold income within minority ethnic groupand sex

2.18 Number of prescribed medicines, by minorityethnic group and sex

Tables

2.1 Self-reported general health, by minority ethnicgroup and sex

2.2 Self-reported general health, by age withinminority ethnic group and sex

2.3 Comparison of bad or very bad self-reportedgeneral health in 2004 and 1999, by age withinminority ethnic group and sex

2.4 Self-reported general health, by equivalisedhousehold income within minority ethnic groupand sex

2.5 Self-reported longstanding illness and limitinglongstanding illness, by minority ethnic groupand sex

2.6 Comparison of self-reported longstandingillness and limiting longstanding illness in 2004and 1999, by age within minority ethnic groupand sex

2.7 Rate per thousand reporting longstandingillness conditions, by minority ethnic group andsex

2.8 Self-reported longstanding illness, byequivalised household income within minorityethnic group and sex

2.9 Self-reported acute sickness in the last twoweeks, by minority ethnic group and sex

2.10 Self-reported acute sickness in the last twoweeks, by age within minority ethnic group andsex

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

2.15 Perceived social support, by minority ethnicgroup and sex


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Table 2.1

Self-reported general health, by minority ethnic group and sex

Aged 16 and over 2004

Self-reported general Minority ethnic group Generalhealth population

Black BlackCaribbean African Indian Pakistani Bangladeshi Chinese Irish

MenObserved %

Very good 27 43 32 35 24 38 37 36

Good 46 42 37 38 43 43 34 41

Good/very good 73 85 69 72 68 81 71 77

Fair 17 11 22 17 17 15 19 17

Bad 7 3 7 7 11 3 7 5

Very bad 2 1 2 3 4 0 2 2

Bad/very bad 9 4 9 10 15 4 10 6

Standardised risk ratios

Good/very good 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 1


WomenObserved %

Very good 23 37 29 27 20 28 40 34

Good 39 41 42 38 44 51 39 41

Good/very good 62 78 71 65 64 78 79 74

Fair 27 15 22 20 21 19 16 19

Bad 9 6 6 9 10 2 4 5

Very bad 2 0 2 6 4 0 1 1

Bad/very bad 11 7 8 15 14 3 5 7


Good/very good 0.81 0.91 0.90 0.73 0.67 0.98 1.07 1


Bad/very bad 1.90 1.68 1.39 3.54 4.02 0.55 0.74 1


Bases (weighted)

Men 478 377 903 421 178 151 1776 46188

Women 675 475 1067 497 208 163 2369 48679

Bases (unweighted)

Men 412 390 550 432 409 348 497 2879

Women 652 468 634 507 478 375 656 3822


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Table 2.2

Self-reported general health, by age within minority ethnic group and sex


Self-reported Age groupgeneral health

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

Very good 27 37 14 27 29 26 12 23

Good 58 46 34 46 50 40 23 39

Good/very good 85 83 48 73 79 66 34 62

Fair 11 12 31 17 17 28 40 27

Bad 3 4 16 7 4 6 20 9

Very bad 1 1 5 2 1 1 6 2

Bad/very bad 4 5 21 9 5 6 26 11

Black African

Very good 50 39 [31] 43 48 28 [14] 37

Good 40 45 [35] 42 41 44 [24] 41

Good/very good 91 83 [66] 85 89 72 [38] 78

Fair 6 13 [27] 11 9 18 [40] 15

Bad 2 3 [6] 3 1 10 [16] 6

Very bad 1 1 [-] 1 - - [6] 0

Bad/very bad 3 3 [6] 4 1 10 [22] 7

Indian

Very good 50 27 13 32 38 26 14 29

Good 33 45 27 37 47 43 31 42

Good/very good 83 71 40 69 85 69 45 71

Fair 15 22 36 22 13 24 33 22

Bad 2 6 19 7 1 5 16 6

Very bad - 1 5 2 1 1 7 2

Bad/very bad 2 7 24 9 2 6 22 8

Pakistani

Very good 49 28 6 35 40 16 4 27

Good 40 39 28 38 43 36 15 38

Good/very good 89 67 34 72 83 52 19 65

Fair 10 20 33 17 12 29 36 20

Bad 1 11 18 7 4 12 25 9

Very bad 0 2 16 3 1 7 20 6

Bad/very bad 1 13 34 10 5 19 45 15

Bangladeshi

Very good 37 12 [8] 24 28 7 - 20

Good 51 42 [15] 43 52 30 27 44

Good/very good 88 54 [23] 68 80 38 27 64

Fair 10 25 [23] 17 15 35 29 21

Bad 1 18 [33] 11 4 20 24 10

Very bad 1 3 [20] 4 1 7 20 4

Bad/very bad 2 21 [53] 15 5 27 44 14

Chinese

Very good 49 34 19 38 36 27 8 28

Good 43 47 35 43 55 48 49 51

Good/very good 91 81 54 81 90 75 57 78

Fair 9 16 33 15 10 22 36 19

Bad - 3 11 3 - 3 7 2

Very bad - - 2 0 - 1 0 0

Bad/very bad - 3 13 4 - 3 7 3

Continued…


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Table 2.2 continued


Self-reported Age groupgeneral health

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Irish

Very good 43 46 25 37 49 41 32 40

Good 38 34 31 34 41 44 32 39

Good/very good 81 80 56 71 90 86 64 79

Fair 15 12 30 19 8 9 29 16

Bad 4 5 12 7 2 4 6 4

Very bad - 3 3 2 - 1 2 1

Bad/very bad 4 8 14 10 2 5 8 5

General population

Very good 45 38 24 36 42 37 23 34

Good 42 42 38 41 45 41 37 41

Good/very good 88 80 62 77 87 78 60 74

Fair 11 14 26 17 11 16 28 19

Bad 1 4 8 5 2 5 9 5

Very bad 0 1 4 2 0 1 2 1

Bad/very bad 2 6 12 6 2 6 12 7

Bases (weighted)

Black Caribbean 141 196 142 478 219 291 165 675

Black African 179 159 40 377 239 198 37 475

Indian 327 384 192 903 408 466 193 1067

Pakistani 205 152 64 421 274 161 62 497

Bangladeshi 91 65 21 178 135 51 21 208

Chinese 74 50 27 151 63 78 22 163

Irish 412 678 686 1776 497 1038 833 2369

General population 14800 16676 14713 46188 14649 16897 17133 48679

Bases (unweighted)

Black Caribbean 122 166 124 412 200 290 162 652

Black African 179 172 39 390 234 190 44 468

Indian 201 231 118 550 240 275 119 634

Pakistani 222 145 65 432 278 164 65 507

Bangladeshi 210 150 49 409 310 118 50 478

Chinese 172 118 58 348 148 176 51 375

Irish 114 194 189 497 149 275 232 656



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Table 2.3

Comparison of bad or very bad self-reported general health in 2004 and1999, by age within minority ethnic groupa and sex

Aged 16 and over 2004, 1999

Bad or very bad Age groupself-reported

Men Womengeneral healthAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

2004 4 5 21 9 5 6 26 11

1999 1 4 20 8 3 7 24 10

Indian

2004 2 7 24 9 2 6 22 8

1999 1 10 23 9 3 9 40 12

Pakistani

2004 1 13 34 10 5 19 45 15

1999 2 17 33 11 4 19 42 12

Bangladeshi

2004 2 21 [53] 15 5 27 44 14

1999 5 21 44 18 4 23 28 11

Chinese

2004 - 3 13 4 - 3 7 3

1999 2 3 15 5 1 4 11 4

Irish

2004 4 8 14 10 2 5 8 5

1999 3 4 17 7 0 7 10 6

General population

2004 2 6 12 6 2 6 12 7

1999 2 6 10 6 3 6 11 7

Bases (weighted)

Black Caribbean 2004 141 196 142 478 219 291 165 675

Black Caribbean 1999 145 92 129 366 189 190 122 501

Indian 2004 327 384 192 903 408 466 193 1067

Indian 1999 218 252 125 595 252 255 108 614

Pakistani 2004 205 152 64 421 274 161 62 497

Pakistani 1999 191 120 47 358 223 117 31 370

Bangladeshi 2004 91 65 21 178 135 51 21 208

Bangladeshi 1999 70 37 29 137 91 33 14 139

Chinese 2004 74 50 27 151 63 78 22 163

Chinese 1999 34 42 19 96 35 62 17 113

Irish 2004 412 678 686 1776 497 1038 833 2369

Irish 1999 385 714 448 1546 566 879 543 1988

General population 2004 14800 16676 14713 46188 14649 16897 17133 48679


Bases (unweighted)

Black Caribbean 2004 122 166 124 412 200 290 162 652

Black Caribbean 1999 212 141 192 545 282 285 179 746

Indian 2004 201 231 118 550 240 275 119 634

Indian 1999 232 267 127 626 267 276 112 655

Pakistani 2004 222 145 65 432 278 164 65 507

Pakistani 1999 326 217 77 620 384 203 56 643

Bangladeshi 2004 210 150 49 409 310 118 50 478

Bangladeshi 1999 274 143 116 533 361 144 58 563

Chinese 2004 172 118 58 348 148 176 51 375

Chinese 1999 109 127 65 301 109 194 58 361

Irish 2004 114 194 189 497 149 275 232 656

Irish 1999 135 240 162 537 203 301 204 708



a Black Africans were include in the 2004 survey but not in the 1999 survey, so therefore are excluded fromthis comparative table.


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Table 2.4

Self-reported general health, by equivalised household incomewithin minority ethnic group and sex


Self-reported general Equivalised household income tertilehealth

Men WomenHighest Middle Lowest Highest Middle Lowest

Observed %Black Caribbean

Very good 41 40 35 49 28 25

Good 46 42 42 36 47 39

Good/very good 88 82 77 85 75 64

Fair 11 13 16 14 19 24

Bad 1 5 5 - 5 10

Very bad - - 2 1 1 2

Bad/very bad 1 5 7 1 6 12

Black African

Very good 47 46 49 53 41 40

Good 47 47 36 38 44 42

Good/very good 94 93 86 92 85 82

Fair 6 6 10 7 11 12

Bad - 1 3 1 3 5

Very bad - - 1 - - 1

Bad/very bad - 1 4 1 3 5

Indian

Very good 49 37 35 47 34 27

Good 36 46 35 35 46 40

Good/very good 85 82 70 82 80 67

Fair 13 14 21 16 14 23

Bad 2 3 9 2 4 7

Very bad 0 1 0 - 2 2


Pakistani

Very good 61 51 37 [64] 39 34

Good 35 41 42 [29] 35 41

Good/very good 96 92 79 [93] 74 74

Fair 4 3 13 [7] 15 16

Bad - 3 5 [ -] 7 7

Very bad - 2 2 [ -] 5 4

Bad/very bad - 5 8 [ -] 11 10

Bangladeshi

Very good a 35 29 a 29 26

Good a 44 47 a 58 49

Good/very good a 80 76 a 87 75

Fair a 11 13 a 8 15

Bad a 6 8 a 5 7

Very bad a 3 3 a - 3

Bad/very bad a 10 11 a 5 10

Chinese

Very good 46 35 42 38 31 33

Good 47 51 31 54 52 43

Good/very good 93 86 73 92 83 76

Fair 7 10 21 8 15 20

Bad - 2 6 - 2 3

Very bad - 1 - - - 1

Bad/very bad - 4 6 - 2 4

a Results are not shown because of small bases. Continued…


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a Results are not shown because of small bases.

Table 2.4 continued


Self-reported general Equivalised household income tertilehealth


Observed %Irish

Very good 62 47 31 62 51 34

Good 28 37 33 34 36 30

Good/very good 90 84 64 96 87 64

Fair 9 11 22 3 9 28

Bad 1 4 10 - 4 7

Very bad 1 1 3 0 0 2


General population

Very good 52 38 31 52 37 29

Good 39 43 39 38 43 38

Good/very good 91 81 71 90 80 67

Fair 7 16 19 8 15 23

Bad 1 3 8 2 3 8

Very bad 1 1 3 0 1 2

Bad/very bad 2 4 11 2 5 10

Standardised risk ratiosGood/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


Indian 0.46 1.22 2.76 0.61 2.07 2.16


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

Bangladeshi a 4.81 4.18 a 3.93 4.66

Standard error of the ratio a 0.98 0.80 a 0.95 0.92

Chinese 0.47 0.42 2.41 0.09 0.43 1.06


Irish 0.38 2.35 3.03 0.11 1.69 1.61


General population 0.37 1.31 2.83 0.37 1.20 2.44


Bad /very bad

Black Caribbean 1.10 0.95 0.82 0.98 0.81 0.69


Black African 0.93 1.48 2.75 0.93 1.48 2.75


Indian 0.61 2.07 2.16 0.61 2.07 2.16


Pakistani 0.75 3.33 4.57 [0.75] 3.33 4.57


Bangladeshi a 3.93 4.66 a 3.93 4.66


Chinese 0.09 0.43 1.06 0.09 0.43 1.06


Irish 0.11 1.69 1.61 0.11 1.69 1.61




Continued…


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Table 2.4 continued


Equivalised household income tertile


Bases (weighted)

Black Caribbean 157 163 323 145 189 418

Black African 115 132 286 128 148 366

Indian 278 292 403 275 299 464

Pakistani 66 70 443 42 87 465

Bangladeshi 4 24 190 7 25 205

Chinese 45 34 62 50 42 60

Irish 885 658 819 1130 823 886

General population 17672 17274 14848 15920 16871 17714

Bases (unweighted)

Black Caribbean 129 129 265 129 164 382

Black African 93 147 284 96 143 371

Indian 158 184 262 151 181 288

Pakistani 54 65 433 33 83 450

Bangladeshi 10 56 423 17 58 445

Chinese 107 79 140 113 89 137

Irish 213 183 227 266 213 279



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Table 2.5

Self-reported longstanding illness and limiting longstanding illness, by minority ethnic group and sex


Longstanding illness Minority ethnic group Generaland limiting populationlongstanding illness Black Black

Caribbean African Indian Pakistani Bangladeshi Chinese Irish

MenObserved %

Longstanding illness 39 24 37 35 30 22 47 43

Limiting longstanding illness 24 10 23 20 24 9 26 23

Number of longstanding illnesses

1 illness 25 17 21 21 15 13 30 27

2 or more illnesses 14 6 16 14 15 9 17 17

Mean number of illnesses 1.36 1.37 1.53 1.54 1.60 1.47 1.38 1.39

Standard error of the mean 0.10 0.08 0.10 0.13 0.13 0.08 0.09


Longstanding illness 0.86 0.67 0.91 0.96 0.95 0.61 1.07 1


Limiting longstanding illness 1.00 0.63 1.12 1.17 1.52 0.57 1.11 1


WomenObserved %



Number of longstanding illnesses

1 illness 25 16 18 23 19 17 28 28

2 or more illnesses 19 8 13 18 12 7 16 19

Mean number of illnesses 1.49 1.49 1.47 1.70 1.60 1.38 1.40 1.44



Longstanding illness 1.02 0.66 0.73 1.17 1.00 0.61 0.91 1




Bases (weighted)

Men 479 374 903 423 178 151 1776 46188

Women 676 473 1067 499 208 163 2366 48706

Bases (unweighted)

Men 413 390 550 433 410 348 497 2879

Women 653 468 634 508 478 375 655 3824


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Table 2.6

Comparison of self-reported longstanding illness and limitinglongstanding illness in 2004 and 1999, by age within minority ethnicgroupa and sex


Longstanding illness Age groupand limiting

Men Womenlongstanding illnessAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

Longstanding illness

2004 17 31 70 39 24 43 73 44

1999 33 39 60 44 30 41 74 45

Limiting longstanding illness

2004 8 19 46 24 17 24 49 28

1999 11 22 39 24 16 21 53 27

Indian


2004 19 37 69 37 16 31 60 30

1999 14 34 62 32 17 41 76 37


2004 9 22 50 23 10 17 46 19

1999 7 21 42 21 8 26 62 25

Pakistani


2004 19 40 72 35 23 56 86 41

1999 15 39 69 30 21 41 76 32


2004 8 23 54 20 14 40 70 30

1999 10 30 49 22 14 30 57 23

Bangladeshi


2004 12 42 [73] 30 18 53 69 31

1999 21 45 70 38 18 48 64 30


2004 8 34 [62] 24 10 38 45 21

1999 15 36 61 30 12 39 53 22

Chinese


2004 8 23 59 22 17 24 42 24

1999 15 23 50 25 16 25 42 25


2004 2 12 22 9 5 11 17 10

1999 8 13 28 14 6 12 24 12

Irish


2004 36 41 66 47 31 43 64 46

1999


2004 9 25 37 26 15 18 34 23

1999 21 22 47 29 14 27 42 27

General population


2004 23 40 67 43 28 43 67 47

1999 26 41 64 44 27 40 64 45


2004 9 21 40 23 15 22 43 27

1999 10 23 39 25 12 22 42 26

Continued …



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Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Bases (weighted)

Black Caribbean 2004 144 196 142 479 219 291 165 675

Black Caribbean 1999 144 93 130 366 190 190 123 503

Indian 2004 327 384 192 903 408 466 193 1067

Indian 1999 218 251 125 595 252 256 108 616

Pakistani 2004 205 152 64 423 274 161 62 497

Pakistani 1999 191 120 47 358 223 117 31 370

Bangladeshi 2004 91 65 21 178 135 51 21 208

Bangladeshi 1999 70 37 29 136 91 33 14 139

Chinese 2004 74 50 27 151 63 78 22 163

Chinese 1999 34 42 19 96 35 62 17 113

Irish 2004 412 678 686 1776 497 1038 833 2369

Irish 1999 385 714 448 1546 566 879 543 1988



Bases (unweighted)

Black Caribbean 2004 122 166 124 413 200 290 162 653

Black Caribbean 1999 211 142 193 546 283 285 180 748

Indian 2004 201 231 118 550 240 277 119 634

Indian 1999 232 266 127 625 267 277 113 657

Pakistani 2004 222 145 65 433 278 164 65 508

Pakistani 1999 326 217 77 620 384 203 56 643

Bangladeshi 2004 210 150 49 410 310 118 50 478

Bangladeshi 1999 274 142 116 532 361 144 58 563

Chinese 2004 172 118 58 348 148 176 51 375

Chinese 1999 109 127 65 301 109 194 58 361

Irish 2004 114 194 189 497 149 275 232 655

Irish 1999 135 240 162 537 203 301 204 708




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Table 2.7

Rate per thousand reporting longstanding illness conditions, by minority ethnic group and sex


Condition group Minority ethnic group General(ICD chapters)a population


MenObserved %

Infectious disease 8 2 2 0 2 0 2 2

Neoplasms & benign growths 6 0 7 1 8 5 23 19

Endocrine & metabolic 86 45 95 94 106 36 69 72

Blood & related organs 14 9 0 5 2 0 10 5

Mental disorders 27 35 33 29 21 10 53 28

Nervous system 14 12 15 23 15 8 43 34

Eye complaints 22 7 24 17 10 6 23 18

Ear complaints 24 0 19 15 6 6 32 29

Heart & circulatory system 126 54 133 110 107 74 134 123

Respiratory system 58 38 64 85 64 69 85 96

Digestive system 17 17 43 19 43 29 51 43

Genito-urinary system 17 16 16 25 17 19 16 17

Skin complaints 7 2 12 15 7 18 12 17

Musculoskeletal system 149 61 132 127 108 60 194 173

Other complaints 10 9 19 6 4 0 4 5


Infectious disease 2.63 0.93 0.58 0.00 0.82 0.00 0.90 1


Neoplasms & benign growths 0.32 0.00 0.52 0.07 0.53 0.29 1.23 1


Endocrine & metabolic 0.97 1.09 1.53 2.01 2.63 0.66 0.92 1


Blood & related organs 4.75 2.11 0.00 3.17 2.71 0.00 2.17 1


Mental disorders 0.93 1.10 1.19 1.10 0.89 0.38 1.80 1


Nervous system 0.30 0.33 0.60 0.83 0.69 0.28 1.27 1


Eye complaints 1.25 1.10 2.03 2.06 0.70 0.43 1.45 1


Ear complaints 1.10 0.00 0.90 0.95 0.22 0.30 1.18 1


Heart & circulatory system 1.12 0.84 1.30 1.47 1.66 0.90 0.99 1


Respiratory system 0.66 0.36 0.70 0.90 0.80 0.85 0.83 1


Digestive system 0.42 0.39 0.96 0.48 1.51 0.85 1.03 1


Genito-urinary system 0.88 1.62 1.03 2.11 1.26 1.62 0.70 1


Skin complaints 0.20 0.11 0.79 0.83 0.45 0.91 0.75 1


Musculoskeletal system 0.85 0.46 0.83 0.95 0.80 0.48 1.13 1


Other complaints 1.31 1.45 2.92 1.06 2.24 0.00 0.82 1


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


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Table 2.7 continued


Condition group Minority ethnic group General(ICD chapters)a population


WomenObserved %

Infectious disease 1 5 0 1 3 5 10 1

Neoplasms & benign growths 10 8 8 3 5 5 26 19

Endocrine & metabolic 109 33 60 111 74 41 54 75

Blood & related organs 16 10 17 20 17 14 12 9


Nervous system 35 25 30 44 26 19 33 44

Eye complaints 32 8 11 16 16 8 28 24

Ear complaints 7 3 8 2 4 3 13 21

Heart & circulatory system 124 66 100 93 91 56 78 118


Digestive system 30 16 33 52 55 25 69 56

Genito-urinary system 27 9 12 37 13 13 28 25

Skin complaints 10 7 8 13 10 18 20 18

Musculoskeletal system 185 95 123 182 107 69 174 208

Other complaints 6 - 6 5 4 0 - 4


Infectious disease 0.41 3.41 0.00 1.12 3.05 2.59 8.03 1


Neoplasms & benign growths 0.77 0.68 0.73 0.53 0.67 0.51 1.47 1


Endocrine & metabolic 1.59 0.90 0.98 2.51 1.79 0.82 0.79 1


Blood & related organs 2.47 1.08 2.36 3.10 2.96 1.73 0.70 1


Mental disorders 0.93 1.10 1.19 1.10 0.89 0.38 1.80 1


Nervous system 0.79 0.54 0.64 0.96 0.70 0.51 0.76 1


Eye complaints 1.84 1.16 0.52 0.60 1.37 0.70 1.36 1


Ear complaints 0.36 0.22 0.49 0.23 0.28 0.11 0.69 1


Heart & circulatory system 1.48 1.23 1.30 1.69 2.00 0.93 0.62 1


Respiratory system 0.93 0.60 0.57 1.14 0.74 0.40 0.98 1


Digestive system 0.64 0.47 0.65 1.30 1.44 0.53 1.22 1


Genito-urinary system 1.05 0.42 0.45 1.62 0.58 0.64 1.36 1


Skin complaints 0.61 0.39 0.49 0.64 0.36 1.19 0.77 1


Musculoskeletal system 1.07 0.77 0.78 1.41 0.99 0.45 0.79 1


Other complaints 1.95 0.09 1.64 0.86 1.50 0.00 0.03 1


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


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Table 2.7 continued


Minority ethnic group Generalpopulation


Bases (weighted)

Men 479 377 903 423 178 151 1776 46188

Women 676 473 1067 499 208 163 2366 48706

Bases (unweighted)

Men 413 390 550 433 408 348 496 2878

Women 651 469 634 508 478 375 655 3821


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Table 2.8

Self-reported longstanding illness, by equivalised household income within minority ethnic group and sex


Longstanding illness Equivalised household income tertile


Observed %Black Caribbean 27 43 51 34 48 50

Black African 23 29 24 22 22 27

Indian 23 38 55 26 29 38

Pakistani [19] 30 45 [24] 44 44

Bangladeshi a 24 36 a 31 30

Chinese 21 23 [42] 26 20 30

Irish 39 55 65 37 54 55



Black Caribbean

Longstanding illness 0.667 0.849 1.109 0.812 1.013 1.173


Black African



Indian



Pakistani



Bangladeshi



Chinese



Irish



General population



Bases (weighted)

Black Caribbean 152 115 106 156 188 179

Black African 113 89 90 123 115 150

Indian 264 241 150 305 287 203

Pakistani 55 119 137 56 134 168

Bangladeshi 8 39 74 9 44 84

Chinese 44 36 21 52 34 24

Irish 833 398 270 1040 568 347


Bases (unweighted)

Black Caribbean 124 90 96 149 163 179

Black African 104 105 94 102 123 149

Indian 159 155 97 179 173 126

Pakistani 47 114 155 46 135 176

Bangladeshi 19 89 170 23 101 191

Chinese 105 77 49 120 74 58

Irish 207 122 89 257 163 123




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Table 2.9

Self-reported acute sickness in the last two weeks, by minority ethnic group and sex


Acute sickness in Minority ethnic group Generallast two weeksa population


Men

Observed %Had acute sickness 13 10 13 15 14 8 15 14

1-3 days 2 5 3 4 3 3 5 4

4-6 days 3 2 2 3 4 2 3 2

7-13 days 2 3 3 3 3 1 3 2

a full 2 weeks 6 1 4 6 5 2 5 6

No acute sickness 87 90 87 85 86 92 85 86

Mean number of days 9.4 5.4 8.0 8.1 8.4 6.1 7.6 8.1

Standard error of the mean 0.78 0.77 0.60 0.68 0.60 1.05 0.72 0.30


Had acute sickness 0.86 0.80 0.90 1.42 1.27 0.64 0.97 1


Women

Observed %Had acute sickness 21 14 15 21 15 9 17 19

1-3 days 7 6 5 5 4 4 5 5

4-6 days 4 3 1 4 3 0 3 3

7-13 days 4 1 4 4 3 1 4 3

a full 2 weeks 6 5 5 8 5 3 5 7

No acute sickness 79 86 85 79 85 91 83 81




Had acute sickness 1.17 0.82 0.85 1.39 1.10 0.56 0.89 1


Bases (weighted)

Men 479 377 903 423 177 151 1775 46178

Women 672 476 1067 499 208 163 2363 48674

Bases (unweighted)

Men 413 390 550 433 408 348 496 2878

Women 651 469 634 508 478 375 656 3821

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


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Table 2.10

Self-reported acute sickness in the last two weeks, by age within minority ethnic group and sex


Acute sickness in Age groupin last two weeks

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean 9 12 18 13 13 23 29 21

Black African 8 10 [15] 10 9 18 [23] 14

Indian 8 10 26 13 12 15 22 15

Pakistani 6 18 39 15 13 28 39 21

Bangladeshi 6 19 [38] 14 8 26 30 15

Chinese 5 8 16 8 8 9 15 9

Irish 4 21 15 15 14 19 17 17


Bases (weighted)

Black Caribbean 141 196 143 479 219 292 162 672

Black African 179 159 40 377 240 198 37 476

Indian 327 384 192 903 408 466 193 1067

Pakistani 205 154 64 423 276 161 62 499

Bangladeshi 91 65 21 177 135 51 21 208

Chinese 74 50 27 151 63 78 22 163

Irish 412 678 685 1775 497 1033 833 2363


Bases (unweighted)

Black Caribbean 122 166 125 413 200 290 161 651

Black African 179 172 39 390 235 190 44 469

Indian 201 231 118 550 240 275 119 634

Pakistani 222 146 65 433 279 164 65 508

Bangladeshi 209 150 49 408 310 118 50 478

Chinese 172 118 58 348 148 176 51 375

Irish 114 194 188 496 149 274 232 655



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Table 2.11

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


Acute sickness in Equivalised household income tertilelast two weeks



Had acute sickness 6 13 15 17 24 25

No acute sickness 94 87 85 83 76 75

Mean number of daysa 7.6 10.6 10.0 6.7 7.3 7.1

Standard error of the mean 1.51 1.20 1.24 1.32 0.93 0.88

Black African





Indian





Pakistani

Had acute sickness [13] 19 19 [13] 19 24

No acute sickness [87] 81 81 [87] 81 76

Mean number of daysa [2.3] 7.0 9.5 [3.7] 8.9 8.0

Standard error of the mean [0.86] 1.18 0.90 [0.40] 0.98 0.92

Bangladeshi

Had acute sickness b 14 14 b 14 17

No acute sickness b 86 86 b 86 83

Mean number of daysa b 8.0 8.3 b 6.1 8.3

Standard error of the mean b 1.46 1.02 b 1.68 0.89

Chinese

Had acute sickness 7 11 [7] 12 11 8

No acute sickness 93 89 [93] 88 89 92

Mean number of daysa 6.0 6.3 [8.2] 11.2 6.6 5.9

Standard error of the mean 1.94 1.70 [3.23] 1.17 1.48 2.13

Irish





General population





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


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Table 2.11 continued


Acute sickness in Equivalised household income tertilelast two weeks


Standardised risk ratiosHad acute sickness

Black Caribbean 0.51 0.71 1.12 0.82 1.25 1.34


Black African 0.43 0.20 1.70 0.54 0.84 1.31


Indian 0.83 0.43 1.36 0.64 0.93 1.33


Pakistani [0.78] 1.54 1.41 [1.15] 1.34 1.43

Standard error of the ratio [0.30] 0.33 0.25 [0.56] 0.28 0.24

Bangladeshi b 1.52 1.21 b 0.97 1.35

Standard error of the ratio b 0.30 0.23 b 0.30 0.25

Chinese 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




Bases (weighted)

Black Caribbean 152 115 106 156 186 179

Black African 113 89 90 123 115 153

Indian 264 241 150 305 287 203

Pakistani 55 119 137 56 134 168


Chinese 44 36 21 52 34 24

Irish 833 398 269 1040 568 347


Bases (unweighted)

Black Caribbean 124 90 96 149 162 178

Black African 104 105 94 102 123 150

Indian 159 155 97 179 173 126

Pakistani 47 114 155 46 135 176

Bangladeshi 19 88 169 23 101 191

Chinese 105 77 49 120 74 58

Irish 207 122 88 257 163 123


b Results are not shown because of small bases.


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Table 2.12

GHQ12 score, by minority ethnic group and sex


GHQ12 score Minority ethnic group Generalpopulation


MenObserved %

0 62 71 64 63 63 70 67 68

1-3 25 18 21 22 19 21 21 21

4 or more 13 11 16 15 18 9 12 11


4 or more 1.21 0.88 1.32 1.56 1.83 0.76 1.08 1


WomenObserved %

0 54 52 61 57 60 61 61 61

1-3 28 29 24 23 25 26 24 24

4 or more 18 19 14 20 15 13 15 15


4 or more 1.27 1.19 0.99 1.73 1.37 0.83 0.95 1


Bases (weighted)

Men 372 295 769 315 104 135 1614 41950

Women 556 364 890 328 122 139 2182 44845

Bases (unweighted)

Men 315 293 464 322 246 310 427 2621

Women 514 350 534 334 283 318 587 3523


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Table 2.13

Comparison of GHQ12 score in 2004 and 1999, by minority ethnic groupa and sex



BlackCaribbean Indian Pakistani Bangladeshi Chinese Irish

% % % % % % %

Men2004

0 62 64 63 63 70 67 68

1-3 25 21 22 19 21 21 21

4 or more 13 16 15 18 9 12 11

1999

0 51 54 55 48 69 51 55

1-3 33 31 27 26 28 31 30

4 or more 16 16 18 26 3 18 15

Women2004

0 54 61 57 60 61 61 61

1-3 28 24 23 25 26 24 24

4 or more 18 14 20 15 13 15 15

1999

0 44 47 49 46 61 51 50

1-3 34 30 28 31 31 29 31

4 or more 23 23 22 23 8 20 19

Bases (weighted)

Men 2004 372 769 315 104 135 1614 41950

Men 1999 331 540 284 104 85 1497 41374

Women 2004 556 890 328 122 139 2182 44845

Women 1999 464 504 269 104 104 1929 49806

Bases (unweighted)

Men 2004 315 464 322 246 310 427 2621

Men 1999 492 565 488 402 264 515 3389

Women 2004 514 534 334 283 318 587 3523

Women 1999 686 546 464 424 328 684 4052



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Table 2.14

GHQ12 score, by equivalised household income within minorityethnic group and sex


GHQ12 score Equivalised household income tertile



0 57 66 66 64 51 47

1-3 32 24 13 23 30 30

4 or more 11 11 21 13 19 23

Black African

0 81 76 56 57 53 43

1-3 10 13 29 31 29 31

4 or more 9 12 15 12 17 26

Indian

0 74 67 49 64 65 51

1-3 18 21 24 23 24 24

4 or more 8 13 26 12 11 25

Pakistani

0 [64] 61 58 [78] 52 59

1-3 [30] 20 26 [19] 23 21

4 or more [6] 20 16 [3] 26 19

Bangladeshi

0 a [69] 58 a [52] 62

1-3 a [18] 18 a [29] 21

4 or more a [13] 23 a [19] 16

Chinese

0 71 66 [66] 62 56 [65]

1-3 22 19 [23] 27 24 [22]

4 or more 7 15 [11] 11 20 [13]

Irish

0 73 70 43 67 57 50

1-3 20 16 30 20 29 24

4 or more 7 14 27 13 14 25

General population

0 70 66 59 65 59 54

1-3 21 21 21 22 25 24

4 or more 9 14 19 12 16 22

Standardised risk ratiosGHQ12 score of 4 or more

Black Caribbean 1.11 0.83 1.92 0.83 1.30 1.55


Black African 0.76 0.92 1.29 0.89 0.89 2.14


Indian 0.58 1.20 2.22 0.79 0.74 1.60


Pakistani [0.47] 1.87 1.39 [0.15] 2.14 1.81


Bangladeshi a [1.37] 1.52 a [1.88] 1.45

Standard error of the ratio a [0.57] 0.39 a [0.66] 0.32

Chinese 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


General Population 0.75 1.17 1.72 0.80 1.06 1.51




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Bases (weighted)

Black Caribbean 130 83 87 141 161 148

Black African 104 67 67 116 75 116

Indian 242 210 124 286 236 168

Pakistani 46 87 106 38 78 117


Chinese 43 32 16 48 30 19

Irish 811 347 232 1013 514 316


Bases (unweighted)

Black Caribbean 106 69 75 130 134 144

Black African 92 76 69 94 84 114

Indian 147 135 77 169 144 104

Pakistani 40 84 117 32 82 120

Bangladeshi 18 44 99 19 48 117

Chinese 103 69 36 108 65 47

Irish 197 103 73 249 140 109



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Table 2.15

Perceived social support, by minority ethnic group and sex


Perceived social Minority ethnic group Generalsupport population


MenObserved %

No lack 46 47 44 38 40 40 56 57

Some lack 29 29 27 25 25 30 26 27

Severe lack 25 23 29 38 35 30 17 16


Severe lack 1.52 1.37 1.76 2.36 2.34 1.89 0.96 1


WomenObserved %

No lack 52 51 51 45 50 44 68 67

Some lack 28 27 28 25 17 30 22 23

Severe lack 20 23 22 30 33 26 11 11


Severe lack 1.97 2.07 1.99 2.47 3.07 2.32 0.84 1


Bases (weighted)

Men 390 296 771 315 104 135 1624 42128

Women 567 377 907 341 126 143 2195 45113

Bases (unweighted)

Men 327 296 467 321 246 312 433 2636

Women 521 362 541 346 292 328 597 3548


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Table 2.16

Comparison of perceived social support in 2004 and 1999, by minority ethnic groupa and sex


Perceived Minority ethnic group Generalsocial support population


% % % % % % %

Men2004

No lack 46 44 38 40 40 56 57

Some lack 29 27 25 25 30 26 27

Severe lack 25 29 38 35 30 17 16

1999

No lack 48 39 38 34 30 55 54

Some lack 33 29 33 30 32 33 30

Severe lack 19 32 29 36 38 12 16

Women2004

No lack 52 51 45 50 44 68 67

Some lack 28 28 25 17 30 22 23

Severe lack 20 22 30 33 26 11 11

1999

No lack 55 39 40 41 33 66 63

Some lack 29 27 33 30 33 25 26

Severe lack 15 33 27 30 34 10 11

Bases (weighted)

Men 2004 390 771 315 104 135 1624 42128

Men 1999 336 542 290 109 90 1486 41573

Women 2004 567 907 341 126 143 2195 45113

Women 1999 470 520 273 112 108 1942 50247

Bases (unweighted)

Men 2004 327 467 321 246 312 433 2636

Men 1999 500 569 500 418 281 512 3404

Women 2004 521 541 346 292 328 597 3548

Women 1999 695 561 472 456 341 688 4088

c Black Africans were include in the 2004 survey but not in the 1999 survey, so therefore are excluded fromthis comparative table.


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Table 2.17

Perceived social support, by equivalised household income withinminority ethnic group and sex


Perceived social support Equivalised household income tertile



No lack 46 37 58 56 52 53

Some lack 32 30 17 29 28 28

Severe lack 22 33 25 16 20 19

Black African

No lack 54 46 44 61 49 38

Some lack 32 31 25 26 29 26

Severe lack 15 23 31 13 22 36

Indian

No lack 52 39 32 59 44 40

Some lack 24 31 25 29 30 26

Severe lack 24 29 43 12 26 34

Pakistani

No lack [46] 39 31 [51] 41 41

Some lack [22] 18 28 [30] 23 28

Severe lack [32] 43 41 [19] 36 31

Bangladeshi

No lack a [56] 32 a [66] 47

Some lack a [5] 30 a [8] 16

Severe lack a [39] 37 a [27] 37

Chinese

No lack 58 32 [36] 60 38 [27]

Some lack 25 33 [23] 28 22 [36]

Severe lack 18 35 [41] 12 40 [37]

Irish

No lack 70 47 30 80 60 42

Some lack 21 29 33 17 29 33

Severe lack 9 24 37 3 11 26

General population

No lack 64 52 44 74 63 50

Some lack 25 28 28 19 25 31

Severe lack 10 20 29 6 12 19

Standardised risk ratiosSevere lack of social support

Black Caribbean 1.39 1.78 1.44 1.49 1.84 1.74


Black African 0.74 1.28 1.99 1.30 2.21 2.62


Indian 1.43 1.84 2.67 1.18 2.21 3.18


Pakistani [2.20] 2.64 2.66 [3.23] 2.58 2.56


Bangladeshi a [2.65] 2.08 a [2.32] 2.88


Chinese 1.05 2.11 [2.92] 1.02 3.64 [3.18]


Irish 0.44 1.36 2.52 0.24 1.05 1.74






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Bases (weighted)

Black Caribbean 131 96 86 139 167 150

Black African 101 67 70 116 79 123

Indian 241 210 124 287 242 170

Pakistani 46 87 106 38 82 126


Chinese 43 33 16 49 31 20

Irish 799 357 243 1023 515 327


Bases (unweighted)

Black Caribbean 108 74 74 129 138 144

Black African 90 76 72 94 88 120

Indian 147 136 77 169 147 104

Pakistani 40 84 117 33 86 127

Bangladeshi 18 43 100 19 49 123

Chinese 103 72 36 112 67 48

Irish 196 104 77 251 145 112




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Table 2.18

Number of prescribed medicines, by minority ethnic group and sex


Number of prescribed Minority ethnic group Generalmedicinesa population

Black Black (2003)b


MenObserved %

1 12 8 11 8 11 7 10 13

2 8 11 8 10 11 3 8 9

3 7 5 6 3 3 1 4 6

4 or more 12 4 17 10 12 9 15 12

Mean number of medicines per person 1.2 0.6 1.5 1.0 1.3 0.7 1.3 1.2


Mean number of medicines per taker 3.1 2.2 3.6 3.3 3.7 3.5 3.5 3.0



4 or more 1.07 0.81 1.78 1.50 1.59 1.36 1.33 1


WomenObserved %

1 12 11 15 16 11 12 17 16

2 15 5 9 8 11 9 15 11

3 8 4 5 6 7 2 6 8

4 or more 12 7 10 14 14 5 13 14

Mean number of medicines per person 1.4 0.7 1.0 1.4 1.4 0.7 1.4 1.5


Mean number of medicines per taker 2.9 2.7 2.7 3.1 3.4 2.5 2.8 3.0



4 or more 1.26 1.08 1.22 2.35 2.50 0.68 0.74 1


Bases (weighted)

Men 243 179 444 202 77 75 890 5531

Women 337 248 538 251 107 80 1143 5877

Bases (unweighted)

Men 218 165 316 208 143 183 320 5086

Women 327 216 382 260 185 199 418 6322

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

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.

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HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 3: CARDIOVASCULAR DISEASE AND DIABETES 63

Cardiovasculardisease and diabetes

Jennifer Mindell & Paola Zaninotto

● 14.5% of Irish men and 13.0% of women from the general population reported everhaving a cardiovascular disorder diagnosed by a doctor. Black African men were one-quarter as likely, and Bangladeshi women over half as likely, to have any CVDcondition, compared with the general population. The prevalence of any CVDcondition 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 informantsreported the lowest prevalence of IHD and of IHD or stroke.

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

● Black Caribbean women showed the highest rates of angina symptoms (3.9% Grades1 and 2 angina combined), and Black Caribbean men showed the highest rates ofsymptoms of possible myocardial infarction (8.2%), based on the Rose AnginaQuestionnaire.

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

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

● The prevalence of doctor-diagnosed diabetes increased markedly with age, in bothmen and women. It was more common in men than women for most minority ethnicgroups 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, BlackAfrican, Indian and Pakistani women aged 55+.

● The prevalence of undiagnosed diabetes did not differ between different minorityethnic groups in men.

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

3Summary

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

minority ethnic groups relative to the general population was the same in 2004 as in1999, among both men and women. Observed prevalence did not rise significantlybetween 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 diseaseburden. Its main components are ischaemic heart disease (IHD, also called coronary heartdisease (CHD) or coronary artery disease (CAD)) and stroke.

Although death rates are falling, CVD remains the main cause of death in England, causingover 190,000 deaths (over 92,500 IHD and over 40,000 stroke deaths) in England and Walesin 2004, of which just under 52,000 were before the age of 75.1 Each year in England thereare 110,000 strokes,2 of which about 40% are recurrent strokes.3 In 2003/04, there werealmost 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 and25% of long term hospital beds.2 The Health Survey for England (HSE) 20035 summarisedtrends in mortality and morbidity of CVD and geographical inequalities across Britain; theHealthcare Commission has recently summarised the impact of CHD on individuals and theNHS.6

Risks of CVD are greatly increased in people who smoke, are physically inactive, have alow-fibre and/or high-fat diet, are obese, have raised blood pressure or cholesterol, or havediabetes. Psychosocial factors, such as depression and anxiety, psychosocial workcharacteristics, and social support, also contribute to the development of and mortalityfrom IHD.7 These factors explain much, but not all, of the marked social class gradient andgeographical inequalities in CHD morbidity and mortality. Cultural factors play a part, butpoverty severely constrains the ability to make and act upon choices, such as lifestyle andhealthcare choices. CVD is a particular problem in many minority ethnic groups; many ofthe statistics that are available on prevalence of CVD and its risk factors among minorityethnic groups in England originate from the HSE series.8

Mortality from IHD is particularly high among Irish and Scottish people and those fromSouth Asian groups, particularly Pakistanis and Bangladeshis.9,10,11 Mortality from IHD is50% higher in people born in Bangladesh, India and Pakistan than among the generalpopulation.6 The extent to which deprivation, adverse lifestyle factors, poorer access tohealthcare, 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 raisedprevalence of diabetes contributes to the raised risk of IHD.6,15 Elevated risks of prematuredeath and poor health have also been reported in second-11 and third-generation15 Irish, aswell as in Irish migrants. Black Caribbean and Black African people have lower prematuredeath rates of IHD than the general population but this is predicted to change as theirsmoking prevalence has been rising.17 IHD is also less common in Chinese people.

Research findings on ethnic inequalities in access to diagnosis and treatment of IHD aremixed, often depending on how and whether ‘South Asians’ are subdivided into ethniccategories:18 Bangladeshi patients appear to be most disadvantaged, and Pakistanipatients 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 ofstrokes caused by infarction or haemorrhage depends on the ethnic composition of thepopulation studied. Black Africans and Black Caribbeans have above average prevalenceof hypertension and of ischaemic stroke2,21,22 (between 69%23,24 and 89%25 of strokes in theUK), although atrial fibrillation (another important risk factor for stroke3) is less importantamong 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, althoughhypertension is again important. Chinese26 and Black24 people are at particular risk of bothtypes of stroke, with hypertension as a predominant risk factor.24,26 Survival after a firststroke 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 withWhite 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, andexamines CVD by household income. The second part covers the prevalence of diabetesamong 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 changesover time are examined, the current definition is used and the 1999 data have been recodedaccordingly.

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

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

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

● Rose Angina Questionnaire: this aims to collect information on symptoms of angina orheart attack irrespective of medical diagnosis. Informants are classified as having anginasymptoms based on answers to questions on whether they have experienced chestpain.29 Informants are classified as having had a possible myocardial infarction (heartattack) if they reported having ever had an attack of severe pain across the front of thechest, lasting for half an hour or more. This is referred to in this chapter as ‘possiblemyocardial 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 notasked of the general population sample in the 2004 survey.

3.1.3 Prevalence of cardiovascular conditions, by minority ethnic group

This section presents the prevalence by sex, age and minority ethnic group separately forany cardiovascular condition and for a number of specific cardiovascular diseases. Forclarity, the text comments on the broader disease groupings before commenting on morespecific conditions. This differs from the order of the tables.

Age is the strongest risk factor for both ischaemic heart disease (IHD) and stroke in thegeneral population.25 Results from HSE 2004 confirm that this is also the case in almostevery minority ethnic group for stroke, angina, heart attack, and abnormal heart rhythm(except Black Caribbean and Chinese women), although numbers of older Black Africanpeople and Bangladeshi men are too small to draw firm conclusions. Age-standardised riskratios are used to take account of differences in the age profile of different minority ethnicgroups (see chapter 1).

Any CVD condition

Irish men had the highest prevalence of any CVD (14.5%) while Black African men had thelowest (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 one-quarter 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 andwomen in other minority ethnic groups were not significantly different from 1. Table 3.3

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The proportion with any CVD condition increased with age in both sexes, and was markedlyhigher in the oldest age group (55 and over). Table 3.4, Figure 3A

Ischaemic heart disease or stroke

The lowest prevalence of ischaemic heart disease (IHD, defined as doctor-diagnosedangina or heart attack) or stroke was seen among Black African informants (0.7% for menand 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, age-standardised risk ratios were significantly low for Black African informants (0.22 for menand 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 55and 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 Africaninformants, aged 55 and over, had also low prevalence of IHD (5.2% for men and 1.5% forwomen, but note small bases). Table 3.4

Ischaemic heart disease

The observed prevalence of ischaemic heart disease (angina or heart attack) was higher inmen than in women. Black African informants had the lowest prevalence of IHD (0.7% formen and 0.5% for women). Among women, the age-standardised risk ratios of IHD weregenerally 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 thehighest risk ratio was 2.43 in Pakistani men. Table 3.3


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Prevalence of CVD, by minority ethnic group and age

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Among men aged 55 and over, Pakistanis had the highest prevalence of IHD (35.1%) andChinese 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 washighest 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 BlackAfrican 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 asthe observed percentages. Relative to men in the general population, risk ratios for anginawere low for Black African men (0.36) and high for Pakistani men (2.85) - the only risk ratioto be significantly greater than the general population (set at 1.0).

In women from minority ethnic groups, the observed prevalence of angina was lowestamong Black African women (0.5%) and highest among Indian women (3.2%). Afteradjusting for age, rates of angina among Black African women were significantly lower thanin the general population (risk ratio 0.19). The observed prevalence of angina was loweramong Bangladeshi women than women from the general population. However, afterstandardising for age, the risk ratio among Bangladeshi women was twice as high (2.22) asfor women in the general population (set at 1). This was the only risk ratio to be significantlyhigher than the general population. Table 3.1, Figure 3B

The age-standardised risk ratios of heart attack for men and women from minority ethnicgroups 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 Chineseinformants (risk ratio 0.12 for men and 0.00 for women). Table 3.1

The highest prevalence of angina and of heart attack was observed in those aged 55 andover: 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% forwomen). Age-standardised risk of stroke for men and women in each minority ethnic groupdid not differ significantly from the general population, except for Chinese women (risk ratio0.22) and Black African men (risk ratio 0.00). Results from other studies suggest that theincidence 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);


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Prevalence of angina, by minority ethnic group

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Figure 3B

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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; andchance. Table 3.1

The prevalence of stroke was highest among informants aged 55 and over. Black Caribbeanand Pakistani men had the highest prevalence (11.5% and 9.6% respectively). Amongwomen aged 55 and over, the highest prevalence was among Bangladeshi (11.9%) andPakistani (10.1%) informants. The difference in prevalence of stroke between Black Africanmen aged 55 and over (0%) and similarly aged men in the general population (6.4%) is notstatistically 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 menand 3.4% for women). After adjusting for age, the rates of heart murmur were still lowest forBlack African men (risk ratio 0.15) and Chinese women (0.30).

The observed prevalence of abnormal heart rhythm was significantly lower among BlackAfrican 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 abnormalheart 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 generalpopulation (2.8% for men and 1.8% for women) among Bangladeshi men (none) andChinese men (0.6%). After adjusting for age, Bangladeshi and Chinese men had the lowestrates (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 amongpeople below the age of 35 than the other conditions. People from minority ethnic groupsreported 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. Theprevalence of self-reported heart murmur rose with age in most groups, except Indian andIrish men. Table 3.2

3.1.4 CVD by equivalised household income

This section presents the prevalence of CVD, IHD and IHD or stroke by equivalisedhousehold income tertile within minority ethnic group. Equivalised household income is ameasure of household income that takes account of the number of persons in thehousehold. The sample was divided into equivalised household income tertiles which wereapplied to all minority ethnic groups: they are not group-specific, and do not divide eachgroup into equal thirds; the income levels that form the boundaries of the tertiles are thesame for each group.

Among men, the observed prevalence of any CVD tended to be highest in the lowestincome. 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 womenin the highest income tertile. Similarly, after adjusting for age, higher rates of CVD werefound among those with the lowest income for Irish men (risk ratio 2.45) and women (riskratio 2.21), than those in the highest income tertile (0.79 for men and 0.69 for women). Thiswas 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 1.43and 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 Bangladeshiinformants in the highest tertile of income were too low to confirm this pattern. However, thepattern in Chinese women was different, as the prevalence of CVD in Chinese women in thehighest income tertile was greater, but not significantly so, than the prevalence in the lowesttertile of income. In other minority ethnic groups, there was no clear relationship betweenincome and prevalence of CVD.


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For both IHD and IHD or stroke, the observed prevalence was also generally higher amonginformants with the lowest income. The largest differences in prevalence were found ininformants 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 forIHD) and for Irish informants (prevalence of IHD in the lowest income tertile13.2% of menand 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 allCVD. The rates were generally higher for informants in the lowest income tertile (except forChinese women, where the reverse pattern was again not significant). Among Irishinformants, the risk ratio for IHD or stroke among women in the lowest income categorywas 3.49 compared with 0.28 for Irish women in the highest income tertile; the equivalentrisk ratios for men were 2.37, compared with 0.09 in the highest income tertile. Higher riskratios 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 highestincome tertile). The pattern was similar but closer to 1 for IHD. The other group for whomrisk ratios differed significantly by income was Black Caribbean women (risk ratio for IHD1.92 for women in the lowest and 0.14 for the highest income tertile, and for IHD or stroke1.75 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 1and 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 morelikely to report milder symptoms (grade 1) than more severe symptoms (grade 2). This wasnot always the case for men.

Comparing the figures for symptoms of chest pain with those for self-reported doctor-diagnosed 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). Incontrast, angina symptoms among Black African women were much higher than theprevalence of doctor-diagnosed angina reported (2.2% and 0.5% respectively). Higherrates for symptoms compared with diagnoses of angina were also reported in Pakistaniwomen.

Age-standardised risk ratios of Grade 1 angina were significantly low for Black Caribbeanmen (0.02), Black African men (0.09) and Chinese women (0.15). The Grade 2 angina riskratios of the minority ethnic groups (in both sexes) were not significantly different from thosein the general population; the only exception was for Black African men and Chinesewomen who both had a risk ratio of 0.00. Tables 3.6, 3.7

The age-standardised risks of symptoms of possible MI were significantly low for BlackAfrican 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 1.80respectively). Table 3.6

The prevalence of possible symptoms of myocardial infarction based on the Rose AnginaQuestionnaire (Table 3.7) increased with age. Generally the rates were much higher thanthose for self-reported heart attack (ever diagnosed) shown in Table 3.2. This confirmsprevious 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 werecompared using results from the 1999 HSE. The definition of CVD used in 1999 includedhigh blood pressure and diabetes. Therefore data from 1999 (and 1998 for the generalpopulation) were re-analysed using the new definition to enable comparisons to be made.


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There was a general but (in the majority of cases) not significant increase in the prevalenceof CVD between 1999 and 2004 in most minority ethnic groups and in the generalpopulation. The only significant increase was among Pakistani men, where the prevalenceof 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 theprevalence of IHD were generally not statistically significant. The only exceptions were forBlack Caribbean and Pakistani men, where the prevalence of IHD doubled between the twosurvey years.

The prevalence of IHD or stroke increased significantly for Pakistani men to 9.1% in 2004from 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 ofIHD 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 weresimilar to those reported in 1999. A few differences were noted, however. For example, inthe 2004 survey, the risk ratios for angina and for IHD for Black Caribbean, and the risk ratioof angina for Chinese men, were not significantly different from those for men in the generalpopulation. For Chinese women, the risk ratios for angina and for IHD were no different fromwomen in the general population. However, age-standardised risk ratios for angina and forIHD were significantly lower in Black Caribbean men and Chinese men and women in 1999than in the general population.8

The relationships found between CVD and income differed between the two surveys. InHSE 2004, the observed prevalence of CVD in men tended to be higher in the lowestincome tertile than the highest income tertile. After adjusting for age, higher rates of CVDwere 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 higher-income Bangladeshi men, higher income Bangladeshi women, and middle and higher-income Black Caribbean women.8

After adjusting for age, the rates of IHD or stroke were higher for informants in the lowestincome category in minority ethnic groups (except for Chinese women) and in the generalpopulation in 2004. However, in 1999, this was seen only in men and women in the generalpopulation and not for any of the minority ethnic groups.8

3.2 Diabetes

3.2.1 Introduction

Diabetes is characterised by high blood glucose levels (hyperglycaemia). The resultingchronic hyperglycaemia is associated with damage and possible failure of many organs,especially the eyes, kidneys, nerves, heart, and blood vessels. Diabetes is a known riskfactor for CVD. It also tends to worsen the effects of other risk factors for CVD, such asdyslipidaemia, hypertension, smoking, and obesity.

There are two main types of diabetes: 1 and 2. Type 1 diabetes (also known in the past asinsulin-dependent, or juvenile diabetes) is the result of autoimmune destruction of the cellsof the pancreas which produce insulin. Type 2 diabetes (formerly known as non insulin-dependent) is characterised by insulin resistance (i.e. the inability of the body to respond toinsulin). Type 2 diabetes is the more common, accounting for over 90% of all diabetes. It ismuch more common in Black Caribbean and South Asian groups.9 In the past, it was adisease 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 risingepidemic of obesity. The first cases in England were reported in 2000 in overweight girlsaged nine to 16 of Pakistani, Indian or Arabic origin32 and in white adolescents in 2002.33 Inthe UK in 2004, children of South Asian origin were more than 13 times more likely to havetype 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 nodistinction between type 1 and 2 diabetes. For classification purposes, type 1 diabeteshas been defined as being diagnosed before the age of 35 and being on insulin therapy atthe time of the survey.

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

● ‘Controlled diabetes’: This can be assessed by measuring glycated haemoglobin (seechapter 10) but the bases were too small to examine levels in men and women withdiabetes 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.

3.2.3 Prevalence of diabetes, by minority ethnic group

Doctor-diagnosed diabetes

Observed prevalence of doctor-diagnosed diabetes was significantly higher in BlackCaribbean, 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 forage, doctor-diagnosed diabetes was almost four times as likely in Bangladeshi men, andalmost three times as likely in Pakistani and in Indian men compared with men in the generalpopulation. Among women, doctor-diagnosed diabetes was more than five times as likelyamong Pakistani women, at least three times as likely in Bangladeshi and Black Caribbeanwomen, and two-and-a-half times as likely in Indian women compared with women in thegeneral population.

Prevalence of type 1 diabetes was below 1% in each minority ethnic group and in thegeneral population. Table 3.9

The prevalence of doctor-diagnosed diabetes increased markedly with age, in both menand women. It was more common in men than women for most minority ethnic groups andage-groups. However, Pakistani women aged 55+ had a significantly higher prevalence ofdiabetes (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) aged55+ 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 Bangladeshigroups aged 35+ and among Black Caribbean, Black African, Indian and Pakistani womenaged 55+.

Doctor-diagnosed diabetes was rare among those aged 16-34, but was highest amongIndian men (2.0%), Black African men (1.7%) and Irish women (1.7%).

Table 3.10, Figures 3C and 3DUndiagnosed diabetes

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


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

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Prevalence of doctor-diagnosed type 2 diabetes, by minority ethnic group

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Figure 3D

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1.0

10.0

participants who provided a fasting blood sample, to enable comparisons betweenprevalence of doctor-diagnosed and of undiagnosed diabetes among the same groups ofinformants. Prevalence of doctor-diagnosed diabetes therefore differs from that quotedelsewhere in this chapter.

Prevalence of undiagnosed diabetes increased with age in men but the differences were notsignificant. Although the prevalence of diabetes (diagnosed plus undiagnosed) variedmarkedly between different ethnic groups, the prevalence of undiagnosed diabetes did notdiffer in men. In women aged 35-54, prevalence of undiagnosed diabetes in South Asianwomen (4.0%) was significantly higher than in Black women (no cases found) or women inthe 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 generalpopulation were undiagnosed. More than three-quarters of cases of diabetes in SouthAsian women were diagnosed, with an even higher proportion of cases diagnosed in Blackand Irish women and women in the general population. Figure 3E

3.2.4 Diabetes by equivalised household income

Observed prevalence of doctor-diagnosed diabetes was significantly inversely related tohousehold income in some groups. The age-standardised risk ratios for doctor-diagnoseddiabetes were significantly higher in informants in the lowest income tertile compared withthe highest tertile for Black Caribbean and Indian men, Pakistani women, and men andwomen 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 differencesseen were not significant. Table 3.12

3.2.5 Comparison between 1999 and 2004

The pattern for age-standardised prevalence of doctor-diagnosed diabetes among minorityethnic 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 inmost minority ethnic groups (for all adults and in age-groups 35-54 and 55 and over), thisincrease was only significant in the general population (up to 4.3% in men and 3.4% inwomen in 2003, from 3.3% and 2.5% respectively in 1998). The largest rises appeared inolder people (aged 55 and over), particularly among Black Caribbean and Indian men andIndian and Pakistani women. However, rises were not universal: prevalence of doctor-diagnosed diabetes appeared to fall in older Bangladeshi women and in older Pakistani


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Black

General

population

South Asian

Irish Black

General

population

South Asian

Irish

Diagnosed and undiagnosed diabetes

Men Women

Per

cent

Figure 3E

0

2

4

6

8

10

12

14

16

18

0

2

4

6

8

10

12

14

16

18

Doctor-diagnosed diabetesUndiagnosed diabetes

Aggregated ethnic group Aggregated ethnic group

men. Although the magnitude of some of these changes was large, none were significant asthe number of informants was small when analysed by sex, age-group and minority ethnicgroup. Changes in the age-composition of informants between the two years within theage-groups could affect the observed prevalence. Additionally, these results do notdistinguish between changes in prevalence of diabetes, associated with increasing obesity,and increased detection of those with diabetes. Table 3.13


1 Death registrations in England and Wales, 2004: causes. Health Statistics Quarterly. 2005; 26:62-69www.statistics.gov.uk/downloads/theme_health/HSQ26.pdf

2 National Audit Office. Reducing brain damage: Faster access to better stroke care. HC 452. Departmentof 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 cohortstudy. 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 - 2003/04www.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 ofprogress 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 groups1999. TSO, London, 2001.

9 Aspinall P, Jacobson B. Ethnic disparities in health and health care: A focused review of the evidence andselected 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). Healthinequalities: 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 treatmentcontribute to social and ethnic differences in coronary heart disease? Whitehall II prospective cohortstudy. BMJ. 2004; 329:318-323.

11 Bardsley M, Hamm J, Lowdell C, Morgan D, Storkey M. Developing health needs assessment for blackand minority ethnic groups. Health of Londoners Project, London, 2000.

12 Nazroo JY. South Asian people and heart disease: an assessment of the importance of socioeconomicposition. 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. InStevens A, Raftery J, Mant JM (eds). Health care needs assessment. The epidemiologically based needsassessment reviews. Radcliffe Press, Oxford, 2003.

15 Bhopal R, Unwin N, White M, Yallop J, Walker L, Alberti KG et al. Heterogeneity of coronary heart diseaserisk factors in Indian, Pakistani, Bangladeshi, and European origin populations: cross sectional study.BMJ. 1999; 319:215-220.

16 Wild S, McKeigue P. Cross sectional analysis of mortality by country of birth in England & Wales 1970-1992. BMJ. 1997; 314: 705-10.

17 Abbotts J, Harding S, Cruickshank K. Cardiovascular risk profiles in UK-born Caribbeans and Irish livingin England and Wales. Atherosclerosis. 2004; 175:295-303.

18 Mindell J, Klodawski E, Fitzpatrick J. Using routine data to measure ethnic inequalities inrevascularisation 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 invasivemanagement 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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21 Hajat C, Tilling K, Stewart JA, Lemic-Stojcevic N, Wolfe CDA. Ethnic Differences in Risk Factors forIschemic 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 StrokeProject). Am J Cardiol. 2003; 92:1476-1479.

23 Intercollegiate Stroke Working Party. National clinical guidelines for stroke. 2nd edition. Royal College ofPhysicians, 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 multiethnicpopulation: 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 event-rate, incidence, case fatality, and mortality for all acute vascular events in all arterial territories (OxfordVascular 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 aCohort 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 multiethnicpopulation: 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. JPediatrics. 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 DisChild. 2002; 86:207-208.

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


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HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 3: CARDIOVASCULAR DISEASE AND DIABETES 77

Tables

3.1 Prevalence of CVD conditions, by minorityethnic group and sex

3.2 Prevalence of CVD conditions, by age withinminority ethnic group and sex

3.3 Prevalence of CVD/IHD/IHD or stroke, byminority ethnic group and sex

3.4 Prevalence of CVD/IHD/IHD or stroke, by agewithin minority ethnic group and sex

3.5 Prevalence of CVD, IHD, IHD or stroke, byequivalised household income tertile withinminority ethnic group and sex

3.6 Prevalence of angina and MI symptoms (usingthe Rose Angina Questionnaire), by minorityethnic group and sex

3.7 Prevalence of angina and MI symptoms (usingthe Rose Angina Questionnaire), by age withinminority ethnic group and sex

3.8 Comparison of CVD/IHD/IHD or stroke in 2004and 1999, by age within minority ethnic groupand sex

3.9 Prevalence of doctor-diagnosed diabetes, byminority ethnic group and sex

3.10 Prevalence of doctor-diagnosed diabetes, byage within minority ethnic group and sex

3.11 Prevalence of undiagnosed and doctor-diagnosed diabetes, by age within aggregatedminority ethnic group and sex

3.12 Prevalence of doctor-diagnosed diabetes, byequivalised household income tertile withinminority ethnic group and sex

3.13 Comparison of doctor-diagnosed diabetes in2004 and 1999, by age within minority ethnicgroup and sex


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Table 3.1

Prevalence of CVD conditions, by minority ethnic group and sex


CVD conditionsa Minority ethnic group Generalpopulation

Black Black (2003)b


MenObserved %

Angina 3.4 0.7 4.9 6.9 3.1 1.6 4.0 4.8

Heart attack 3.2 - 3.9 4.1 2.9 0.3 3.0 3.8

Heart murmur 1.6 0.4 1.8 2.6 0.7 1.6 2.6 3.1

Abnormal heart rhythm 3.8 0.4 1.9 3.0 1.6 3.1 4.5 5.1

‘Other’ heart trouble 1.0 0.8 2.6 2.9 - 0.6 1.7 2.8

Stroke 3.4 - 1.1 1.8 1.8 0.7 4.5 2.4


Angina 0.73 0.36 1.26 2.85 1.24 0.60 0.73 1


Heart attack 0.79 0.00 1.33 1.71 1.75 0.12 0.85 1


Heart murmur 0.49 0.15 0.67 0.90 0.22 0.57 1.36 1


Abnormal heart rhythm 1.01 0.08 0.46 0.75 0.59 0.84 0.83 1


‘Other’ heart trouble 0.34 0.37 1.01 1.83 0.00 0.25 0.74 1


Stroke 1.26 0.00 0.59 1.06 2.05 0.71 1.98 1


WomenObserved %

Angina 1.5 0.5 3.2 2.5 2.0 1.2 2.5 3.4

Heart attack 1.4 - 1.0 1.1 0.6 - 0.8 1.7

Heart murmur 2.7 1.7 1.5 1.4 1.0 0.8 2.1 3.4


‘Other’ heart trouble 2.3 1.3 1.6 1.6 1.0 1.0 1.4 1.8

Stroke 1.8 0.5 1.2 1.7 1.8 0.4 2.7 2.2


Angina 0.61 0.19 1.79 2.19 2.22 1.00 0.87 1


Heart attack 1.49 0.00 1.15 1.95 1.47 0.00 0.55 1


Heart murmur 0.90 0.77 0.52 0.59 0.72 0.30 0.51 1


Abnormal heart rhythm 0.53 0.89 0.64 0.75 0.90 0.62 0.91 1


‘Other’ heart trouble 1.69 1.37 1.19 1.98 1.08 0.57 0.90 1


Stroke 1.31 0.69 0.72 2.25 2.73 0.22 1.20 1


Bases (weighted)

Men 480 377 903 423 178 151 1776 7202

Women 676 476 1067 499 208 163 2369 7634

Bases (unweighted)

Men 414 390 550 433 411 348 497 6602

Women 653 469 634 508 478 375 656 8234

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.


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Table 3.2

Prevalence of CVD conditions, by age within minority ethnic group and sex


CVD conditiona Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

Angina - 0.4 10.7 3.4 - 0.9 4.6 1.5

Heart attack - 1.1 9.3 3.2 0.4 0.8 3.7 1.4

Heart murmur - 2.2 2.5 1.6 1.3 2.5 4.6 2.7


‘Other’ heart trouble - 0.3 3.0 1.0 0.4 3.3 3.1 2.3

Stroke - - 11.5 3.4 - 1.1 5.6 1.8

Black African

Angina 0.3 - [5.2] 0.7 0.1 1.0 [ - ] 0.5

Heart attack - - [ - ] - - - [ - ] -

Heart murmur 0.8 - [ - ] 0.4 1.2 1.2 [8.1] 1.7

Abnormal heart rhythm 0.9 [ - ] 0.4 0.6 3.1 [11.0] 2.5

‘Other’ heart trouble 1.3 0.5 [ - ] 0.8 1.1 1.4 [2.3] 1.3

Stroke - - [ - ] - 0.4 0.4 [1.5] 0.5

Indian

Angina - 2.8 17.3 4.9 - 1.2 14.7 3.2

Heart attack - 0.8 16.5 3.9 - 0.8 3.5 1.0

Heart murmur 0.4 2.9 2.2 1.8 0.7 1.4 3.7 1.5



Stroke - - 5.2 1.1 - 1.0 4.2 1.2

Pakistani

Angina - 6.2 30.9 6.9 0.6 1.5 13.7 2.5

Heart attack - 3.4 19.0 4.1 - 0.7 6.9 1.1

Heart murmur 2.1 2.3 4.7 2.6 0.5 2.4 2.8 1.4



Stroke - 1.1 9.6 1.8 0.2 0.9 10.1 1.7

Bangladeshi

Angina - 4.8 [11.4] 3.1 - 2.7 12.7 2.0

Heart attack - 2.9 [15.1] 2.9 - - 5.6 0.6

Heart murmur - 1.0 [2.4] 0.7 - - 9.7 1.0

Abnormal heart rhythm - 2.0 [7.5] 1.6 0.4 2.7 14.1 2.3

‘Other’ heart trouble - - [ - ] - 0.2 2.5 2.2 1.0

Stroke - 1.9 [9.2] 1.8 0.3 1.6 11.9 1.8

Chinese

Angina - 1.1 7.2 1.6 - 0.1 8.2 1.2

Heart attack - 1.1 - 0.3 - - - -

Heart murmur 0.6 - 7.5 1.6 - 1.2 1.9 0.8


‘Other’ heart trouble 0.6 - 1.8 0.6 - 1.1 3.7 1.0

Stroke - 0.8 2.2 0.7 - 0.5 0.8 0.4

Irish

Angina - 0.6 9.7 4.0 - 1.1 5.7 2.5

Heart attack 0.4 2.5 5.1 3.0 - 0.4 1.8 0.8

Heart murmur 6.4 2.0 1.0 2.6 1.8 0.9 3.9 2.1



Stroke - 2.2 9.4 4.5 0.9 0.6 6.3 2.7

a Ever had condition diagnosed by a doctor. Continued…


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Table 3.2 continued


CVD conditiona Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

General population (2003)b

Angina - 1.5 13.4 4.8 0.1 0.8 8.7 3.4

Heart attack - 1.5 10.4 3.8 - 0.5 4.5 1.7

Heart murmur 2.4 2.6 4.6 3.1 2.4 2.9 4.7 3.4



Stroke 0.3 0.7 6.4 2.4 0.3 0.7 5.2 2.2

Bases (weighted)

Black Caribbean 141 196 143 480 219 292 165 676

Black African 179 159 40 377 240 198 37 476

Indian 327 384 192 903 408 466 193 1067

Pakistani 205 154 64 423 276 161 62 499

Bangladeshi 92 65 21 178 135 51 21 208

Chinese 74 50 27 151 63 78 22 163

Irish 412 678 686 1776 497 1038 833 2369

General population (2003) 2320 2601 2281 7202 2319 2640 2675 7634

Bases (unweighted)

Black Caribbean 122 167 125 414 200 291 162 653

Black African 179 172 39 390 235 190 44 469

Indian 201 231 118 550 240 275 119 634

Pakistani 222 146 65 433 279 164 65 508

Bangladeshi 212 150 49 411 310 118 50 478

Chinese 172 118 58 348 148 176 51 375

Irish 114 194 189 497 149 275 232 656


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.


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Table 3.3

Prevalence of CVD/IHD/IHD or stroke, by minority ethnic group and sex


Any CVD/IHD/IHD or Minority ethnic group Generalstroke population

Black Black (2003)a


MenObserved %

Any CVD 9.4 2.3 10.7 12.0 5.6 5.3 14.5 13.6

IHD 4.4 0.7 6.4 8.2 4.2 1.6 5.5 6.4

IHD or stroke 6.6 0.7 7.1 9.1 5.1 2.2 7.9 7.9


Any CVD 0.73 0.25 0.91 1.28 0.69 0.58 1.16 1


IHD 0.77 0.27 1.34 2.43 1.40 0.44 0.86 1


IHD or stroke 0.85 0.22 1.18 2.12 1.34 0.52 0.98 1


WomenObserved %

Any CVD 9.2 5.5 7.3 7.0 4.8 5.3 11.4 13.0

IHD 2.4 0.5 3.3 2.7 2.0 1.2 2.9 4.1

IHD or stroke 3.9 1.0 4.2 3.6 3.1 1.5 5.4 5.8


Any CVD 0.89 0.83 0.72 0.93 0.83 0.56 0.83 1


IHD 0.91 0.15 1.51 1.90 1.80 0.81 0.80 1


IHD or stroke 1.10 0.37 1.24 1.77 1.82 0.64 0.97 1


Bases (weighted)

Men 480 377 903 423 178 151 1776 7202

Women 676 476 1067 499 208 163 2369 7634

Bases (unweighted)

Men 414 390 550 433 411 348 497 6602

Women 653 469 634 508 478 375 656 8234

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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Table 3.4

Prevalence of CVD/IHD/IHD or stroke, by age within minority ethnic group and sex


Any CVD/IHD/IHD or Age groupstoke

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

Any CVD 3.1 3.9 23.1 9.4 3.8 8.9 16.8 9.2

IHD - 1.5 12.8 4.4 0.4 1.6 6.3 2.4

IHD or stroke - 1.5 20.1 6.6 0.4 2.7 10.8 3.9

Black African

Any CVD 2.4 1.4 [5.2] 2.3 2.6 6.0 [20.6] 5.5

IHD 0.3 - [5.2] 0.7 0.1 1.0 [ - ] 0.5

IHD or stroke 0.3 - [5.2] 0.7 0.4 1.5 [1.5] 1.0

Indian

Any CVD 3.6 6.8 30.6 10.7 2.2 4.9 23.7 7.3

IHD - 3.2 23.9 6.4 - 1.5 14.7 3.3

IHD or stroke - 3.2 26.9 7.1 - 1.8 18.9 4.2

Pakistani

Any CVD 3.4 11.1 42.0 12.0 3.2 7.7 22.2 7.0

IHD - 7.9 35.1 8.2 0.6 2.2 13.7 2.7

IHD or stroke - 8.0 41.1 9.1 0.8 3.1 17.6 3.6

Bangladeshi

Any CVD - 7.5 [24.2] 5.6 0.8 8.4 21.4 4.8

IHD - 5.5 [18.0] 4.2 - 2.7 12.7 2.0

IHD or stroke - 6.1 [24.2] 5.1 0.3 4.2 18.2 3.1

Chinese

Any CVD 1.1 3.6 20.1 5.3 1.8 5.5 14.7 5.3

IHD - 1.1 7.2 1.6 - 0.1 8.2 1.2

IHD or stroke - 1.9 8.7 2.2 - 0.6 9.0 1.5

Irish

Any CVD 8.8 8.3 24.1 14.5 5.2 7.7 19.7 11.4

IHD 0.4 2.5 11.5 5.5 1.4 6.6 2.9

IHD or stroke 0.4 4.3 16.0 7.9 0.9 1.9 12.4 5.4

General population (2003)a

Any CVD 4.6 8.0 29.4 13.6 5.2 9.4 23.5 13.0

IHD - 2.1 17.9 6.4 0.1 1.1 10.6 4.1

IHD or stroke 0.3 2.6 21.6 7.9 0.4 1.7 14.5 5.8

Bases (weighted)

Black Caribbean 141 196 143 480 219 292 165 676

Black African 179 159 40 377 240 198 37 476

Indian 327 384 192 903 408 466 193 1067

Pakistani 205 154 64 423 276 161 62 499

Bangladeshi 92 65 21 178 135 51 21 208

Chinese 74 50 27 151 63 78 22 163

Irish 412 678 686 1776 497 1038 833 2369


Bases (unweighted)

Black Caribbean 122 167 125 414 200 291 162 653

Black African 179 172 39 390 235 190 44 469

Indian 201 231 118 550 240 275 119 634

Pakistani 222 146 65 433 279 164 65 508

Bangladeshi 212 150 49 411 310 118 50 478

Chinese 172 118 58 348 148 176 51 375

Irish 114 194 189 497 149 275 232 656




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Table 3.5

Prevalence of CVD, IHD, IHD or stroke, by equivalised householdincome tertile within minority ethnic group and sex


Any CVD/IHD/IHD or Equivalised household income tertilestroke



Any CVD 7.8 7.7 6.9 6.0 9.9 10.4

IHD 2.3 2.7 4.7 0.5 2.8 4.5

IHD or stroke 2.3 6.2 6.4 1.2 3.7 5.9

Black African

Any CVD 1.8 1.5 3.5 9.2 4.8 4.4

IHD - - 0.6 1.2 - 0.5

IHD or stroke - - 0.6 1.2 0.7 1.4

Indian

CVD 8.9 3.8 15.4 7.9 6.7 7.5

IHD 3.1 1.8 10.4 0.9 4.7 4.0

IHD or stroke 3.1 2.4 12.3 0.9 5.1 6.8

Pakistani

Any CVD [8.5] 11.5 14.7 [2.3] 7.0 7.8

IHD [ - ] 10.7 10.5 [ - ] 0.8 3.8

IHD or stroke [ - ] 10.7 11.8 [ - ] 2.6 5.1

Bangladeshi

Any CVD a 2.9 7.9 a 2.4 6.7

IHD a 2.9 6.1 a 1.8 2.1

IHD or stroke a 2.9 6.7 a 1.8 4.2

Chinese

Any CVD 4.2 7.2 [6.2] 9.6 2.7 3.5

IHD - 2.6 [4.2] 1.9 1.5 1.8

IHD or stroke - 3.8 [4.2] 2.7 1.5 1.8

Irish

Any CVD 8.4 21.4 30.3 7.8 12.8 25.2

IHD 0.6 8.9 13.2 - 2.7 13.6

IHD or stroke 0.6 15.0 20.1 1.1 7.2 18.4


Any CVD 8.9 17.0 21.2 9.0 16.1 16.5

IHD 2.7 9.2 11.9 1.3 6.3 6.1

IHD or stroke 3.3 10.9 15.2 1.9 8.6 8.8

Standardised risk ratiosAny CVD

Black Caribbean 0.91 0.48 0.45 0.56 0.86 0.97


Black African 0.17 0.12 0.37 1.04 0.56 0.89


Indian 0.83 0.38 1.07 0.95 0.72 0.57


Pakistani [0.64] 1.23 1.39 [0.23] 0.92 1.03


Bangladeshi a 0.49 0.86 a 0.39 1.16


Chinese 0.49 0.83 [0.38] 1.09 0.31 0.30


Irish 0.79 1.25 2.45 0.69 0.88 2.21


General population (2003)b 0.78 1.15 1.43 0.83 1.12 1.20


Continued…


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


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Table 3.5 continued


Any CVD/IHD/IHD or Equivalised household income tertilestroke


Standardised risk ratiosIHD

Black Caribbean 0.93 0.51 0.71 0.14 0.88 1.92


Black African 0.00 0.00 0.36 0.42 0.00 0.16


Indian 0.79 0.44 1.74 0.69 2.10 1.28


Pakistani [0.00] 2.85 2.47 [0.00] 0.62 2.61


Bangladeshi a 1.23 1.65 a 1.48 2.02


Chinese 0.00 0.76 [0.64] 2.31 0.84 0.63


Irish 0.12 1.35 1.52 0.00 0.75 2.95




IHD or stroke

Black Caribbean 0.76 0.75 0.78 0.42 0.79 1.75


Black African 0.00 0.00 0.29 0.29 0.19 0.95


Indian 0.64 0.49 1.63 0.47 1.56 1.49


Pakistani [0.00] 2.30 2.27 [0.00] 1.33 2.09


Bangladeshi a 0.99 1.55 a 1.01 2.48


Chinese 0.00 0.82 [0.52] 1.72 0.58 0.43


Irish 0.09 1.65 2.37 0.28 1.14 3.49




Bases (weighted)

Black Caribbean 151 115 106 156 188 179

Black African 113 89 90 123 115 153

Indian 264 241 150 305 287 203

Pakistani 55 119 137 56 134 168


Chinese 44 36 21 52 34 24

Irish 833 398 270 1040 568 347

General population (2003)b 3244 1887 959 2956 2218 1199

Bases (unweighted)

Black Caribbean 123 90 96 149 163 179

Black African 104 105 94 102 123 150

Indian 159 155 97 179 173 126

Pakistani 47 114 155 46 135 176

Bangladeshi 19 89 171 23 101 191

Chinese 105 77 49 120 74 58

Irish 207 122 89 257 163 123



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


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Table 3.6

Prevalence of angina and MI symptoms (using the Rose Angina Questionnaire), by minority ethnic group and sex


Angina or myocardial Minority ethnic group Generalinfarction symptoms population

Black Black (2003)a


MenObserved %

Grade 1 angina 0.1 0.1 1.2 0.8 1.0 1.1 0.9 1.5

Grade 2 angina 0.3 - 0.6 1.1 1.4 0.3 1.4 0.7

Symptoms of possible MI 8.2 3.0 5.6 6.2 6.8 2.2 7.7 7.5


Grade 1 angina 0.02 0.09 0.93 0.61 0.76 0.82 0.34 1


Grade 2 angina 0.56 0.00 1.66 2.28 5.02 0.61 1.92 1


Symptoms of possible MI 1.29 0.42 0.76 1.12 1.44 0.33 1.18 1


WomenObserved %

Grade 1 angina 2.7 1.6 1.0 2.4 0.6 0.3 1.5 1.7

Grade 2 angina 1.2 0.6 0.5 0.5 0.3 - 0.9 0.6



Grade 1 angina 1.94 1.22 0.80 1.77 0.81 0.15 1.03 1


Grade 2 angina 2.75 1.80 1.24 1.25 0.55 0.00 1.47 1


Symptoms of possible MI 1.80 1.17 0.61 1.85 2.03 0.17 1.05 1


Bases (weighted)

Men 480 377 903 423 178 151 1776 7202

Women 676 476 1067 499 208 163 2369 7634

Bases (unweighted)

Men 414 390 550 433 411 348 497 6602

Women 653 469 634 508 478 375 656 8234



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Table 3.7

Prevalence of angina and MI symptoms (using the Rose AnginaQuestionnaire), by age within minority ethnic group and sex


Angina or myocardial Age groupinfarction symptoms

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

Grade 1 angina - - 0.4 0.1 2.0 2.8 3.3 2.7

Grade 2 angina - 0.2 0.8 0.3 0.4 0.9 3.0 1.2


Black African

Grade 1 angina 0.3 - [ - ] 0.1 1.0 2.4 [1.4] 1.6

Grade 2 angina - - [ - ] - - 0.1 [6.8] 0.6

Symptoms of possible MI 1.9 4.5 [1.9] 3.0 2.9 6.4 [9.0] 4.9

Indian

Grade 1 angina 1.9 0.4 1.5 1.2 0.7 0.8 2.0 1.0

Grade 2 angina - - 3.0 0.6 - - 3.0 0.5


Pakistani

Grade 1 angina 0.6 0.1 2.9 0.8 1.4 4.3 1.4 2.4

Grade 2 angina 0.1 2.2 1.8 1.1 0.6 - 1.8 0.5


Bangladeshi

Grade 1 angina - 2.6 [ - ] 1.0 - 1.7 1.9 0.6

Grade 2 angina 0.5 0.8 [7.6] 1.4 0.3 0.4 - 0.3

Symptoms of possible MI 1.2 10.8 [18.6] 6.8 2.4 12.5 14.6 6.1

Chinese

Grade 1 angina - 0.8 2.9 1.1 - 0.5 - 0.3

Grade 2 angina - - 1.6 0.3 - - - -

Symptoms of possible MI 0.7 3.6 4.0 2.2 - 1.6 1.9 1.0

Irish

Grade 1 angina - 0.5 1.8 0.9 1.5 1.3 1.7 1.5

Grade 2 angina - 0.7 3.0 1.4 - 0.8 1.5 0.9


General population (2003)a

Grade 1 angina 0.5 1.0 3.0 1.5 0.9 1.1 2.9 1.7

Grade 2 angina - 0.5 1.5 0.7 0.1 0.5 1.3 0.6


Bases (weighted)

Black Caribbean 141 196 143 480 219 292 165 676

Black African 179 159 40 377 240 198 37 476

Indian 327 384 192 903 408 466 193 1067

Pakistani 205 154 64 423 276 161 62 499

Bangladeshi 92 65 21 178 135 51 21 208

Chinese 74 50 27 151 63 78 22 163

Irish 412 678 686 1776 497 1038 833 2369


Bases (unweighted)

Black Caribbean 122 167 125 414 200 291 162 653

Black African 179 172 39 390 235 190 44 469

Indian 201 231 118 550 240 275 119 634

Pakistani 222 146 65 433 279 164 65 508

Bangladeshi 212 150 49 411 310 118 50 478

Chinese 172 118 58 348 148 176 51 375

Irish 114 194 189 497 149 275 232 656




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Table 3.8

Comparison of CVD/IHD/IHD or stroke in 2004 and1999, by age within minority ethnic groupa and sex


Any CVD/IHD/IHD or Age groupstroke

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

2004

Any CVD 3.1 3.9 23.1 9.4 3.8 8.9 16.8 9.2

IHD - 1.5 12.8 4.4 0.4 1.6 6.3 2.4

IHD or stroke - 1.5 20.1 6.6 0.4 2.7 10.8 3.9

1999

Any CVD 4.3 5.2 14.6 8.2 2.9 6.7 15.2 7.3

IHD - - 5.6 2.0 - 1.6 7.1 2.3

IHD or stroke - 1.6 12.4 4.8 - 1.6 8.9 2.8

Indian

2004

Any CVD 3.6 6.8 30.6 10.7 2.2 4.9 23.7 7.3

IHD - 3.2 23.9 6.4 - 1.5 14.7 3.3

IHD or stroke - 3.2 26.9 7.1 - 1.8 18.9 4.2

1999

Any CVD 1.3 7.5 32.7 10.5 1.7 3.7 18.5 5.5

IHD - 4.0 24.5 6.8 - 0.5 8.2 1.7

IHD or stroke - 4.8 29.2 8.2 - 1.3 10.1 2.3

Pakistani

2004

Any CVD 3.4 11.1 42.0 12.0 3.2 7.7 22.2 7.0

IHD - 7.9 35.1 8.2 0.6 2.2 13.7 2.7

IHD or stroke - 8.0 41.1 9.1 0.8 3.1 17.6 3.6

1999

Any CVD 0.7 7.9 24.8 6.3 1.3 6.5 19.0 4.4

IHD - 5.0 19.9 4.3 0.3 2.7 11.6 2.0

IHD or stroke - 6.0 21.3 4.8 0.5 2.7 16.8 2.6

Bangladeshi

2004

Any CVD - 7.5 [24.2] 5.6 0.8 8.4 21.4 4.8

IHD - 5.5 [18.0] 4.2 - 2.7 12.7 2.0

IHD or stroke - 6.1 [24.2] 5.1 0.3 4.2 18.2 3.1

1999

Any CVD 0.5 8.4 21.3 7.0 2.2 6.9 11.2 4.3

IHD 0.5 4.0 15.4 4.6 - 4.0 4.6 1.4

IHD or stroke 0.5 4.0 17.8 5.1 0.2 4.6 6.3 1.9

Chinese

2004

Any CVD 1.1 3.6 20.1 5.3 1.8 5.5 14.7 5.3

IHD - 1.1 7.2 1.6 - 0.1 8.2 1.2

IHD or stroke - 1.9 8.7 2.2 - 0.6 9.0 1.5

1999

Any CVD 1.0 4.8 11.6 4.8 1.6 4.5 9.3 4.3

IHD - 2.1 5.8 2.1 - 0.3 1.3 0.4

IHD or stroke - 2.1 9.7 2.9 - 0.3 2.5 0.6

Continued…

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 non-response. 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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Table 3.8 continued


Any CVD/IHD/IHD or Age groupstroke

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Irish

2004

Any CVD 8.8 8.3 24.1 14.5 5.2 7.7 19.7 11.4

IHD 0.4 2.5 11.5 5.5 1.4 6.6 2.9

IHD or stroke 0.4 4.3 16.0 7.9 0.9 1.9 12.4 5.4

1999

Any CVD 5.0 8.2 29.3 13.5 6.5 8.3 22.8 11.8

IHD - 2.6 16.3 5.9 - 1.8 9.9 3.5

IHD or stroke - 2.6 21.5 7.4 0.3 1.8 14.9 5.0

General population

2003b

Any CVD 4.6 8.0 29.4 13.6 5.2 9.4 23.5 13.0

IHD - 2.1 17.9 6.4 0.1 1.1 10.6 4.1

IHD or stroke 0.3 2.6 21.6 7.9 0.4 1.7 14.5 5.8

1998c

Any CVD 4.2 8.2 28.3 13.7 5.1 8.3 23.0 12.4

IHD 0.3 2.6 18.2 7.1 0.2 1.2 11.9 4.6

IHD or stroke 0.3 3.2 21.9 8.5 0.6 1.9 15.5 6.2

Bases (weighted)

Black Caribbean 2004 141 196 143 480 219 292 165 676

Black Caribbean 1999 216 138 193 547 282 282 183 748

Indian 2004 327 384 192 903 408 466 193 1067

Indian 1999 229 265 132 626 268 273 115 657

Pakistani 2004 92 65 21 178 135 51 21 208

Pakistani 1999 331 207 81 620 387 203 53 643

Bangladeshi 2004 74 50 27 151 63 78 22 163

Bangladeshi 1999 275 146 112 533 370 135 58 563

Chinese 2004 74 50 27 151 63 78 22 163

Chinese 1999 107 133 61 301 110 197 54 361

Irish 2004 412 678 686 1776 497 1038 833 2369

Irish 1999 134 248 155 537 202 313 193 708


General population 1998 b b b b b b b b

Bases (unweighted)

Black Caribbean 2004 122 167 125 414 200 291 162 653

Black Caribbean 1999 212 142 193 547 283 285 180 748

Indian 2004 201 231 118 550 240 275 119 634

Indian 1999 232 267 127 626 267 277 113 657

Pakistani 2004 222 146 65 433 279 164 65 508

Pakistani 1999 326 217 77 620 384 203 56 643

Bangladeshi 2004 212 150 49 411 310 118 50 478

Bangladeshi 1999 274 143 116 533 361 144 58 563

Chinese 2004 172 118 58 348 148 176 51 375

Chinese 1999 109 127 65 301 109 194 58 361

Irish 2004 114 194 189 497 149 275 232 656

Irish 1999 135 240 162 537 203 301 204 708



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




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Table 3.9

Prevalence of doctor-diagnosed diabetes, by minority ethnic group and sex


Doctor-diagnosed Minority ethnic group Generaldiabetes population

Black Black (2003)a


MenObserved %

Type 1b 0.5 0.7 0.9 - 0.2 0.3 - 0.6

Type 2 9.5 4.3 9.2 7.3 8.0 3.4 3.6 3.8

Type 1 or type 2 10.0 5.0 10.1 7.3 8.2 3.8 3.6 4.3


Type 1b 0.48 1.05 1.31 0.00 0.37 0.53 0.00 1


Type 2 2.37 2.17 3.17 3.27 4.59 1.44 0.80 1


Type 1 or type 2 2.05 1.98 2.86 2.72 3.87 1.29 0.67 1


WomenObserved %

Type 1b 0.8 0.1 - 0.2 0.6 - 0.3 0.3

Type 2 7.6 2.0 5.9 8.4 4.5 3.3 2.0 3.1

Type 1 or type 2 8.4 2.1 5.9 8.6 5.2 3.3 2.3 3.4


Type 1b 2.35 0.11 0.00 0.65 1.00 0.00 0.58 1


Type 2 3.16 2.14 2.95 6.25 3.64 2.06 0.90 1


Type 1 or type 2 3.03 1.80 2.46 5.32 3.20 1.72 0.84 1


Bases (weighted)

Men 480 377 903 423 178 151 1776 7202

Women 676 476 1067 499 208 163 2369 7634

Bases (unweighted)

Men 414 390 550 433 411 348 497 6602

Women 653 469 634 508 478 375 656 8234


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 groupand sex


Doctor-diagnosed Age groupdiabetes

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

Type 1a - - 1.8 0.5 1.3 0.7 0.5 0.8

Type 2 - 5.3 24.8 9.5 - 3.1 25.7 7.6

Types 1 and 2 combinedb - 5.3 26.5 10.0 1.3 3.7 26.2 8.4

Black African

Type 1a 1.4 - - 0.7 0.1 - - 0.1

Type 2 0.3 5.6 [17.3] 4.3 - 0.7 [22.2] 2.0

Types 1 and 2 combinedb 1.7 5.6 [17.3] 5.0 0.1 0.7 [22.2] 2.1

Indian

Type 1a 0.4 1.7 - 0.9 - - - -

Type 2 1.5 8.1 24.3 9.2 0.7 4.3 20.5 5.9

Types 1 and 2 combinedb 2.0 9.8 24.3 10.1 0.7 4.3 20.5 5.9

Pakistani

Type 1a - - - - - 0.7 - 0.2

Type 2 - 9.7 25.3 7.3 - 9.0 44.4 8.4

Types 1 and 2 combinedb - 9.7 25.3 7.3 - 9.7 44.4 8.6

Bangladeshi

Type 1a - 0.7 - 0.2 0.9 - - 0.6

Type 2 - 12.0 [29.9] 8.0 0.7 10.9 13.5 4.5

Types 1 and 2 combinedb - 12.7 [29.9] 8.2 1.6 10.9 13.5 5.2

Chinese

Type 1a - 1.1 - 0.3 - - - -

Type 2 - 1.7 16.1 3.4 0.7 2.5 13.1 3.3


Irish

Type 1a - - - - - 0.6 - 0.3

Type 2 - 1.0 8.3 3.6 1.7 1.2 3.2 2.0


General population (2003)c

Type 1a 0.2 1.0 0.4 0.6 0.5 0.3 0.2 0.3

Type 2 0.2 2.2 9.7 3.8 0.4 1.7 6.9 3.1

Types 1 and 2 combinedb 0.3 3.1 10.1 4.3 0.9 2.0 7.0 3.4

Bases (weighted)

Black Caribbean 141 196 143 480 219 292 165 676

Black African 179 159 40 377 240 198 37 476

Indian 327 384 192 903 408 466 193 1067

Pakistani 205 154 64 423 276 161 62 499

Bangladeshi 92 65 21 178 135 51 21 208

Chinese 74 50 27 151 63 78 22 163

Irish 412 678 686 1776 497 1038 833 2369

General population (2003)c 2320 2601 2281 7202 2319 2640 2675 7634

Bases (unweighted)

Black Caribbean 122 167 125 414 200 291 162 653

Black African 179 172 39 390 235 190 44 469

Indian 201 231 118 550 240 275 119 634

Pakistani 222 146 65 433 279 164 65 508

Bangladeshi 212 150 49 411 310 118 50 478

Chinese 172 118 58 348 148 176 51 375

Irish 114 194 189 497 149 275 232 656


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

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


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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 2004

Undiagnosed and doctor- Age groupdiagnosed diabetesa

Men WomenMen Womenaged aged

35-54 55+ 35+ 35-54 55+ 35+

% % % % % %

Blackb

Undiagnosed diabetes 0.9 [3.2] 1.6 - [-] -

Doctor-diagnosed diabetesc 12.3 [21.2] 15.3 0.9 [19.2] 5.8

South Asiand

Undiagnosed diabetes 1.6 [4.7] 2.5 4.0 [ -] 3.1

Doctor-diagnosed diabetes 11.5 [16.7] 13.0 2.5 [36.8] 10.2

Irish

Undiagnosed diabetes - 5.6 2.7 - 0.9 0.5

Doctor-diagnosed diabetes 0.4 6.8 3.5 1.1 3.1 2.1

General population (2003)e

Undiagnosed diabetes 1.4 4.5 2.9 0.6 1.1 0.8

Doctor-diagnosed diabetes 3.8 4.6 4.2 1.5 7.1 4.2

Bases (weighted)

Black 68 33 101 95 35 130

South Asian 107 42 149 119 35 154

Irish 126 121 248 182 185 367

General population (2003) 190 167 358 208 196 404

Bases (unweighted)

Black 74 34 108 100 34 134

South Asian 123 42 165 119 35 154

Irish 69 60 129 83 79 162


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,

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 householdincome tertile within minority ethnic group and sex


Doctor-diagnosed Equivalised household income tertilediabetes


Observed %Black Caribbean 1.7 15.5 17.3 4.0 9.0 7.7

Black African 4.9 7.1 5.2 3.1 2.2 1.2

Indian 3.4 12.8 16.9 2.2 7.0 7.0

Pakistani [2.3] 4.9 12.4 [2.6] 7.9 9.2

Bangladeshi a 6.2 8.9 a 2.6 5.5

Chinese 6.8 1.5 [2.0] 0.8 3.0 6.5

Irish 2.2 5.4 7.5 0.7 2.1 8.0


Standardised risk ratiosBlack Caribbean 0.52 2.45 4.25 1.82 2.89 3.61


Black African 1.77 2.76 2.63 4.43 1.54 1.36


Indian 1.49 3.55 4.03 1.34 3.13 2.36


Pakistani [3.35] 1.72 3.76 [1.18] 5.49 6.71


Bangladeshi a 3.31 3.36 a 1.76 3.72


Chinese 2.40 0.43 [0.40] 1.01 1.57 2.20


Irish 0.54 0.81 1.26 0.46 0.44 2.75




Bases (weighted)

Black Caribbean 152 115 106 156 188 179

Black African 113 89 90 123 115 153

Indian 264 241 150 305 287 203

Pakistani 55 119 137 56 134 168


Chinese 44 36 21 52 34 24

Irish 833 398 270 1040 568 347


Bases (unweighted)

Black Caribbean 124 90 96 148 163 179

Black African 104 105 94 102 123 150

Indian 159 155 97 179 173 126

Pakistani 47 114 155 46 135 176

Bangladeshi 19 89 171 23 101 191

Chinese 105 77 49 120 74 58

Irish 207 122 89 257 163 123


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.


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Table 3.13

Comparison of doctor-diagnosed diabetesa in 2004 and 1999, by agewithin minority ethnic group and sex


Doctor-diagnosed Age groupdiabetes

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

2004 - 5.3 26.5 10.0 1.3 3.7 26.2 8.4

1999 1.9 3.2 17.6 7.8 0.4 3.9 25.7 7.9

Indian

2004 2.0 9.8 24.3 10.1 0.7 4.3 20.5 5.9

1999 0.7 8.0 19.2 7.7 0.6 4.4 15.3 4.7

Pakistani

2004 - 9.7 25.3 7.3 - 9.7 44.4 8.6

1999 0.8 9.6 39.0 8.7 1.1 7.4 28.3 5.3

Bangladeshi

2004 - 12.7 [29.9] 8.2 1.6 10.9 13.5 5.2

1999 2.4 10.6 30.6 10.6 0.4 12.1 26.0 5.9

Chinese

2004 - 2.7 16.1 3.8 0.7 2.5 13.1 3.3

1999 - 2.2 16.1 4.2 1.6 0.7 11.8 2.6

Irish

2004 - 1.0 8.3 3.6 1.7 1.9 3.2 2.3

1999 1.6 0.8 11.8 4.2 - 1.9 5.9 2.4

General population

2003b 0.3 3.1 9.7 4.3 0.9 2.0 7.1 3.4

1998c 0.5 2.2 6.9 3.3 0.8 1.2 5.3 2.5

Bases (weighted)

Black Caribbean 2004 141 196 143 480 219 292 165 676

Black Caribbean 1999 216 138 193 547 282 282 183 748

Indian 2004 327 384 192 903 408 466 193 1067

Indian 1999 229 265 132 626 268 273 115 657

Pakistani 2004 205 154 64 423 276 161 62 499

Pakistani 1999 331 207 81 620 387 203 53 643

Bangladeshi 2004 92 65 21 178 135 51 21 208

Bangladeshi 1999 275 146 112 533 370 135 58 563

Chinese 2004 74 50 27 151 63 78 22 163

Chinese 1999 107 133 61 301 110 197 54 361

Irish 2004 412 678 686 1776 497 1038 833 2369

Irish 1999 134 248 155 537 202 313 193 708

General population (2003)b 2320 2601 2281 7202 2319 2640 2675 7634

General population (1998) c c c c c c c c

Bases (unweighted)

Black Caribbean 2004 122 167 125 414 200 291 162 653

Black Caribbean 1999 212 142 193 547 283 285 180 748

Indian 2004 201 231 118 550 240 275 119 634

Indian 1999 232 267 127 626 267 277 113 657

Pakistani 2004 222 146 65 433 279 164 65 508

Pakistani 1999 326 217 77 620 384 203 56 643

Bangladeshi 2004 212 150 49 411 310 118 50 478

Bangladeshi 1999 274 143 116 533 361 144 58 563

Chinese 2004 172 118 58 348 148 176 51 375

Chinese 1999 109 127 65 301 109 194 58 361

Irish 2004 114 194 189 497 149 275 232 656

Irish 1999 135 240 162 537 203 301 204 708



a Black Africans were included in the 2004 survey but not in the 1999 survey, so are therefore excluded fromthis comparative table.



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HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 4: USE OF TOBACCO PRODUCTS 95

Use of tobaccoproducts

Heather Wardle

● Self-reported cigarette smoking prevalence was 24% among men within the generalpopulation. Equivalent estimates among each ethnic group were 25% BlackCaribbean, 21% Black African, 20% Indian, 29% Pakistani, 40% Bangladeshi, 21%Chinese and 30% among Irish men. After adjustments for age, Bangladeshi and Irishmen 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 toreport smoking cigarettes than men in the general population (Indian risk ratio 0.78).

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

● Among men in the general population, cigarette smoking prevalence was greatestamong those aged 16-34, and decreased with age. The same pattern was evidentamong 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 prevalencefalling 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 alsoless prevalent in 2004 than in 1999, for example among Black Caribbean menprevalence fell to 25% in 2004 from 35% in 1999.

● For women in the general population and Irish women, cigarette smoking prevalencewas lower in 2004 than in 1999. Among the general population estimates were 23% in2004 compared with 27% in 1999. Equivalent estimates for Irish women were 26% in2004 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 amongBangladeshi groups, with 9% of men and 16% of women reporting using chewingtobacco. Among Bangladeshi women, use of chewing tobacco was greatest amongthose aged 35 and over (26%). Among men, there was no difference in use of chewingtobacco by age.

● Significantly fewer Bangladeshi men and women reported using chewing tobacco in2004 than in 1999. For men, prevalence fell to 9% in 2004 from 19% in 1999.

4Summary

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

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

● There is evidence, from saliva cotinine samples, that prevalence of tobacco use isgreater than self-reported estimates. For example, among Bangladeshi men andwomen, 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 ormore) are included, this estimate rises to 60% for men and 35% for women.

4.1 Introduction

4.1.1 Introduction

In 1998, the government White Paper, Smoking Kills identified smoking as the singlebiggest cause of preventable illness and death.1 The White Paper set the target to reducelevels of smoking within the general population to 24% by 2010. In 2004, this was revisedwith the publication of the Public Service Agreement targets which set the target to reduceadult smoking rates to 21% or less by 2010, with a reduction in prevalence among routineand manual groups to 26% or less.2

The White Paper recognised that levels of smoking varied between different socio-economic groups and stated that reductions in levels of smoking should occur equitablyamong 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 minorityethnic groups.3 This chapter focuses on use of different types of tobacco product amongminority ethnic groups and the general population. Where appropriate, differences bysocio-economic status within minority ethnic groups are presented, and comparisons withresults from HSE 1999 are made.

4.1.2 Methods

Informants aged 25 and over were asked about their use of tobacco products within theface to face interview. The interview collected information about use of various tobaccoproducts including cigarettes, cigars and, for men, pipes. Informants who stated that theycurrently smoked were asked to estimate their daily cigarette consumption. For those aged16-17, information about use of tobacco products was collected through a self-completionquestionnaire. This offered informants privacy, allowing them to reply without disclosingtheir smoking behaviour to other household members. At the interviewer’s discretion, thoseaged 18-24 could answer the questions either through the face to face interview or throughthe self-completion questionnaire. 12% of adults aged 18-24 answered the smokingquestions through the self-completion questionnaire.

Both the self-completion questionnaire and the interview questions focused on currentsmoking status, estimated daily consumption of cigarettes among current smokers and useof 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).

Questions about use of chewing tobacco were introduced in HSE 1999 and repeated in2004. They were asked of South Asian informants, who were believed to be the only groupsin which use of chewing tobacco was likely to be significant. These questions were includedbecause of the related health risks of using chewing tobacco. Chewing tobacco is a majorrisk factor for oral cancer, which is prevalent on the Indian subcontinent.

Chewing tobacco comes in three forms: plain chewing tobacco, tobacco paste (zarda) andpaan masala (tobacco mixed with betel nut). Use of any of these was defined as use ofchewing tobacco. Informants were also asked whether they used a Hukka (tobaccosmoked 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 anytobacco product but were not included within the definition of use of chewing tobacco. Useof paan without tobacco was not included within the definition of use of any tobaccoproducts.

4.1.3 Cotinine

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

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has a half-life in the body of 16-20 hours, which means that it will detect regular tobaccouse, but not occasional tobacco use if the last occasion was several days ago. A level of 15nanograms per millilitre (ng/ml) is regarded as indicative of smoking; it is unlikely to be dueto anything other than personal use of tobacco.

In 2004, nurse visits were confined to those from minority ethnic groups. As such, cotininedata for the general population are not available and comparative general population datahave 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 stillsmoked nowadays. Former cigarette smokers were asked whether they had smokedregularly or just occasionally. This information was used to classify informants into thefollowing categories: current cigarette smoker, ex-regular cigarette smoker, and neverregular cigarette smoker. Informants who reported smoking cigars or pipes only were notincluded in this classification. However, this information is included within the classificationfor use of any type of tobacco product (see section 4.6.2).

4.2.2 Cigarette smoking by minority ethnic group

Cigarette smoking status among men

Among the general population, 24% of men currently smoked cigarettes. Within minorityethnic 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 ofdifferent minority ethnic groups (see chapter 1). Both Bangladeshi and Irish men were morelikely to report current smoking than the general population (Bangladeshi men risk ratio1.43, Irish men risk ratio 1.30). Indian men were less likely to report currently smokingcigarettes than men in the general population (Indian men risk ratio 0.78).

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Indian

Pakistani

Bangladeshi

IrishChinese

Self-reported cigarette smoking, by minority ethnic group

Men Women

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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 morelikely 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 reportedthat they had never smoked regularly.

Within the general population, the proportion of current smokers decreased with age. Asimilar pattern was observed among Irish and Chinese men. However, for South Asian andBlack 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 womenthan 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 allother minority ethnic groups, prevalence of cigarette smoking was low, ranging from 2%among Bangladeshi women to 10% among Black African women. Correspondingly, womenfrom South Asian, Chinese and Black African groups were significantly more likely thanthose in the general population to report never regularly smoking cigarettes, withBangladeshi women being most likely to report this (risk ratio, 1.72).

A more consistent association between age and cigarette smoking prevalence wasobserved among women than among men. With the exception of Pakistani andBangladeshi women, cigarette smoking became less prevalent as age increased. This wasmost notable among Black Caribbean women: 44% of those aged 16-34 smokedcigarettes, 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 thegeneral 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 with35%. Equivalent figures for Irish men were 30% in 2004 and 39% in 1999. For men in thegeneral population they were 24% in 2004 and 27% in 1999. For all other minority ethnicgroups, there were no significant differences between the two years.

Among Irish women and those in the general population, smoking prevalence was alsolower in 2004 than in 1999. In 2004, 26% of Irish women were current cigarette smokerscompared with 33% in 1999. Among women in the general population, the proportion fell to23% in 2004 from 27% in 1999. There were no significant differences among any of theother ethnic groups. Table 4.3, Figure 4B


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Indian

Pakistani

Bangladeshi

IrishChinese

Black

Caribbean

General

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Indian

Pakistani

Bangladeshi

IrishChinese

Self-reported cigarette smoking, 1999 and 2004, by minority ethnic group

Men Women

Per

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Figure 4B

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25

30

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45

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19992004

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 thenumber of persons in the household. Among men from Black African, Indian and Irishgroups, and men within the general population, smoking prevalence was higher amongthose 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 ofmen within each income group, this pattern only remained among men in the generalpopulation.

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% and34% respectively. The equivalent figures among women in the highest income tertile were18% (Black Caribbean women) and 19% (Irish women and women in the generalpopulation). 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 hassimilarities to the Registrar General’s Social Class. Informants are assigned to an NS-SECcategory based on the current or former occupation of the household reference person. Thethree categories presented here are managerial and professional, intermediate, and routineand manual occupations.

For men in the general population, cigarette smoking was most prevalent within routine andmanual households. The same was true among men from Black African, Chinese and Irishgroups. Among Black African men, estimates increased from 14% among those frommanagerial and professional households, to 29% among those from routine and manualhouseholds. Equivalent estimates for Chinese men were 15% and 28%, and for Irish menwere 19% and 37%. Among Indian men, no pattern was observed. After these estimateshad 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 remainedamong Black African and Irish groups.

For women in the general population, Irish women and Chinese women, cigarette smokingprevalence was greatest among those from routine and manual households (30%, 32% and14% respectively). In contrast, among Pakistani women, cigarette smoking prevalence was5 p.p. higher among women from managerial and professional households (10%) thanthose from routine and manual households (5%), although the low number of observationsmeant that this difference was not significant. Results for the other minority ethnic groupsvaried and no clear pattern emerged. Table 4.5

4.3 Number of cigarettes smoked

4.3.1 Introduction

Informants who reported that they smoked cigarettes were asked how many cigarettes theysmoke on weekdays and how many cigarettes they smoke on weekends. These responseswere 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 ofcigarettes among current smokers: fewer than 10 cigarettes per day, 10 to fewer than 20cigarettes 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 fewerthan 20 cigarettes per day, and 20 or more cigarettes per day within the general populationwas 29%, 39% and 31% respectively. Men from each minority ethnic group (except Irishmen) were less likely to report smoking 20 or more cigarettes per day than men in the


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general population, ranging from one in twenty Black African male smokers to one in sixPakistani male smokers.

Among female smokers, Black Caribbean and Black African women were also less likelythan women in the general population to smoke 20 or more cigarettes a day (BlackCaribbean women risk ratio 0.23, Black African women risk ratio 0.08). Among South Asianand Chinese groups, the number of women who reported smoking cigarettes was too smallfor 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 cigarettesper day in 2004 (31%) than in 1999 (37%). Among men in minority ethnic groups there wereno significant differences in levels of daily cigarette consumption between 2004 and 1999.Similarly, among women, estimates of daily cigarette consumption were very similar in 2004and 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 ofother tobacco products, namely chewing tobacco and use of tobacco in conjunction withother products such as paan, as well as use of paan without tobacco. (See section 4.1.2 fora full description of the different types of tobacco product). Only observed percentages arepresented in this section as there are no general population figures to use for comparativepurposes.

Informants were classified as using chewing tobacco if they reported using paan withtobacco, paan with masala, or chewing tobacco. Among Indian and Pakistani groups, useof chewing tobacco was low. Estimates ranged between 1% of Pakistani women to 4% ofIndian 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 Pakistani Bangladeshi

% % %

Men

Uses chewing tobacco 4 2 9

Does not use chewing tobacco 96 98 91

Women

Uses chewing tobacco 1 1 16

Does not use chewing tobacco 99 99 84

Among men, the proportion reporting that they used chewing tobacco as well as smokingcigarettes, and those who reported using chewing tobacco only, were roughly similar. Forexample, 4% of Indian men reported using chewing tobacco. Of these, half stated they alsosmoked cigarettes, whilst half used chewing tobacco only. There was no clear pattern inuse of chewing tobacco by age.

Among South Asian women, those who used chewing tobacco did not do so in conjunctionwith cigarette smoking (prevalence of cigarette smoking was particularly low among thesegroups). Among Bangladeshi women, use of chewing tobacco was most prevalent amongthose aged 35 and over; 26% of Bangladeshi women aged 35-54 used chewing tobaccocompared with 9% for those aged 18-34. Tables 4.8, 4.9


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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 similarto 1999. Figures for Indian men in 2004 and 1999 were 4% and 6% respectively, and forPakistani men the prevalence was 2% in both years. For both Bangladeshi men andwomen, 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 tobaccouse. 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 replacementproducts as an adjunct to smoking cessation. Only 16 informants reported using nicotinereplacement products within the last seven days. Therefore, a cotinine measurement of 15ng/ml or over is likely to be the result of personal tobacco use or use of other tobaccoproducts. As such, cotinine measurements can provide an objective check of self-reporteduse of tobacco products.

Saliva cotinine samples were taken from informants as part of the nurse visit. To correct forbiases within the sub-sample providing a valid cotinine sample, an additional weight wasapplied to the cotinine data. Table 4.11 shows the distribution of the sample for whom wehave a valid cotinine measurement (before the additional weight was applied) comparedwith the distribution of the total sample across a number of different categories, such asage 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. Withinminority ethnic groups, estimates ranged from 23% for Chinese men to 35% for Pakistaniand 57% for Bangladeshi men. The proportion of men with a cotinine level of 15 ng/ml ormore 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 thegeneral population ranging from 7% for Indian women to 14% for Black African women. Forwomen from Black Caribbean, Irish and Bangladeshi groups, prevalence was similar to thegeneral population and was highest among Bangladeshi women (29%). The high cotininelevels among Bangladeshi women contrasts with their low rate of self-reported smokingand is probably due to use of chewing tobacco. Table 4.12

4.5.3 Comparisons of cotinine levels in 1999 and 2004

Prevalence of cotinine levels of 15 ng/ml or more was significantly lower among BlackCaribbean and Irish men in 2004 than in 1999. In 2004, 26% of Black Caribbean men and32% of Irish men had a cotinine level of 15 ng/ml or more. The equivalent figures in 1999were 40% for both groups. Similarly, cotinine prevalence was significantly lower amongIrish women in 2004 (26%) than in 1999 (33%). Among all other minority ethnic groups andthe general population, there were no other significant differences between the two years.

Table 4.14


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4.6 Prevalence and cotinine-adjusted prevalence of use oftobacco products

4.6.1 Introduction

This section presents information about overall use of any tobacco product including self-reported use of cigarettes, cigars, pipes (among men) and chewing tobacco. Thisinformation has been combined to produce an overall estimate of use of any tobaccoproducts. In section 4.6.4, self-reported estimates of any tobacco are analysed in relation tocotinine levels. An ‘adjusted’ measure of tobacco use was created by including within themeasure informants who either reported using any tobacco product or had a cotinine levelof 15 ng/ml or more. This enables the level of under-reporting of prevalence of tobacco useto 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 tobaccouse 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 Irishmen (36% compared with 30%). Overall, cigarette smoking accounted for the majority oftobacco use among men.

Among most minority ethnic groups, cigar smoking prevalence was the next most popularform of tobacco use, with the exception of Bangladeshi men, where chewing tobacco wasmore common (9%) than smoking cigars (4%).

Similarly, with the exception of Bangladeshi women, cigarette consumption accounted fornearly all tobacco use among women. Among Bangladeshi women, virtually all tobacco usewas 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 generalpopulation, there were no significant differences between NS SEC groups in the use of anytobacco products. For Irish men, Black African men and men in the general population, useof tobacco products was higher among those from routine and manual households thanthose from managerial and professional households.

Among Irish women, and women in the general population, use of any tobacco product wasmore prevalent among women from routine and manual households than those frommanagerial and professional households, the difference ranging between 21% and 32% forIrish 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 professionalhouseholds (16%), than those from intermediate (5%) and routine and manual groups (6%).

Table 4.16

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 whoreport using any type of tobacco product or have a cotinine level of 15 ng/ml or more (in theabsence of self-reported tobacco use). For both men and women, adjusted tobacco useestimates were higher than self-reported estimates within all minority ethnic groups. Thegreatest difference between self-reported estimates of tobacco use and adjusted tobaccouse was observed among Bangladeshi men and women. For Bangladeshi men, adjustedtobacco use prevalence (60%) was 16 percentage points (p.p.) higher than self-reporteduse 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 tobaccouse estimates were double the self-reported estimates for use of any tobacco product.


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Figures 4C shows the age-standardised relative risk ratios of adjusted use of tobaccoproducts for men and women within each minority ethnic group, compared with the generalpopulation. Among men, Bangladeshis were the only group more likely than the generalpopulation to report using any type of tobacco product, or have a cotinine level suggestingthey had recently used a tobacco product (risk ratio 1.66). Chinese men were the only groupwho had a significantly lower adjusted use of tobacco than the general population (risk ratio0.66).

Black African, Indian, Pakistani and Chinese women had a significantly lower adjusted useof tobacco than women in the general population (Black African risk ratio 0.60, Indianwomen risk ratio 0.37, Pakistani women 0.47, Chinese women 0.41). No group had asignificantly higher adjusted use of tobacco than the general population.

Table 4.17, Figure 4C


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.

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.


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HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 4: USE OF TOBACCO PRODUCTS 105

4.17 Prevalence of self-reported tobacco use, ofsaliva cotinine of 15 ng/ml or over, and ofadjusted tobacco use, by minority ethnic groupand sex

Tables

4.1 Self-reported cigarette smoking status, byminority ethnic group and sex

4.2 Self-reported cigarette smoking status, by agewithin minority ethnic group and sex

4.3 Comparison of self-reported cigarette smokingstatus in 2004 and 1999, by age within minorityethnic group and sex

4.4 Self-reported cigarette smoking status, byequivalised household income tertile withinminority ethnic group and sex

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

4.6 Number of cigarettes smoked by currentsmokers, by minority ethnic group and sex

4.7 Comparison of number of cigarettes smoked in2004 and 1999, by minority ethnic group andsex

4.8 Use of chewing tobacco, by South Asianminority ethnic group and sex

4.9 Use of chewing tobacco, by age within SouthAsian minority ethnic group and sex

4.10 Comparison of use of chewing tobacco in 2004and 1999, by age within South Asian minorityethnic group and sex

4.11 Comparison of saliva cotinine sample with totalsample, by minority ethnic group and sex

4.12 Saliva cotinine levels, by minority ethnic groupand sex

4.13 Saliva cotinine, by age within minority ethnicgroup and sex

4.14 Comparison of saliva cotinine prevalence in2004 and 1999, by age within minority ethnicgroup and sex

4.15 Self-reported use of tobacco products, byminority ethnic group and sex

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


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Table 4.1

Self-reported cigarette smoking status, by minority ethnic group and sex


Cigarette smoking status Minority ethnic group Generalpopulation


MenObserved %

Current cigarette smoker 25 21 20 29 40 21 30 24

Ex-regular cigarette smoker 16 8 13 8 13 11 30 29

Never regular cigarette smoker 59 71 66 63 47 68 40 47


Current cigarette smoker 1.02 0.80 0.78 1.08 1.43 0.81 1.30 1


Ex-regular cigarette smoker 0.60 0.35 0.52 0.35 0.67 0.54 1.01 1


Never regular cigarette smoker 1.18 1.42 1.35 1.28 0.93 1.33 0.84 1


WomenObserved %





Current cigarette smoker 1.08 0.34 0.23 0.19 0.11 0.32 1.11 1


Ex-regular cigarette smoker 0.62 0.15 0.11 0.07 0.05 0.15 1.12 1


Never regular cigarette smoker 1.10 1.58 1.65 1.68 1.72 1.59 0.91 1


Bases (weighted)

Men 472 366 899 412 172 150 1773 45652

Women 658 464 1061 490 197 162 2362 48357

Bases (unweighted)

Men 403 379 547 423 396 345 496 2855

Women 637 457 630 497 453 372 653 3805


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Table 4.2

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


Cigarette smoking status Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean




Black African

Current cigarette smoker 21 20 [25] 21 15 6 [2] 10

Ex-regular cigarette smoker 5 13 [6] 8 3 3 [1] 3

Never regular cigarette smoker 75 67 [69] 71 82 91 [96] 87

Indian




Pakistani

Current cigarette smoker 28 34 18 29 5 7 - 5



Bangladeshi


Ex-regular cigarette smoker 3 18 [41] 13 1 - [2] 1


Chinese




Irish




General population




Bases (weighted)

Black Caribbean 135 195 142 472 202 291 165 658

Black African 170 156 40 366 230 197 37 464

Indian 324 383 192 899 404 464 193 1061

Pakistani 195 153 64 412 267 161 62 490

Bangladeshi 86 65 21 172 125 51 21 197

Chinese 73 50 27 150 62 78 22 162

Irish 412 678 683 1773 493 1038 831 2362


Bases (unweighted)

Black Caribbean 114 165 124 403 186 289 162 637

Black African 172 169 38 379 224 189 44 457

Indian 199 230 118 547 237 274 119 630

Pakistani 213 145 65 423 268 164 65 497

Bangladeshi 198 149 49 396 287 117 49 453

Chinese 170 117 58 345 145 176 51 372

Irish 114 194 188 496 147 275 231 653



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Table 4.3

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



Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

2004




1999




Indian

2004




1999




Pakistani

2004

Current cigarette smoker 28 34 18 29 5 7 - 5



1999


Ex-regular cigarette smoker 5 9 11 7 2 0 - 1


Bangladeshi

2004


Ex-regular cigarette smoker 3 18 [41] 13 1 - [2] 1


1999




Chinese

2004




1999




Continued…


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Table 4.3 continued



Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Irish

2004




1999




General population

2004




1999




Bases (weighted)

2004

Black Caribbean 135 195 142 472 202 291 165 658

Indian 324 383 192 899 404 464 193 1061

Pakistani 195 153 64 412 267 161 62 490

Bangladeshi 86 65 21 172 125 51 21 197

Chinese 73 50 27 150 62 78 22 162

Irish 412 678 683 1773 493 1038 831 2362


1999

Black Caribbean 141 92 129 362 186 190 122 498

Indian 215 251 124 591 249 255 108 612

Pakistani 184 119 47 349 218 117 31 365

Bangladeshi 68 37 29 134 89 33 14 136

Chinese 33 42 19 95 34 62 17 112

Irish 385 711 448 1544 566 876 543 1985


Bases (unweighted)

2004

Black Caribbean 114 165 124 403 186 289 162 637

Indian 199 230 118 547 237 274 119 630

Pakistani 213 145 65 423 268 164 65 497

Bangladeshi 198 149 49 396 287 117 49 453

Chinese 170 117 58 345 145 176 51 372

Irish 114 194 188 496 147 275 231 653


1999

Black Caribbean 207 141 192 540 278 285 178 741

Indian 229 266 125 620 263 275 113 651

Pakistani 312 216 77 605 375 203 56 634

Bangladeshi 261 143 116 520 347 144 58 549

Chinese 105 127 65 297 107 194 58 359

Irish 135 239 162 536 203 300 204 707


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


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Table 4.4

Self-reported cigarette smoking status, by equivalised householdincome tertile within minority ethnic group and sex


Cigarette smoking status Equivalised household income tertile



Current cigarette smoker 26 28 24 18 23 33

Black African


Indian


Pakistani

Current cigarette smoker [30] 21 40 [5] 5 7

Bangladeshi

Current cigarette smoker a 42 43 a - 3

Chinese

Current cigarette smoker 18 22 [23] 9 12 4

Irish


General population


Standardised risk ratiosBlack Caribbean

Current cigarette smoker 1.01 1.23 0.94 0.70 1.05 1.30


Black African



Indian



Pakistani

Current cigarette smoker [0.92] 0.80 1.49 [0.20] 0.16 0.25


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


Irish



General population



a Results are not shown because of small base sizes.

Continued…


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Table 4.4 continued




Bases (weighted)

Black Caribbean 151 115 101 154 181 177

Black African 112 84 86 123 113 146

Indian 263 239 149 302 285 203

Pakistani 55 117 131 56 131 165


Chinese 44 35 21 52 34 23

Irish 833 396 270 1037 565 345


Bases (unweighted)

Black Caribbean 122 90 90 147 157 176

Black African 103 101 90 102 121 145

Indian 158 154 96 177 172 126

Pakistani 47 112 151 46 132 171

Bangladeshi 19 87 160 23 97 182

Chinese 105 76 47 120 74 56

Irish 207 121 89 256 162 122


a Results are not shown because of small base sizes.


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Table 4.5

Self-reported cigarette smoking status, by NS-SEC of household reference person (HRP) within minority ethnic group and sex


Cigarette smoking NS-SEC of household reference personstatus

Men WomenManagerial Intermediate Routine Managerial Intermediate Routine

& & & &professional manual professional manual



Black African


Indian


Pakistani


Bangladeshi

Current cigarette smoker 35 34 42 [-] 2 2

Chinese


Irish


General population





Black African



Indian



Pakistani



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



Irish



General population




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Table 4.5 continued


NS-SEC of household reference person



Bases (weighted)

Black Caribbean 150 72 239 216 122 282

Black African 128 61 146 154 70 167

Indian 330 191 356 382 211 408

Pakistani 76 120 176 75 139 198

Bangladeshi 25 23 101 21 25 106

Chinese 55 38 43 69 45 38

Irish 673 312 780 1028 436 812


Bases (unweighted)

Black Caribbean 123 65 202 201 121 278

Black African 128 55 161 134 67 178

Indian 189 107 236 214 125 257

Pakistani 68 116 188 74 133 201

Bangladeshi 55 52 232 49 56 237

Chinese 130 88 100 154 101 88

Irish 171 88 232 256 123 247



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Table 4.6

Number of cigarettes smoked by current smokers, by minority ethnic group and sex

Current smokers aged 16 and over 2004

Number of cigarettes Minority ethnic group Generalsmoked per day population


MenObserved %

Under 10 cigarettes per day 59 63 55 44 49 51 22 29

10 to under 20 per day 31 32 32 40 41 41 45 39

20 or more per day 10 5 13 16 11 8 33 31

Mean number of cigarettes smoked per day by current smokers 8.2 8.1 9.7 10.0 9.6 8.8 14.8 14.6



20 or more per day 0.35 0.13 0.42 0.51 0.26 0.35 1.04 1


WomenObserved %

Under 10 cigarettes per day 56 [63] a a a a 39 30

10 to under 20 per day 37 [35] a a a a 37 43

20 or more per day 7 [2] a a a a 24 27

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


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

Bases (weighted)

Men 116 74 180 118 68 31 544 10861

Women 156 46 57 25 4 13 622 10873

Bases (unweighted)b

Men 111 70 107 123 159 69 162 640

Women 144 39 29 25 10 29 199 851

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.


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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 2004

Number of cigarettes Minority ethnic group Generalsmoked per day population


% % % % % % %

Men2004

Under 10 cigarettes per day 59 55 44 49 51 22 29

10 to under 20 per day 31 32 40 41 41 45 39

20 or more per day 10 13 16 11 8 33 31

1999

Under 10 cigarettes per day 54 47 34 50 40 23 27

10 to under 20 per day 32 38 42 36 40 36 35

20 or more per day 13 14 21 14 19 40 37

Women2004

Under 10 cigarettes per day 56 b b b b 39 30

10 to under 20 per day 37 b b b b 37 43

20 or more per day 7 b b b b 24 27

1999

Under 10 cigarettes per day 53 [66] b b [54] 28 29

10 to under 20 per day 38 [20] b b [34] 41 44

20 or more per day 9 [14] b b [9] 31 27

Bases (weighted)

2004

Men 116 180 118 68 31 544 10861

Women 156 57 25 4 13 622 10873

1999

Men 126 134 92 59 16 602 11581

Women 125 36 17 2 10 651 13725

Bases (unweighted)

2004

Men 111 107 123 159 69 162 640

Women 144 29 25 10 29 199 851

1999

Men 190 134 161 236 53 215 960

Women 181 40 29 7 32 241 1113

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.


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Table 4.8

Use of chewing tobacco, by South Asian minority ethnic group and sex

South Asians aged 18 and over 2004

Types of chewing Minority ethnic grouptobacco useda

Men Women

Indian Pakistani Bangladeshi Indian Pakistani Bangladeshi

% % % % % %

Paan with tobacco (zarda) 1 1 8 - 0 13

Paan masala 3 1 1 1 1 5

Chewing tobacco 1 0 - - 0 -

Any chewing tobacco 4 2 9 1 1 16

Paan without tobacco 2 1 16 2 0 13

Hukka/Hookah 1 1 0 0 0 -

Bidi 0 - 0 0 0 0

Other tobacco substances 0 0 - - 0 -

Does not use any of these substances 93 96 75 97 97 71

Bases (weighted) 845 386 166 1009 458 184

Bases (unweighted) 514 395 380 597 465 423

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


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Table 4.9

Use of chewing tobacco, by age within South Asian minority ethnic group and sex

South Asians aged 18 and over 2004

Use of chewing tobacco Age group

Men WomenAll All

18-34 35-54 55+ men 18-34 35-54 55+ women

% % % % % % % %

Indian

Uses chewing tobacco 3 5 4 4 1 1 1 1

Uses chewing tobacco and smokes cigarettes - 3 1 2 - - - -

Uses chewing tobacco and does not smoke cigarettes 3 2 3 2 1 1 1 1

Does not use chewing tobacco 97 95 96 96 99 99 99 99

Pakistani


Uses chewing tobacco and smokes cigarettes 1 1 - 1 - - - -



Bangladeshi

Uses chewing tobacco 8 10 [14] 9 9 28 [29] 16

Uses chewing tobacco and smokes cigarettes 5 7 [5] 5 - 2 [3] 1

Uses chewing tobacco and does not smoke cigarettes 3 3 [10] 4 9 26 [27] 16

Does not use chewing tobacco 92 90 [86] 91 91 72 [71] 84

Bases (weighted)

Indian 272 382 192 845 355 461 193 1009

Pakistani 169 153 64 386 235 161 62 458

Bangladeshi 80 65 21 166 113 50 21 184

Bases (unweighted)

Indian 167 229 118 514 205 273 119 597

Pakistani 185 145 65 395 236 164 65 465

Bangladeshi 182 149 49 380 258 116 49 423


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Table 4.10

Comparison of use of chewing tobacco in 2004 and 1999, by age within SouthAsian minority ethnic group and sex

South Asians aged 18 and over 2004, 1999

Use of chewing tobacco Age group

Men WomenAll All

18-34a 35-54 55+ men 18-34a 35-54 55+ women

% % % % % % % %

Indian

2004


Uses chewing tobacco and smokes cigarettes - 3 1 2 - - - -



1999


Uses chewing tobacco and smokes cigarettes 5 2 1 3 - - - -



Pakistani

2004


Uses chewing tobacco and smokes cigarettes 1 1 - 1 - - - -



1999

Uses chewing tobacco 2 1 5 2 2 2 - 2

Uses chewing tobacco and smokes cigarettes 1 - 1 1 - 1 - 0

Uses chewing tobacco and does not smoke cigarettes 1 1 4 2 2 2 - 2


Bangladeshi

2004

Uses chewing tobacco 8 10 [14] 9 9 28 [29] 16

Uses chewing tobacco and smokes cigarettes 5 7 [5] 5 - 2 [3] 1

Uses chewing tobacco and does not smoke cigarettes 3 3 [10] 4 9 26 [27] 16

Does not use chewing tobacco 92 90 [86] 91 91 72 [71] 84

1999


Uses chewing tobacco and smokes cigarettes 10 11 17 12 0 - 2 0



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…


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South Asians aged 18 and over 2004, 1999

Age group

Men WomenAll All

18-34a 35-54 55+ men 18-34a 35-54 55+ women

% % % % % % % %

Bases (weighted)

2004

Indian 272 382 192 845 355 461 193 1009

Pakistani 169 153 64 386 235 161 62 458

Bangladeshi 80 65 21 166 113 50 21 184

1999

Indian 213 251 124 588 248 255 108 611

Pakistani 179 119 47 345 213 117 31 360

Bangladeshi 65 37 29 132 87 33 14 135

Bases Men (unweighted)

2004

Indian 167 229 118 514 205 273 119 597

Pakistani 185 145 65 395 236 164 65 465

Bangladeshi 182 149 49 380 258 116 49 423

1999

Indian 224 266 125 615 261 275 113 649

Pakistani 304 216 77 597 364 203 56 623

Bangladeshi 253 143 116 512 340 144 58 542

a In 2004, questions about chewing tobacco were asked of those aged 18 and over whereas in 1999 these questions were asked to everyone aged 16 and over.


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Table 4.11

Comparison of saliva cotinine sample with totalsample, by minority ethnic group and sex


Age and tobacco status Men WomenTotal Sample Total Sample

sample with sample withcotinine cotinine

assay assay

% % % %

Black Caribbean

Age

16-34 29 29 32 33

35-54 41 39 43 44

55 and over 30 32 24 23

Tobacco status

Self-reported user of tobacco 28 31 24 29

Black African

Age

16-34 47 46 50 54

35-54 42 45 42 41

55 and over 11 9 8 5

Tobacco status


Indian

Age

16-34 36 32 38 36

35-54 43 45 44 49

55 and over 21 23 18 16

Tobacco status


Pakistani

Age

16-34 49 47 55 51

35-54 36 37 32 35

55 and over 15 17 12 14

Tobacco status


Bangladeshi

Age

16-34 51 45 65 57

35-54 37 42 25 33

55 and over 12 13 10 10

Tobacco status


Chinese

Age

16-34 49 49 39 36

35-54 33 37 48 55

55 and over 18 15 14 9

Tobacco status


Irish

Age

16-34 23 24 21 22

35-54 38 39 44 44

55 and over 39 37 35 34

Tobacco status


Continued…


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Age and tobacco status Men WomenTotal Sample Total Sample

sample with sample withcotinine cotinine

assay assay

General population (2003)

Age

16-34 32 28 30 30

35-54 36 39 35 39

55 and over 32 33 35 32

Tobacco status


Bases (weighted)

Black Caribbean 480 195 676 282

Black African 377 149 476 193

Indian 903 462 1067 497

Pakistani 423 170 499 174

Bangladeshi 178 48 208 61

Chinese 151 64 163 62

Irish 1776 1053 2369 1305

General population (2003) 7202 779 7634 803

Bases (unweighted)

Black Caribbean 414 162 653 256

Black African 390 137 469 173

Indian 550 274 634 302

Pakistani 433 165 508 173

Bangladeshi 411 110 478 136

Chinese 348 144 375 141

Irish 497 272 656 340

General population (2003) 6602 736 8234 882


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Table 4.12

Saliva cotinine levels, by minority ethnic group and sexa

Aged 16 and over with a valid cotinine assay 2004

Saliva cotinine (ng/ml) Minority ethnic group Generalpopulation

Black Black (2003)


MenObserved %

% with 15 ng/ml and over 26 27 27 35 57 23 32 30


15 ng/ml and over 0.93 0.79 0.86 1.07 1.79 0.72 1.13 1


WomenObserved %



15 ng/ml and over 1.00 0.63 0.26 0.48 1.18 0.40 1.02 1


Bases (weighted)

Men 195 149 462 170 48 64 1053 779

Women 282 193 497 174 61 62 1305 803

Bases (unweighted)

Men 162 137 274 165 110 144 272 736

Women 256 173 302 173 136 141 340 882

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).


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Table 4.13

Saliva cotinine, by age within minority ethnic group and sexa


Saliva cotinine (ng/ml) Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

% with 15 ng/ml and over [33] 34 10 26 38 25 12 26

Black African

% with 15 ng/ml and over 30 25 b 27 19 5 b 14

Indian


Pakistani

% with 15 ng/ml and over 38 34 29 35 14 11 b 13

Bangladeshi

% with 15 ng/ml and over [59] [52] b 57 21 [37] b 29

Chinese

% with 15 ng/ml and over 26 28 b 23 19 5 b 10

Irish




Bases (weighted)

Black Caribbean 56 75 65 195 89 125 69 282

Black African 69 67 13 149 105 78 9 193

Indian 147 210 105 462 180 239 77 497

Pakistani 79 63 28 170 88 61 25 174

Bangladeshi 22 20 6 48 35 19 6 61

Chinese 31 23 9 64 22 34 5 62

Irish 262 404 387 1053 289 568 447 1305


Bases (unweighted)

Black Caribbean 46 64 52 162 77 118 61 256

Black African 60 64 13 137 90 72 11 173

Indian 84 124 66 274 104 145 53 302

Pakistani 79 56 30 165 89 60 24 173

Bangladeshi 49 46 15 110 77 46 13 136

Chinese 70 54 20 144 52 76 13 141

Irish 59 111 102 272 72 146 122 340


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 Results are not shown because of small base sizes.


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Table 4.14

Comparison of saliva cotinine prevalence in 2004 and 1999, by age withinminority ethnic groupa and sexb

Aged 16 and over with a valid cotinine assay 2004, 1999

Saliva cotinine (ng/ml) Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

2004

% with 15 ng/ml and over [33] 34 10 26 38 25 12 26

1999


Indian

2004


1999

% with 15 ng/ml and over 35 26 24 29 11 9 [12] 10

Pakistani

2004

% with 15 ng/ml and over 38 34 29 35 14 11 c 13

1999

% with 15 ng/ml and over 39 33 [24] 35 11 8 c 10

Bangladeshi

2004

% with 15 ng/ml and over [59] [52] c 57 21 [37] c 29

1999

% with 15 ng/ml and over 49 50 [77] 55 18 [68] c 34

Chinese

2004

% with 15 ng/ml and over 26 28 c 23 19 5 c 10

1999

% with 15 ng/ml and over [12] 24 c 18 [4] 11 c 9

Irish

2004


1999


General population

2003


1998


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 (see section 4.5).

c Results are not shown because of small base sizes.

Continued…


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Aged 16 and over with a valid cotinine assay 2004, 1999

Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Bases (weighted)

2004

Black Caribbean 56 75 65 195 89 125 69 282

Indian 147 210 105 462 180 239 77 497

Pakistani 79 63 28 170 88 61 25 174

Bangladeshi 22 20 6 48 35 19 6 61

Chinese 31 23 9 64 22 34 5 62

Irish 262 404 387 1053 289 568 447 1305


1999

Black Caribbean 77 48 62 188 101 102 47 251

Indian 127 146 57 329 127 134 37 298

Pakistani 82 62 22 167 98 51 13 162

Bangladeshi 22 14 11 46 31 8 4 43

Chinese 14 23 6 43 16 32 5 53

Irish 199 424 261 883 318 444 206 968

General population (1998) d d d d d d d d

Bases(unweighted)

2004

Black Caribbean 46 64 52 162 77 118 61 256

Indian 84 124 66 274 104 145 53 302

Pakistani 79 56 30 165 89 60 24 173

Bangladeshi 49 46 15 110 77 46 13 136

Chinese 70 54 20 144 52 76 13 141

Irish 59 111 102 272 72 146 122 340


1999

Black Caribbean 109 71 90 270 148 148 68 364

Indian 127 158 63 348 134 143 44 321

Pakistani 136 107 36 279 167 88 23 278

Bangladeshi 88 54 37 179 126 36 12 174

Chinese 45 71 20 136 49 99 17 165

Irish 65 139 98 302 115 147 89 351


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 (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


Use of tobacco Minority ethnic group Generalproducts population


MenObserved %

Cigarettes 25 21 20 29 40 21 30 24

Cigarsa 7 11 7 5 4 10 11 12

Pipesb 0 1 - 1 0 2 2 2

Chewing tobaccoc c c 4 2 9 c c c

Any tobacco product 28 22 24 30 44 23 36 28


Any tobacco product 0.98 0.74 0.83 1.00 1.40 0.77 1.28 1


WomenObserved %

Cigarettes 24 10 5 5 2 8 26 23

Cigarsa 0 1 - - - 1 0 1

Chewing tobaccoc c c 1 1 16 c c c

Any tobacco product 24 10 6 7 17 8 26 23


Any tobacco product 1.07 0.34 0.27 0.29 0.84 0.33 1.10 1


Bases (weighted)

Men 472 366 897 412 172 150 1773 45621

Women 658 464 1055 490 196 162 2362 48331

Bases (unweighted)

Men 403 379 546 423 396 345 496 2853

Women 637 457 628 497 451 372 653 3803

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 informants.


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Table 4.16

Self-reported use of tobacco products, by NS-SEC of household reference person(HRP) within minority ethnic group and sex


Use of tobacco NS-SEC of household reference personproducts




Cigarettes 28 18 24 16 32 24

Cigarsa 11 11 4 1 - -

Pipesb 1 - - b b b

Chewing tobaccoc c c c c c c

Any tobacco product 32 21 25 16 32 24

Black African

Cigarettes 14 18 29 7 17 11

Cigarsa 13 3 11 2 - -

Pipesb 3 - - b b b



Indian

Cigarettes 20 19 21 5 5 5

Cigarsa 7 4 10 - - -

Pipesb - - - b b b

Chewing tobaccoc 5 2 4 3 1


Pakistani

Cigarettes 18 35 28 10 4 5

Cigarsa 5 6 5 - - -

Pipesb - 2 2 b b b

Chewing tobaccoc 1 2 2 4 0 2


Bangladeshi

Cigarettes 35 34 42 [-] 2 2

Cigarsa 17 5 1 [-] - -

Pipesb - - 0 [b] b b

Chewing tobaccoc 2 9 11 [12] 15 15

Any tobacco product 39 38 47 [11] 17 16

Chinese

Cigarettes 15 21 28 8 4 14

Cigarsa 16 12 1 3 - -

Pipesb 2 5 - b b b



Irish

Cigarettes 19 36 37 21 27 32

Cigarsa 16 11 8 0 - 1

Pipesb 2 - 2 b b b



General population

Cigarettes 17 24 32 15 23 30

Cigarsa 14 12 9 1 1 1

Pipesb 2 2 1 b b b



Continued…



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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Use of tobacco NS-SEC of household reference personproducts




Any tobacco product 1.06 0.69 1.01 0.71 1.29 1.20


Black African



Indian



Pakistani



Bangladeshi

Any tobacco product 1.26 1.13 1.58 [0.47] 0.82 0.81


Chinese



Irish



General population



Bases (weighted)

Black Caribbean 150 72 239 216 122 282

Black African 128 61 146 154 70 167

Indian 329 191 356 382 211 408

Pakistani 76 120 176 75 139 198

Bangladeshi 25 23 101 21 25 106

Chinese 55 38 43 69 45 38

Irish 673 312 780 1028 436 812


Bases (unweighted)

Black Caribbean 123 65 202 201 121 278

Black African 128 55 161 134 67 178

Indian 188 107 236 214 125 257

Pakistani 68 116 188 74 133 201

Bangladeshi 55 52 232 49 56 237

Chinese 130 88 100 154 101 88

Irish 171 88 232 256 123 247




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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Table 4.17

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


Use of tobacco products, Minority ethnic group Generalsaliva cotinine (ng/ml), populationadjusted tobacco use Black Black (2003)b


MenObserved %

Self-reported use of any tobacco products 28 22 24 30 44 23 36 31

Saliva cotinine level 15 ng/ml or over 26 27 27 35 57 23 32 30

Adjusted tobacco use prevalence 30 30 32 37 60 25 38 34

Extent of under reporting 3 8 8 7 16 2 2 2


Adjusted tobacco use 0.98 0.79 0.95 1.02 1.66 0.66 1.15 1


WomenObserved %

Self-reported use of any tobacco products 24 10 6 7 17 8 26 24

Saliva cotinine level 15 ng/ml or over 26 14 7 13 29 10 26 25

Adjusted tobacco use prevalence 28 14 10 14 35 11 28 27

Extent of under reporting 4 4 4 6 18 3 2 3


Adjusted tobacco use 1.03 0.60 0.37 0.47 1.26 0.41 1.02 1


Bases (weighted)

Men 195 148 460 168 48 64 1053 775

Women 277 187 497 173 57 62 1303 800

Bases (unweighted)

Men 162 136 273 163 109 144 272 733

Women 253 169 302 171 129 141 339 880

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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HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 5: ALCOHOL CONSUMPTION 131

Alcohol consumption

Elizabeth Becker, Amy Hills and Bob Erens

● Men and women from all minority ethnic groups reported drinking alcohol lessfrequently 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 otherminority ethnic groups were more likely than the general population to be non-drinkers, apart from the Irish who were as likely. The highest percentage of non-drinkers were found among Pakistani adults (89% of men and 95% of women), andBangladeshi adults (97% of men and 98% of women).

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

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

● 45% of men in the general population drank more than 4 units of alcohol on theirheaviest drinking day in the last week. The proportion exceeding 4 units was higheramong Irish men (at 56%), but lower for all other minority ethnic groups: 28% for BlackCaribbean men, 22% for Indian men, 19% for Chinese men, 17% for Black Africanmen, 4% for Pakistani men and 1% for Bangladeshi men. 25% of men in the generalpopulation 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 allthe other minority ethnic groups.

● In the general population, the proportion of women consuming 3 or more units on theirheaviest drinking day was 30%. It was higher among Irish women (36%), but lower forall other minority ethnic groups: 18% for Black Caribbean women, 12% for Chinesewomen, 8% for Indian women, 7% for Black African women, and only 1% or less forPakistani and Bangladeshi women. The pattern was similar for binge drinking amongwomen (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 Chinesewomen, 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 consumedon the heaviest drinking day between 1999 and 2004. In the general population, theonly change was an increase in the proportion of women in the general population whowere binge drinking, from 12% to 14%. For the minority ethnic groups, the onlydifferences over this five year period were: an increase in the percentage of Indianwomen exceeding 3 units (from 5% to 8%); and an increase in Chinese men exceedingboth 4 units (from 8% to 19%) and 8 units (from 2% to 10%).

5Summary

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 andsuicide. Many social problems have also been linked to the misuse of alcohol, such as anti-social behaviour, crime and domestic violence. However, there is also evidence that lowlevels of alcohol consumption can have positive effects. For example, low levels ofconsumption can have a protective effect against coronary heart disease and stroke formen over 40, and post-menopausal women.1 The advice currently given on sensibledrinking states that:

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

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

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

In Britain alcohol is consumed by the majority of people. However, there are majordifferences in the frequency and levels of consumption when looking at minority ethnicgroups, largely due to cultural differences and religious beliefs (which may also affectpeople’s willingness to report their consumption). Results from HSE 1999 confirmed thatmany 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 withgovernment 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 thepast 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. Thisis 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. Age-standardised risk ratios are used to take account of differences in the age profile of differentminority ethnic groups (see Chapter 1).

This chapter contains sections on usual frequency of drinking (Section 5.3), frequency ofdrinking in the past week (Section 5.4) and the amount consumed on the heaviest drinkingday in the past week (Section 5.5).

5.2 Measures

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

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 andmartini; spirits and liqueurs; and alcoholic soft drinks), which were then converted to unitsof alcohol consumed.4 By combining these estimates, it is possible to derive an estimate forthe heaviest day's consumption out of the last seven.

For informants aged 16-17, the module of questions on drinking was administered using aspecial 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 thatresponses might be unduly affected by the presence of other household members. In these

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cases, the 16-17 self-completion questionnaire was given to informants (and it wascompleted by 12% of those aged 18-24).

As yet, there is no consensus on a formal definition of the term ‘binge drinking.’ However, itis often defined as consuming 8 units or more for men and 6 units or more for women on atleast one drinking day in the week, and it is this definition that is used in this report (as inprevious HSE reports). These amounts are double the daily recommended amounts used incurrent 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 ayear. The proportions of women in the general population falling in these two categorieswere higher at 14% and 10% respectively. About one in five men (18%) and one in tenwomen (10%) in the general population said they drank almost every day, while about two-fifths 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 moredays 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 thislevel. 28% of Black Caribbean men, 18% of Indian and Chinese men, 17% of Black Africanmen, 2% of Pakistani men and 1% of Bangladeshi men reported drinking on three or moredays 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 inthe sample drinking on three or more days a week). The vast majority of Pakistani andBangladeshi adults were non-drinkers (89% Pakistani men, 95% Pakistani women, 97%Bangladeshi men and 98% Bangladeshi women). These differences between minorityethnic groups and the general population remained significant for all groups afterstandardisation for age, apart from Irish women. Table 5.1, Figure 5A

Usual frequency of drinking varied by age, as Table 5.2 shows. Among men in the generalpopulation, the likelihood of drinking almost every day increased with age from 9% at age16-34, 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 Caribbeanand Black African men. Given the low prevalence of drinking among Pakistani andBangladeshi men, it was not observable in these groups.

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Usually drank on 3 or more days a week

Per

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Figure 5A

0

10

20

30

40

50

60

MenWomen

Black

Caribbean

Black

African

Indian

Pakistani

Bangladeshi

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population

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 groupof 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 inthe 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-drinkersor only very occasional drinkers (33% compared with 18% of women aged 16-34). A similarrelationship between age and drinking almost every day was found only among Irishwomen. However, the proportion who were non-drinkers or only occasional drinkersincreased 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 wasvery similar in 2004 to that found in 1999. The biggest difference was found among Chinesemen, with an apparent decrease in the proportion of non-drinkers or very occasionaldrinkers, from 43% in 1999 to 31% in 2004. The biggest change was found among theoldest 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 thenumber persons in the household. Table 5.4 shows usual self-reported drinking frequencyby equivalised household income tertiles. In the general population, men and women in thehighest income tertile were the least likely to be non-drinkers or only very occasionaldrinkers (7% men, 13% women). This was also found to be the case among Indian men andwomen, 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 mostlikely to drink on three or more days a week (48% men, 36% women). This was also foundto be statistically significant among Irish women. Table 5.4

5.4 Frequency of drinking in the past week

5.4.1 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 lastweek (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 thenconverted to the number of units of alcohol consumed.

Among the general population, the proportion who said they had drunk alcohol on at leastone day in the past week was 76% for men and 61% for women. It was slightly higheramong Irish men and women (80% and 67% respectively), but after standardisation for agethe difference was not significant for men. In all minority ethnic groups (exceptBangladeshi), women were less likely than men to report drinking alcohol on at least oneday 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 thepast week was lower for all minority ethnic groups (except Irish) than it was for the generalpopulation. The proportion was lowest among Bangladeshi (1% men, 1% women) andPakistani informants (7% men, 3% women). For the other groups, the proportion of menwho 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 andChinese minority ethnic groups were more likely to have drunk on at least one day thanPakistani and Bangladeshi men and women, but were less likely than the general


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

In the general population, the mean number of days in the past week when alcohol wasconsumed was 2.7 for men and 1.8 for women. (The base for this mean includes those whohad not drunk alcohol in the past week, giving them a value of zero.) The means wereslightly higher for Irish men and women (3.0 and 2.1 respectively), but were much lower forthe other minority ethnic groups. The next highest means were for Black Caribbean menand women (1.8 and 1.0 respectively) and Chinese men and women (1.4 and 0.7respectively). The mean number of days on which alcohol was drunk was 0.2 or less forBangladeshi and Pakistani men and women.

Table 5.6 shows the number of days on which alcohol was consumed in the past week byage within minority ethnic group. Among both sexes, but especially among men, the patternof drinking frequency in the past week was similar to the pattern of usual drinking frequencyin the past year (as described in Section 5.3.1). For example, in the general population, itwas men in the oldest group (55 and over) who were the most likely to say they drankalmost every day, and they were also the most likely to report drinking on all seven days inthe 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 theage groups). Table 5.6


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Per

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Per

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Figure 5B

0

10

20

30

40

50

60

70

80

90

100

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

Black

Caribbean

Black

African

Indian

Pakistani

Bangladeshi

IrishChinese

General

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Caribbean

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Indian

Pakistani

Bangladeshi

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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 onwhich 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 onlychanges were an increase in drinking on at least one day in the last week among Indianwomen (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 householdincome tertiles. Although there were some minor differences in detail, the pattern found fordrinking in the past week was similar to that described in Section 5.3.3 for usual frequencyof drinking by equivalised household income tertiles. In the general population, men andwomen in the highest income tertile had the highest mean number of days on which theydrank in the past week (3.1 for men, 2.4 for women). Irish women in the highest incometertile 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 pastweek

5.5.1 Amount consumed on the heaviest drinking day in the past week by minorityethnic group

Table 5.9 shows the amount of alcohol consumed on the heaviest drinking day in the pastweek, 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 HSE1999; the method of calculating alcohol consumption on the heaviest day is described inSection 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% forIndian men, 19% for Chinese men, 17% for Black African men, 4% for Pakistani men andonly 1% for Bangladeshi men.

One in four (25%) men in the general population were binge drinking (defined as consuming8 or more units) on their heaviest drinking day in the past week. The proportion bingedrinking was higher among Irish men (32%), but much lower for all other groups: 12% forBlack 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 generalpopulation were significant after standardisation for age.

The proportion of women drinking more than government guidelines (i.e. 3 or more units) ontheir heaviest drinking day was 30% among the general population, rising to 36% amongIrish women. It was lower among all other minority ethnic groups: 18% for Black Caribbeanwomen, 12% for Chinese women, 8% for Indian women, 7% for Black African women, andonly 1% or less for both Pakistani and Bangladeshi women.

The pattern was similar for binge drinking (6 or more units) among women: 14% of womenin 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 bothPakistani and Bangladeshi women.

Except for Irish women, the differences between minority ethnic groups and the generalpopulation in the proportions drinking 3 or more, and 6 or more, units were still significantafter controlling for age. Table 5.9, Figure 5C


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

5.5.2 Comparison of the amount consumed on the heaviest drinking day in the pastweek in 1999 and 2004

Table 5.11 compares the 1999 and 2004 surveys in respect of the amount drunk on theheaviest drinking day in the past week. Among men in the general population there wasvirtually 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 increasein binge drinking from 12% to 14% over the five year period. These results are in line withlonger-term drinking trends shown by HSE.

Trends for minority ethnic groups are difficult to interpret, given there are only two datapoints (1999 and 2004). The only statistically significant differences between the 1999 and2004 surveys are: firstly, an increase in the proportion of Indian women drinking 3 or moreunits on their heaviest drinking day from 5% to 8%; secondly, an increase in Chinese men


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Per

cent

Per

cent

Figure 5C

0

10

20

30

40

50

60

Drank 4 or more unitsDrank 8 or more units

Drank 3 or more unitsDrank 6 or more units

Black

Caribbean

Black

African

Indian

Pakistani

Bangladeshi

IrishChinese

General

population

Black

Caribbean

Black

African

Indian

Pakistani

Bangladeshi

IrishChinese

General

population

Men

0

10

20

30

40

50

60Women

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

5.5.3 Amount consumed on the heaviest drinking day in the past week byequivalised household income

Table 5.12 shows the amount drunk on the heaviest drinking day by equivalised householdincome tertiles. Among the general population, informants of both sexes in the highestincome tertile were the most likely to exceed government recommendations (4 units men, 3units women) and to binge drink (8 units men, 6 units women).

Because of small sample sizes, there are few statistically significant differences betweenincome tertiles for the minority ethnic groups. The only differences that were significantwere: 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 moreunits.

Compared with past week drinkers in the general population, after controlling for age (seethe standardised risk ratios in Table 5.12), it appears that most minority ethnic income tertilegroups are less likely to binge drink than the general population. In about four-fifths of thesegroups, the proportion binge drinking was lower than the general population aftercontrolling for age; only Irish men in the highest income tertile were more likely to bingedrink, while the other income tertile sub-groups were not significantly different from thegeneral population.

Table 5.12


1 Bondy S et al. Low-risk drinking guidelines: the scientific evidence. Canadian J Publ Hlth 1999; 90:264-270. 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, December1995.

3 Erens B and Laiho J. Chapter 5: Alcohol consumption in Erens B, Primatesta P, Prior G (eds) HealthSurvey for England 1999: The health of minority ethnic groups. Volume 1: Findings. The Stationery Office,London 2001.


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Caribbean

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Indian

Pakistani

Bangladeshi

IrishChinese

Black

Caribbean

General

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Indian

Pakistani

Bangladeshi

IrishChinese

Percentage binge drinking on heaviest drinking day in past week in 1999 and 2004

Men Women

Per

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Figure 5D

0

5

10

15

20

25

30

35

40

0

5

10

15

20

25

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40

19992004

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


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

Tables

5.1 Self-reported usual frequency of drinkingalcohol in the past year, by minority ethnicgroup and sex

5.2 Self-reported usual frequency of drinkingalcohol in the past year, by age within minorityethnic group and sex

5.3 Comparison of self-reported usual frequency ofdrinking alcohol in the past year, 2004 and1999, by minority ethnic group and sex

5.4 Usual drinking frequency, by equivalisedhousehold income tertile within minority ethnicgroup and sex

5.5 Number of days on which alcohol wasconsumed in the past week, by minority ethnicgroup and sex

5.6 Number of days on which alcohol wasconsumed in the past week, by age withinminority ethnic group and sex

5.7 Comparison of frequency of drinking in the lastweek, 2004 and 1999, by minority ethnic groupand sex

5.8 Frequency of drinking in the past week, byequivalised household income tertile withinminority ethnic group and sex

5.9 Amount consumed on the heaviest drinkingday in the past week, by minority ethnic groupand sex

5.10 Amount consumed on heaviest drinking day inthe past week, by age within minority ethnicgroup and sex

5.11 Comparison of amount consumed on heaviestdrinking day in the past week, 2004 and 1999,by minority ethnic group and sex

5.12 Amount consumed on the heaviest drinkingday in the past week, by equivalised householdincome tertile within minority ethnic group andsex


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Table 5.1

Self-reported usual frequency of drinking alcohol in the past year, by minority ethnic group and sex


Usual drinking frequency Minority ethnic group Generalpopulation


MenObserved %

Almost every day 10 7 7 1 - 7 20 18

Five or six days a week 5 1 3 0 - 2 7 6

Three or four days a week 13 9 7 1 1 9 23 18

Once or twice a week 29 19 24 3 0 26 28 29

Once or twice a month 13 13 12 2 1 17 5 11

Once every couple of months 8 10 7 1 1 9 3 4

Once or twice a year 7 9 5 1 0 12 3 5

Not at all in the last 12 months/non-drinker 15 32 33 89 97 19 10 8

Sub-total: three or more days a week 28 17 18 2 1 18 51 41


Three or more days a week 0.75 0.47 0.44 0.05 0.01 0.49 1.23 1


WomenObserved %

Almost every day 4 2 2 - - 4 11 10

Five or six days a week 1 0 1 0 - 1 3 4

Three or four days a week 6 3 2 0 - 4 16 12

Once or twice a week 20 15 9 1 1 16 30 26

Once or twice a month 21 15 10 1 - 13 14 15

Once every couple of months 13 9 8 1 1 10 9 9

Once or twice a year 14 11 9 2 0 18 7 10

Not at all in the last 12 months/non-drinker 21 45 59 95 98 33 11 14

Sub-total: three or more days a week 11 6 5 0 - 9 30 26


Three or more days a week 0.42 0.28 0.21 0.01 0.00 0.37 1.06 1


Bases (weighted)

Men 472 366 899 411 172 150 1763 45610

Women 656 464 1058 489 196 162 2352 48284

Bases (unweighted)

Men 403 378 547 422 396 345 495 2852

Women 634 457 628 496 452 372 652 3799


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Table 5.2

Self-reported usual frequency of drinking alcohol in the past year, by age withinminority ethnic group and sex


Usual drinking frequency Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

Non- or very occasional drinker 17 21 26 21 24 29 60 35

Drinks at least once every 2 months 83 79 74 79 76 71 40 65

Drinks on 3 or more days a week 31 26 27 28 10 13 7 11

Drinks almost every day 7 11 12 10 2 5 4 4

Black African

Non- or very occasional drinker 45 41 [22] 41 60 54 [42] 56

Drinks at least once every 2 months 55 59 [78] 59 40 46 [58] 44

Drinks on 3 or more days a week 14 18 [26] 17 3 7 [13] 6

Drinks almost every day 4 10 [13] 7 1 3 [2] 2

Indian





Pakistani




Drinks almost every day - 2 - 1 - - - -

Bangladeshi




Drinks almost every day - - [-] - - - [-] -

Chinese





Irish





General population






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Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Bases (weighted)

Black Caribbean 135 195 142 472 201 291 165 656

Black African 169 156 40 366 230 197 37 464

Indian 324 383 192 899 401 464 193 1058

Pakistani 195 152 64 411 266 161 62 489

Bangladeshi 86 65 21 172 124 51 21 196

Chinese 73 50 27 150 62 78 22 162

Irish 412 678 673 1763 493 1038 820 2352


Bases (unweighted)

Black Caribbean 114 165 124 403 184 288 162 634

Black African 171 169 38 378 224 189 44 457

Indian 199 230 118 547 235 274 119 628

Pakistani 213 144 65 422 267 164 65 496

Bangladeshi 198 149 49 396 286 117 49 452

Chinese 170 117 58 345 145 176 51 372

Irish 114 194 187 495 147 275 230 652



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Table 5.3

Comparison of self-reported usual frequency of drinking alcohol in the pastyear, 2004 and 1999, by minority ethnic groupa and sex



Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

2004





1999





Indian

2004





1999





Pakistani

2004




Drinks almost every day - 2 - 1 - - - -

1999


Drinks at least once every 2 months 7 8 9 8 2 3 - 2

Drinks on 3 or more days a week 2 3 3 2 1 2 - 1

Drinks almost every day 1 2 - 1 1 2 - 1

Bangladeshi

2004




Drinks almost every day - - [-] - - - [-] -

1999


Drinks at least once every 2 months 5 4 - 3 0 2 - 1

Drinks on 3 or more days a week 2 1 - 1 - - - -

Drinks almost every day 1 1 - 1 - - - -

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

Continued…


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Table 5.3 continued



Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Chinese

2004





1999





Irish

2004





1999





General population

2004





1999





Continued…


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Table 5.3 continued


Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Bases (weighted)

Black Caribbean 2004 135 195 142 472 201 291 165 656

Black Caribbean 1999 141 92 129 362 187 189 122 497

Indian 2004 324 383 192 899 401 464 193 1058

Indian 1999 215 251 124 589 248 255 108 611

Pakistani 2004 195 152 64 411 266 161 62 489

Pakistani 1999 183 119 47 348 217 117 31 364

Bangladeshi 2004 86 65 21 172 124 51 21 196

Bangladeshi 1999 66 37 29 132 87 33 14 134

Chinese 2004 73 50 27 150 62 78 22 162

Chinese 1999 33 42 19 95 34 62 17 112

Irish 2004 412 678 673 1763 493 1038 820 2352

Irish 1999 385 709 446 1540 566 876 543 1985



Bases (unweighted)

Black Caribbean 2004 114 165 124 403 184 288 162 634

Black Caribbean 1999 206 141 192 539 277 283 178 738

Indian 2004 199 230 118 547 235 274 119 628

Indian 1999 228 265 125 618 262 275 113 650

Pakistani 2004 213 144 65 422 267 164 65 496

Pakistani 1999 310 216 77 603 373 203 56 632

Bangladeshi 2004 198 149 49 396 286 117 49 452

Bangladeshi 1999 256 142 116 514 340 144 58 542

Chinese 2004 170 117 58 345 145 176 51 372

Chinese 1999 105 127 65 297 107 194 58 359

Irish 2004 114 194 187 495 147 275 230 652

Irish 1999 135 238 161 534 203 300 204 707




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Table 5.4

Usual drinking frequency, by equivalised household income tertilewithin minority ethnic group and sex


Usual drinking frequency Equivalised household income tertile



Non- or very occasional drinker 14 28 18 23 32 42

Drinks at least once every 2 months 86 72 82 77 68 58

Drinks on 3 or more days a week 33 26 27 13 14 5

Drinks almost every day 12 9 10 7 5 1

Black African





Indian





Pakistani

Non- or very occasional drinker [76] 94 92 [91] 96 98

Drinks at least once every 2 months [24] 6 8 [9] 4 2

Drinks on 3 or more days a week [5] 1 1 [0] 0 1

Drinks almost every day [4] - 1 [-] - -

Bangladeshi

Non- or very occasional drinker a 96 99 a 99 99

Drinks at least once every 2 months a 4 1 a 1 1

Drinks on 3 or more days a week a 0 1 a 0 0

Drinks almost every day a - - a - -

Chinese

Non- or very occasional drinker 19 37 [45] 40 58 70

Drinks at least once every 2 months 81 63 [55] 60 42 30

Drinks on 3 or more days a week 23 16 [15] 14 7 3

Drinks almost every day 4 7 [9] 5 2 3

Irish





General population






Drinks on 3 or more days a week 0.91 0.70 0.67 0.47 0.60 0.20


Drinks almost every day 0.89 0.67 0.52 0.61 0.59 0.15


Black African





Continued…



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Table 5.4 continued


Usual drinking frequency Equivalised household income tertile


Standardised risk ratiosIndian





Pakistani

Drinks on 3 or more days a week [0.10] 0.03 0.02 [0.00] 0.00 0.03


Drinks almost every day [0.20] 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


Drinks almost every day 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


Drinks almost every day 0.23 0.62 [0.58] 0.58 0.35 0.34


Irish





General population





Bases (weighted)

Black Caribbean 151 115 101 154 181 176

Black African 112 84 86 123 113 146

Indian 263 239 149 302 284 203

Pakistani 55 117 130 56 131 163


Chinese 44 35 21 52 34 23

Irish 833 396 260 1037 565 335


Bases (unweighted)

Black Caribbean 122 90 90 147 157 175

Black African 103 101 89 102 121 145

Indian 158 154 96 177 171 126

Pakistani 47 112 150 46 132 170

Bangladeshi 19 87 160 23 97 181

Chinese 105 76 47 120 74 56

Irish 207 121 88 256 162 121




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Table 5.5

Number of days on which alcohol was consumed in the past week, by minority ethnic group and sex


Number of days Minority ethnic group Generalpopulation


MenObserved %

0 40 62 53 93 99 52 20 24

1 20 13 18 3 0 19 11 17

2 14 9 11 2 0 9 19 15

3 7 4 6 1 0 4 14 11

4 5 2 3 0 0 6 11 8

5 5 3 2 0 - 1 6 5

6 2 1 3 - - 1 1 4

7 7 5 6 1 - 8 18 15

Sub-total: drank on at least 1 day 60 38 47 7 1 48 80 76




Drank on at least 1 day 0.80 0.51 0.62 0.09 0.01 0.64 1.07 1.00


Drank on all 7 days 0.51 0.43 0.42 0.04 - 0.65 1.10 1.00

Standard error of the ratio 0.13 0.13 0.08 0.04 - 0.14 0.17



WomenObserved %

0 53 74 79 97 99 68 33 39

1 24 15 11 1 0 14 20 20

2 11 5 5 1 0 9 12 13

3 4 2 3 - - 3 11 9

4 2 1 0 0 - 2 6 5

5 1 1 0 - - 0 6 4

6 0 0 0 - - 1 3 2

7 3 2 2 0 - 3 9 9

Sub-total: drank on at least 1 day 47 26 21 3 1 32 67 61




Drank on at least 1 day 0.75 0.43 0.33 0.04 0.01 0.49 1.10 1.00


Drank on all 7 days 0.41 0.23 0.23 0.01 - 0.40 0.97 1.00

Standard error of the ratio 0.13 0.10 0.09 0.01 - 0.16 0.18



Bases (weighted)

Men 465 357 874 406 172 147 1754 45399

Women 640 454 1044 488 194 157 2329 47791

Bases (unweighted)

Men 397 369 532 416 395 338 491 2837

Women 617 447 619 495 448 363 642 3755


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Table 5.6

Number of days on which alcohol was consumed in the past week, by agewithin minority ethnic group and sex


Number of days Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

Drank on at least 1 day 59 63 58 60 52 53 27 47

Drank on all 7 days 1 9 12 7 2 3 4 3


Black African

Drank on at least 1 day 33 43 [42] 38 22 30 [27] 26

Drank on all 7 days 3 7 [9] 5 1 3 [2] 2

Mean number of days 1.0 1.3 [1.1] 1.1 0.4 0.6 [0.6] 0.5

Indian


Drank on all 7 days 2 6 11 6 1 3 1 2


Pakistani


Drank on all 7 days - 1 - 1 0 - - 0


Bangladeshi


Drank on all 7 days 0 0 [0] 0 0 0 [0] 0


Chinese

Drank on at least 1 day 46 54 41 48 35 35 [13] 32

Drank on all 7 days 3 9 19 8 1 3 [7] 3

Mean number of days 1.1 1.7 1.8 1.4 0.7 0.8 [0.6] 0.7

Irish


Drank on all 7 days 8 17 25 18 2 11 10 9


General population


Drank on all 7 days 7 15 23 15 3 9 13 9


Bases (weighted)

Black Caribbean 134 192 140 465 201 288 152 640

Black African 167 151 39 357 229 189 37 454

Indian 316 375 183 874 400 456 189 1044

Pakistani 194 150 61 406 265 161 62 488

Bangladeshi 85 65 21 172 124 50 21 194

Chinese 73 49 25 147 60 76 21 157

Irish 410 675 670 1754 486 1027 816 2329


Bases (unweighted)

Black Caribbean 113 163 121 397 184 284 149 617

Black African 169 164 36 369 223 181 43 447

Indian 194 226 112 532 234 268 117 619

Pakistani 211 142 63 416 266 164 65 495

Bangladeshi 197 149 49 395 284 116 48 448

Chinese 169 114 55 338 142 173 48 363

Irish 112 193 186 491 144 269 229 642



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Table 5.7

Comparison of frequency of drinking in the last week, 2004 and 1999, byminority ethnic groupa and sex



Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

2004


Drank on all 7 days 1 9 12 7 2 3 4 3


1999


Drank on all 7 days 4 10 11 8 1 5 1 2


Indian

2004


Drank on all 7 days 2 6 11 6 1 3 1 2


1999


Drank on all 7 days 2 9 13 7 0 - - 0


Pakistani

2004


Drank on all 7 days - 1 - 1 0 - - 0


1999

Drank on at least 1 day 5 5 9 5 1 3 - 2

Drank on all 7 days 0 2 - 1 0 - - 0


Bangladeshi

2004


Drank on all 7 days 0 0 [0] 0 0 0 [0] 0


1999

Drank on at least 1 day 4 2 - 2 0 2 - 1

Drank on all 7 days 1 1 - 1 - - - -


Chinese

2004

Drank on at least 1 day 46 54 41 48 35 35 [13] 32

Drank on all 7 days 3 9 19 8 1 3 [7] 3

Mean number of days 1.1 1.7 1.8 1.4 0.7 0.8 [0.6] 0.7

1999


Drank on all 7 days 4 5 8 5 1 2 2 2



Continued…


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Table 5.7 continued



Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Irish

2004


Drank on all 7 days 8 17 25 18 2 11 10 9


1999


Drank on all 7 days 10 12 20 14 5 9 10 8


General population

2004


Drank on all 7 days 7 15 23 15 3 9 13 9


1999


Drank on all 7 days 9 13 21 15 3 8 14 9


Bases (weighted)

Black Caribbean 2004 134 192 140 465 201 288 152 640

Black Caribbean 1999 141 91 127 360 186 189 118 493

Indian 2004 316 375 183 874 400 456 189 1044

Indian 1999 215 250 120 585 244 250 108 601

Pakistani 2004 194 150 61 406 265 161 62 488

Pakistani 1999 181 118 46 346 216 117 31 364

Bangladeshi 2004 85 65 21 172 124 50 21 194

Bangladeshi 1999 66 37 29 132 87 33 14 134

Chinese 2004 73 49 25 147 60 76 21 157

Chinese 1999 33 42 18 92 34 59 16 109

Irish 2004 410 675 670 1754 486 1027 816 2329

Irish 1999 385 710 444 1539 553 874 539 1966



Bases (unweighted)

Black Caribbean 2004 113 163 121 397 184 284 149 617

Black Caribbean 1999 206 140 189 535 276 283 172 731

Indian 2004 194 226 112 532 234 268 117 619

Indian 1999 228 265 121 614 259 271 112 642

Pakistani 2004 211 142 63 416 266 164 65 495

Pakistani 1999 308 215 76 599 372 203 56 631

Bangladeshi 2004 197 149 49 395 284 116 48 448

Bangladeshi 1999 256 140 116 512 340 143 58 541

Chinese 2004 169 114 55 338 142 173 48 363

Chinese 1999 104 126 60 290 107 187 54 348

Irish 2004 112 193 186 491 144 269 229 642

Irish 1999 135 238 160 533 199 299 201 699




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Table 5.8

Frequency of drinking in the past week, by equivalisedhousehold income tertile within minority ethnic group and sex


Number of days Equivalised household income tertile



Drank on at least 1 day 72 55 58 56 52 40

Drank on all 7 days 8 4 9 5 5 -

Mean number of days 2.2 1.5 1.8 1.3 1.1 0.7

Black African


Drank on all 7 days 3 3 9 2 1 2


Indian


Drank on all 7 days 5 5 6 2 - 1


Pakistani

Drank on at least 1 day [21] 6 4 [8] 2 2

Drank on all 7 days [4] - - [-] - 0

Mean number of days [0.5] 0.1 0.0 [0.1] 0.0 0.1

Bangladeshi

Drank on at least 1 day a - 1 a 1 1

Drank on all 7 days a - - a - -

Mean number of days a - 0.0 a 0.0 0.0

Chinese

Drank on at least 1 day 62 45 [41] 42 24 27

Drank on all 7 days 6 9 [12] 2 4 5

Mean number of days 1.7 1.4 [1.4] 1.0 0.5 0.7

Irish


Drank on all 7 days 17 27 19 11 10 6


General population


Drank on all 7 days 16 16 9 11 8 6



Continued…


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Table 5.8 continued


Number of days Equivalised household income tertile



Drank on at least 1 day 0.94 0.76 0.75 0.85 0.90 0.63


Black African



Indian



Pakistani

Drank on at least 1 day [0.34] 0.08 0.06 [0.14] 0.02 0.03


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



Irish



General population



Bases (weighted)

Black Caribbean 148 115 100 153 178 171

Black African 111 84 81 121 113 141

Indian 260 233 139 297 281 198

Pakistani 55 112 130 56 130 163


Chinese 43 35 19 52 34 22

Irish 833 390 260 1031 560 326


Bases (unweighted)

Black Caribbean 121 90 89 146 152 171

Black African 101 100 85 100 121 140

Indian 156 151 89 175 169 122

Pakistani 47 108 149 46 131 170

Bangladeshi 19 87 159 23 97 179

Chinese 104 75 43 119 73 54

Irish 207 118 88 254 161 116




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Table 5.9

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


Alcohol consumption Minority ethnic group General(units per day) population


MenObserved %

None 40 62 53 93 99 52 20 24

Under 2 units 12 8 11 1 0 14 10 13

2, under 3 units 14 7 9 1 - 12 9 12

3, under 4 units 6 6 4 1 - 3 5 6

4, under 5 units 5 6 8 1 0 4 13 8

5, under 6 units 4 1 2 - - 1 3 3

6, under 8 units 7 3 3 0 0 4 9 9

8 or more units 12 7 9 3 0 10 32 25

Sub total: 4 or more unitsa 28 17 22 4 1 19 56 45



Consumed 4 or more units 0.64 0.35 0.48 0.08 0.01 0.38 1.27 1




WomenObserved %

None 53 74 79 97 99 68 33 39

Under 2 units 17 11 8 1 - 15 18 18

2, under 3 units 11 7 5 0 - 5 13 13

3, under 4 units 7 2 3 0 - 4 10 8

4, under 5 units 4 2 0 0 0 2 5 5

5, under 6 units 1 1 1 0 - 2 5 3

6, under 8 units 3 1 1 0 - 2 8 7

8 or more units 3 1 2 0 0 2 8 7








Bases (weighted)

Men 465 357 873 406 172 147 1751 45229

Women 641 454 1043 488 194 158 2329 47623

Bases (unweighted)

Men 397 369 531 416 395 337 490 2829

Women 618 446 618 495 448 364 642 3745

a These figures are cumulative.


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Table 5.10

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


Number of units Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

4/3 or more units 36 32 15 28 31 17 5 18

8/6 or more units 17 16 3 12 12 5 1 6

Mean units 3.7 3.5 1.7 3.0 2.2 1.3 0.5 1.4


Black African

4/3 or more units 15 17 20 17 7 8 7 7

8/6 or more units 9 6 2 7 3 0 5 2

Mean units 2.2 1.8 1.5 1.9 0.6 0.6 0.8 0.6


Indian

4/3 or more units 25 25 11 22 13 6 0 8

8/6 or more units 13 9 2 9 7 3 0 4

Mean units 2.6 2.2 1.1 2.1 0.9 0.7 0.1 0.7


Pakistani

4/3 or more units 4 5 1 4 2 0 0 1

8/6 or more units 3 4 1 3 1 0 0 1

Mean units 0.4 0.5 0.1 0.4 0.1 0.0 0.0 0.1


Bangladeshi

4/3 or more units 0 1 0 1 0 2 0 1

8/6 or more units - 1 - 0 0 1 0 0

Mean units 0.0 0.1 0.0 0.1 0.0 0.1 0.0 0.0


Chinese

4/3 or more units 24 15 13 19 21 8 2 12

8/6 or more units 17 3 3 10 10 2 0 4

Mean units 2.7 1.6 1.3 2.1 1.5 0.7 0.2 0.9


Irish

4/3 or more units 72 57 46 56 51 41 20 36

8/6 or more units 51 34 17 32 27 18 6 16

Mean units 10.6 6.3 3.9 6.4 3.7 2.9 1.5 2.6


General population

4/3 or more units 54 49 32 45 39 35 16 30

8/6 or more units 37 27 12 25 23 15 5 14

Mean units 7.7 5.0 3.1 5.2 3.1 2.5 1.2 2.2


Continued…


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Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Bases (weighted)

Black Caribbean 134 192 140 465 199 288 153 641

Black African 165 152 39 357 228 189 37 454

Indian 314 375 183 873 400 455 189 1043

Pakistani 194 150 61 406 265 161 62 488

Bangladeshi 85 65 21 172 124 50 21 194

Chinese 73 48 25 147 60 76 21 158

Irish 410 675 667 1751 486 1027 816 2329


Bases (unweighted)

Black Caribbean 113 163 121 397 183 285 150 618

Black African 168 165 36 369 222 181 43 446

Indian 193 226 112 531 234 267 117 618

Pakistani 211 142 63 416 266 164 65 495

Bangladeshi 197 149 49 395 284 116 48 448

Chinese 169 113 55 337 142 173 49 364

Irish 112 193 185 490 144 269 229 642



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Table 5.11

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



Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

2004

4/3 or more units 36 32 15 28 31 17 5 18

8/6 or more units units 17 16 3 12 12 5 1 6

Mean units 3.7 3.5 1.7 3.0 2.2 1.3 0.5 1.4

1999

4/3 or more units 29 32 21 27 22 21 5 17


Mean units 4.5 3.3 2.3 3.4 3.5 1.5 0.5 2.0

Indian

2004

4/3 or more units 25 25 11 22 13 6 0 8


Mean units 2.6 2.2 1.1 2.1 0.9 0.7 0.1 0.7

1999

4/3 or more units 28 22 13 22 9 3 1 5


Mean units 6.2 2.0 1.5 3.4 0.7 0.3 0.1 0.5

Pakistani

2004

4/3 or more units 4 5 1 4 2 - 0 1

8/6 or more units units 3 4 1 3 1 - 0 1

Mean units 0.4 0.5 0.1 0.4 0.1 0.0 0.0 0.1

1999

4/3 or more units 3 3 4 3 1 0 - 1

8/6 or more units units 0 1 1 1 1 0 - 1

Mean units 0.3 0.3 0.4 0.3 0.1 0.0 - 0.1

Bangladeshi

2004

4/3 or more units 0 1 [-] 1 0 2 [-] 1

8/6 or more units units - 1 [-] 0 0 1 [-] 0

Mean units 0.0 0.1 [-] 0.1 0.0 0.1 [-] 0.0

1999

4/3 or more units 3 - - 2 - 2 - 0

8/6 or more units units 3 - - 2 - - - -

Mean units 0.7 0.0 - 0.4 - 0.1 - 0.0

Chinese

2004

4/3 or more units 24 15 13 19 21 8 [2] 12

8/6 or more units units 17 3 3 10 10 2 [0] 4

Mean units 2.7 1.6 1.3 2.1 1.5 0.7 [0.2] 0.9

1999

4/3 or more units 13 6 4 8 16 5 6 9

8/6 or more units units 4 1 - 2 4 2 - 3

Mean units 1.4 0.9 0.5 1.0 1.1 0.6 0.4 0.7

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


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Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Irish

2004

4/3 or more units 72 57 46 56 51 41 20 36


Mean units 10.6 6.3 3.9 6.4 3.7 2.9 1.5 2.6

1999

4/3 or more units 78 55 46 58 48 43 16 37


Mean units 18.4 5.7 4.5 8.4 3.6 2.7 1.2 2.5

General population

2004

4/3 or more units 54 49 32 45 39 35 16 30


Mean units 7.7 5.0 3.1 5.2 3.1 2.5 1.2 2.2

1999

4/3 or more units 57 52 31 46 42 34 13 29


Mean units 8.0 5.3 2.9 5.2 4.9 2.2 1.1 2.6

Bases (weighted)

Black Caribbean 2004 134 192 140 465 199 288 153 641

Black Caribbean 1999 133 90 126 348 179 189 118 486

Indian 2004 314 375 183 873 400 455 189 1043

Indian 1999 200 250 118 568 241 250 108 598

Pakistani 2004 194 150 61 406 265 161 62 488

Pakistani 1999 181 118 46 346 216 117 31 364

Bangladeshi 2004 85 65 21 172 124 50 21 194

Bangladeshi 1999 66 37 29 132 87 33 14 134

Chinese 2004 73 48 25 147 60 76 21 158

Chinese 1999 30 42 18 90 33 59 16 108

Irish 2004 410 675 667 1751 486 1027 816 2329

Irish 1999 370 707 444 1520 526 874 539 1939



Bases (unweighted)

Black Caribbean 2004 113 163 121 397 183 285 150 618

Black Caribbean 1999 195 138 187 520 266 283 172 721

Indian 2004 193 226 112 531 234 267 117 618

Indian 1999 212 265 120 597 255 271 112 638

Pakistani 2004 211 142 63 416 266 164 65 495

Pakistani 1999 307 215 76 598 372 203 56 631

Bangladeshi 2004 197 149 49 395 284 116 48 448

Bangladeshi 1999 256 140 116 512 339 143 58 540

Chinese 2004 169 113 55 337 142 173 49 364

Chinese 1999 97 125 60 282 103 187 54 344

Irish 2004 112 193 185 490 144 269 229 642

Irish 1999 131 236 160 527 193 299 201 693





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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


Number of units Equivalised household income tertile



4/3 or more units 40 28 22 24 24 16

8/6 or more units 19 11 8 5 10 8

Mean units 4.1 3.0 2.2 1.5 1.8 1.4


Black African

4/3 or more units 15 20 13 6 10 4

8/6 or more units 3 8 10 1 3 1

Mean units 1.5 1.9 1.8 0.6 0.7 0.4


Indian

4/3 or more units 22 26 17 14 5 3

8/6 or more units 11 8 8 7 2 5

Mean units 2.2 2.0 2.0 1.2 0.3 0.3


Pakistani

4/3 or more units [8] 5 2 [1] 2 2

8/6 or more units [4] 4 2 [0] 2 0

Mean units [0.7] 0.5 0.4 [0.1] 0.2 0.1


Bangladeshi

4/3 or more units a - 1 a 1 1

8/6 or more units a - 1 a 0 1

Mean units a - 0.1 a 0.0 0.1

Standard error of the mean a - 0.09 a 0.04 0.07

Chinese

4/3 or more units 28 25 [7] 14 9 6

8/6 or more units 12 18 [-] 4 4 2

Mean units 2.8 2.9 [0.8] 1.2 0.7 0.6


Irish

4/3 or more units 62 44 50 47 24 32

8/6 or more units 41 21 23 19 14 19

Mean units 7.3 4.6 5.3 3.1 2.0 2.7


General population

4/3 or more units 52 40 32 38 23 19

8/6 or more units 29 21 19 17 10 13

Mean units 6.1 4.4 3.9 2.7 1.8 1.8




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Number of units Equivalised household income tertile



8/6 or more units (risk ratio) 0.78 0.50 0.25 0.35 0.77 0.51


Black African



Indian



Pakistani

8/6 or more units (risk ratio) [0.11] 0.13 0.07 [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


Irish



General population



Bases (weighted)

Black Caribbean 148 115 101 153 178 170

Black African 111 84 80 121 113 140

Indian 260 233 139 297 278 198

Pakistani 55 112 130 56 130 163


Chinese 43 35 19 52 34 22

Irish 833 390 260 1031 560 326


Bases (unweighted)

Black Caribbean 121 90 90 146 152 171

Black African 101 100 84 100 121 139

Indian 156 151 89 175 167 122

Pakistani 47 108 149 46 131 170

Bangladeshi 19 87 159 23 97 179

Chinese 104 75 42 119 73 54

Irish 207 118 88 254 161 116



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HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY 163

Anthropometricmeasures, overweight,and obesity

Vasant Hirani and Emmanuel Stamatakis

● After adjusting for age, Bangladeshi, Chinese, Indian, Pakistani and Black African menwere, on average, shorter than men in the general population, whereas BlackCaribbean 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 generalpopulation, apart from Irish, Black Caribbean and Black African women, who were asimilar height to women in the general population.

● Mean BMI of Chinese (24.1kg/m2), Bangladeshi (24.7kg/m2), Indian (25.8kg/m2) andPakistani (25.9kg/m2) men was lower than in the general population (27.1kg/m2). MeanBMI 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 BlackAfrican (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 alack of evidence of the validity of the thresholds for defining overweight and obesityused in this report for different ethnic groups.

● After adjusting for age, Chinese and Bangladeshi men were least likely to beoverweight 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 lesslikely to be overweight or obese (risk ratios 0.82 and 0.89 respectively). The likelihoodof Black African, Black Caribbean and Irish men being overweight or obese was thesame as for men in the general population. Among women, levels of overweightincluding 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). Chinesewomen were half as likely to be overweight or obese (risk ratio 0.46) as women in thegeneral 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 almostfour times, less likely to be obese than men in the general population. For women, riskratios were higher for Black African women (prevalence 38%, risk ratio 2.00), BlackCaribbean 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 generalpopulation.

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

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

6Summary

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164 HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY

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

● The prevalence of obesity (BMI>30kg/m2) among women increased from the highestto 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 inIrish women, from 2% to 9% in Black Caribbean women, and from 3% to 10% inBlack African women.

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

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

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

6.1 Introduction

6.1.1 Context

The prevalence of obesity is increasing rapidly worldwide.1 In England more than half of alladults are currently classified as overweight or obese.2 Obesity can reduce overall quality oflife and lead to premature death due to its association with serious chronic conditions suchas type 2 diabetes, hypertension, and cancer.4,5 In particular, it is generally recognised thatthe central deposition of fat (abdominal or visceral obesity) is more closely associated withthese chronic diseases.6 The International Obesity Task Force (IOTF)7 has emphasised thatthe health burden of obesity would be more easily predicted if the hazards of accumulatingintra-abdominal fat were also monitored, in addition to body mass index (BMI), by simplemeasures such as waist circumference.

The public health White Paper Choosing Health: Making healthy choices easier8 set out theGovernment’s commitments for action on obesity and on reducing ethnic inequalities inhealth in general. Delivering choosing health,9 Food and Health Action Plan10 and PhysicalActivity Plan11 specified the action that needs to be taken at national, regional and locallevel to combat obesity and improve people’s health through better diet and nutrition andincreasing physical activity. It is widely acknowledged that both treatment and preventionare important to combat obesity. The Health Development Agency has reviewed theevidence on the best approaches to prevent and treat obesity in individuals.12 A wide rangeof evidence-based approaches exist, including low-calorie diets, increased physicalactivity, combinations of physical activity and dieting, and a combination of behaviouraltherapy with other practices. The National Institute for Clinical Excellence (NICE) ispreparing definitive guidance on prevention, identification and management of treatment ofobesity, to be published in 2007.

This chapter focuses on anthropometric measurements and prevalence of overweight andobesity among minority ethnic groups living in England. In recent years, there has beenmuch discussion of the appropriate obesity and overweight standards for certain minorityethnic 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 groupstend to carry a higher body fat content for a given BMI than the white population, while theopposite is true for Black people.13 However, widely accepted ethnicity-specific BMI cut-offpoints have not yet been devised. Proposals by the World Health Organisation/InternationalObesity Task Force14 to set a cut-off of 23kg/m2 for overweight in Asian populations islimited to specific populations and cannot be applied to all Asians.15

Ethnic subgroup-specific standards have been proposed for waist circumference andwaist-hip ratio (WHR)16 but their applicability is limited for the same reason. However, arecent study across 52 countries found a consistent association between quintile of WHRand risk of a heart attack within each ethnic group examined.17 This chapter uses thegeneral population BMI standards used in HSE 1999 and previous HSE reports to defineoverweight and obesity.

The chapter presents anthropometric measures for adults aged 16 and over, focusing onobesity. First, the methods used are described and the measurements defined. Therelationships of BMI, overweight and obesity prevalence, waist-hip ratio and waistcircumference with ethnicity, age-group within ethnicity, and equivalised household incomewithin ethnicity are examined. Finally, data on BMI, waist circumference and WHR arecompared 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 interviewervisit 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 plateand three connecting rods marked with a metric measuring scale. Informants were asked toremove their shoes. One measurement was taken, with the informant stretching to themaximum height and the head positioned in the Frankfort plane. The reading was recordedto the nearest millimetre.

Weight

Weight was measured using Soehnle, Seca and Tanita electronic scales with a digitaldisplay. Informants were asked to remove their shoes and any bulky clothing. A singlemeasurement was recorded to the nearest 100g. Informants who were pregnant,chairbound, or unsteady on their feet were not weighed. Informants who weighed morethan 130 kg were asked for their estimated weights because the scales are inaccurateabove this level. These estimated weights were included in the analysis, as omitting themwould have given more misleading population results than including estimated weights.

In the analysis of height and weight, data from those who were considered by theinterviewer to have unreliable measurements, for example those wearing excessive clothingsuch 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 fordifferences in weight due to height. A widely accepted measure of weight for height, theBody Mass Index (BMI, defined as weight (kg) / height (m2)), has been used for this purposein the Health Survey series. However BMI does not distinguish between mass due to bodyfat and mass due to muscular physique. It also does not take account of the distribution offat.

BMI was calculated for all those informants for whom both a valid height and weightmeasurement were recorded. Adult informants were classified into the following BMIgroups:

BMI (kg/m2) Description18.5 or less UnderweightOver 18.5 to 25 DesirableOver 25 to 30 OverweightOver 30 Obese

In earlier HSE reports, the healthy (‘desirable’) weight range for BMI was taken as over 20 to25kg/m2, but medical opinion7 now regards it as more appropriate to define it as over 18.5to 25kg/m2, and the present report therefore uses this revised definition. BMI greater than25.0kg/m2 but no greater than 30.0kg/m2 is defined as overweight and BMI exceeding30.0kg/m2 is defined as obesity. These two categories have frequently been combined inthis report to show the proportion who are either overweight or obese. As in the HSE 1998report 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 highrisk of morbidity and mortality.18

Waist and hip

Waist was defined as the midpoint between the lower rib and the upper margin of the iliaccrest (the top of the hip bone). It was measured using a tape with an insertion buckle at oneend. 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 thenearest millimetre. Those whose two waist or hip measurements differed by more than 3cmhad a third measurement taken. The mean of the two valid measurements was used in theanalysis.

For waist and hip measurements, all those who reported that they had a colostomy orileostomy, or were chairbound or pregnant were excluded from the measurement. All those

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with measurements considered unreliable by the nurse, for example due to excessiveclothing 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 populationgroup. In this chapter, waist and waist-hip ratio comparisons between minority ethnicgroups and the general population were performed using HSE 2003 general populationdata for the latter.

Waist-hip ratio

Waist-hip ratio (WHR) of an individual was defined as mean waist circumference divided bymean hip circumference, i.e. waist girth (m) / hip girth (m). WHR is a measure of depositionof abdominal fat, i.e. central obesity. Unlike BMI, there is no consensus about appropriateWHR 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: araised 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 avalid waist and hip circumference measurement were recorded. The mean WHR for groupsof 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 WHRto identify those with a health risk from being overweight. The definition of raised waistcircumference used is the definition of abdominal obesity used by the National Institutes ofHealth (USA) ATP (Adult Treatment Panel) III.20 A raised waist circumference has been takento be 102cm or more in men and 88cm or more in women. These levels identify people atrisk of the metabolic syndrome, a disorder characterised by increased risk of developingdiabetes and cardiovascular disease. Abdominal obesity is more highly correlated withmetabolic risk factors (high levels of triglycerides, low HDL-cholesterol) than is elevatedBMI.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 and77% to 90% of women from different minority ethnic groups, compared with 85% and87% in the general population.

● Fewer informants agreed to a nurse visit, but a very high proportion of those who did hadvalid waist and hip measurements taken (94% - 100%).

Section 6.3 in Volume 2 gives more details of response rates to the different stages of thesurvey. Table 6.1

6.2 Anthropometric measures, by minority ethnic groups

6.2.1 Height

The mean observed height of men aged 16 and over ranged from 167.8cm (Bangladeshimen) to 175.2cm (Black Caribbean men). The mean height of men in the general populationwas 175.0cm. After adjusting for age, Bangladeshi, Chinese, Indian, Pakistani and BlackAfrican 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 generalpopulation.

Mean observed height in women varied from 154.7cm in Bangladeshi women to 163.0cm inBlack 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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groups were on average shorter than their counterparts in the general population, apartfrom Irish, Black Caribbean and Black African women, who were a similar height to womenin the general population. Table 6.2

Mean height was generally greater among men than women in each minority ethnic groupand in the general population. In men and women in each minority ethnic group and in thegeneral population, mean height was greatest in those aged 16-34 and was lowest in thoseaged 55 and over. The cross-sectional survey could not distinguish the extent to which thisrepresents loss of height with increasing age or younger people being taller than earliergenerations. Table 6.3

6.2.2 Weight

The observed mean weight in men of most minority ethnic groups was lower than in thegeneral population (82.9 kg); the exception was among Black Caribbean and Irish menwhere mean weight was about the same as the general population. Among other minorityethnic groups it varied from 69.8kg among Bangladeshi men to 79.6 kg among BlackAfrican men. After age standardisation, men from each minority ethnic group, except thoseof 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 Chineseorigin 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 andChinese origin were significantly lighter than those in the general population; BlackCaribbean and Black African women were heavier than the general population; andPakistani and Irish women were about the same weight as women in the generalpopulation. Table 6.4

In both sexes, mean weight increased from age 16-34 to age 35-54, and then decreased inthose aged 55 and over, in most minority ethnic groups and in the general population. Theonly 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 oldestgroup. Table 6.5

6.2.3 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 foroverweight (>25kg/m2 )and obesity (>30.0kg/m2 ) used may not be entirely appropriate forall 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 thanin the general population (27.1kg/m2).

Among women, those of Chinese origin had a markedly lower mean BMI (23.2kg/m2) thanthose in the general population (26.8kg/m2 ). Indian and Irish women had a similar meanBMI to those in the general population. In contrast, mean BMI was higher among BlackCaribbean (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 agestandardisation. Age-standardised risk ratios are used to take account of differences in theage profile of different minority ethnic groups (see chapter 1). Chinese and Bangladeshimen were least likely to be overweight or obese (standardised risk ratios, compared withthe general population, of 0.62 and 0.75). Indian and Pakistani men were also less likely tobe overweight or obese (risk ratios 0.82 and 0.89 respectively). The likelihood of Black


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African, Black Caribbean and Irish men being overweight or obese was the same as formen 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): afteradjusting for age, Bangladeshi men were almost five times, and Chinese men almost fourtimes, less likely to be obese than men in the general population. Table 6.6, Figure 6A

The observed prevalence of morbid obesity was around 1% or less in men in each minorityethnic 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 BlackCaribbean (65%), Black African (70%) and Pakistani (62%) groups than in the generalpopulation (57%). Bangladeshi (51%) women and, particularly, Chinese women (25%) hadlower prevalence of overweight including obesity than the general population.

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 ratio1.37), Pakistani women (1.24) and Black Caribbean women (1.16). Chinese women werehalf 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), BlackCaribbean women (32%, risk ratio 1.43) and Pakistani women (28%, risk ratio 1.48) andlower 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 aslikely, and Pakistani women about 50% more likely, to be obese, while Chinese womenwere about three times less likely to be obese than women in the general population.

Table 6.6, Figure 6A


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Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

Prevalence of obesity (BMI>30 kg/m2), by minority ethnic group

Men Women

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Figure 6A

2.0

0.5


0.1

1.0

10.0

Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

2.0

0.5

0.1

1.0

10.0

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Among Black Caribbean and Black African women (4% and 5%, respectively), observedmorbid obesity (BMI>40kg/m2) prevalence was about twice that for women in the generalpopulation (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 inthis report. A higher proportion of South Asian (Indian, Pakistani and Bangladeshi), andChinese men and women, than of other minority ethnic groups were underweight; this wasmore apparent in the 16-34 age group. Bangladeshi informants had the highest prevalenceof underweight (4% of men and 5% of women, compared with 1% for men and 2% forwomen 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 and26.8kg/m2 respectively) and a higher proportion of men than women were overweight orobese (BMI>25kg/m2). The proportion morbidly obese (BMI>40kg/m2) was 2% amongwomen, 1% among men.

Women had a higher mean BMI than men in each minority ethnic group except the Chineseand Irish. The largest difference in prevalence of obesity between men and women wasobserved in Black Africans, where women’s obesity prevalence was more than double thatin men (38% vs 17%), and among the Bangladeshi group, where obesity prevalence wasalmost 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 ethnicgroups, and in the general population, except among the Irish where there was nosignificant difference in mean BMI by age. It declined at age 55 and over among Indianmen.

In men, the prevalence of overweight including obesity increased between age 16-34 andage 35-54 in the general population and in all minority groups. Thereafter it levelled off inthe general population and among Irish men, but increased at age 55+ among BlackCaribbean men, while tending to decrease among Asian groups. (The sample of BlackAfrican men aged 55+ was too small for analysis.)

In women, the prevalence of overweight including obesity generally increased with age inall minority ethnic groups and the general population. The increase in obesity prevalencewith age was particularly marked among Black Caribbean, Black African and Indianwomen: among Black Caribbean women, from 13% in the 16-34 age group to 48% inthose aged 55 and over, and among Indian women, from 11% to 27%. Obesity prevalenceincreased in Black African women from 23% (16-34 age group) to 54% in those aged 35-54years and 66% in those aged 55+ (but this last percentage is based on a small sample).

Table 6.7

170 HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY

Prevalence of obesity (BMI>30kg/m2)


Men

Observed % 25 17 14 15 6 6 25 23

Standardised risk ratio 1.03 0.79 0.60 0.76 0.22 0.26 1.07 1

Women

Observed % 32 38 20 28 17 8 21 23


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. Amongminority 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 considerablybetween minority ethnic groups. Indian, Pakistani and Irish and Bangladeshi men had ahigher prevalence of raised WHR than men in the general population. The lowest rate inmen was found among Black African (16%) and Chinese men (17%); the highest prevalencewas among Indian men (38%). With age standardisation, risk ratios for raised WHR weresignificantly higher than the general population among Pakistani men (1.46) andBangladeshi 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 inthe general population. Table 6.8, Figure 6B

Men’s waist circumference

The prevalence of raised waist circumference (102 cm or more in men) was 31% in men inthe general population. As with raised WHR, there was considerable variation betweenminority 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 ofraised waist circumference than the general population. The other groups had risk levels notsignificantly different from the general population.


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Black African

Indian

Pakistani

Bangladeshi

IrishChinese

Prevalence of raised WHR (0.95+), by minority ethnic group

Men Women

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Figure 6B

2.0

0.5


0.1

1.0

10.0

Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

2.0

0.5

0.1

1.0

10.0

Prevalence of raised waist circumference


% % % % % % % %

Men

Observed % 22 19 20 30 12 8 33 31


Women

Observed % 47 53 38 48 43 16 43 41


Women’s WHR

Among the general population, the mean waist-hip ratio (WHR) was 0.82 in women. Amongwomen in minority ethnic groups, means ranged from 0.81 (Black African and Chinese) to0.85 (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. Thelowest 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 weresignificantly higher than the general population for women in each minority ethnic group,except among Indian women and Chinese women where risk ratios were not significantlydifferent 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 BlackAfrican women and was 86.4cm for women in the general population.

Women of Black Caribbean, Black African and Pakistani origin had a significantly higherprevalence of raised waist circumference (88cm or higher) than the general population andChinese women had a lower prevalence of raised waist circumference than the generalpopulation. Prevalence ranged from 16% of Chinese women to 53% of Black Africanwomen. With age standardisation, risk ratios for raised waist circumference were higherthan 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 inwomen in all minority ethnic groups and the general population, although the reverse wastrue for prevalence of raised waist circumference. Women had an increased prevalence ofraised WHR compared with men in the Black Caribbean, Black African and Bangladeshigroups, 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 andChinese 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 menand women) increased with age in each minority ethnic group and in the general populationfor both men and women. Table 6.9

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

Equivalised household income is a measure of household income that takes account of thenumber of persons in the household. Age-standardised risk ratios compare the results formen (or women) in each tertile of equivalised household income in each minority ethnicgroup with men (or women) in the general population, all tertiles of equivalised incomecombined.

Overweight (including obesity) and obesity prevalence, by equivalised household income

In men, mean observed BMI increased with income in Black African men (mean BMI25.7kg/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 relatedto equivalised household income in any other minority ethnic group, nor in the generalpopulation. 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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by income in most minority ethnic groups, except for those of Black African, Irish andChinese origin. Black African men in the highest income tertile had a greater prevalence ofoverweight 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 with43% in the lowest, and were 46% and 21% respectively in Chinese men. Standardised riskratios confirmed the tendency for overweight or obesity to increase with income amongBlack African and Irish men. Among men in the other minority ethnic groups the differenceswere much smaller.

Among men, the proportion who were obese (BMI >30kg/m2) was not related to equivalisedhousehold 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 andChinese women, mean BMI was higher among those in the lowest income tertile than thosein the highest income tertile. There was also no clear pattern in the prevalence ofoverweight including obesity by income for all minority ethnic groups, although in thegeneral population the prevalence of overweight including obesity increased with higherincome (38% in the lowest to 49% in the highest income tertile).

The prevalence of obesity (BMI >30kg/m2) among women increased from the highest tolowest income tertile for almost all minority ethnic groups, except for women of BlackAfrican, Bangladeshi and Chinese origin. For women of Indian and Irish origin, the increasein the prevalence of obesity from the highest to lowest income tertile was greater than othergroups: for Indian women it doubled from 14% in the highest income tertile to 29% in thelowest income tertile, and for Irish women it increased from 16% to 31%. This increase fromthe 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 incometertiles for overweight including obesity, but age standardisation confirmed the pattern forobesity. Table 6.10

The observed prevalence of morbid obesity among women by equivalised householdincome tertiles is shown in the table below.

Prevalence of morbid obesity (BMI>40kg/m2) in women, by equivalised household income tertile and minority ethnic group

Highest Middle Lowest

% % %

Black Caribbean 2 3 9

Black African 3 4 10

Indian 0 1 2

Pakistani - 1 3

Bangladeshi - - 1

Chinese 1 - -

Irish 1 4 6

General population 1 4 5

The observed prevalence of morbid obesity (BMI >40kg/m2 ) was higher among women inthe lowest than highest income tertile, in almost all minority ethnic groups except amongChinese, Pakistani and Bangladeshi women, where the differences were not significant. Theprevalence of morbid obesity for Irish women increased from 1% in the highest incometertile to 6% in the lowest income tertile; for Black Caribbean women from 2% to 9%, andBlack 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 meanobserved WHR and waist circumference by income.


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The prevalence of raised WHR among Black Caribbean and Indian men was higher in thelowest 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 and29% in the highest income tertile). For Black African and Black Caribbean men this was alsotrue for raised waist circumference. After age standardisation, the observed findings weregenerally confirmed.

Among Black Caribbean and Indian women there was an inverse association with incomefor raised WHR but not for raised waist circumference: the prevalence of raised WHR washigher in the lowest income tertile (33% among Black Caribbean women, 39% in Indianwomen) than in the highest income tertile (19% and 21%, respectively). This income patternwas also true for women of Irish origin and those in the general population, but for bothraised WHR and waist circumference. Age standardisation generally confirmed theobserved 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 orwomen in all age groups.

Among men in minority ethnic groups and in the general population, the prevalence ofoverweight including obesity increased between 1999 and 2004. There were markeddifferences between the years among Black Caribbean men in the 16-34 age group: theproportion either overweight or obese increased substantially to 58% in 2004 from 40% in1999. Among men and women of Bangladeshi origin, there was also a significant increasein overweight including obesity: from 36% in 1999 to 44% in 2004 in men, and from 37% to51% in women.

There was a significant decline in overweight including obesity among Chinese women to25% 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. Theexception 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 orobese increased significantly between 1999 and 2004, from 63% to 67% among men andfrom 54% to 57% among women. The proportion who were obese increased from 19% ofmen in 1999 to 23% in 2004, and among women from 21% to 23%. Table 6.12, Figure 6C

WHR

Among men, the prevalence of raised WHR increased significantly between 1999 and 2004among Pakistani men, particularly in the 16-24 age group (from 9% to 17%) and in BlackCaribbean men in the 35-54 age group (10% in 1999 and 25% in 2004). For other minorityethnic groups there was little change in the prevalence of raised WHR between the twoyears.

The prevalence of raised WHR tended to rise in women in each group (except Chinesewomen) between 1999 and 2004. The proportion with a raised WHR increased greatlyamong women of Irish origin (from 25% in 1999 to 37% in 2004, and among Irish womenaged 16-34 from 9% to 30%). The prevalence of raised WHR also increased among BlackCaribbean 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 10percentage point increase (from 20% to 30%) in raised WHR among women in the generalpopulation between 1998 and 2003.


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Waist circumference

A similar increase to that for raised WHR was observed for raised waist circumferenceamong Black Caribbean men and Pakistani men between the years. The proportion with araised waist circumference more than doubled between 1999 and 2004 amongBangladeshi men (5% to 12%). Chinese men aged 35-54 had a marked increase in raisedwaist circumference between 1999 and 2004 (3% to 10%). There were few differencesamong men between the years in other ethnic groups and the general population.

Raised waist circumference increased among women of Irish and Bangladeshi origin (inboth cases from 33% in 1999 to 43% in 2004). There were no significant differencesbetween the two years in other ethnic groups. There was also an increase in raised waistcircumference (from 31% to 41%) among women in the general population between 1998and 2003, an increase of similar magnitude to that in WHR.

Overall, the results show that the patterns for BMI, overweight and obesity, WHR and waistcircumference in 2004 reflect those in 1999, but for most groups the absolute levels ofoverweight and obesity and raised WHR and raised waist circumference have increasedbetween the years. Table 6.13 Figure 6D


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Black

Caribbean

General

population

Indian

Pakistani

Bangladeshi

IrishChinese

Black

Caribbean

General

population

Indian

Pakistani

Bangladeshi

IrishChinese

Prevalence of overweight, including obesity (BMI>25 kg/m2), 1999 and 2004, by minority ethnic group

Men Women

Per

cent

Figure 6C

0

10

20

30

40

50

60

70

0

10

20

30

40

50

60

70

19992004

Black

Caribbean

General

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Indian

Pakistani

Bangladeshi

IrishChinese

Black

Caribbean

General

population

Indian

Pakistani

Bangladeshi

IrishChinese

Prevalence of raised waist circumference (102cm+ in menand 88cm+ in women), 1999 and 2004, by minority ethnic group

Men Women

Per

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Figure 6D

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10

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30

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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 StationeryOffice, London, 2004.

3 Jonsson S, Hedblad B, Engstrom G et al Influence of obesity on cardiovascular risk. Twenty-three-yearfollow-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 & Metabolism2004; 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. LondonSchool 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 andhypertension. American Journal of Epidemiology 2002; 155:346-353.

16 Snehalatha C, Viswanathan V, Ramachandran A. Cutoff values for normal anthropometric variables inAsian 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 participantsfrom 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 - acritical review. International Journal of Obesity 1998: 22:719-727.

20 National Institutes of Health. Third report of the National Cholesterol Education Program Expert Panel onDetection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III):National Institutes of Health, Bethesda, Md ,2001. NIH Publication 01-3670.


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HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 6: ANTHROPOMETRIC MEASURES, OVERWEIGHT, AND OBESITY 177

Tables

6.1 Response to anthropometric measurements, byminority ethnic group and sex

6.2 Height, by minority ethnic group and sex

6.3 Height, by age within minority ethnic group andsex

6.4 Weight, by minority ethnic group and sex

6.5 Weight, by age within minority ethnic group andsex

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 withinminority ethnic group and sex

6.11 Waist-hip ratio (WHR) and waist circumference,by equivalised household income tertile withinminority ethnic group and sex

6.12 Comparison of body mass index (BMI),overweight and obesity in 2004 with 1999, byage within minority ethnic group and sex

6.13 Comparison of waist-hip ratio (WHR) and waistcircumference in 2004 with 1999, by age withinminority 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 2004

Proportion providing valid Minority ethnic group Generalmeasurement populationa


% % % % % % % %

MenHeight 81 79 89 80 82 91 90 87

Weight 81 79 90 81 80 90 90 87

BMI 79 77 88 80 80 89 88 84

Waist-hip 96 95 98 95 97 99 97 96

Waist circumference 95 94 98 95 97 100 98 97

WomenHeight 78 77 90 84 81 86 89 87

Weight 80 80 89 84 78 86 87 85

BMI 75 75 88 83 77 85 86 83

Waist-hip 98 97 94 94 95 97 98 97

Waist circumference 98 98 95 95 96 97 98 97

Bases (weighted)

Men

Height, weight, BMI (interviewed) 480 377 903 423 178 151 1776 46188

Waist, hip (saw nurse)a 243 179 444 202 77 75 890 5531

Women

Height (interviewed) 676 476 1067 499 208 163 2369 48719

Weight, BMI (interviewed, notpregnant) 665 456 1048 465 199 159 2330 47793


Bases (unweighted)

Men

Height, weight, BMI (interviewed) 414 390 550 433 411 348 497 2879


Women

Height (interviewed) 653 469 634 508 478 375 656 3825

Weight, BMI (interviewed, not pregnant) 643 448 621 476 459 366 648 3765

Waist,hip (saw nurse)a 324 207 370 238 180 191 414 6180

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


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Table 6.2

Height, by minority ethnic group and sex

Aged 16 and over with a valid height measurement 2004

Height (cm) Minority ethnic group Generalpopulation


MenObserved

Mean height 175.2 173.5 170.2 172.1 167.8 170.8 174.2 175.0


Standardised

Mean height: ratio of means 1.00 0.98 0.97 0.98 0.95 0.97 1.00 1


WomenObserved

Mean height 162.8 163.0 156.4 157.8 154.7 157.9 161.4 161.4


Standardised

Mean height: ratio of means 1.01 1.00 0.96 0.97 0.95 0.97 1.00 1


Bases (weighted)

Men 391 299 807 339 146 137 1600 40070

Women 527 365 958 421 168 140 2113 42289

Bases (unweighted)

Men 328 303 487 348 338 313 427 2496

Women 489 351 568 423 387 319 584 3311


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Table 6.3

Height, by age within minority ethnic group and sex


Height (cm) Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Black Caribbean

Mean height 177.3 176.4 171.2 175.2 164.9 162.6 159.7 162.8


5th percentile 167.1 164.0 158.7 163.2 153.8 152.4 148.8 152.1

10th percentile 173.0 169.1 166.1 168.2 158.2 157.0 154.7 157.0

Median 177.2 176.9 170.7 175.9 164.4 162.4 160.2 162.7

90th percentile 181.9 182.4 178.0 181.0 170.3 168.1 164.4 168.3

95th percentile 189.6 188.9 182.0 187.6 177.5 174.3 170.1 174.9

Black African

Mean height 174.8 172.9 a 173.5 163.3 163.2 [160.3] 163.0

Standard error of the mean 0.49 0.49 a 0.49 0.60 0.59 [1.05] 0.46

5th percentile 163.4 162.4 a 162.6 153.0 154.4 [151.5] 153.0

10th percentile 170.0 165.9 a 167.5 156.8 158.1 [156.2]] 157.1

Median 175.3 172.9 a 173.6 163.3 162.8 [160.2 162.8

90th percentile 179.5 179.0 a 179.0 169.5 168.0 [164.4] 168.5

95th percentile 184.8 185.4 a 184.8 175.6 173.3 [171.8] 173.6

Indian

Mean height 172.1 170.3 166.5 170.2 157.6 156.5 153.5 156.4


5th percentile 162.3 158.0 156.3 158.1 147.7 147.0 142.9 145.6

10th percentile 165.5 165.0 160.5 164.1 152.8 151.5 147.8 151.5

Median 171.4 171.1 166.4 170.2 157.1 156.5 153.2 156.3

90th percentile 178.2 175.5 173.2 176.0 162.7 161.6 158.5 161.8

95th percentile 184.0 179.4 177.6 182.5 168.3 166.2 165.2 167.3

Pakistani

Mean height 173.0 171.6 [169.8] 172.1 158.9 156.7 [155.9] 157.8

Standard error of the mean 0.77 0.55 [0.99] 0.44 0.42 0.59 [0.96] 0.35

5th percentile 161.5 160.1 [161.8] 161.4 150.0 147.1 [145.9] 148.2

10th percentile 167.7 166.5 [165.1] 166.9 153.4 151.1 [150.8] 152.1

Median 173.4 171.4 [169.0] 172.2 158.6 156.9 [155.1] 157.6

90th percentile 178.4 176.8 [174.6] 177.5 163.9 162.4 [161.6] 163.2

95th percentile 186.2 183.0 [180.0] 183.7 169.1 167.5 [168.7] 168.4

Bangladeshi

Mean height 169.8 166.5 [163.1] 167.8 155.9 152.6 [151.4] 154.7


5th percentile 157.6 155.1 [154.8] 156.5 146.1 142.4 [142.3] 144.7

10th percentile 163.3 160.3 [157.9] 161.6 150.5 147.8 [146.4] 149.4

Median 169.8 166.1 [162.8] 168.0 155.2 153.0 [151.0] 154.0

90th percentile 176.8 172.5 [168.8] 174.2 161.3 157.7 [156.7] 160.2

95th percentile 180.2 179.2 [-] 179.5 167.3 162.6 [-] 165.7

Chinese

Mean height 173.6 169.1 165.8 170.8 159.8 157.2 [154.1] 157.9

Standard error of the mean 0.68 0.69 1.15 0.52 0.67 0.50 [1.23] 0.48

5th percentile 162.3 159.7 153.0 158.5 149.7 148.8 [142.5] 148.0

10th percentile 168.4 163.0 158.2 165.0 154.8 152.4 [149.3] 152.9

Median 173.4 169.0 167.2 171.0 160.1 157.8 [154.1] 158.0

90th percentile 179.0 173.9 172.7 176.7 164.3 160.8 [158.8] 162.9

95th percentile 185.0 182.9 184.1 184.6 170.2 166.3 [-] 169.1


Continued…


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Table 6.3 continued


Height (cm) Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Irish

Mean height 176.3 175.3 171.7 174.2 163.3 163.1 158.0 161.4


5th percentile 164.4 164.0 160.1 162.2 152.5 153.1 148.4 150.6

10th percentile 170.3 170.2 165.6 168.5 159.1 158.2 152.9 155.8

Median 177.0 175.0 171.4 174.4 163.2 163.6 156.9 161.9

90th percentile 182.1 180.8 177.7 180.0 168.0 168.0 163.5 166.8

95th percentile 186.7 185.4 183.2 185.2 172.4 171.9 169.1 171.5

General population

Mean height 177.2 175.5 171.9 175.0 162.9 162.5 158.8 161.4


5th percentile 166.3 163.8 160.3 162.7 152.0 152.2 148.1 150.6

10th percentile 171.8 169.8 166.3 169.1 157.4 157.4 153.4 155.8

Median 177.5 175.2 171.9 174.9 162.9 162.5 158.6 161.4

90th percentile 183.0 181.5 177.8 181.1 168.2 168.0 164.7 167.1

95th percentile 188.9 187.0 183.2 187.2 174.1 173.0 169.6 172.5

Bases (weighted)

Black Caribbean 115 164 112 391 180 235 112 527

Black African 144 126 30 299 195 144 26 365

Indian 293 343 170 807 376 423 159 958

Pakistani 165 130 44 339 234 139 48 421

Bangladeshi 76 54 16 146 112 40 16 168

Chinese 69 44 23 137 55 68 18 140

Irish 387 631 582 1600 459 958 696 2113


Bases (unweighted)

Black Caribbean 97 137 94 328 160 220 109 489

Black African 142 134 27 303 183 138 30 351

Indian 179 205 103 487 219 250 99 568

Pakistani 182 119 47 348 236 138 49 423

Bangladeshi 174 126 38 338 257 93 37 387

Chinese 159 104 50 313 127 152 40 319

Irish 103 174 150 427 137 248 199 584




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Table 6.4

Weight, by minority ethnic group and sex

Aged 16 and over with a valid weight measurement 2004

Weight (kg) Minority ethnic group Generalpopulation


MenObserved

Mean weight 83.3 79.6 74.5 77.0 69.8 70.4 82.8 82.9


Standardised

Mean weight: ratio of means 1.00 0.96 0.90 0.93 0.84 0.85 1.00 1


WomenObserved

Mean weight 73.9 75.9 64.4 67.6 61.5 57.8 69.6 69.7


Standardised

Mean weight: ratio of means 1.06 1.11 0.92 0.99 0.90 0.83 1.00 1


Bases (weighted)

Men 391 298 814 341 143 136 1595 39976

Women 532 365 930 389 155 137 2019 40736

Bases (unweighted)

Men 326 305 492 351 331 309 430 2497

Women 492 352 551 394 357 311 559 3214


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Table 6.5

Weight, by age within minority ethnic group and sex


Weight (kg) Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Black Caribbean

Mean weight 81.3 85.2 83.0 83.3 67.1 76.8 78.1 73.9


5th percentile 56.9 61.0 62.6 59.8 49.9 54.3 59.0 52.0

10th percentile 67.5 70.8 72.1 69.8 56.8 62.5 65.4 60.4

Median 82.0 85.0 81.8 82.8 66.1 72.3 77.9 70.6

90th percentile 93.3 97.9 92.3 94.5 74.4 91.3 88.5 85.9

95th percentile 107.2 115.2 106.5 108.4 97.8 109.5 103.8 104.5

Black African

Mean weight 77.1 82.7 a 79.6 69.9 82.5 [82.3] 75.9

Standard error of the mean 1.34 1.51 a 1.06 1.40 1.42 [2.72] 1.09

5th percentile 57.6 61.4 a 58.8 48.3 59.5 [64.0] 52.1

10th percentile 65.8 69.9 a 68.4 56.0 68.9 [68.9] 61.2

Median 75.7 80.2 a 78.4 68.6 79.6 [82.0] 74.9

90th percentile 87.1 93.6 a 90.3 82.2 98.0 [95.8] 88.0

95th percentile 99.8 111.9 a 104.1 92.6 112.7 [117.5] 105.5

Indian

Mean weight 73.2 77.9 70.0 74.5 60.0 66.8 66.0 64.1


5th percentile 53.7 58.3 51.8 54.5 42.3 49.5 48.8 46.2

10th percentile 60.9 66.1 62.8 63.1 51.0 55.8 57.4 54.0

Median 72.3 75.1 69.7 72.6 58.5 64.9 64.0 62.3

90th percentile 83.4 89.2 77.3 84.1 67.8 76.8 72.1 73.1

95th percentile 104.7 103.9 86.3 101.5 81.9 90.8 89.2 89.9

Pakistani

Mean weight 75.0 78.8 [79.3] 77.0 63.8 71.6 [73.1] 67.6


5th percentile 55.1 61.3 [59.2] 56.4 44.6 50.9 [50.9] 47.1

10th percentile 61.9 68.5 [65.0] 65.1 52.9 59.6 [62.8] 55.1

Median 72.6 78.2 [80.7] 76.1 61.5 68.8 [71.8] 65.9

90th percentile 88.3 88.2 [87.7] 88.2 75.0 84.2 [82.8] 79.3

95th percentile 105.9 100.4 [97.6] 102.6 88.5 97.3 [92.9] 92.9

Bangladeshi

Mean weight 69.2 71.7 [66.3] 69.8 59.6 66.1 [62.3] 61.5


5th percentile 51.0 56.9 [47.2] 52.0 42.3 51.2 [46.7] 43.8

10th percentile 58.3 64.3 [58.1] 60.0 49.8 56.9 [52.4] 51.4

Median 69.7 71.5 [68.5] 69.7 58.4 66.4 [61.5] 60.4

90th percentile 77.1 79.7 [74.5] 77.8 68.7 74.2 [70.4] 70.4

95th percentile 91.7 91.3 [-] 90.3 80.8 83.3 [-] 81.3

Chinese

Mean weight 69.5 73.3 67.8 70.4 57.0 58.8 [56.4] 57.8


5th percentile 53.3 56.2 50.0 53.0 44.0 46.0 [44.3] 45.1

10th percentile 60.1 64.3 57.9 60.7 49.4 50.1 [48.3] 49.8

Median 68.6 72.9 67.9 69.8 56.2 56.9 [55.4] 56.3

90th percentile 79.1 82.2 76.0 79.2 62.5 67.0 [66.5] 65.4

95th percentile 92.9 96.7 98.6 92.6 78.8 79.7 [-] 78.7


Continued…


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Weight (kg) Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Irish

Mean weight 79.7 83.6 83.8 82.8 70.2 70.5 68.1 69.6


5th percentile 52.7 61.3 61.3 58.0 49.4 53.7 49.3 50.7

10th percentile 66.3 71.8 68.6 69.8 58.6 59.2 57.5 58.6

Median 75.6 83.3 81.2 81.4 65.8 68.2 67.3 66.8

90th percentile 92.5 92.2 99.0 94.4 76.5 80.0 78.1 79.6

95th percentile 121.3 109.4 119.5 115.1 129.9 96.9 89.9 98.0

General population

Mean weight 79.0 86.3 82.8 82.9 66.7 71.5 70.3 69.7


5th percentile 57.6 65.0 61.9 60.6 49.7 51.6 50.9 50.8

10th percentile 64.9 74.1 71.6 70.0 55.7 59.5 58.8 57.8

Median 76.4 84.7 80.6 81.4 64.1 68.7 68.2 67.1

90th percentile 90.8 98.0 93.0 94.8 76.5 82.3 81.0 80.2

95th percentile 107.4 112.2 109.1 109.8 95.1 101.1 96.5 97.9

Bases (weighted)

Black Caribbean 118 158 115 391 175 236 121 532

Black African 148 124 26 298 191 147 27 365

Indian 293 346 175 814 351 412 167 930

Pakistani 166 130 45 341 208 135 46 389

Bangladeshi 75 53 16 143 101 38 16 155

Chinese 68 43 24 136 51 68 18 137

Irish 369 631 595 1595 445 900 673 2019


Bases (unweighted)

Black Caribbean 97 132 97 326 155 222 115 492

Black African 146 134 25 305 178 143 31 352

Indian 179 207 106 492 203 245 103 551

Pakistani 183 119 49 351 211 136 47 394

Bangladeshi 171 122 38 331 233 88 36 357

Chinese 156 101 52 309 118 153 40 311

Irish 99 174 157 430 132 232 195 559




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Table 6.6

Body mass index (BMI), by minority ethnic group and sex

Aged 16 and over with both valid height and weight measurements 2004

BMI (kg/m2) and Minority ethnic group GeneralBMI status (%) population


MenObserved

18.5 or undera 0 1 3 3 4 3 2 1

Over 18.5 to 25 32 37 44 41 51 60 31 32

Over 25 to 30 42 45 39 40 39 31 42 44

Over 30 to 40 25 17 13 14 6 6 24 22

Over 40 0 0 0 1 0 0 2 1

All over 25 (overweight, including obese) 67 62 53 55 44 37 67 67

All over 30 (obese) 25 17 14 15 6 6 25 23

Mean BMI 27.1 26.4 25.8 25.9 24.7 24.1 27.2 27.1



Overweight, including obese 1.02 1.00 0.82 0.89 0.75 0.62 0.99 1


Obese 1.03 0.79 0.60 0.76 0.22 0.26 1.07 1


WomenObserved

18.5 or undera 3 2 3 2 5 5 2 2

Over 18.5 to 25 33 29 42 35 44 70 40 41

Over 25 to 30 32 31 35 34 34 17 37 34

Over 30 to 40 28 34 19 26 17 7 19 21

Over 40 4 5 1 2 1 0 2 2

All over 25 (overweight, including obese) 65 70 55 62 51 25 58 57

All over 30 (obese) 32 38 20 28 17 8 21 23

Mean BMI 28.0 28.8 26.2 27.1 25.7 23.2 26.7 26.8



Overweight, including obese 1.16 1.37 1.00 1.24 1.06 0.46 0.99 1


Obese 1.43 2.00 0.89 1.48 0.89 0.32 0.88 1


Bases (weighted)

Men 380 291 798 336 143 135 1574 39244

Women 500 344 921 387 153 136 2008 39803

Bases (unweighted)

Men 317 297 482 346 330 307 420 2444

Women 459 332 546 391 353 308 555 3135

a Those with BMI of 18.5 kg/m2 or under are referred to as underweight using the revised definition.


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Table 6.7

Body mass index (BMI), overweight and obesity, by age within minorityethnic group and sex


BMI (kg/m2) and Age groupBMI status (%)

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Black Caribbean

18.5 or undera 1 - - 0 6 2 - 3

Over 18.5 to 25 41 32 23 32 55 26 9 33

Over 25 to 30 40 41 46 42 26 32 43 32

Over 30 to 40 17 27 30 25 11 34 44 28

Over 40 1 - - 0 2 6 4 4

All over 25 (overweight including obese) 58 68 77 67 38 72 91 65

All over 30 (obese) 18 27 30 25 13 39 47 32

Mean BMI 26.2 27.2 28.0 27.1 24.8 29.1 30.5 28.0


Black African

18.5 or undera 2 - b 1 3 - [ -] 2

Over 18.5 to 25 48 27 b 37 43 14 [7] 29

Over 25 to 30 43 46 b 45 32 32 [27] 31

Over 30 to 40 7 26 b 17 21 46 [54] 34

Over 40 1 - b 0 1 9 [12] 5

All over 25 (overweight including obese) 51 73 b 62 54 86 [93] 70

All over 30 (obese) 7 26 b 17 23 54 [66] 38

Mean BMI 25.3 27.5 b 26.4 26.5 31.2 [32.4] 28.8

Standard error of the mean 0.37 0.42 b 0.31 0.52 0.58 [1.20] 0.44

Indian

18.5 or undera 6 1 - 3 7 0 - 3

Over 18.5 to 25 50 36 51 44 58 35 24 42

Over 25 to 30 34 43 43 39 24 39 49 35

Over 30 to 40 9 21 6 13 11 23 26 19

Over 40 0 0 - 0 0 2 2 1


All over 30 (obese) 10 21 6 14 11 25 27 20

Mean BMI 24.7 26.9 25.3 25.8 24.1 27.3 27.8 26.2


Pakistani

18.5 or undera 6 1 - 3 4 - [ -] 2

Over 18.5 to 25 50 31 [39] 41 50 21 [13] 35

Over 25 to 30 33 51 [35] 40 31 38 [35] 34

Over 30 to 40 11 15 [26] 14 14 37 [49] 26

Over 40 1 2 [ -] 1 1 4 [3] 2

All over 25 (overweight including obese) 45 68 [61] 55 46 79 [87] 62

All over 30 (obese) 11 16 [26] 15 14 41 [52] 28

Mean BMI 24.9 26.8 [26.9] 25.9 25.2 29.2 [30.0] 27.1


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…


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Table 6.7 continued



Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Bangladeshi

18.5 or undera 6 2 [4] 4 8 - [2] 5

Over 18.5 to 25 60 41 [42] 51 53 21 [40] 44

Over 25 to 30 28 49 [52] 39 26 51 [38] 34

Over 30 to 40 5 8 [1] 6 12 28 [21] 17

Over 40 1 - [ -] 0 1 - [ -] 1

All over 25 (overweight including obese) 33 57 [53] 44 39 79 [58] 51

All over 30 (obese) 5 8 [1] 6 13 28 [21] 17

Mean BMI 24.0 25.8 [24.8] 24.7 24.5 28.4 [27.0] 25.7


Chinese

18.5 or undera 4 1 2 3 9 1 [6] 5

Over 18.5 to 25 73 45 54 60 74 69 [65] 70

Over 25 to 30 20 43 38 31 11 20 [24] 17

Over 30 to 40 3 10 5 6 6 9 [5] 7

Over 40 - 1 - 0 - 1 [ -] 0

All over 25 (overweight including obese) 23 54 44 37 18 29 [29] 25

All over 30 (obese) 3 11 5 6 6 9 [5] 8

Mean BMI 23.0 25.6 [24.9] 24.1 22.3 23.8 [23.6] 23.2


Irish

18.5 or undera 4 2 - 2 4 0 2 2

Over 18.5 to 25 44 27 28 31 49 44 30 40

Over 25 to 30 32 53 35 42 30 36 42 37

Over 30 to 40 19 16 35 24 11 17 26 19

Over 40 - 2 2 2 6 2 0 2

All over 25 (overweight ncluding obese) 51 71 72 67 47 56 68 58

All over 30 (obese) 19 18 37 25 17 19 26 21

Mean BMI 25.6 27.0 28.5 27.2 26.3 26.5 27.3 26.7


General population

18.5 or undera 3 1 0 1 3 1 1 2

Over 18.5 to 25 51 23 23 32 54 40 31 41

Over 25 to 30 33 49 49 44 28 33 40 34

Over 30 to 40 13 26 26 22 13 23 26 21

Over 40 1 1 1 1 2 3 2 2


All over 30 (obese) 13 27 27 23 15 25 28 23

Mean BMI 25.2 28.0 28.0 27.1 25.1 27.1 27.8 26.8



Continued…


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Table 6.7 continued



Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Bases (weighted)

Black Caribbean 113 158 109 380 171 220 109 500

Black African 142 123 26 291 182 136 26 344

Indian 290 338 170 798 350 412 159 921

Pakistani 165 130 42 336 207 135 46 387

Bangladeshi 74 53 16 143 100 38 15 153

Chinese 68 43 23 135 51 67 17 136

Irish 369 628 578 1574 445 898 665 2008


Bases (unweighted)

Black Caribbean 95 131 91 317 150 204 105 459

Black African 140 132 25 297 170 132 30 332

Indian 177 203 102 482 202 245 99 546

Pakistani 182 119 45 346 209 135 47 391

Bangladeshi 170 122 38 330 231 88 34 353

Chinese 156 101 50 307 118 151 39 308

Irish 99 173 148 420 132 231 192 555




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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 2004

WHR and waist Minority ethnic group Generalcircumference population

Black Black (2003)a


MenObserved

Mean WHR 0.90 0.87 0.92 0.92 0.91 0.87 0.93 0.92


Mean waist circumference 92.5 90.6 93.0 95.0 88.7 86.8 97.3 96.5


% with waist-hip ratio 0.95 and over 25 16 38 36 32 17 36 33

% with waist circumference 102 cm and over 22 19 20 30 12 8 33 31


% with waist-hip ratio 0.95 and over 0.73 0.77 1.15 1.46 1.34 0.66 0.98 1


% with waist circumference 102 cm and over 0.66 0.81 0.70 1.23 0.51 0.28 0.96 1


WomenObserved

Mean WHR 0.83 0.81 0.82 0.84 0.85 0.81 0.83 0.82




% with waist-hip ratio 0.85 and over 37 32 30 39 50 22 37 30

% with waist circumference 88 cm and over 47 53 38 48 43 16 43 41


% with waist-hip ratio 0.85 and over 1.42 1.64 1.15 1.77 2.29 1.00 1.27 1


% with waist circumference 88 cm and over 1.23 1.51 0.97 1.49 1.39 0.50 1.00 1


Bases (weighted)b

Men 231 169 434 192 75 75 872 4962

Women 327 232 485 217 100 75 1110 5995

Bases (unweighted)b

Men 209 156 310 197 138 182 311 5397

Women 314 200 345 224 171 185 405 5554


b Bases vary: those shown are for those aged 16 and over with a valid waist and hip measurement.


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Table 6.9

Waist-hip ratio (WHR) and waist circumference, by age within minority ethnicgroup and sex


WHR and waist Age groupcircumference

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Black Caribbean

Mean WHR 0.85 0.90 0.95 0.90 0.78 0.83 0.89 0.83




% with raised waist-hip ratioa 1 25 53 25 14 35 77 37

% with raised waist circumferenceb 9 24 34 22 19 47 88 47

Black African

Mean WHR 0.84 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


% with raised waist-hip ratioa 4 21 c 16 14 42 c 32

% with raised waist circumferenceb 10 24 c 19 30 73 c 53

Indian

Mean WHR 0.86 0.94 0.97 0.92 0.78 0.84 0.84 0.82






Pakistani

Mean WHR 0.88 0.94 [1.01] 0.92 0.81 0.85 [0.92] 0.84


Mean waist circumference 91.0 96.7 [105.4] 95.0 82.0 91.1 [100.3] 87.7


% with raised waist-hip ratioa 17 46 [84] 37 22 47 [85] 39

% with raised waist circumferenceb 21 26 [71] 30 29 57 [96] 48

Bangladeshi

Mean WHR 0.87 0.95 c 0.91 0.82 0.89 c 0.85


Mean waist circumference 84.0 93.4 c 88.7 81.3 93.0 c 85.7


% with raised waist-hip ratioa 14 41 c 32 33 77 c 50

% with raised waist circumferenceb 7 15 c 12 27 67 c 43

Chinese

Mean WHR 0.84 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


% with raised waist-hip ratioa 4 20 [53] 17 12 25 c 22

% with raised waist circumferenceb 5 10 [14] 8 9 19 c 16

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…


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Table 6.9 continued


WHR and waist Age groupcircumference

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Irish

Mean WHR 0.88 0.92 0.97 0.93 0.80 0.82 0.85 0.83






General population (2003)d

Mean WHR 0.87 0.93 0.96 0.92 0.79 0.82 0.85 0.82




% with raised waist-hip ratio 9 36 54 33 15 27 46 30


Bases (weighted)e

Black Caribbean 78 83 69 231 110 144 73 327

Black African 85 69 14 169 115 99 18 232

Indian 145 181 108 434 177 230 78 485

Pakistani 96 69 26 192 111 76 30 217

Bangladeshi 36 27 11 75 61 31 8 100

Chinese 39 24 12 75 28 40 7 75

Irish 198 352 322 872 232 463 415 1110

General population (2003)d 1740 1964 1693 5397 1643 1940 1971 5554

Bases (unweighted)e

Black Caribbean 60 84 65 209 92 148 74 314

Black African 68 75 13 156 95 88 17 200

Indian 94 140 76 310 120 164 61 345

Pakistani 97 70 30 197 114 79 31 224

Bangladeshi 61 55 22 138 103 53 15 171

Chinese 85 67 30 182 66 100 19 185

Irish 67 131 113 311 82 169 154 405


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




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Table 6.10

Body mass index (BMI), overweight and obesity, by equivalisedhousehold income tertile within minority ethnic group and sex


BMI (kg/m2) and Equivalised household income tertileBMI status (%)


ObservedBlack Caribbean

Over 25 (overweight including obese) 77 64 70 66 61 69

Over 30 (obese) 25 20 32 27 36 40

Mean BMI 27.5 26.3 27.9 27.5 28.2 29.2


Black African


Over 30 (obese) 19 14 18 39 44 37

Mean BMI 27.3 26.0 25.7 28.4 30.2 28.8


Indian


Over 30 (obese) 12 15 17 14 21 29

Mean BMI 25.9 25.8 25.6 25.4 26.6 26.9


Pakistani

Over 25 (overweight including obese) [60] 56 54 [45] 66 63

Over 30 (obese) [14] 17 14 [19] 28 31

Mean BMI [25.8] 25.9 25.8 [25.5] 27.3 27.6


Bangladeshi

Over 25 (overweight including obese) a 48 46 a 48 53

Over 30 (obese) - 4 7 - 13 19

Mean BMI a 24.9 24.9 a 25.5 26.0

Standard error of the mean a 0.35 0.27 a 0.43 0.43

Chinese

Over 25 (overweight including obese) 46 34 [21] 28 18 32

Over 30 (obese) 12 4 [2] 9 7 9

Mean BMI 25.1 24.0 [23.1] 23.5 22.8 23.9


Irish


Over 30 (obese) 21 31 16 16 24 31

Mean BMI 27.5 27.5 25.6 25.9 27.3 28.4


General population


Over 30 (obese) 21 27 26 19 28 29

Mean BMI 27.1 27.5 26.9 26.0 27.6 27.6




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Standardised risk ratiosb

Black Caribbean

Overweight, including obese 1.18 0.85 1.02 1.15 0.99 1.24


Obese 1.01 0.70 1.31 1.03 1.41 1.82


Mean BMI: ratio of means 1.02 0.95 1.03 1.02 1.04 1.10


Black African



Obese 0.72 0.87 0.66 2.03 1.96 2.03




Indian



Obese 0.44 0.57 0.85 0.73 0.82 1.22




Pakistani

Overweight, including obese [0.74] 0.87 0.82 [1.02] 1.25 1.23


Obese [0.47] 0.83 0.63 [1.53] 1.39 1.70


Mean BMI: ratio of means [0.95] 0.97 0.96 [1.00] 1.05 1.06


Bangladeshi

Overweight, including obese a 0.82 0.67 a 0.96 1.09


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


Chinese

Overweight, including obese 0.69 0.54 [0.45] 0.54 0.32 0.54


Obese 0.52 0.16 [0.18] 0.31 0.31 0.36


Mean BMI: ratio of means 0.93 0.89 [0.87] 0.88 0.86 0.89


Irish



Obese 0.97 1.15 0.54 0.64 1.21 1.28




Continued…


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.


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Standardised risk ratiosb

General population



Obese 0.89 1.18 1.11 0.81 1.19 1.20




Bases (weighted)

Black Caribbean 130 95 86 130 152 133

Black African 98 79 65 104 90 107

Indian 245 213 139 280 252 176

Pakistani 48 98 119 37 106 142


Chinese 41 33 18 45 31 21

Irish 799 349 201 943 489 301


Bases (unweighted)

Black Caribbean 103 74 76 117 128 129

Black African 88 94 71 82 99 106

Indian 146 138 90 163 154 109

Pakistani 41 96 136 30 108 146

Bangladeshi 17 83 149 20 79 156

Chinese 97 70 41 99 68 51

Irish 194 105 67 234 142 105


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.


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Table 6.11

Waist-hip ratio (WHR) and waist circumference, by equivalisedhousehold income tertile within minority ethnic group and sex


WHR and waist Equivalised household income tertilecircumference



Mean WHR 0.88 0.90 [0.92] 0.81 0.84 0.83


Mean waist circumference 94.1 90.5 [97.2] 86.0 91.1 88.2


% with raised waist-hip ratioa 13 32 [44] 19 48 33

% with raised waist circumferenceb 20 20 [41] 34 58 47

Black African

Mean WHR 0.87 [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

% with raised waist-hip ratioa 16 [23] [15] [40] 31 30

% with raised waist circumferenceb 11 [13] [27] [49] 62 54

Indian

Mean WHR 0.92 0.92 0.94 0.81 0.82 0.83


Mean waist circumference 93.8 92.4 93.9 82.0 84.4 84.3


% with raised waist-hip ratioa 31 40 51 21 32 39

% with raised waist circumferenceb 19 21 28 31 44 42

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 c 39 39 c 43 35

% with raised waist circumferenceb c 28 34 c 49 50

Bangladeshi

Mean WHR 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 c c 35 c [53] 48

% with raised waist circumferenceb c c 6 c [46] 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.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


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


Continued…


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Observed %Chinese

Mean WHR 0.88 [0.88] c 0.81 [0.81] c

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 [21] c 25 [25] c

% with raised waist circumferenceb 11 [5] c 18 [18] c

Irish

Mean WHR 0.92 0.94 [0.95] 0.81 0.84 0.84


Mean waist circumference 96.7 96.8 [96.6] 85.7 87.7 90.9


% with raised waist-hip ratioa 28 42 [43] 25 46 49

% with raised waist circumferenceb 30 30 [31] 36 41 61

General population 2003

Mean WHR 0.91 0.92 0.92 0.81 0.83 0.83


Mean waist circumference 96.5 96.6 96.0 84.6 87.8 87.9


% with raised waist-hip ratioa 29 37 38 24 35 38

% with raised waist circumferenceb 30 34 32 35 45 49

Standardised risk ratiosf

Black Caribbean

Raised waist-hip ratioa 0.41 0.71 [1.35] 0.65 1.55 1.39


Raised waist circumferenceb 0.62 0.45 [1.37] 0.85 1.27 1.31


Mean WHR: ratio of means 0.97 0.96 [1.01] 0.99 1.01 1.02


Mean waist circumference: ratio of means 0.99 0.91 [1.02] 1.00 1.03 1.05


Black African

Raised waist-hip ratioa 0.55 [0.93] [0.68] [1.83] 1.34 1.73

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


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


Indian

Raised waist-hip ratioa 0.97 1.20 1.50 0.83 1.20 1.42


Raised waist circumferenceb 0.58 0.66 1.01 0.84 1.05 1.05


Mean WHR: ratio of means 1.01 1.00 1.02 1.00 1.00 1.01


Mean waist circumference: ratio of means 0.98 0.95 0.97 0.97 0.98 0.98


Continued…

a Raised waist-hip ratio for men is 0.95 and overand 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 2003survey, which was weighted for non-response. The 2004 survey is weighted for differential selection probabilities and non-response.


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.


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Standardised risk ratiosf

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


Mean WHR: ratio of means c 1.03 1.02 c 1.05 1.04


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 c c 0.21 c [1.59] 1.16

Raised waist-hip ratioa c c 0.11 c [0.34]] 0.15

Mean WHR: ratio of means c c 1.00 c [1.07] 1.05


Mean waist circumference: ratio of means c c 0.91 c [1.07] 1.01


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


Mean waist circumference: ratio of means 0.94 [0.93] c 0.91 [0.92] c


Irish

Raised waist-hip ratioa 0.88 0.98 [0.82] 0.99 1.65 1.75


Raised waist circumferenceb 0.99 0.74 [0.59] 0.84 1.13 1.48


Mean WHR: ratio of means 1.00 1.01 [1.01] 1.00 1.02 1.03


Mean waist circumference: ratio of means 1.00 0.98 [0.98] 1.00 1.04 1.07


General population 2003

Raised waist-hip ratioa 0.93 1.09 1.08 0.86 1.06 1.27


Raised waist circumferenceb 0.99 1.04 0.96 0.90 1.05 1.16


Mean WHR: ratio of means 1.00 1.00 1.00 0.99 1.00 1.02


Mean waist circumference: ratio of means 1.01 1.00 0.99 0.99 1.01 1.01


Continued…

a Raised waist-hip ratio for men is 0.95 and overand for women is 0.85 and over.

b Raised waist circumference for men is 102cm and over and for women is 88cm and over.


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


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.


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Bases (weighted)e

Black Caribbean 70 59 47 76 92 102

Black African 67 30 47 62 60 79

Indian 113 128 87 136 140 111

Pakistani 24 74 61 19 62 80


Chinese 26 17 10 31 13 10

Irish 461 223 93 487 317 159

General population 2003d 2535 1468 701 2242 1712 830

Bases (unweighted)e


Black African 57 34 43 49 55 68

Indian 84 94 64 97 98 80

Pakistani 22 71 74 18 63 89


Chinese 70 40 23 78 32 27

Irish 149 83 46 172 115 71

General population 2003d 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


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



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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 2004, 1999


Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Black Caribbean

2004

Over 25 (overweight including obese) 58 68 77 67 38 72 91 65

Over 30 (obese) 18 27 30 25 13 39 47 32

Mean BMI 26.2 27.2 28.0 27.1 24.8 29.1 30.5 28.0


1999


Over 30 (obese) 10 28 21 18 20 32 52 32

Mean BMI 24.6 27.4 27.1 26.2 26.0 28.3 31.1 28.0


Indian

2004


Over 30 (obese) 10 21 6 14 11 25 27 20

Mean BMI 24.7 26.9 25.3 25.8 24.1 27.3 27.8 26.2


1999


Over 30 (obese) 9 13 14 12 9 23 36 20

Mean BMI 24.1 26.0 25.7 25.2 23.9 26.7 28.4 25.9


Pakistani

2004

Over 25 (overweight including obese) 45 68 [61] 55 46 79 [87] 62

Over 30 (obese) 11 16 [26] 15 14 41 [52] 28

Mean BMI 24.9 26.8 [26.9] 25.9 25.2 29.2 [30.0] 27.1


1999


Over 30 (obese) 10 19 10 13 15 39 48 26

Mean BMI 24.5 26.6 26.2 25.4 24.5 29.3 29.3 26.5


Bangladeshi

2004

Over 25 (overweight including obese) 33 57 [53] 44 39 79 [58] 51

Over 30 (obese) 5 8 [1] 6 13 28 [21] 17

Mean BMI 24.0 25.8 [24.8] 24.7 24.5 28.4 [27.0] 25.7


1999


Over 30 (obese) 3 12 3 5 6 18 12 10

Mean BMI 22.9 25.1 24.7 23.8 22.9 26.5 [25.5] 24.1



Continued…


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Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Chinese

2004

Over 25 (overweight including obese) 23 54 44 37 18 29 [29] 25

Over 30 (obese) 3 11 5 6 6 9 [5] 8

Mean BMI 23.0 25.6 24.9 24.1 22.3 23.8 [23.6] 23.2


1999


Over 30 (obese) 4 5 12 6 3 6 2 5

Mean BMI 23.0 24.7 24.9 24.1 22.4 23.9 24.6 23.6


Irish

2004


Over 30 (obese) 19 18 37 25 17 19 26 21

Mean BMI 25.6 27.0 28.5 27.2 26.3 26.5 27.3 26.7


1999


Over 30 (obese) 16 21 24 20 14 24 25 21

Mean BMI 25.7 26.9 27.3 26.7 24.9 27.1 27.3 26.5


General population

2004


Over 30 (obese) 13 27 27 23 15 25 28 23

Mean BMI 25.2 28.0 28.0 27.1 25.1 27.1 27.8 26.8


1999


Over 30 (obese) 13 22 21 19 13 22 27 21

Mean BMI 25.0 27.2 27.2 26.6 24.6 26.7 27.5 26.4



Continued…


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Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Bases (weighted)

Black Caribbean 2004 113 158 109 380 171 220 109 500

Black Caribbean 1999 128 83 107 318 162 160 99 422

Indian 2004 290 338 170 798 350 412 159 921

Indian 1999 187 217 96 501 218 226 93 537

Pakistani 2004 165 130 42 336 207 135 46 387

Pakistani 1999 175 109 41 325 185 104 26 316

Bangladeshi 2004 74 53 16 143 100 38 15 153

Bangladeshi 1999 57 28 21 106 66 24 11 101

Chinese 2004 68 43 23 135 51 67 17 136

Chinese 1999 32 41 18 91 31 59 15 106

Irish 2004 369 628 578 1574 445 898 665 2008

Irish 1999 358 655 376 1389 510 794 477 1781



Bases (unweighted)

Black Caribbean 2004 95 131 91 317 150 204 105 459

Black Caribbean 1999 184 124 158 466 240 237 141 618

Indian 2004 177 203 102 482 202 245 99 546

Indian 1999 196 231 100 527 228 245 99 572

Pakistani 2004 182 119 45 346 209 135 47 391

Pakistani 1999 294 195 67 556 320 183 47 550

Bangladeshi 2004 170 122 38 330 231 88 34 353

Bangladeshi 1999 215 110 84 409 256 109 43 408

Chinese 2004 156 101 50 307 118 151 39 308

Chinese 1999 101 122 61 284 98 187 54 339

Irish 2004 99 173 148 420 132 231 192 555

Irish 1999 126 221 134 481 179 276 176 631





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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 2004, 1999

WHR and waist Age groupcircumference (%)

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Black Caribbean

2004

% with raised waist-hip ratiob 1 25 53 25 15 35 78 37

% with raised waist circumferencec 9 24 34 22 19 47 88 47

1999



Indian

2004



1999



Pakistani

2004

% with raised waist-hip ratiob 17 46 [84] 37 22 47 [85] 39

% with raised waist circumferencec 21 26 [71] 30 29 57 [96] 48

1999



Bangladeshi

2004

% with raised waist-hip ratiob 14 41 d 32 33 77 d 50

% with raised waist circumferencec 7 15 d 12 27 67 d 43

1999



Chinese

2004

% with raised waist-hip ratiob 4 20 [53] 17 12 25 d 22

% with raised waist circumferencec 5 10 [14] 8 9 19 d 16

1999



Irish

2004



1999



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


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


Continued…


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Aged 16 and over with a valid waist and hip measurement 2004, 1999

WHR and waist Age groupcircumference (%)

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

General population(2003e,1998,g)

2003



1998



Bases (weighted)f

Black Caribbean 2004 78 83 69 231 110 144 73 327

Black Caribbean 1999 145 93 130 367 190 190 123 503

Indian 2004 145 181 108 434 177 230 78 485

Indian 1999 218 252 125 595 252 256 108 616

Pakistani 2004 96 69 26 192 111 76 30 217

Pakistani 1999 191 120 47 358 223 117 31 370

Bangladeshi 2004 36 27 11 75 61 31 8 100

Bangladeshi 1999 70 37 29 137 91 33 14 139

Chinese 2004 39 24 12 75 28 40 7 75

Chinese 1999 34 42 19 96 35 62 17 113

Irish 2004 198 352 322 872 232 463 415 1110

Irish 1999 385 714 448 1546 566 879 543 1988

General population 2003e 1740 1964 1693 5397 1643 1940 1971 5554

General population 1998g g g g g g g g g

Bases (unweighted)f

Black Caribbean 2004 60 65 209 84 92 148 74 314

Black Caribbean 1999 212 142 193 547 283 285 180 748

Indian 2004 94 76 310 140 120 164 61 345

Indian 1999 232 267 127 626 267 277 113 657

Pakistani 2004 97 30 197 70 114 79 31 224

Pakistani 1999 326 217 77 620 384 203 56 643

Bangladeshi 2004 61 22 138 55 103 53 15 171

Bangladeshi 1999 274 143 116 533 361 144 58 563

Chinese 2004 85 30 182 67 66 100 19 185

Chinese 1999 109 127 65 301 109 194 58 361

Irish 2004 67 113 311 131 82 169 154 405

Irish 1999 135 240 162 537 203 301 204 708

General population 2003e 1211 1908 4962 1843 1482 2206 2307 5995


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


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


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HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE 205

Blood pressure

Moushumi Chaudhury & Paola Zaninotto

● Age-standardised ratios of mean systolic blood pressure (SBP) were significantlylower 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 generalpopulation (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 notshow any significant differences from the men in the general population, except forIndian men (1.02).

● Age-adjusted ratios for women showed DBP in the Pakistani group (1.02) to be slightlyhigher 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, 0.94women), and Bangladeshi informants (0.89 men, 0.96 women).

● The prevalence of high blood pressure was significantly lower among Bangladeshimen (0.63) than men in the general population (set at 1.0). There were no otherdifferences between ethnic groups.

● Black Caribbean (risk ratio 1.58), Black African (1.71) and Bangladeshi (1.43) womenwere significantly more likely to have high blood pressure than women in the generalpopulation.

● No clear pattern was observed between urinary sodium, potassium and high bloodpressure.

● There was no clear relationship between high blood pressure and equivalised incomefor 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 decreasewas not significant in many groups. Changes in SBP were statistically significantamong Indian male informants and men in the general population. The decrease inSBP was highly significant in Indian, Pakistani and Chinese women and women in thegeneral population.

● No significant differences were found in mean DBP between 1999 and 2004, in any ofthe minority ethnic groups, except for Pakistani women.

● The prevalence of hypertension was higher in 2004 than in 1999 in most minorityethnic groups, although many of the increases were not statistically significant. Thelargest increases in 2004 were in the prevalence of controlled hypertension, while thelargest decreases were in the prevalence of untreated hypertension.

7Summary

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, anddeveloped, countries. Numerous national and regional studies have been conductedworldwide to estimate the prevalence of hypertension: hypertension rates have varied from3.4% in rural Indian men to as high as 72.5% in Polish women.2,3 Hypertension is one of themain risk factors for heart attack and stroke.4 It appears to be more common among AfricanCaribbeans and South Asians in Britain.5,6 A number of studies in the UK have shown thatmortality rates for stroke, coronary heart disease (CHD) and end-stage renal failure arehigher 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 allpeople with sustained levels of blood pressure ≥160/100, and at lower levels in those withadditional risk factors, such as diabetes, or with end-organ damage. The guidelinesrecommend a reduction of BP to <140/85, but give lower target BP levels (<130/80) forpatients with diabetes or chronic renal failure.9

There are a number of unmodifiable predisposing risk factors in those more at risk ofhypertension, such as age, gender, family history and ethnicity.1 Ethnic groups differ in theirprevalence of hypertension.10 Some of the differences are thought to be related to the waythe body reacts to salt (salt–sensitivity)11 and the differences in various hormones thatcontrol blood pressure (vasoactive neuropeptides) in blood.1

The majority of UK-based surveys have shown that people of Black African or BlackCaribbean origin have higher average BP levels and rates of hypertension than their whitecounterparts.12,13,14 Recent reviews of population-based studies have examined theprevalence of hypertension and mean blood pressure among different ethnic groups in theUK. The majority, but not all, of these studies reported a greater prevalence of hypertensionand significantly raised BP among Black Caribbeans compared with white Europeans.15,16

Recent studies have demonstrated high prevalence of hypertension amongst British SouthAsians, although mean BP was comparable to the white population.9,14,15

Epidemiological, clinical and animal experimental evidence show a direct relationshipbetween dietary electrolyte consumption and blood pressure.9 Clinical trials have shownthat reduction of salt (sodium chloride, NaCl) intake reduces BP levels in normotensive andhypertensive 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 inblood pressure between socio-economic groups, and comparisons with HSE 1999, are alsopresented. The concentration of urinary sodium and potassium and their correlation withblood pressure are also reported.

7.2 Methods and definitions

7.2.1 BP measurements

In HSE 2003, a new oscillometric automated device, the Omron HEM 907, was introducedto measure blood pressure, as a replacement for the Dinamap 8100, which had becomeobsolete.18 The Omron was used again in HSE 2004. A calibration study for HSE 2003provided suitable regression equations to derive, for adults aged 16 and over, predictedOmron readings from Dinamap readings and vice versa. Both ‘Dinamap to Omron’conversions and ‘Omron to Dinamap’ conversions were derived. For this report, theDinamap values obtained in 1999 were converted into Omron values when comparingblood pressure measurements over time, as follows:

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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 previousyears. Using an appropriately sized cuff, three blood pressure readings were taken at one-minute 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 eachmeasurement.

The BP variables used in this chapter are the means of the second and third measurementsobtained from informants providing three valid readings. Those who had smoked, drunk,eaten, or exercised vigorously in the preceding half hour were excluded, as were pregnantwomen.

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 addingthe 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 urinecollection. In the present survey as with 2003, a spot urine sample was collected. Althoughurine samples do not allow definitive quantification of sodium intake, they can distinguishbetween subgroups of the population with higher or lower sodium excretion, and enableexamination of trends in sodium excretion over time.18 The spot urine sample was collectedfrom both men and women aged 16 and over in minority ethnic groups during the nursevisit. 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 andpotassium/creatinine ratios are less sensitive to random variation due to urine dilution, soare a more useful measure than excretion of the individual analytes.

7.3 Response rates

In 2004, nurse visits were offered to all individuals in minority ethnic groups in the boostsample. The general population data presented are from HSE 2003, as the generalpopulation did not receive a nurse visit in 2004. Response rates for BP measurements andurine samples are based on those receiving a nurse visit, though women who werepregnant were not asked for a urine sample. In 2003 only a sub sample of informants in thegeneral population were asked to give a urine sample. Section 6.3 in Volume 2 gives moredetails of 2004 response rates to the different stages of the survey.

Among those who participated in a nurse visit, the proportion with three valid bloodpressure readings ranged from 69% of Bangladeshi men, to 84% of Chinese and Indianmen. Among women, the proportion with three valid blood pressure readings ranged from71% of Black African women to 84% of Indian women. Table 7.1 presents the proportionsof participants who were excluded from the analysis for a variety of reasons. Informantswere excluded if they were pregnant or had eaten, drunk, exercised vigorously or smoked inthe half hour before the measurement; a proportion of the remainder refused to have theirblood pressure taken or failed to complete the measurements or measurements were notpossible for technical reasons. Table 7.1

The proportion with a valid urine sample ranged from 76% of Pakistani men to 89% of Irishmen. 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). Asmall proportion of men and women refused to give a sample; for the remainder, the samplewas not obtained for reasons other than refusal, for example being unable to provide a urinesample at that time. Table 7.2

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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 bloodpressure measurements (SBP121.0mmHg, DBP 72.2mmHg, PP 48.9mmHg and MAP88.4mmHg) 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 ofdifferent minority ethnic groups (see chapter 1, section 1.6.5). After age standardisation, therisk ratios of Bangladeshi men, relative to the general population, remained significantlylower than 1.0 for mean SBP (0.94), DBP (0.98), PP (0.89), and MAP (0.96). Other groups ofAsian origin also showed significantly low age-standardised risk ratios for mean PP: Indian0.92, Pakistani 0.91, and Chinese 0.90.

Chinese women had the lowest observed SBP, DBP and MAP (115.1mmHg, 70.0mmHgand 85.0mmHg respectively), while Pakistani women had the lowest observed PP(43.8mmHg). After adjusting for age, risk ratios were significantly lower than the generalpopulation (set at 1.0) among Chinese women, who had the lowest mean DBP and MAPrisk 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

7.4.2 Systolic blood pressure (SBP), by age within minority ethnic group

Mean systolic blood pressure (SBP) was higher among men than women in each minorityethnic group and in the general population. Among men, mean SBP was highest amongBlack Caribbean (133.3mmHg) and Irish informants (131.5mmHg), a level similar to that ofmen in the general population (131.4mmHg), and lowest in Bangladeshi men (121.0mmHg).

Overall, women in minority ethnic groups had lower mean SBP than females in the generalpopulation (125.9mmHg), ranging from 115.1mmHg in Chinese women to 123.0mmHg and124.6mmHg in Black Caribbean and Irish women, respectively.

Mean SBP increased significantly with age in Black Caribbean men and women, BlackAfrican men, Indian men and women, Irish women, and in both sexes in the generalpopulation. 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 inmales and 73.7 mmHg in females) and Black Caribbean females (73.7mmHg), than among


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Mean SBP and DBP


(2003)

Men

Observed mean SBP (mmHg) 133.3 128.0 127.3 124.2 121.0 125.2 131.5 131.4

Standardised ratio of means 1.02 1.01 0.97 0.97 0.94 0.96 1.01 1

Observed mean DBP (mmHg) 74.7 73.5 75.2 73.8 72.2 74.1 73.9 74.3


Women

Observed mean SBP (mmHg) 123.0 118.1 119.2 117.1 116.4 115.1 124.6 125.9


Observed mean DBP (mmHg) 73.7 72.8 73.7 73.2 72.3 70.0 73.2 73.2


the other minority ethnic groups and the general population. In the general population, DBPtends to peak in middle age (45-64) and fall thereafter.18 There were insufficient numbers ofolder informants to confirm whether this pattern was also seen in some minority ethnicgroups. DBP was higher in those aged 55 and over than in those aged 35-54 in BlackCaribbean men, and Irish men and women, and in Indian women, but numbers did notpermit separate analysis by smaller age-bands. Table 7.5

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. Itis the difference between the systolic pressure and the diastolic pressure and is an indicatorof arterial stiffness. Recent prospective data from the Framingham study suggested that itappears to be a more sensitive measure of risk than other indices of BP. High PP is a strongindicator of heart problems, in particular in older adults.20

Men had higher mean PP than women in each minority ethnic group and in the generalpopulation. PP ranged from 48.9mmHg among Bangladeshi men to 58.6mmHg in BlackCaribbean males. Among women, PP was highest among Irish informants and those in thegeneral population (51.5mmHg and 52.7mmHg respectively) and lowest in Pakistaniwomen (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 pressurein an individual. Mean arterial pressure is defined as the diastolic pressure plus 1/3 of the


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Systolic blood pressure, by age group

SB

P (m

mH

g)

SB

P (m

mH

g)

Figure 7A

0

20

40

60

80

100

120

140

160

16 to 3435 to 5455+

Black

Caribbean

Black

African

Indian

Pakistani

Bangladeshi

IrishChinese

General

population

Black

Caribbean

Black

African

Indian

Pakistani

Bangladeshi

IrishChinese

General

population

Men

0

20

40

60

80

100

120

140

160Women

pulse pressure. MAP increased with age for male and female informants, in each minorityethnic group and in the general population. Overall, women had lower mean MAP than menacross 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 hypertensionmanagement9 using the threshold values of 140/90: informants were consideredhypertensive if their SBP was 140mmHg or over, their DBP was 90mmHg or over, or theywere taking medicine prescribed to treat high blood pressure.

It should be noted that HSE 2004 measures blood pressure as a one-off measurement in across sectional survey and does not provide information on whether high BP is sustainedover 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. Allthose in any of the last three categories are classified as having hypertension.

Treatment rates for hypertension were estimated by examining the proportion of all thosedefined as having high blood pressure at the time of the survey (as defined above, using acombination of the BP measured and the drugs recorded at the nurse visit) who were ondrug treatment for hypertension at the time of the survey. Efficacy of treatment wasassessed as the proportion of those on treatment for hypertension whose BP wascontrolled (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 lifestyleadvice and support. We have therefore also reported the proportion of informants who hadBP ≥160/100mmHg but were not on drug treatment for hypertension.

Hypertensive untreated SBP ≥160mmHg or DBP ≥100mmHg and not taking(160 /100) medicine prescribed for high blood pressure

7.5.2 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 minorityethnic 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 ofhypertension (16%). Among women, the lowest prevalence of hypertension was amongPakistani and Chinese informants (15% and 16% respectively).

The age-standardised risk ratio for hypertension was significantly higher for BlackCaribbean women (1.58), while only Bangladeshi men had significantly lower prevalence of


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hypertension (risk ratio 0.63), than the general population. Bangladeshi women (1.43) had asignificantly higher risk of hypertension than women in the general population butBangladeshi men had a lower likelihood of hypertension than men in the generalpopulation. Table 7.8, Figure 7B

The prevalence of hypertension increased across the age groups for men and women ineach minority ethnic group, and in the general population. The majority of men and womenaged 55 and over had raised blood pressure or were on treatment for hypertension. Theprevalence of hypertension in this age group was 73% in Black Caribbean men, 65% inIndian 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 baseswere too small in the other minority ethnic groups to comment. Table 7.9

7.5.3 Treatment of hypertension

Irish informants were more likely to have untreated hypertension ≥140/90 mmHg (23% ofall men with valid BP measurements and 15% of women), than Bangladeshi and Chineseinformants 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 thegeneral population (5%). Table 7.8

The proportion of men in minority ethnic groups with untreated BP ≥160/100 mmHg rangedfrom 1% of Bangladeshi men to 5% of Irish men; 4% of men within the general populationhad untreated BP ≥160/100mmHg. These differences were not significant. Among womenin minority ethnic groups, the prevalence of untreated BP ≥160/100mmHg was highest forBlack African women (4%) and lowest among Black Caribbean and Chinese women (1%


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Prevalence of hypertension


(2003)

Men

Observed % 38.4 25.1 32.6 19.9 15.9 20.2 36.4 31.7

Standardised risk ratio (of being hypertensive) 1.37 1.21 1.15 0.98 0.63 0.78 1.13 1

Women

Observed % 31.7 19.3 17.6 14.5 18.6 16.2 28.6 29.5

Standardised riskratio (of beinghypertensive) 1.58 1.71 0.91 1.01 1.43 1.12 0.95 1

Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

Prevalence of hypertension

Men WomenR

isk

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og

arit

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Figure 7B

2.0

0.5


0.10

1.0

10.0

Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

2.0

0.5

0.10

1.0

10.0

and 2% respectively) but no significant differences were found between the minority ethnicgroups and the general population (3%). Table 7.8

The table above shows the proportion of informants with hypertension (≥140/90 mmHg), asdefined in this survey, who were on drug treatment. Among those with hypertension, ahigher proportion of Black Caribbean, Bangladeshi and Indian men and women, andPakistani women, were on drug treatment than informants in the general population.However, a significantly lower proportion of Black African women with hypertension wereon drug treatment (compared with women in the general population).

Considering only those on drug treatment, adequate control of BP (<140/90) was achievedin 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 Chinesewomen, significantly more than among women in the general population (42%).

7.6 Urinary sodium and potassium and their relationship withblood pressure

Sodium:creatinine (Na/Cre) ratio shows little change with age,18 so differences betweenminority ethnic groups are likely to reflect difference in sodium intake in the diet rather thandifferences to ethnicity. Potassium:creatinine (K/Cre) ratio varied more between ethnicgroups in women than men. Correlation coefficients between blood pressure and urinarysodium, potassium and creatinine were generally low between all minority ethnic groups formen and women. The highest correlations were found for Na/Cre ratio among Bangladeshiwomen (0.39 for SBP and 0.28 for DBP). Tables 7.10 and 7.11

7.7 Blood pressure levels by equivalised household income

This section presents the observed prevalence of blood pressure levels, and thestandardised risk ratios of hypertension, by equivalised household income tertile withinminority ethnic group. Equivalised household income is a measure of household incomethat takes account of the number of persons in the household. The sample was divided intotertiles which were applied to all minority ethnic groups: they are not group specific, and donot divide each group into equal thirds.

Due to small bases is not possible to comment on the relationship between blood pressurelevels and equivalised income across most minority ethnic groups. However is possible tomake some comments on hypertension for informants from the Indian and the generalpopulation group.


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Proportion of men and women with hypertension who were being treated, and proportion of those whose blood pressure was controlled


(2003)

% % % % % % % %

Men

Drug treatment ratea 51 36 52 44 58 44 37 43

Adequate control of BPb 48 40 67 74 36 47 51 55

Women

Drug treatment ratea 60 39 58 66 61 56 46 51

Adequate control of BPb 48 71 44 44 56 64 32 42a

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).

bPercentage of those on treatment for hypertension whose measured BP was <140/90.

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The observed prevalence of hypertension was higher among informants in the lowest thanthe highest income tertile for Indian informants (43% for men and 20% for women) and thegeneral population (40% for men and for women). Age standardisation confirmed theobserved results only for Indian men (risk ratio 1.58 in the lowest tertile and 1.15 in thehighest, risk ratios not significant in Indian women), and for women in the generalpopulation (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 2004and 1999

This section compares results for SBP and DBP by age, within minority ethnic group, in2004 and 1999. To allow for comparisons between the 1999 and 2004 surveys, theDinamap values (from HSE 1999) were converted into Omron values using equationsdescribed in Section 7.2. Comparative data for the general population are taken from HSE2003 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 thatseen in 1999.

Mean SBP was lower in 2004 than in 1999 in general in both sexes but the decrease wasnot significant in many groups. The fall was statistically significant among Indian men (130.8mmHg in 1999 to 127.3 mmHg in 2004) and men in the general population (133.4 mmHg in1999 to 125.9 mmHg). Among women, the decrease in SBP from 1999 to 2004 was highlysignificant in Indian (123.8 mmHg in 1999 to 119.2 mmHg in 2004), Pakistani (120.8 mmHgin 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 amongwomen than men. Informants aged 16-34 from most ethnic groups (and from the generalpopulation) had noticeably decreased mean SBP in 2004 compared with 1999 (2003 and1998 for the general population).These differences were significant for Indian maleinformants and male informants in the general population, and in women from the majorityof minority ethic groups (except Bangladeshi women) and in the general population. Amongwomen, mean SBP also decreased in 2004 from 1999. The differences were significant inPakistani 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 agegroups and minority ethnic groups for males and females. No significant differences werefound in mean DBP between the two years except for Pakistani women and men andwomen in the general population.

Unlike SBP, DBP was slightly higher in young women in most minority ethnic groups and inwomen in the general population (in 2004 and 2003 respectively) than it had been in 1999and 1998. However these rises were not significant, except for women in the generalpopulation in those aged 16-34 and 35-54. Table 7.13

7.9 Comparison of prevalence of hypertension (140/90 mmHg) in2004 and 1999

The prevalence of hypertension among men was higher in 2004 than in 1999 in mostminority ethnic groups, although the differences were not statistically significant. ForBangladeshi and Chinese men, there was no difference between the two surveys. Amongwomen, the largest significant increase between 1999 and 2004 was seen for Bangladeshiwomen (19% in 2004 compared with 10% in 1999). For Indian and Chinese women therewas a non-significant decrease in prevalence.

In each minority ethnic group, where a rise in hypertension was seen, the largest increase in2004 was in the prevalence of controlled hypertension, while the largest fall was in theprevalence of untreated hypertension. Table 7.14

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1 Maryon-Davis, A, Press V Easing the pressure: tackling hypertension. A toolkit for developing a localstrategy 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. JHypertens. 2004; 22:11-19.

3 Ezzati M, Lopez AD, Rodgers A et al. Comparative Risk Assessment Collaborating Group. Selected majorrisk 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 cohortstudy. 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 inBirmingham, 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 forIschemic 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 diseasein 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 fourthworking 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 EthnicGroups. The Stationery Office, London, 1999.

11 Stewart JA, Dundas R, Howard RS et al. Ethnic differences in incidence of stroke: prospective study withstroke register. BMJ. 1997; 313:967-971.

12 Cappuccio FP, Cooj DG, Atkinson RW et al. The Wandsworth Heart and Stroke Study. A populationbased study of CVD risk factors in different ethnic groups. Methods and baseline findings. Nutr MetabCardiovasc Dis. 1998; 8:371-385.

13 Lane D, Beevers DG, Lip GYH. Ethnic differences in blood pressure and prevalence of hypertension inEngland. J Human Hypertens. 2002; 16:267-273.

14 Primetesta P, Bost L, Poulter NR. Blood pressure levels and hypertension status among ethnic groups inEngland. 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 thatin 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 onblood 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. Volume2. 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 becomplete. Ann Clin Biochem. 1988; 25:610.

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.

214 HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 7: BLOOD PRESSURE

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Tables

7.1 Response to blood pressure measurement, byminority ethnic group and sex

7.2 Response to urine spot sample, by minorityethnic group and sex

7.3 Blood pressure measurement, by minorityethnic group and sex

7.4 Systolic blood pressure (SBP), by age withinminority ethnic group and sex

7.5 Diastolic blood pressure (DBP), by age withinminority ethnic group and sex

7.6 Pulse pressure (PP), by age within minorityethnic group and sex

7.7 Mean arterial pressure (MAP), by age withinminority ethnic group and sex

7.8 Blood pressure levels, by minority ethnic groupand sex

7.9 Blood pressure levels, by age within minorityethnic group and sex

7.10 Urinary sodium (Na), potassium (K) andcreatinine (Cre), by minority ethnic group andsex

7.11 Pearsons correlation coefficient for bloodpressure with urinary sample, by minorityethnic groups and sex

7.12 Blood pressure levels, by equivalisedhousehold income tertile within minority ethnicgroup and sex

7.13 Comparison of mean systolic blood pressure(SBP) in 2004 and 1999, by age within minorityethnic group and sex

7.14 Comparison of mean diastolic blood pressure(DBP) in 2004 and 1999, by age within minorityethnic group and sex

7.15 Comparison of blood pressure levels in 2004and 1999, by age within minority ethnic groupand sex


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Table 7.1

Response to blood pressure measurement, by minority ethnic group and sex

Aged 16 and over who had a nurse visit 2004

Response to blood Minority ethnic group Generalpressure measurement population

Black Black (2003)a


% % % % % % % %

MenValid blood pressure measurementb 71 75 84 78 69 84 75 81

Ate, drank, exercised or smoked in previous half hour 25 21 14 20 27 14 23 17

Three valid readings not obtained 2 3 1 0 1 1 1 2

Refused, attempted but not obtained, not attempted 1 1 1 1 3 1 1 1

WomenValid blood pressure measurementb 74 71 84 80 78 83 78 80

Ate, drank, exercised or smoked in previous half hour 22 23 12 9 18 10 20 15

Three valid readings not obtained 2 2 1 2 - 2 1 2

Pregnant 1 4 3 8 3 4 1 2

Refused, attempted but not obtained, not attempted - - 1 0 2 1 0 1

Bases (unweighted)

Men 218 165 316 208 143 183 320 5086

Women 327 216 382 260 185 199 418 6322

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.


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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 2004

Response to urine Minority ethnic group Generalsample population

Black Black (2003)a


% % % % % % % %

MenUrine sample obtained 78 83 85 76 82 81 89 87

Attempted but not obtained 1 - 0 - - 1 0 1

Respondent refused to give urine sample 9 10 8 14 8 5 3 6

Unable to obtain urine sample for reason other than refusal 12 7 6 10 10 13 8 6

WomenUrine sample obtained 81 86 85 73 75 78 87 87

Attempted but not obtained - - 0 0 - - 0 0

Respondent refused to give urine sample 8 5 8 13 13 8 5 7

Unable to obtain urine sample for reason other than refusal 10 9 7 14 12 14 8 6

Bases (unweighted)

Men 218 165 316 208 143 183 320 852

Women 324 207 370 238 180 191 414 1085

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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Table 7.3

Blood pressure measurements, by minority ethnic group and sex

Aged 16 and over with valid blood pressure reading 2004

SBP, DBP, MAP, PP Minority ethnic group General(mmHg) population

Black Black (2003)a

Caribbean African Indian Pakistani Bangladeshi Chinese IrishMenObserved %

Systolic blood pressure (SBP)

Mean 133.3 128.0 127.3 124.2 121.0 125.2 131.5 131.4


Diastolic blood pressure (DBP)

Mean 74.7 73.5 75.2 73.8 72.2 74.1 73.9 74.3


Pulse pressure (PP)

Mean 58.6 54.5 52.1 50.4 48.9 51.2 57.6 57.1


Mean arterial pressure (MAP)

Mean 94.2 91.7 92.6 90.7 88.4 91.1 93.1 93.3


Standardised ratios of means

Mean SBP 1.02 1.01 0.97 0.97 0.94 0.96 1.01 1


Mean DBP 1.02 1.01 1.02 1.01 0.98 1.01 0.98 1


Mean PP 1.02 1.01 0.92 0.91 0.89 0.90 1.04 1


Mean MAP 1.02 1.01 1.00 0.99 0.96 0.99 0.99 1


WomenObserved

Systolic blood pressure (SBP)

Mean 123.0 118.1 119.2 117.1 116.4 115.1 124.6 125.9


Diastolic blood pressure (DBP)

Mean 73.7 72.8 73.7 73.2 72.3 70.0 73.2 73.2


Pulse pressure (PP)

Mean 49.4 45.2 45.6 43.8 44.1 45.1 51.5 52.7


Mean arterial pressure (MAP)

Mean 90.1 87.9 88.9 87.8 87.0 85.0 90.3 90.8


Standardised ratios of means

Mean SBP 1.01 1.00 0.98 0.99 0.99 0.97 0.99 1


Mean DBP 1.01 1.02 1.01 1.02 1.02 0.97 0.99 1


Mean PP 1.01 0.98 0.94 0.94 0.96 0.97 0.99 1


Mean MAP 1.01 1.01 1.00 1.01 1.01 0.97 0.99 1


Bases (weighted)

Men 169 136 361 159 53 63 667 4420

Women 249 183 442 207 83 66 923 4702

Bases (unweighted)

Men 155 123 265 162 99 153 240 4108

Women 243 154 320 207 144 166 328 5075



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Table 7.4

Systolic blood pressure (SBP), by age within minority ethnic group and sex

Aged 16 and over with valid blood pressure readings 2004

Systolic blood pressure Age group(mmHg)

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Black Caribbean

Mean [126.3] 132.0 141.8 133.3 113.1 121.1 140.2 123.0

Standard error of the mean [1.84] 2.07 2.77 1.43 1.67 1.23 3.05 1.35

Black African

Mean 120.3 134.0 a 128.0 112.1 121.1 a 118.1

Standard error of the mean 1.84 2.52 a 1.71 1.43 2.07 a 1.72

Indian

Mean 119.8 127.6 136.8 127.3 108.8 119.3 138.3 119.2


Pakistani

Mean 122.1 123.9 a 124.2 110.6 117.9 a 117.1


Bangladeshi

Mean [117.9] [120.5] a 121.0 109.3 [122.6] a 116.4

Standard error of the mean [2.34] [1.64] a 1.36 1.30 [3.45] a 1.73

Chinese

Mean 123.9 124.3 a 125.2 108.8 114.8 a 115.1


Irish

Mean [128.3] 127.0 138.6 131.5 110.6 119.7 137.7 124.6



Mean 124.9 129.6 139.1 131.4 113.8 120.6 140.0 125.9


Bases (weighted)

Black Caribbean 59 53 57 169 78 113 58 249

Black African 66 59 11 136 94 78 12 183

Indian 117 156 89 361 151 209 82 442

Pakistani 79 58 22 159 102 77 28 207

Bangladeshi 25 22 6 53 48 28 8 83

Chinese 33 19 11 63 24 35 7 66

Irish 119 301 247 667 194 377 352 923


Bases (unweighted)

Black Caribbean 43 59 53 155 70 114 59 243

Black African 50 62 11 123 73 71 10 154

Indian 77 119 69 265 103 151 66 320

Pakistani 79 57 26 162 101 77 29 207

Bangladeshi 41 45 13 99 83 47 14 144

Chinese 73 54 26 153 59 88 19 166

Irish 48 105 87 240 68 130 130 328


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



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Table 7.5

Diastolic blood pressure (DBP), by age within minority ethnic group and sex


Diastolic blood pressure Age group(mmHg)

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Black Caribbean

Mean [70.2] 78.6 75.7 74.7 68.0 75.7 77.4 73.7


Black African

Mean 66.3 81.2 a 73.5 68.6 76.7 a 72.8


Indian

Mean 70.9 78.5 75.1 75.2 69.7 75.4 76.4 73.7


Pakistani

Mean 71.0 76.7 a 73.8 70.3 75.5 a 73.2


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


Irish

Mean [70.3] 73.8 76.0 73.9 69.5 73.7 74.6 73.2



Mean 68.7 77.5 75.8 74.3 69.5 74.4 74.9 73.2


Bases (weighted)

Black Caribbean 59 53 57 169 78 113 58 249

Black African 66 59 11 136 94 78 12 183

Indian 117 156 89 361 151 209 82 442

Pakistani 79 58 22 159 102 77 28 207

Bangladeshi 25 22 6 53 48 28 8 83

Chinese 33 19 11 63 24 35 7 66

Irish 119 301 247 667 194 377 352 923


Bases (unweighted)

Black Caribbean 43 59 53 155 70 114 59 243

Black African 50 62 11 123 73 71 10 154

Indian 77 119 69 265 103 151 66 320

Pakistani 79 57 26 162 101 77 29 207

Bangladeshi 41 45 13 99 83 47 14 144

Chinese 73 54 26 153 59 88 19 166

Irish 48 105 87 240 68 130 130 328





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Table 7.6

Pulse pressure (PP), by age within minority ethnic group and sex


Pulse pressure (mmHg) Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Black Caribbean

Mean [56.1] 53.4 66.1 58.6 45.1 45.4 62.8 49.4


Black African

Mean 54.1 52.8 a 54.5 43.5 44.4 a 45.2


Indian

Mean 48.9 49.1 61.7 52.1 39.1 43.8 61.9 45.6


Pakistani

Mean 51.0 47.2 a 50.4 40.2 42.4 a 43.8


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


Irish

Mean [58.0] 53.2 62.6 57.6 41.0 46.0 63.1 51.5



Mean 56.2 52.1 63.3 57.1 44.3 46.2 65.1 52.7


Bases (weighted)

Black Caribbean 59 53 57 169 78 113 58 249

Black African 66 59 11 136 94 78 12 183

Indian 117 156 89 361 151 209 82 442

Pakistani 79 58 22 159 102 77 28 207

Bangladeshi 25 22 6 53 48 28 8 83

Chinese 33 19 11 63 24 35 7 66

Irish 119 301 247 667 194 377 352 923


Bases (unweighted)

Black Caribbean 43 59 53 155 70 114 59 243

Black African 50 62 11 123 73 71 10 154

Indian 77 119 69 265 103 151 66 320

Pakistani 79 57 26 162 101 77 29 207

Bangladeshi 41 45 13 99 83 47 14 144

Chinese 73 54 26 153 59 88 19 166

Irish 48 105 87 240 68 130 130 328





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Table 7.7

Mean arterial pressure (MAP), by age within minority ethnic group and sex


Mean arterial pressure Age group(mmHg)

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Black Caribbean

Mean [88.9] 96.4 97.7 94.2 83.0 90.8 98.3 90.1


Black African

Mean 84.3 98.8 a 91.7 83.1 91.5 a 87.9


Indian

Mean 87.2 94.8 95.7 92.6 82.7 90.1 97.0 88.9


Pakistani

Mean 88.1 92.4 a 90.7 83.7 89.6 a 87.8


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


Irish

Mean [89.6] 91.5 96.8 93.1 83.2 89.0 95.6 90.3



Mean 87.5 94.9 96.9 93.3 84.2 89.8 96.6 90.8


Bases (weighted)

Black Caribbean 59 53 57 169 78 113 58 249

Black African 66 59 11 136 94 78 12 183

Indian 117 156 89 361 151 209 82 442

Pakistani 79 58 22 159 102 77 28 207

Bangladeshi 25 22 6 53 48 28 8 83

Chinese 33 19 11 63 24 35 7 66

Irish 119 301 247 667 194 377 352 923


Bases (unweighted)

Black Caribbean 43 59 53 155 70 114 59 243

Black African 50 62 11 123 73 71 10 154

Indian 77 119 69 265 103 151 66 320

Pakistani 79 57 26 162 101 77 29 207

Bangladeshi 41 45 13 99 83 47 14 144

Chinese 73 54 26 153 59 88 19 166

Irish 48 105 87 240 68 130 130 328





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Table 7.8

Blood pressure levels, by minority ethnic group and sex


Blood pressure levels Minority ethnic group Generalpopulation

Black Black (2003)a


MenObserved %

Normotensive untreatedb 62 75 67 80 84 80 64 68

Hypertensive controlledb 10 4 11 6 3 4 7 5

Hypertensive uncontrolledb 10 5 6 2 6 5 7 6

Hypertensive untreatedb 19 16 16 11 7 11 23 20

All with hypertension 38 25 33 20 16 20 36 32

Hypertensive untreatedc 2 4 3 2 1 2 5 5


All with hypertension 1.37 1.21 1.15 0.98 0.63 0.78 1.13 1


WomenObserved %

Normotensive untreatedb 68 81 82 85 81 84 71 71

Hypertensive controlledb 9 5 4 4 6 6 4 6

Hypertensive uncontrolledb 10 2 6 5 5 3 9 8





All with hypertension 1.58 1.71 0.91 1.01 1.43 1.12 0.95 1


Bases (weighted)

Men 169 136 361 159 53 63 667 4420

Women 249 183 442 207 82 66 923 4702

Bases (unweighted)

Men 155 123 265 162 99 153 240 4108

Women 243 154 320 207 144 166 328 5075


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.

c Hypertensive untreated (160/100): SBP ≥160mmHg or DBP ≥100mmHg and not taking medicine prescribed for high blood pressure


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Table 7.9

Blood pressure levels, by age within minority ethnic group and sex


Blood pressure levels Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

Normotensive untreateda [89] 69 27 62 91 77 20 68

Hypertensive controlleda [1] 1 26 10 - 4 32 9

Hypertensive uncontrolleda [-] 4 27 10 1 4 32 10

Hypertensive untreateda [10] 26 20 19 8 15 16 13

All with hypertension [11] 31 73 38 9 23 80 32

Hypertensive untreatedb [1] 3 3 2 1 1 3 1

Black African

Normotensive untreateda 91 62 c 75 97 72 c 81

Hypertensive controlleda 2 6 c 4 - 7 c 5

Hypertensive uncontrolleda - 9 c 5 - 4 c 2

Hypertensive untreateda 7 24 c 16 3 17 c 12

All with hypertension 9 38 c 25 3 28 c 19

Hypertensive untreatedb - 7 c 4 0 3 c 4

Indian

Normotensive untreateda 90 69 35 67 97 88 41 82

Hypertensive controlleda 1 13 23 11 - 2 18 4

Hypertensive uncontrolleda - 4 17 6 1 3 20 6

Hypertensive untreateda 9 15 26 16 2 6 21 7



Pakistani


Hypertensive controlleda - 4 c 6 - 4 c 4


Hypertensive untreateda 6 15 c 11 4 3 c 5

All with hypertension 6 21 c 20 4 13 c 15

Hypertensive untreatedb 3 2 c 2 2 3 c 3

Bangladeshi

Normotensive untreateda [93] 78 c 84 98 [66] c 81

Hypertensive controlleda [-] 7 c 3 - [14] c 6

Hypertensive uncontrolleda [-] 11 c 6 - [9] c 5

Hypertensive untreateda [7] 5 c 7 2 [11] c 7

All with hypertension [7] 22 c 16 2 [34] c 19

Hypertensive untreatedb [-] - c 1 - [6] c 3

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 non-response.

Continued…


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Table 7.9 continued


Blood pressure levels Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Chinese


Hypertensive controlleda - 5 c 4 - 6 c 6


Hypertensive untreateda 6 18 c 11 - 8 c 7

All with hypertension 6 28 c 20 - 14 c 16

Hypertensive untreatedb - 4 c 2 - 1 c 2

Irish

Normotensive untreateda [85] 78 36 64 98 86 41 71

Hypertensive controlleda [-] 3 14 7 - 0 11 4

Hypertensive uncontrolleda [1] 3 13 7 - 2 21 9

Hypertensive untreateda [13] 16 37 23 2 12 27 15


Hypertensive untreatedb [3] 3 9 5 - - 9 3

General population (2003)d

Normotensive untreateda 91 74 42 68 96 83 39 71

Hypertensive controlleda 0 3 12 5 0 3 13 6

Hypertensive uncontrolleda 0 3 16 6 0 2 19 8

Hypertensive untreateda 9 20 30 20 3 12 29 16



Bases (weighted)

Black Caribbean 59 53 57 169 78 113 58 249

Black African 66 59 11 136 94 78 12 183

Indian 117 156 89 361 151 209 82 442

Pakistani 79 58 22 159 102 77 28 207

Bangladeshi 25 22 6 53 48 28 8 83

Chinese 33 19 11 63 24 35 7 66

Irish 119 301 247 667 194 377 352 923


Bases (unweighted)

Black Caribbean 43 59 53 155 70 114 59 243

Black African 50 62 11 123 73 71 10 154

Indian 77 119 69 265 103 151 66 320

Pakistani 79 57 26 162 101 77 29 207

Bangladeshi 41 45 13 99 83 47 14 144

Chinese 73 54 26 153 59 88 19 166

Irish 48 105 87 240 68 130 130 328


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 non-response.


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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 2004

Urinary sodium, Minority ethnic group Generalpotassium, creatinine population

Black Black (2003)a


MenNa/Cre ratio

Mean 8.4 9.5 12.8 9.0 10.5 11.0 9.6 11.2


K/Cre ratio

Mean 4.2 4.2 5.7 4.5 3.6 4.8 5.3 5.7


Sodium (mmol/l)

Mean 139.5 140.9 138.4 116.9 115.0 132.7 111.8 122.7


Potassium (mmol/l)

Mean 70.7 66.7 69.7 65.2 45.4 63.6 66.6 68.3


Creatinine (mmol/l)

Mean 18.5 16.9 13.9 16.5 14.0 14.0 14.0 14.1


WomenNa/Cre ratio

Mean 10.1 9.6 15.1 13.2 13.7 13.6 11.9 12.9


K/Cre ratio

Mean 4.9 4.6 6.7 6.3 4.4 6.4 7.4 7.2


Sodium (mmol/l)

Mean 130.0 134.4 126.3 116.1 116.6 111.7 90.0 102.4


Potassium (mmol/l)

Mean 70.1 70.4 62.7 64.2 45.3 58.0 62.5 61.3


Creatinine (mmol/l)

Mean 16.2 17.3 10.8 11.8 11.0 10.1 10.4 10.1


Bases (weighted)

Men 186 151 374 156 64 60 801 821

Women 273 208 435 171 78 60 1008 870

Bases (unweighted)

Men 170 137 270 159 117 148 284 737

Women 263 178 314 173 135 149 359 938



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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 2004

Correlation Minority ethnic group Generalcoefficients population

Black Black (2003)a


MenCorrelation of SBP with:

Na/Cre ratio 0.04 -0.11 0.05 -0.04 0.07 0.22 0.16c 0.12c

K/Cre ratio 0.11 0.01 0.02 0.07 0.10 0.04 0.09b 0.10b

Sodium result -0.09 -0.25c -0.04 -0.11 -0.09 0.17 -0.01 -0.04

Potassium result -0.07 -0.05 -0.09 -0.15 0.06 0.01 0.01 -0.08b

Creatinine result -0.17 -0.07 -0.15c -0.18c -0.04 -0.08 -0.03 -0.09b

Correlation of DBP with:

Na/Cre ratio 0.12 -0.13 -0.02 0.04 0.06 0.08 0.03 0.07

K/Cre ratio -0.13 -0.10 -0.09 0.02 -0.04 0.03 0.06 0.04

Sodium result 0.13 -0.21b 0.00 -0.06 -0.16 0.03 -0.04 -0.03

Potassium result -0.08 -0.09 -0.06 -0.17 -0.13 0.00 0.09b -0.05

Creatinine result -0.01 -0.03 -0.04 -0.19b -0.10 -0.07 0.09b -0.08b

WomenCorrelation of SBP with:

Na/Cre ratio 0.12 -0.07 0.11b 0.02 0.39c 0.07 0.07b 0.14c

K/Cre ratio 0.09 0.04 0.14c 0.05 -0.04 0.04 -0.03 0.17c

Sodium result -0.25c -0.20b -0.17c -0.29c -0.05 -0.02 0.00 -0.12c

Potassium result -0.19c -0.05 -0.08c -0.22c -0.31b -0.06 -0.14c -0.12c

Creatinine result -0.18b -0.06 -0.14c -0.24c -0.32b -0.16 -0.11c -0.11c

Correlation of DBP with:

Na/Cre ratio 0.04 -0.13 0.09 0.06 0.28b 0.05 -0.05 0.03

K/Cre ratio -0.07 -0.03 0.10b 0.05 -0.08 -0.09 -0.05 -0.04

Sodium result -0.06 -0.16b -0.07 -0.15 -0.19 -0.03 -0.04 0.04

Potassium result -0.16b -0.03 0.01 -0.15 -0.35c -0.18 -0.06 -0.08b

Creatinine result -0.11 0.05 -0.06 -0.18b -0.34c -0.16 0.02 -0.01

Bases (weighted)

Men 135 120 322 127 46 51 615 684

Women 202 158 383 153 62 51 832 693

Bases (unweighted)

Men 125 107 237 129 86 124 219 608

Women 201 131 276 153 108 128 288 740


b Correlation is significant at the 0.05 level (2-tailed).c Correlation is significant at the 0.01 level (2-tailed).


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Table 7.12

Blood pressure levels, by equivalised household income tertile within minority ethnic group and sex


Blood pressure levels Equivalised household income tertile


% % % % % %ObservedBlack Caribbean

Normotensive untreateda 62 [54] b 78 58 77

Hypertensive controlleda 7 [14] b 5 6 7

Hypertensive uncontrolleda 3 [21] b 6 15 8

Hypertensive untreateda 28 [10] b 11 22 8

All with hypertension 38 [46] b 22 42 23

Black African

Normotensive untreateda [69] b [84] [70] [80] 89

Hypertensive controlleda [5] b [2] [9] - 4

Hypertensive uncontrolleda [8] b [8] [4] [3] 1

Hypertensive untreateda [18] b [5] [17] [17] 6

All with hypertension [31] b [16] [30] [20] 11

Indian

Normotensive untreateda 75 69 57 90 85 80

Hypertensive controlleda 7 10 17 2 4 6

Hypertensive uncontrolleda 1 7 11 4 6 6

Hypertensive untreateda 17 15 14 5 6 9

All with hypertension 25 31 43 10 15 20

Pakistani

Normotensive untreateda b 76 78 b 89 85

Hypertensive controlleda b 10 6 b 2 3

Hypertensive uncontrolleda b 2 4 b 6 6

Hypertensive untreateda b 12 12 b 3 5

All with hypertension b 24 22 b 11 15

Bangladeshi

Normotensive untreateda b b [80] b b 83

Hypertensive controlleda b b [4] b b 5

Hypertensive uncontrolleda b b [8] b b 4

Hypertensive untreateda b b [8] b b 8

All with hypertension b b [20] b b 17

Chinese

Normotensive untreateda 83 b b 91 b b

Hypertensive controlleda 3 b b 3 b b

Hypertensive uncontrolleda 3 b b 2 b b

Hypertensive untreateda 11 b b 3 b b

All with hypertension 17 b b 9 b b

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 high blood pressure.These four categories were labelled in the previous reports as follows: normotensive untreated, normotensive treated, hypertensive treated, hypertensive untreated.


Continued…


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Blood pressure levels Equivalised household income tertile


% % % % % %ObservedIrish

Normotensive untreateda 71 56 [55] 81 67 [63]

Hypertensive controlleda 5 11 [6] 3 1 [14]

Hypertensive uncontrolleda 2 7 [12] 2 14 [10]

Hypertensive untreateda 21 26 [27] 14 17 [13]

All with hypertension 29 44 [45] 19 33 [37]


Normotensive untreateda 73 66 60 81 64 60

Hypertensive controlleda 4 7 8 4 7 8

Hypertensive uncontrolleda 4 7 9 3 11 12

Hypertensive untreateda 19 20 22 12 18 20

All with hypertension 27 34 40 19 36 40

Standardised risk ratiosAll 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

Black African [1.71] b [0.90] [2.16] [1.38] 0.43

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


Pakistani 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

Chinese 0.73 b b 0.74 b b

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]


General population (2003)c 0.96 1.03 1.10 0.86 1.10 1.18


Bases (weighted)


Black African 56 25 38 48 46 63

Indian 95 108 71 129 124 105

Pakistani 16 60 57 18 59 76


Chinese 23 12 8 25 12 10

Irish 367 182 61 426 268 124


Bases (unweighted)


Black African 47 27 33 36 43 53

Indian 71 82 53 93 91 76

Pakistani 14 57 65 17 57 83


Chinese 60 29 19 65 29 27

Irish 119 66 33 149 94 49


a Informants were considered hypertensive iftheir systolic blood pressure was 140mmHg or over or their diastolic bloodpressure was 90 mmHg or over or they weretaking medicine prescribed for high bloodpressure. The specific definitions of the fourlevels were:

Normotensive untreated:SBP <140mmHg and DBP <90mmHg andnot taking medicine. prescribed for highblood pressure.

Hypertensive controlled:SBP <140mmHg and DBP <90mmHg andtaking medicine prescribed for high bloodpressure.

Hypertensive uncontrolled:SBP ≥140mmHg or DBP ≥90mmHg andtaking medicine prescribed for high bloodpressure.

Hypertensive untreated:SBP≥140mmHg or DBP ≥90mmHg and nottaking medicine prescribed for highbloodpressure.

These four categories were labelled in theprevious reports as follows: normotensiveuntreated, normotensive treated,hypertensive treated, hypertensiveuntreated.

b Results are not shown because of smallbases.

c Comparative data for the generalpopulation are not available on this topicfrom the 2004 survey, so data have beentaken from the 2003 survey, which wasweighted for non-response. The 2004survey is weighted for differential selectionprobabilities and non-response.


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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 2004, 1999

Systolic blood Age grouppressure (mmHg)

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Black Caribbean

2004

Mean [126.3] 132.0 141.8 133.3 113.1 121.1 140.2 123.0


1999

Mean 125.4 129.6 143.7 133.0 118.0 125.2 143.0 126.6


Indian

2004

Mean 119.8 127.6 136.8 127.3 108.8 119.3 138.3 119.2


1999

Mean 125.3 130.4 141.8 130.8 114.7 122.2 146.5 123.8


Pakistani

2004

Mean 122.1 123.9 c 124.2 110.6 117.9 c 117.1


1999

Mean 122.9 126.8 [142.0] 127.0 115.1 123.8 [148.9] 120.8


Bangladeshi

2004

Mean [117.9] [120.5] c 121.0 109.3 [122.6] c 116.4

Standard error of the mean [2.34] [1.64] c 1.36 1.30 [3.45] c 1.73

1999

Mean 118.8 122.6 135.4 124.0 112.6 125.1 [134.2] 118.2


Chinese

2004

Mean 123.9 124.3 c 125.2 108.8 114.8 c 115.1


1999

Mean 124.3 125.4 [138.6] 127.7 113.5 122.4 [145.2] 122.8


Irish

2004

Mean [128.3] 127.0 138.6 131.5 110.6 119.7 137.7 124.6


1999

Mean 127.2 129.3 141.7 132.5 117.3 122.7 144.1 127.6


General population

2003d

Mean 113.8 120.6 140.0 125.9 113.8 120.6 140.0 125.9


1998e

Mean 126.9 130.6 141.8 133.4 118.4 125.0 143.0 129.5


Continued…

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.


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


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Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Bases (weighted)

Black Caribbean 2004 59 53 57 169 78 113 58 249

Black Caribbean 1999 83 45 73 201 106 118 66 291

Indian 2004 117 156 89 361 151 209 82 442

Indian 1999 140 170 77 388 154 172 73 400

Pakistani 2004 79 58 22 159 102 77 28 207

Pakistani 1999 94 72 26 192 123 67 18 209

Bangladeshi 2004 25 22 6 53 48 28 8 83

Bangladeshi 1999 26 16 14 56 40 17 7 64

Chinese 2004 33 19 11 63 24 35 7 66

Chinese 1999 17 27 11 56 19 43 9 70

Irish 2004 119 301 247 667 194 377 352 923

Irish 1999 232 465 292 988 357 612 404 1373


General population (1998)e e e e e e e e e

Bases (unweighted)

Black Caribbean 2004 43 59 53 155 70 114 59 243

Black Caribbean 1999 117 65 105 287 160 176 96 432

Indian 2004 77 119 69 265 103 151 66 320

Indian 1999 142 179 80 401 160 183 75 418

Pakistani 2004 79 57 26 162 101 77 29 508

Pakistani 1999 152 125 42 319 213 118 31 362

Bangladeshi 2004 41 45 13 99 83 47 14 144

Bangladeshi 1999 105 58 51 214 162 74 23 259

Chinese 2004 73 54 26 153 59 88 19 166

Chinese 1999 55 80 38 173 59 130 30 219

Irish 2004 48 105 87 240 68 130 130 328

Irish 1999 74 154 110 338 118 199 143 460


General population (1998)e 1578 1962 1861 5401 1834 2354 2295 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




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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 2004, 1999

Diastolic blood Age grouppressure (mmHg)

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Black Caribbean

2004

Mean [70.2] 78.6 75.7 74.7 68.0 75.7 77.4 73.7


1999

Mean 67.8 76.1 80.7 74.3 67.3 74.6 77.1 72.5


Indian

2004

Mean 70.9 78.5 75.1 75.2 69.7 75.4 76.4 73.7


1999

Mean 70.6 79.7 80.0 76.5 68.5 73.3 76.6 72.1


Pakistani

2004

Mean 71.0 76.7 c 73.8 70.3 75.5 c 73.2


1999

Mean 68.0 77.1 [77.5] 72.7 67.4 72.2 [78.9] 69.9


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


Chinese

2004

Mean 71.4 78.1 c 74.1 67.7 71.0 c 70.0


1999

Mean 69.5 77.6 [77.4] 75.0 67.6 71.9 [78.8] 71.6


Irish

2004

Mean [70.3] 73.8 76.0 73.9 69.5 73.7 74.6 73.2


1999

Mean 70.1 77.1 77.4 75.5 68.4 72.6 74.9 72.2


General population

2003d

Mean 68.7 77.5 75.8 74.3 69.5 74.4 74.9 73.2


1998e

Mean 69.1 77.2 78.8 75.4 68.5 72.9 75.4 72.5


Continued…

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.


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.



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Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Bases (weighted)

Black Caribbean 2004 59 53 57 169 78 113 58 249

Black Caribbean 1999 83 45 73 201 106 118 66 291

Indian 2004 117 156 89 361 151 209 82 442

Indian 1999 140 170 77 388 154 172 73 400

Pakistani 2004 79 58 22 159 102 77 28 207

Pakistani 1999 94 72 26 192 123 67 18 209

Bangladeshi 2004 25 22 6 53 48 28 8 83

Bangladeshi 1999 26 16 14 56 40 17 7 64

Chinese 2004 33 19 11 63 24 35 7 66

Chinese 1999 17 27 11 56 19 43 9 70

Irish 2004 119 301 247 667 194 377 352 923

Irish 1999 232 465 292 988 357 612 404 1373


General population (1998)e e e e e e e e e

Bases (unweighted)

Black Caribbean 2004 43 59 53 155 70 114 59 243

Black Caribbean 1999 117 65 105 287 160 176 96 432

Indian 2004 77 119 69 265 103 151 66 320

Indian 1999 142 179 80 401 160 183 75 418

Pakistani 2004 79 57 26 162 101 77 29 508

Pakistani 1999 152 125 42 319 213 118 31 362

Bangladeshi 2004 41 45 13 99 83 47 14 144

Bangladeshi 1999 105 58 51 214 162 74 23 259

Chinese 2004 73 54 26 153 59 88 19 166

Chinese 1999 55 80 38 173 59 130 30 219

Irish 2004 48 105 87 240 68 130 130 328

Irish 1999 74 154 110 338 118 199 143 460



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




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Table 7.15

Comparison of blood pressure levels in 2004 and 1999a, by age withinminority ethnic groupb and sex


Blood pressure Age grouplevels

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

2004

Normotensive untreatedc [89] 69 27 62 91 77 20 68

Hypertensive controlledc [1] 1 26 10 - 4 32 9

Hypertensive uncontrolledc [-] 4 27 10 1 4 32 10

Hypertensive untreatedc [11] 26 20 19 8 15 16 13


1999

Normotensive untreated 89 78 29 65 96 80 33 75

Hypertensive controlled 1 3 14 6 1 8 19 8

Hypertensive uncontrolled - 5 20 8 - 5 23 7

Hypertensive untreated 10 14 36 21 3 7 26 10


Indian

2004

Normotensive untreatedc 90 69 35 67 97 88 41 82

Hypertensive controlledc 1 13 23 11 - 2 18 4

Hypertensive uncontrolledc - 4 17 6 1 3 20 6



1999


Hypertensive controlled - 4 10 4 - 4 5 3

Hypertensive uncontrolled 1 7 17 7 - 4 16 5



Pakistani

2004

Normotensive untreatedc 94 79 d 80 96 87 d 85

Hypertensive controlledc - 4 d 6 - 4 d 4

Hypertensive uncontrolledc - 1 d 2 - 6 d 5

Hypertensive untreatedc 6 15 d 11 4 3 d 5

All with hypertension 6 21 d 20 4 13 d 15

1999

Normotensive untreated 93 83 [38] 82 96 86 [22] 87

Hypertensive controlled - 2 [7] 2 1 2 [15] 2

Hypertensive uncontrolled - 4 [15] 3 - 3 [14] 2

Hypertensive untreated 7 12 [41] 13 3 9 [50] 9

All with hypertension 7 17 [63] 18 4 14 [78] 13

Bangladeshi

2004

Normotensive untreatedc [93] 78 d 84 98 [66] d 81

Hypertensive controlledc [ - ] 7 d 3 - [14] d 6

Hypertensive uncontrolledc [ - ] 11 d 6 - [9] d 5

Hypertensive untreatedc [7] 5 d 7 2 [11] d 7

All with hypertension [7] 22 d 16 2 [35] d 19

1999

Normotensive untreated 96 81 64 84 100 81 d 90

Hypertensive controlled 3 7 5 5 - 3 d 2

Hypertensive uncontrolled - 3 5 2 - 7 d 2

Hypertensive untreated 1 9 26 9 - 9 d 6

All with hypertension 4 19 36 16 - 19 d 10

a To allow for comparison with 2004and 2003, Dinamap values weretranslated into Omron for 1998 and1999 data.

b Black Africans were included in the2004 survey but not in the 1999, soare therefore excluded from thiscomparative table.

c Informants were consideredhypertensive if their systolic bloodpressure was 140 mmHg or over ortheir diastolic blood pressure was90mmHg or over or they were takingmedicine prescribed for high bloodpressure. The specific definitions ofthe four levels were:

Normotensive untreated:SBP <140mmHg and DBP <90mmHgand not taking medicine prescribedfor high blood pressure.

Hypertensive controlled:SBP <140mmHg and DBP <90mmHgand taking medicine prescribed forhigh blood pressure.

Hypertensive uncontrolled:SBP ≥140mmHg or DBP ≥90mmHgand taking medicine prescribed forhigh blood pressure.

Hypertensive untreated:SBP ≥140mmHg or DBP ≥90mmHgand not taking medicine prescribedfor high blood pressure.

These four categories were labelled inthe previous reports as follows:normotensive untreated,normotensive treated, hypertensivetreated, hypertensive untreated.

d Results are not shown because ofsmall bases.

e Comparative data for the generalpopulation are not available on thistopic from the 2004 survey, so datahave been taken from the 2003 surveywhich was weighted for non-response. The 2004 survey isweighted for differential selectionprobabilities and non-response.

f Comparative data for the generalpopulation are not available on thistopic from the 1999 survey, so datahave been taken from the 1998survey, in which no weighting wasinvolved.

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Blood pressure Age grouplevels

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % 5 % % % % %

Chinese

2004

Normotensive untreatedc 94 72 d 80 100 86 d 84

Hypertensive controlledc - 5 d 4 - 6 d 6

Hypertensive uncontrolledc - 5 d 5 - 1 d 3

Hypertensive untreatedc 6 18 d 11 - 8 d 7

All with hypertension 6 28 d 20 - 14 d 16

1999

Normotensive untreated 95 84 [45] 79 100 83 [30] 81

Hypertensive controlled - 2 [7] 2 - 4 [12] 4

Hypertensive uncontrolled - - [18] 4 - 2 [13] 3

Hypertensive untreated 5 14 [31] 15 - 11 [46] 12

All with hypertension 5 16 [56] 21 - 17 [71] 19

Irish

2004

Normotensive untreatedc [85] 78 36 64 98 86 41 71

Hypertensive controlledc [-] 3 14 7 - 0 11 4

Hypertensive uncontrolledc [2] 3 13 7 - 2 21 9

Hypertensive untreatedc [13] 16 37 23 2 12 27 15


1999


Hypertensive controlledc - 1 5 2 - 3 8 4

Hypertensive uncontrolledc 1 3 15 6 - 2 15 5

Hypertensive untreatedc 11 20 41 24 - 9 37 15

All with hypertension 12 24 60 32 - 15 60 24

General population

2003e


Hypertensive controlledc 0 3 12 5 0 3 13 6

Hypertensive uncontrolledc 0 3 16 6 0 2 19 8



1998f


Hypertensive controlled 0 3 7 3 0 2 8 4

Hypertensive uncontrolled 0 2 13 5 0 2 17 7



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Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Bases (weighted)

Black Caribbean 2004 59 53 57 169 78 113 58 249

Black Caribbean 1999 83 45 73 201 106 118 66 291

Indian 2004 117 156 89 361 151 209 82 442

Indian 1999 140 170 77 388 154 172 73 400

Pakistani 2004 79 58 22 159 102 77 28 207

Pakistani 1999 94 72 26 192 123 67 18 208

Bangladeshi 2004 25 22 6 53 48 28 8 83

Bangladeshi 1999 26 16 14 56 40 17 7 63

Chinese 2004 33 19 11 63 24 35 7 66

Chinese 1999 17 27 11 56 19 43 9 70

Irish 2004 119 301 247 667 194 377 352 923

Irish 1999 234 465 292 990 357 612 404 1373


General population (1998)f f f f f f f f f

Bases (unweighted)

Black Caribbean 2004 43 59 53 155 70 114 59 243

Black Caribbean 1999 117 65 105 287 160 176 96 432

Indian 2004 77 119 69 265 103 151 66 320

Indian 1999 142 179 80 401 160 183 75 418

Pakistani 2004 79 57 26 162 101 77 29 508

Pakistani 1999 152 125 42 319 212 118 31 361

Bangladeshi 2004 41 45 13 99 83 47 14 144

Bangladeshi 1999 105 58 51 214 161 74 23 258

Chinese 2004 73 54 26 153 59 88 19 166

Chinese 1999 55 80 38 173 59 130 30 219

Irish 2004 48 105 87 240 68 130 130 328

Irish 1999 75 154 110 339 118 199 143 460


General population (1998)f 1578 1962 1861 5401 1834 2354 2295 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, 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 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.

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HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 8: PHYSICAL ACTIVITY 237

Physical activity

Emmanuel Stamatakis

● In the general population, over a third of men (37%) and a quarter of women (25%) metthe current physical activity recommendations. As in 1999, Asian (Indian, Pakistani,Bangladeshi and Chinese) men and women had lower age-standardised risk ratios ofmeeting the physical activity recommendations than the general population. 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.

● 79% of men and 75% of women in the general population took part in some physicalactivity for at least 30 continuous minutes in the four weeks prior to interview. Inagreement with the patterns observed in 1999, age-adjusted participation in anyphysical activity of at least moderate intensity was lower in most minority ethnicgroups than the general population (ranging from 0.58 in Bangladeshi men, to 0.95 inBlack Caribbean men, and from 0.45 in Bangladeshi women to 0.93 in Black Africanwomen).

● 32% of men and 27% of women in the general population reported brisk walking forat least 30 minutes in the four weeks prior to interview. All Black and Asian minorityethnic groups had lower age-adjusted participation in walking than the generalpopulation. Among Asian informants, age-standardised ratios ranged from 0.38 inPakistani men to 0.57 in Indian and Chinese men, and from 0.21 in Bangladeshiwomen to 0.60 in Indian women.

● 41% of men and 34% of women in the general population had participated in sportsand exercise in the four weeks prior to interview. Indian, Pakistani, Bangladeshi andBlack African men and women had lower age-standardised risk ratios of participationin sports and exercise than men and women in the general population (age-standardised 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 inthe general population and most minority ethnic groups. Exceptions were BlackAfrican, Indian and Chinese women, whose participation in any activities remainedrelatively stable up to age 54 (or even increased).

● Participation in any activity at least once a week on average increased by 4percentage points (p.p.) for men and women in the general population (from 64% to68% in men, and from 57% to 61% in women) between 1999 and 2004. Increaseswere also observed among Bangladeshi and Chinese men (increases of 6 and 10 p.p.,respectively). In contrast, a notable reduction in regular physical activity participationwas found among Pakistani men (7 p.p.)

● Overall increases in activity among the general population were accompanied by anincrease (4 p.p. for both men and women) in the percentage meeting the activityrecommendations between 1999 and 2004. Notable increases were also observedamong Chinese men (increase of 7 p.p.) and Indian women (increase of 6 p.p.).

8Summary

8.1 Introduction

Physical inactivity is associated with increased risk of many chronic conditions, mostnotably cardiovascular disease, obesity, type 2 diabetes, some types of cancers, andosteoporosis.1,2 Adults who are physically active have 20-30% reduced risk of prematuredeath, and up to 50% reduced risk of developing major chronic diseases.2 Beyond its role inthe development of obesity, physical inactivity and associated poor cardio-respiratoryfitness pose direct health risks. For example, lean unfit men may have higher risk ofcardiovascular disease and death than obese fit men.3,4 It has been estimated that 37% ofcoronary heart disease in the UK is attributable to physical inactivity.5 The World HealthOrganisation rated physical inactivity as one of the leading causes of death in developedcountries, and estimated that it is responsible for 22-23% of coronary heart disease, 16-17% of colon cancer, 15% of diabetes, 12-13% of stroke and 11% of breast cancer.6 Interms 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 NationalHealth Service.1 It is not, therefore, surprising that promoting physical activity has beendescribed as ‘public health’s best buy’.7 The 2005 public health document Physical ActivityPlan8 specified the action that needs to be taken at national, regional and local level toimprove people’s health through increasing physical activity.

Physical activity recommendations for optimal health have been available since the mid tolate 1970s.9 The current guidelines for adults are that they should take part in at least 30minutes of moderate activity on a regular basis (at least five days a week).2 The latestguidance is that this 30 minutes can be achieved through bouts of activity of 10 minutes ormore. However, the physical activity questions included in HSE 2004 were the same asthose used in 1999 (in order to enable comparison between the two years), and thesequestions asked only about sessions of at least 30 minutes duration (15 minutes for sportsand exercise). Consequently, these findings may slightly underestimate the proportion ofthe population who meet the current recommendations (through shorter bouts of activity).

Self-reported physical activity measures are subject to recall limitations, social desirabilitybias and lack of objectivity. Despite these limitations, questionnaires are the most practicaland cost-effective way of measuring physical activity in large-scale epidemiologicalresearch. Questions relating to the physical activity of adults (aged 16 and over) have beenincluded in the Health Survey since its inception in 1991. The Health Survey questions foradults were originally based on a major national study of activity carried out in 1990, theAllied Dunbar National Fitness Survey.10 The physical activity module was repeated in HSE1991-1994 with minor changes, and received more substantial revisions in 1997. A shorterversion of the questionnaire was first introduced in 1999 when the focus was minority ethnicgroups; the shorter questionnaire was repeated in the 2002, 2003 and 2004 surveys.

This chapter focuses on participation in physical activity among minority ethnic groups andreports on the proportion of people achieving the recommended guidelines. In this chapterthe term ‘Asian’ refers to the Indian, Pakistani, Bangladeshi and Chinese groups, while theterm ‘South Asian’ refers to the Indian, Pakistani and Bangladeshi groups.

8.2 Methods

8.2.1 The physical activity questionnaire

Adults’ physical activity in the four weeks prior to interview was measured by examiningoverall participation in any activity, frequency of participation in activities that lasted at least30 minutes (15 minutes for sports and exercise), and type of activity. Information on thespecific duration of activities was collected for sports and exercise only, while a questionrelated to intensity was asked for sports and exercise and walking only. There was a singlequestion relating to occupational activity levels: ‘Thinking about your job in general wouldyou 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

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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 30minutes or more. The lead-in question was: ‘Have you done any housework (orgardening/ DIY/building - in a separate question) in the last four weeks?‘ Informants wereshown a card with a list of examples of housework (or gardening/DIY/building) and wereasked 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 thegardening/DIY/building category). Frequency of heavy housework (or heavygardening/DIY/building) was assessed by showing another card with higher intensityactivities, such as carrying heavy shopping and moving furniture (or digging andbricklaying for the gardening/DIY/building category) and asking informants: ‘During thepast four weeks on how many days have you done this kind of (heavy housework orheavy gardening/DIY/building activities) for at least 30 minutes a time?’ Frequency ofnon-heavy home activity (i.e. those activities listed in the first set of show cards) was notassessed.

● Walks of 30 minutes or more. The key question was: ‘During the past four weeks, on howmany days did you do a walk of least 30 minutes?’ Walking intensity was assessed byasking 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 exerciseactivities in the four weeks prior to interview, informants were asked: ‘Can you tell me onhow many separate days did you do (name of specific sport and exercise activity) for atleast 15 minutes at a time during the past four weeks…?’, followed by a question aboutthe activity’s usual duration on these days. The intensity of these activities was assessedby asking informants whether or not the activity had made them ‘out of breath orsweaty’. For comparability with the other activity types (where the minimum was set at30 minutes) the lower duration limit for sport and exercise activities, at the analysisstage, 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 moderateintensity.

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 oftypes of housework/gardening /DIY that counted as ‘heavy’ and ‘light’. Heavy houseworkand heavy gardening/DIY were classified as ‘moderate’, other gardening/DIY as ‘light’, andlight housework only as ‘inactive’.11

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 tomake 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 30minutes in the four weeks prior to interview, and each component of physical activity, byminority ethnic group and sex. Physical activity is expressed as any participation for at

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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 tovigorous intensity is included in these measures.

Any physical activities

79% of men and 75% of women in the general population took part in some physicalactivity for at least 30 continuous minutes in the four weeks prior to interview. Amongminority ethnic groups, participation rates ranged from 54% among Bangladeshi men to78% among Irish men, and from 41% among Bangladeshi women to 81% among Irishwomen.

Two thirds of men in the general population reported regular participation in any physicalactivity (at least once a week on average). Regular participation was also reported by abouttwo 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 andBangladeshi men, and about six in ten Indian and Chinese men.

Six in ten women in the general population participated regularly in physical activity. Amongminority ethnic groups regular participation ranged from around a third of Bangladeshiwomen to two thirds of Irish women. Irish women had higher rates, while Indian, PakistaniBangladeshi and Chinese women had lower regular participation rates, than women in thegeneral population.

Age-standardised risk ratios are used to take into account the differences in the age profileof different minority ethnic groups (see chapter 1). As Figure 8A shows, the pattern ofparticipation in any physical activity (in the form of age-standardised ratios) was almostidentical between men and women. Black African (0.88) and Asian (0.85 for Indian, 0.58 forBangladeshi, 0.67 for Pakistani and 0.90 for Chinese) men had lower age-adjusted riskratios than men in the general population. Among women, Black African (0.81), BlackCaribbean (0.93) and Asian (0.83 for Indian, 0.45 for Bangladeshi, 0.70 for Pakistani, 0.80for Chinese) women had lower age-adjusted risk ratios than women in the generalpopulation. This lower age-standardised activity rate among Asian minority ethnic groupsconfirms the pattern found in 1999. Table 8.1, Figure 8A

Home activity

38% of men and 55% of women in the general population participated in heavy houseworkin 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


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Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

Age-standardised ratios for participation in any physical activity, by minority ethnic group

Men Women

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Figure 8A

2.0

0.5


0.1

1.0

10.0

Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

2.0

0.5

0.1

1.0

10.0

women, rates ranged from around a third of Bangladeshi women to about half of BlackCaribbean, 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 menparticipated in heavy housework compared with men in the general population (ratios of0.48 and 0.44, respectively). There were no other significant differences among men.Among women, with the exception of Irish informants who had higher age-standardisedrisk ratios than the general population, all other minority ethnic groups had lower age-adjusted 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 8.129% of men and 11% of women in the general population carried out heavygardening/DIY/building in the four weeks prior to interview. Among men, rates were under20% in each minority ethnic group with the exception of Irish men (24%). With theexception of Black Caribbean (10%) and Irish (10%) women, all other minority ethnicgroups had lower participation rates (range 4-6%) than women in the general population.

Table 8.1As with the observed results, all minority ethnic groups, except Irish men, had significantlylower age-standardised risk ratios of participation in heavy gardening/DIY/building thanmen 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 (Indianmen). With the exception of Black Caribbean women, all other minority ethnic groups hadsignificantly lower age-standardised risk ratios of participation in heavy gardening/DIY/building than women in the general population. Age-standardised risk ratios ofparticipation in heavy gardening/DIY/building were markedly lower in Asian groups (range0.31 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 tointerview was reported by 32% of men and 27% of women of the general population. Withthe exception of Irish men and women (32% and 33% respectively), minority ethnic groupshad lower participation rates (range 14-27% in men and 8-24% in women) than the generalpopulation. South Asian (Indian, Bangladeshi and Pakistani) men and women had thelowest walking rates (consistently under 20%). Table 8.1

As with the observed results, all minority ethnic groups, with the exception of Irish men andwomen, had significantly lower age-standardised risk ratios of participation in walking (forat least 30 continuous minutes) than general population men and women. The age-standardised ratio for participation in walking was lowest among Asian men (ratios rangedfrom 0.38 in Pakistani men to 0.57 in Indian and Chinese men) and women (range from 0.21in Bangladeshi to 0.60 in Indian women). Table 8.1, Figure 8B

Sports and exercise

Participation in sports and exercise in the four weeks prior to interview was reported by41% of men and 34% of women in the general population. Chinese men (49%) were morelikely 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. Sportsand exercise participation among Black Caribbean and Chinese women was comparable tothat of women in the general population (between 34 and 36%) while Irish women hadhigher participation rates. Lower than the general population participation rates in sportsand exercise were reported by Bangladeshi (12%), Pakistani (16%), Indian (27%) and BlackAfrican (28%) women . Table 8.1

South Asian and Black African men had lower age-standardised risk ratios of participationin sports and exercise (for at least 30 continuous minutes) than men in the generalpopulation. Age-adjusted risk ratios ranged from 0.46 in Bangladeshi men to 0.83 in BlackAfrican men. After age standardisation, risk ratios among Chinese men were no longersignificantly different from the general population. Among women, as with the observedresults, age-standardised sports and exercise risk ratios were lower in South Asian and


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Black African informants than women in the general population. The lowest standardisedrate was found among Bangladeshi women (a ratio of 0.24) followed by Pakistani (0.35) andBlack African (0.64) women. Table 8.1, Figure 8C

8.3.2 Summary activity levels by minority ethnic group

Summary measure

The summary measure of physical activity levels classifies informants according to currentphysical activity guidelines (which are that adults should take part in activity of at leastmoderate intensity for 30 minutes or more, on five or more days per week). For this analysisit was assumed that activity sessions were done on different days. The measure aims toincorporate the basic dimensions of the informant’s overall activity level (frequency,intensity and duration). However, the summary variable may underestimate overall activitylevels, as the questionnaire only collected information on bouts of activity that lasted 30minutes 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


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Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

Age-standardised ratios for participation in brisk walking, by minority ethnic group

Men Women

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Figure 8B

2.0

0.5


0.1

1.0

10.0

Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

2.0

0.5

0.1

1.0

10.0

Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

Age-standardised ratios for participation in sports and exercise, by minority ethnic group

Men Women

Ris

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Figure 8C

2.0

0.5


0.1

1.0

10.0

Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

2.0

0.5

0.1

1.0

10.0

active in their work are counted as having done 20 days’ activity in the four weeks prior tointerview, 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 30minutes’ 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 30minutes’ duration in the four weeks prior to interview (at least five days a week). It isnoted that the term ‘high’ is relative in this context and corresponds to the minimumactivity level required to acquire some general health benefits (e.g. reduction in therelative risk for cardiovascular morbidity). However, it does not necessarily indicate theextent 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, definedas meeting the current physical activity recommendations. Among minority ethnic groups,Irish (39%) and Black Caribbean (37%) men had the highest observed rates of adherenceto the recommendations. Among women, Black Caribbean, Black African and Irishinformants had the highest rates (31%, 29% and 29%, respectively). Only 11% ofBangladeshi and 14% of Pakistani women did the recommended amounts of physicalactivity in the four weeks prior to interview.

As in 1999, Asian men and women had lower age-standardised ratios for meeting thephysical activity recommendations than general population men and women. AmongAsians, age-standardised risk ratios ranged from 0.58 in Bangladeshi men to 0.75 in Indianmen, and from 0.32 in Bangladeshi women to 0.81 in Indian women. Table 8.2, Figure 8D

Prevalence of low activity

Table 8.2 also shows the observed proportions of men and women who had low activitylevels, defined as participation in less than one 30-minute moderate or vigorous activitysession a week on average. 32% of men and 39% of women in the general population hadlow activity levels. The highest prevalence of low activity levels was observed amongBangladeshi and Pakistani men (both 51%), and Bangladeshi (68%) and Pakistani (52%)women. Table 8.2


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Black African

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Pakistani

Bangladeshi

IrishChinese

Age-standardised ratios for meeting the physical activity recommendations, by minority ethnic group

Men Women

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Figure 8D

2.0

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0.1

1.0

10.0

Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

2.0

0.5

0.1

1.0

10.0

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) inany activities, and each activity type, by age, minority ethnic group and sex.


Overall participation in any activities decreased with age among men in the generalpopulation and most minority ethnic groups. Among general population women,participation was relatively stable in informants aged 16-24 and 35-54. The same was truefor Black African, Black Caribbean, Indian and Chinese women, whose participation in anyactivities 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 andwomen aged 35-54 in the general population and the majority of minority ethnic groups.

Table 8.3Walking

Walking continuously for at least 30 minutes, on one or more occasion in the four weeksprior to interview, declined with age in the general population, from 42% among men aged16-34 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 allminority ethnic groups for men and for most minority ethnic groups for women. Markedlylow walking rates were recorded among Asian women aged 55 and over (range 0-6%).

Table 8.3Sports and exercise

There was a consistent decline in participation in sports and exercise with increasing ageacross all minority ethnic groups and in the general population. Rates in the generalpopulation fell from 63% in men aged 16-34 to 18% in men aged 55 and over, and from49% 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 whomet the activity recommendations) decreased with age from 51% in men aged 16-34, to39% among those aged 35-54, and 22% in men aged 55 and over. Among minority ethnicgroups, decreases with age were found among Black Caribbean, Pakistani and Irish men,while among Black African, Indian, Bangladeshi and Chinese men rates remained relativelyunchanged to the age of 35-54. In women, rates of adherence to the guidelines tended toremain relatively stable between age groups 16-34 and 35-54, and then to decrease. Theexception to this was Bangladeshi women, whose rates decreased from 15% in those aged16-34, to 7% among those aged 35-54, and 2% among those aged 55 and over.

Table 8.4The prevalence of low activity levels (defined as participation in less than 30 minutes a weekin activity of at least moderate intensity) increased with age in most groups, except forwomen in the general population and Black African and Chinese women, whose ratesstayed relatively unchanged up to age 54. The prevalence of low activity was markedly highamong older (aged 55 and over) South Asian men (at least 68%) and women (at least 74%).

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 thenumber of persons in the household. An equivalised household income tertile is 1/3 of theequivalised household income distribution of the general population, e.g. the top tertilerefers 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 menand women in the general population as shown in Table 8.5. 87% of men in the highestincome tertile had taken part in physical activity, decreasing to 63% among men in thelowest tertile. Similarly, 86% of women in the highest income tertile in the general


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HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 8: PHYSICAL ACTIVITY 245

population had taken part in physical activity, compared with 64% among women in thelowest tertile. Reductions in physical activity participation rates with decreasing incomewere observed across most minority ethnic groups.

Table 8.5 also shows participation in any physical activity in the form of age-standardisedratios. South Asian men in the middle and lowest income tertiles had significantly lowerage-standardised risk ratios of participation in any physical activity than the generalpopulation as a whole. The same pattern of age-standardised ratios with equivalisedincome 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 meetingthe physical activity recommendations, by equivalised household income tertile. There wasa decrease in the observed proportion of men and women meeting the recommendationswith decreasing household income, in the general population and most minority ethnicgroups.

Table 8.6 also shows the age-standardised risk ratios for the proportions of men andwomen meeting the physical activity recommendations, by equivalised household incomeand minority ethnic group. South Asian men in the middle and bottom income tertiles wereless likely to meet the physical activity recommendations than men, overall, in the generalpopulation (age-standardised risk ratios ranged from 0.49 among Bangladeshi men in themiddle tertile to 0.58 in Indian and Bangladeshi men in the lowest tertiles). The samepattern was found in Bangladeshi and Pakistani women in the middle and bottom incometertiles, 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 aweek on average) in any physical activity in 1999 and 2004 by age and minority ethnicgroup.

Regular participation rates increased by 4 percentage points (p.p.) for men and women inthe 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%), Chinesemen (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 Pakistanimen (decrease by 7 p.p., from 56% to 49%). Table 8.7

8.4.2 Comparison of the percentage meeting the physical activityrecommendations in 1999 and 2004

The increases in regular activity participation in the general population described in theprevious section, were accompanied by same size increases of 4 p.p. for both men (from33% to 37%) and women (from 21% to 25%) in the percentage meeting the activityrecommendations (participation in activity of at least moderate intensity on five or moredays per week, at least 30 minutes on each ocassion). Notable increases were recordedamong Chinese men (increase of 7 p.p., from 23% to 30%) and Indian women (increase of6 p.p., from 17% to 23%).

It should be noted that figures and bases for 1999 differ from the published figures (in the1999 report) due to changes in the analyses and weighting to make results comparablebetween the two years. Table 8.8, Figure 8E


1 Chakravarthy MV, Joyner MJ, Booth FW. An obligation for primary care physicians to prescribe physicalactivity 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 itsrelationship to health. Department of Health, London, 2004.

3 Lee CD, Blair SN, Jackson AS. Cardiorespiratory fitness, body composition, and all-cause andcardiovascular 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 andAmerican 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 riskfactors. 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 bathroomor any similar heavy manual work.

Examples of ‘heavy’ housework classified as moderate intensity:

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, minorhousehold 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, butotherwise coded as moderate intensity including: cycling, aerobics, keep fit, gymnastics, dance for fitness, weight training, football, rugby, swimming, tennis, badminton.


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Black

Caribbean

General

population

Indian

Pakistani

Bangladeshi

IrishChinese

Black

Caribbean

General

population

Indian

Pakistani

Bangladeshi

IrishChinese

Comparison of the percentage meeting the physical activity recommendations in 1999 and 2004, by ethnic group

Men Women

Per

cent

Figure 8E

0

5

10

15

20

25

30

35

40

45

0

5

10

15

20

25

30

35

40

45

19992004

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).

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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248 HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 8: PHYSICAL ACTIVITY

Tables

8.1 Participation in each activity type, by minorityethnic group and sex

8.2 Summary activity levels, by minority ethnicgroup and sex

8.3 Participation in each activity type, by age withinminority ethnic group and sex

8.4 Summary activity levels, by age within minorityethnic group and sex

8.5 Participation in any physical activity, byequivalised household income tertile withinminority ethnic group and sex

8.6 Percentage meeting physical activityrecommendations, by equivalised householdincome tertile within minority ethnic group andsex

8.7 Comparison of regular participation in anyphysical activity in 2004 and 1999, by agewithin minority ethnic group and sex

8.8 Comparison of the proportion meeting thephysical activity recommendations in 2004 and1999, by age within minority ethnic group andsex


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Table 8.1

Participation in each activity type, by minority ethnic group and sex


Participation in moderate or Minority ethnic group Generalvigorous activity in the four populationweeks prior to interview Black Black


Men

Observed %Heavy housework

Anya 42 34 35 20 19 34 38 38

At least once a weekb 22 18 14 7 10 16 20 17

Heavy gardening/DIY/building

Anya 18 9 15 10 5 10 24 29


Walking

Anya 24 27 19 14 17 21 32 32


Sports and exercise

Anya 46 43 32 31 26 49 39 41



Anya 74 75 68 58 54 76 78 79


Standardised risk ratiosHeavy housework

Anya 1.11 0.89 0.90 0.48 0.44 0.89 1.04 1


At least once a weekb 1.29 1.09 0.81 0.40 0.54 0.98 1.29 1



Anya 0.58 0.31 0.50 0.32 0.22 0.37 0.90 1




Walking

Anya 0.77 0.77 0.57 0.38 0.44 0.57 1.08 1




Sports and exercise

Anya 1.10 0.83 0.73 0.63 0.46 0.99 1.02 1





Anya 0.95 0.88 0.85 0.67 0.58 0.90 1.01 1




Bases (weighted) 477 373 901 420 177 151 1776 46089

Bases (unweighted) 409 386 549 429 408 348 497 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…


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Participation in moderate or Minority ethnic group Generalvigorous activity in the four populationweeks prior to interview Black Black


Women

Observed %Heavy housework

Anya 50 47 48 49 32 42 63 55



Anya 10 4 6 4 4 4 9 11


Walking

Anya 24 22 18 12 8 17 33 27


Sports and exercise

Anya 36 28 27 16 12 34 38 34



Anya 73 70 68 60 41 67 81 75


Standardised risk ratiosHeavy housework

Anya 0.90 0.75 0.81 0.81 0.50 0.70 1.11 1





Anya 0.87 0.30 0.51 0.40 0.31 0.38 0.71 1




Walking

Anya 0.77 0.65 0.60 0.34 0.21 0.52 1.12 1




Sports and exercise

Anya 0.96 0.64 0.67 0.35 0.24 0.85 1.05 1





Anya 0.93 0.81 0.83 0.70 0.45 0.80 1.04 1




Bases (weighted) 673 472 1067 499 207 163 2369 48643


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.


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Table 8.2

Summary activity levels, by minority ethnic group and sex


Summary activity Minority ethnic group Generallevelsa,b population


MenObserved %

Low levels 34 35 44 51 51 38 33 32

High levels 37 35 30 28 26 30 39 37


High levels 1.03 0.84 0.75 0.64 0.58 0.74 1.05 1


WomenObserved %

Low levels 39 43 45 52 68 47 33 39

High levels 31 29 23 14 11 17 29 25


High levels 1.17 1.03 0.81 0.46 0.32 0.59 1.08 1


Bases (weighted)

Men 477 373 901 420 177 151 1776 46089

Women 673 472 1067 499 207 163 2369 48643

Bases (unweighted)

Men 409 386 549 429 408 348 497 2873

Women 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 five days a week). Low levels indicate inactivity defined as less than one 30-minute moderate or vigorous activity session a week.

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.


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Table 8.3

Participation in each activity type, by age within minority ethnic group and sex


Participation in moderate or Age groupvigorous activity in the four

Men Womenweeks prior to interview

All All16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

Heavy housework

Anya 41 50 32 42 57 56 32 50



Anya 9 28 12 18 7 14 7 10


Walking

Anya 37 25 10 24 26 28 12 24


Sports and exercise

Anya 68 55 11 46 51 35 16 36



Anya 88 85 46 74 81 78 53 73


Black African

Heavy housework

Anya 30 37 [42] 34 45 55 [21] 47

At least once a weekb 12 21 [28] 18 25 32 [16] 27


Anya 5 12 [11] 9 3 5 [4] 4


Walking

Anya 33 21 [23] 27 27 18 [13] 22


Sports and exercise

Anya 58 34 [12] 43 33 25 [6] 28



Anya 77 74 [67] 75 69 75 [42] 70


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.

Continued…


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Table 8.3 continued




All All16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Indian

Heavy housework

Anya 37 37 25 35 51 57 22 48



Anya 9 19 16 15 4 9 3 6


Walking

Anya 25 18 10 19 27 16 6 18


Sports and exercise

Anya 47 32 9 32 39 25 4 27



Anya 78 73 44 68 77 76 31 68


Pakistani

Heavy housework

Anya 21 25 5 20 52 50 31 49



Anya 9 12 5 10 2 6 7 4


Walking

Anya 18 12 5 14 15 9 2 12


Sports and exercise

Anya 43 27 4 31 20 12 4 16



Anya 69 60 20 58 68 58 34 60




Continued…


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Table 8.3 continued




All All16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Bangladeshi

Heavy housework

Anya 19 21 [10] 19 35 32 11 32

At least once a weekb 9 11 [7] 10 20 22 5 19


Anya 5 5 [4] 5 3 6 0 4


Walking

Anya 20 14 [12] 17 11 6 0 8


Sports and exercise

Anya 40 15 [2] 26 16 7 1 12



Anya 64 49 [25] 54 48 36 14 41


Chinese

Heavy housework

Anya 36 31 35 34 34 51 33 42



Anya 4 13 20 10 1 6 5 4


Walking

Anya 25 16 20 21 21 18 2 17


Sports and exercise

Anya 65 38 23 49 46 31 13 34



Anya 85 74 55 76 69 73 41 67




Continued…


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Table 8.3 continued




All All16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Irish

Heavy housework

Anya 41 46 29 38 69 64 59 63



Anya 29 27 19 24 8 12 6 9


Walking

Anya 48 38 16 32 35 38 26 33


Sports and exercise

Anya 64 45 17 39 51 41 26 38



Anya 93 87 59 78 91 84 70 81


General population

Heavy housework

Anya 38 41 35 38 55 64 45 55



Anya 23 35 28 29 8 15 10 11


Walking

Anya 42 33 20 32 34 32 17 27


Sports and exercise

Anya 63 42 18 41 49 39 17 34



Anya 90 84 63 79 84 85 58 75


Bases (weighted)

Black Caribbean 140 194 143 477 217 291 164 673

Black African 176 157 40 373 238 198 37 472

Indian 325 384 192 901 408 466 193 1067

Pakistani 205 151 64 420 276 161 62 499

Bangladeshi 91 65 21 177 135 51 21 207

Chinese 74 50 27 151 63 78 22 163

Irish 412 678 686 1776 497 1038 833 2369


Bases (unweighted)

Black Caribbean 120 164 125 409 198 289 161 648

Black African 177 170 39 386 234 190 43 467

Indian 200 231 118 549 240 275 119 634

Pakistani 222 142 65 429 279 164 65 508

Bangladeshi 210 150 48 408 309 118 50 477

Chinese 172 118 58 348 148 176 51 375

Irish 114 194 189 497 149 275 232 656


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.


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Table 8.4

Summary activity levels, by age within minority ethnic group and sex


Summary activity Age grouplevelsa

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

Low levels 17 22 66 34 28 37 57 39

High levels 49 39 22 37 37 36 17 31

Black African

Low levels 33 35 [45] 35 43 38 [69] 43

High levels 36 34 [33] 35 33 26 [21] 29

Indian

Low levels 35 40 68 44 35 40 79 45

High levels 34 33 18 30 26 26 11 23

Pakistani

Low levels 39 50 88 51 44 56 74 52

High levels 37 26 5 28 15 13 10 14

Bangladeshi

Low levels 42 57 [78] 51 62 71 92 68

High levels 29 27 [9] 26 15 7 2 11

Chinese

Low levels 30 43 50 38 45 42 67 47

High levels 31 28 31 30 16 19 15 17

Irish

Low levels 11 27 53 33 21 28 46 33

High levels 54 41 27 39 30 36 19 29

General population

Low levels 20 26 51 32 28 29 57 39

High levels 51 39 22 37 31 31 14 25

Bases (weighted)

Black Caribbean 140 194 143 477 217 291 164 673

Black African 176 157 40 373 238 198 37 472

Indian 325 384 192 901 408 466 193 1067

Pakistani 205 151 64 420 276 161 62 499

Bangladeshi 91 65 21 177 135 51 21 207

Chinese 74 50 27 151 63 78 22 163

Irish 412 678 686 1776 497 1038 833 2369


Bases (unweighted)

Black Caribbean 120 164 125 409 198 289 161 648

Black African 177 170 39 386 234 190 43 467

Indian 200 231 118 549 240 275 119 634

Pakistani 222 142 65 429 279 164 65 508

Bangladeshi 210 150 48 408 309 118 50 477

Chinese 172 118 58 348 148 176 51 375

Irish 114 194 189 497 149 275 232 656


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.


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Table 8.5

Participation in any physical activity, by equivalised householdincome tertile within minority ethnic group and sex


Participation in moderate or Equivalised household income tertilevigorous activity in the four


Highest Middle Lowest Highest Middle Lowest


Anya 90 72 67 84 72 73

At least once a weekb 83 68 55 75 60 57

Black African

Anya 78 74 70 79 66 64


Indian

Anya 81 67 45 72 68 62


Pakistani

Anya [75] 60 46 [74] 55 64

At least once a weekb [67] 49 38 [69] 43 47

Bangladeshi

Anya c 41 53 c 30 42

At least once a weekb c 41 47 c 28 32

Chinese

Anya 84 74 [63] 72 59 64

At least once a weekb 71 66 [50] 58 47 58

Irish

Anya 91 71 51 90 75 70


General population

Anya 87 74 63 86 69 64



Anya 1.08 0.98 0.86 1.04 0.92 0.91


Black African

Anya 0.91 0.93 0.85 0.93 0.80 0.77


Indian

Anya 0.96 0.81 0.61 0.84 0.84 0.82


Pakistani

Anya [0.97] 0.71 0.56 [0.86] 0.59 0.76


Bangladeshi

Anya c 0.46 0.60 c 0.34 0.46


Chinese

Anya 1.00 0.87 [0.79] 0.86 0.70 0.84


Irish

Anya 1.10 0.97 0.82 1.13 1.01 0.97


General population

Anya 1.06 0.98 0.82 1.07 0.95 0.88




c Results not shown because of small bases.


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Table 8.5 continued


Participation in moderate or Equivalised household income tertilevigorous activity in the four


Highest Middle Lowest Highest Middle Lowest

Bases (weighted)

Black Caribbean 152 115 105 156 188 179

Black African 111 89 90 123 114 150

Indian 263 241 150 305 287 203

Pakistani 55 117 136 56 134 168


Chinese 44 36 21 52 34 24

Irish 833 398 270 1040 568 347


Bases (unweighted)

Black Caribbean 123 89 95 149 163 178

Black African 103 105 94 102 122 149

Indian 158 155 97 179 173 126

Pakistani 47 112 154 46 135 176

Bangladeshi 19 89 170 23 101 190

Chinese 105 77 49 120 74 58

Irish 207 122 89 257 163 123




c Results not shown because of small bases.


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Table 8.6

Percentage meeting physical activity recommendations, by equivalisedhousehold income tertile within minority ethnic group and sex


Percentage meeting the Equivalised household income tertilephysical activity

Men Womenrecommendations

Highest Middle Lowest Highest Middle Lowest(high activity levels)

Observed %Black Caribbean 45 40 30 38 31 33

Black African 42 34 27 33 31 27

Indian 29 39 21 26 23 18

Pakistani [35] 29 21 [26] 13 13

Bangladeshi a 21 26 a 12 13

Chinese 31 29 [30] 13 15 21

Irish 45 35 23 29 31 23



Standardised risk ratio 1.16 1.14 0.83 1.38 1.12 1.18


Black African



Indian



Pakistani

Standardised risk ratio [0.92] 0.66 0.51 [1.11] 0.43 0.42


Bangladeshi

Standardised risk ratio a 0.49 0.58 a 0.32 0.41


Chinese

Standardised risk ratio 0.75 0.73 [0.67] 0.56 0.46 0.75


Irish



General population



Bases (weighted)

Black Caribbean 152 115 105 156 188 179

Black African 111 89 90 123 114 150

Indian 263 241 150 305 287 203

Pakistani 55 117 136 56 134 168


Chinese 44 36 21 52 34 24

Irish 833 398 270 1040 568 347


Bases (unweighted)

Black Caribbean 123 89 95 149 163 178

Black African 103 105 94 102 122 149

Indian 158 155 97 179 173 126

Pakistani 47 112 154 46 135 176

Bangladeshi 19 89 170 23 101 190

Chinese 105 77 49 120 74 58

Irish 207 122 89 257 163 123


a Results not shown because of small bases.


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Table 8.7

Comparison of regular participation in any physical activity in 2004 and1999, by age within minority ethnic groupa and sex


Regular paricipationb Age groupin moderate or vigorous

Men Womenvigorous activity in the

All Allfour weeks prior to

16-34 35-54 55+ men 16-34 35-54 55+ womeninterview

% % % % % % % %

Black Caribbean

2004 83 78 34 66 72 63 43 61

1999 83 73 43 66 66 70 41 61

Indian

2004 65 60 32 56 65 60 21 55

1999 70 62 33 59 61 55 22 51

Pakistani

2004 61 50 12 49 56 44 26 48

1999 67 50 27 56 55 53 15 51

Bangladeshi

2004 58 43 [22] 49 38 29 8 32

1999 57 38 15 43 41 27 8 35

Chinese

2004 70 57 50 62 55 58 33 53

1999 71 46 32 52 56 52 36 51

Irish

2004 89 73 47 67 79 72 54 67

1999 75 69 48 65 78 64 42 62

General population

2004 80 74 49 68 72 71 43 61

1999 81 69 43 64 68 65 38 57

Bases (weighted)

Black Caribbean 2004 140 194 143 477 217 291 164 673

Black Caribbean 1999 213 134 189 536 277 278 181 736

Indian 2004 325 384 192 901 408 466 193 1067

Indian 1999 223 257 129 609 262 266 113 641

Pakistani 2004 205 151 64 420 276 161 62 499

Pakistani 1999 324 203 80 606 374 196 51 622

Bangladeshi 2004 91 65 21 177 135 51 21 207

Bangladeshi 1999 266 141 109 516 355 129 56 539

Chinese 2004 74 50 27 151 63 78 22 163

Chinese 1999 107 134 62 303 109 193 53 355

Irish 2004 412 678 686 1776 497 1038 833 2369

Irish 1999 130 239 151 519 191 297 183 671



Bases (unweighted)

Black Caribbean 2004 120 164 125 409 198 289 161 648

Black Caribbean 1999 211 140 191 542 281 283 180 744

Indian 2004 200 231 118 549 240 275 119 634

Indian 1999 229 265 126 620 267 276 112 655

Pakistani 2004 222 142 65 429 279 164 65 508

Pakistani 1999 326 217 77 620 383 202 56 641

Bangladeshi 2004 210 150 48 408 309 118 50 477

Bangladeshi 1999 273 142 116 531 361 143 58 562

Chinese 2004 172 118 58 348 148 176 51 375

Chinese 1999 108 127 65 300 109 194 58 361

Irish 2004 114 194 189 497 149 275 232 656

Irish 1999 135 238 162 535 203 301 204 708



a Black Africans were included in the 2004 survey but not in 1999, and aretherefore 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.


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Table 8.8

Comparison of the proportion meeting the physical activity recommendationsa

in 2004 and 1999, by age within minority ethnic groupb and sex


Percentage meeting Age groupthe physical activity

Men Womenrecommendations

All All16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

2004 49 39 22 37 37 36 17 31

1999 54 44 20 39 27 38 14 28

Indian

2004 34 33 18 30 26 26 11 23

1999 34 38 22 33 18 23 2 17

Pakistani

2004 37 26 5 28 15 13 10 14

1999 33 28 15 29 17 18 6 16

Bangladeshi

2004 29 27 [9] 26 15 7 2 11

1999 31 26 7 25 13 7 1 10

Chinese

2004 31 28 31 30 16 19 15 17

1999 30 23 13 23 18 19 14 18

Irish

2004 54 41 27 39 30 36 19 29

1999 42 40 22 35 32 31 10 26

General population

2004 51 39 22 37 31 31 14 25

1999 48 36 18 33 26 27 11 21

Bases (weighted)

Black Caribbean 2004 140 194 143 477 217 291 164 673

Black Caribbean 1999 213 134 189 536 277 278 181 736

Indian 2004 325 384 192 901 408 466 193 1067

Indian 1999 223 257 129 609 262 266 113 641

Pakistani 2004 205 151 64 420 276 161 62 499

Pakistani 1999 324 203 80 606 374 196 51 622

Bangladeshi 2004 91 65 21 177 135 51 21 207

Bangladeshi 1999 266 141 109 516 355 129 56 539

Chinese 2004 74 50 27 151 63 78 22 163

Chinese 1999 107 134 62 303 109 193 53 355

Irish 2004 412 678 686 1776 497 1038 833 2369

Irish 1999 130 239 151 519 191 297 183 671



Bases (unweighted)

Black Caribbean 2004 120 164 125 409 198 289 161 648

Black Caribbean 1999 211 140 191 542 281 283 180 744

Indian 2004 200 231 118 549 240 275 119 634

Indian 1999 229 265 126 620 267 276 112 655

Pakistani 2004 222 142 65 429 279 164 65 508

Pakistani 1999 326 217 77 620 383 202 56 641

Bangladeshi 2004 210 150 48 408 309 118 50 477

Bangladeshi 1999 273 142 116 531 361 143 58 562

Chinese 2004 172 118 58 348 148 176 51 375

Chinese 1999 108 127 65 300 109 194 58 361

Irish 2004 114 194 189 497 149 275 232 656

Irish 1999 135 238 162 535 203 301 204 708



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.

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HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS 263

Eating habits

Rachel Craig, Melanie Doyle and Dhriti Jotangia

● Over a third of Indian and Chinese men met the recommended guidelines ofconsuming 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 ‘5a day’ guidelines was significantly higher among all minority ethnic groups than amongmen in the general population (23%).

● Similarly to men, the proportion eating five or more portions of fruit and vegetables perday was highest among Chinese and Indian women (42% and 36%, respectively).Among the general population, a significantly higher proportion of women than menmet 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 minorityethnic groups, with a mean fat score of 24.3, and 72% having a low fat score. Irish menwere the most similar to the general population, with a mean fat score of 23.5, and alow fat score among 77%. Indian, Chinese and Black African men had the lowest fatintakes (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 thegeneral population, and 84% of women had low fat scores (compared with 72% ofmen). Irish women were the most similar to women in the general population (mean fatscore 20.5), while women in all other minority ethnic groups apart from Pakistaniwomen had lower fat scores. Indian and Black Caribbean women had the lowest meanfat scores (17.3, 17.9).

● The pattern of salt use in cooking was similar for men and women. Use of salt incooking was higher among men in minority ethnic groups (from 74% among BlackAfrican men to 95% among Bangladeshi men) than among of men in the generalpopulation (56%). Similarly more women in minority ethnic groups added salt to foodduring cooking (ranging from 69% among Black Caribbean women to 92% amongIndian women) than did women in the general population (53%).The exception was theIrish group, with fewer using salt in cooking than in the general population (45% ofmen, 46% of women).

● There were slight differences in salt use at the table, with men in the general populationand 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 inthe general population and Irish women generally added salt without tasting (15% and16%, respectively, compared with 5% to 12% among other groups). More Chineseand 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 saltin cooking among those from Chinese and Irish backgrounds, though little changeamong other groups. The proportion of women who used salt in cooking decreased

9Summary

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slightly over the same period in all minority ethnic groups, with the greatest differencesamong Chinese, Irish, Black Caribbean and Pakistani women.

● Salt use at the table also decreased between 1999 and 2004 among adults in mostminority ethnic groups. The proportion of adults who add salt at the table decreasedmost 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 BlackCaribbean groups.

9.1 Introduction

Diet and nutrition play a critical role in the prevention of many chronic diseases such ascardiovascular disease and its associated risk factors, and many forms of cancer. It issuggested that diets high in fat (particularly saturated fats) and salt and low in fruit andvegetables 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 akey part in reducing early deaths from these diseases.

Evidence from the 1999 Health Survey suggests that eating habits vary between differentminority ethnic groups.3 The latest government white paper: Choosing Health, sets out theobjective of reducing health inequalities between disadvantaged groups such as those fromsocio-economically deprived backgrounds and those from minority ethnic groups.4 Thischapter examines data from the Health Survey for England 2004 and looks at fruit andvegetable 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 keystrategies 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 atleast five portions (400g) per day. This is in accordance with dietary recommendationsaround the world, including those set out by the World Health Organisation (WHO).5 Healthbenefits of a diet rich in fruit and vegetables include improving bowel function and helpingto 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 advantagesof eating a healthy well balanced diet among the population. A number of key initiativeshave been introduced to increase awareness of the programme and motivate people tomake healthier choices, such as the introduction of the ‘5 a day’ Logo, the National SchoolFruit 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 toobesity and associated health risks, while a diet with a low fat intake provides protectivehealth benefits. Recommended upper limits for fat intake are expressed in terms of totalenergy intake. The WHO report (2003), recommended a total fat intake between 15% and30%, with levels as high as 35% for selected groups. The current UK recommendation isthat total fat intake should contribute no more than 35% of daily food energy intake. In2003, the average daily intake of total fat for men (86.5g) represented 36% of total foodenergy intake, whilst average total fat intake for women (61.4g) represented 35% of totalfood energy intake.8

Evidence indicates that the traditional diets of Black Caribbean, Indian, Pakistani andBangladeshi 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

Salt intake

High salt intake has been linked to increased prevalence of high blood pressure, andreducing salt intake has been shown to benefit people with high blood pressure.11 The WHOhave recommended that individuals limit their intake of dietary sodium from all sources toless than 5g per day and, in the UK, the Scientific Advisory Committee on Nutritions aim toreduce 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 ofHealth is working with the food industry to reduce the salt content of processed foods andto improve information on food labels.11 Other sources of salt are salt used in cooking andsalt added to food at the table. The Food Standards Agency has recently launched acampaign to increase public awareness of the health risks associated with diets high insalt.13

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9.2 Methodology

9.2.1 Fruit and vegetable consumption

Informants aged five and over were asked questions about their daily fruit and vegetableconsumption. These questions have been included in the Health Survey series since 2001,and are administered via Computer Assisted Personal Interviewing (CAPI). The module isdesigned 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 wasdefined as 24 hours from midnight to midnight. This 24-hour period was used to ensure thatvariations in informants’ meal times and work patterns did not affect the measure of dailyconsumption reported.

Portion size

Fruit and vegetable consumption in the Health Survey series has been examined using theguidelines specified in the ‘5 a day’ programme. Five portions are defined as 400g of fruitand vegetables per day (an average portion is 80g). A variety of different foodstuffsrepresents a portion, including vegetables (fresh, frozen, canned), vegetables in compositedishes, 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 hadconsumed, portion sizes were converted into everyday measures. For example, informantswere asked how many tablespoons of vegetables, cereal bowlsful of salad, pieces ofmedium sized fruit (such as apples), or handfuls of small fruit (such as berries) they hadeaten in the previous 24 hours. The table below illustrates the portion sizes defined for eachof the different food items included in the analysis.

Food item Portion size Vegetables (fresh, raw, tinned and frozen) 3 tablespoonsPulses 3 tablespoonsSalad 1 cereal bowlVegetables in composites, such as vegetable curry 3 tablespoonsVery large fruit, such as melon 1 average slice Large fruit, such as grapefruit Half a fruit Medium fruit, such as apples 1 fruit Small fruit, such as plums 2 fruitsVery small fruit, such as blackberries 1 handfulDried fruit 1 tablespoonFrozen fruit/canned fruit 3 tablespoonsFruit in composites, such as stewed fruit 3 tablespoonsFruit juice 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 examplequestions about vegetable consumption specified the exclusion of potatoes. Additionally,fruit juice, pulses and dried fruit were counted as one portion, regardless of how much hadbeen consumed in a given day.

Interpretation of data

Data collected on fruit and vegetable consumption are based on self-reported informationcollected during a 24-hour period. Every attempt has been made to ensure that informantsreport an accurate picture of consumption levels through identifying portions in everydaymeasures. However, survey estimates can be sensitive to under or over-reporting, and thedata may be prone to variations in the way questions are interpreted by informants, forinstance in assessing the amount of fruit contained in foods such as apple pie. Self-reported data are also susceptible to social desirability biases and difficulties with recall.Nevertheless, survey estimates can still provide useful comparisons of consumptionpatterns of the population.

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Within specific groups, mean consumption may also be increased by a small number ofinformants 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 measurethat is not influenced by extreme values. Both observed results and age-standardised riskratios are shown where data are not analysed in separate age groups. Age-standardisedrisk ratios are used to take account of differences in the age profile of different minorityethnic groups (see Chapter 1).

9.2.2 Fat intake

Questions used to assess intake of saturated fats were administered in self-completionformat to those aged 16 and over. These were administered during the nurse visit so thesample size is smaller than for the fruit and vegetable data. Informants in the generalpopulation were not offered a nurse visit in 2004, so data for minority ethnic groups arecompared with that for the 2003 general population sample.

The questions were based on those introduced in HSE 1998. These were derived from theDietary Instrument for Nutritional Education (DINE) questionnaire, developed by the ImperialCancer Research Fund’s General Practice Research Group.14 The DINE questionnaire is aweighted food frequency questionnaire designed to assess fat and fibre intake. Fat andfibre consumption is based on the 19 key food groups which together account for 70% ofthe fat and fibre in a typical UK diet (according to the National Food Survey15) as well astypes of spreads and cooking fats used.

The 2003 and 2004 self-completion questionnaire included questions about fatconsumption, 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 averageday.

Fat scores were based on frequency of consumption of these foods and the fat content of astandard 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 (lowintake) represents a fat intake of 83g/day or less, whilst a fat score of more than 40represents 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 wasdifferent from that used in 2004, and it is therefore not possible to compare results from thetwo years.

9.2.3 Salt intake

Adults aged 16 and over were asked about their use of salt in cooking and at the table. Thequestions were also included in the self-completion questionnaire administered by thenurse. While objective measures, such as sodium content in urine, are more appropriate forassessing total salt intake, self-report data may be used to assess the extent to whichinformants add salt to their food. Informants in the general population were not offered anurse visit in 2004, so data for minority ethnic groups are compared with that for the 2003general 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 ofconsuming five or more portions of fruit and vegetables a day. With the exception of Irishmen, the proportion of men meeting the guidelines was significantly higher among allminority 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


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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 inminority ethnic groups consuming, on average, more portions than men in the generalpopulation (3.3 portions). Mean daily fruit and vegetable consumption was highest amongChinese and Pakistani men (4.4 and 4.3 portions per day, respectively).

These differences remained after adjusting for age profiles within the minority ethnicgroups. Chinese and Indian men were 1.66 and 1.64 times more likely to consume at leastfive portions of fruit and vegetables per day than men in the general population. With theexception of Irish men, all minority ethnic groups were more likely to consume therecommended five portions a day than men in the general population.

In the general population, and in most minority ethnic groups, fruit and vegetableconsumption among men tended to increase with age and this was most marked amongBlack 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

Consumption among women

In the general population, a significantly higher proportion of women than men met the ‘5 aday’ 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 portionswas higher among Chinese and Indian women (42% and 36%, respectively) than thegeneral population.

Mean daily fruit and vegetable consumption was highest among Chinese and Indianwomen (4.9 and 4.4 portions per day, respectively). Bangladeshi women and women in thegeneral 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


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Proportion of men consuming 5 or more portions of fruit and vegetables per day


Men

Observed % 32 31 37 33 32 36 26 23


Mean portions 3.9 3.7 4.2 4.3 3.8 4.4 3.6 3.3

Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

Consumption of five portions or more, by minority ethnic group

Men Women

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2.0

0.5


0.10

1.0

10.0

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Black African

Indian

Pakistani

Bangladeshi

IrishChinese

2.0

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general population in being likely to consume the recommended five portions a day (riskratio: 1.65). Black African, Indian, Chinese and Irish women all had significantly higher riskratios than the general population.

As with men, women in the oldest age group (55 and over) tended to consume the most fruitand vegetables, although this pattern was not apparent among women of Irish orBangladeshi origin. The increase in consumption of fruit and vegetables with age was mostmarked among Indian women.

In most minority ethnic groups the proportion of adults meeting the guidelines was similarfor men and women. The exception was the Irish group, where the proportion reportingconsuming five or more portions per day was significantly higher among women than men(32% and 26%, respectively). Tables 9.1, 9.2, Figure 9B

9.3.2 Fruit and vegetable consumption by equivalised household income

Equivalised household income is a measure of household income that takes account of thenumber of persons in the household. Among the general population, a clear relationshipwas found between equivalised household income and fruit and vegetable consumption.Men and women in the highest income tertile were most likely to meet the recommendedguidelines of consuming five or more portions per day (26% and 33%, respectively), whilethose 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% ofmen and 42% of women in the highest income tertile met the daily guidelines of consumingfive portions a day, compared with 27% of men and 20% of women in the lowest incometertile.

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 betweenequivalised household income and fruit and vegetable consumption in the other minorityethnic groups. Table 9.3


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Proportion of women consuming 5 or more portions of fruit and vegetables per day


Women

Observed % 31 32 36 32 28 42 32 27


Mean portions 3.9 3.8 4.4 4.0 3.6 4.9 3.9 3.6

Mean fruit and vegetable consumption, by minority ethnic group and sex

Mea

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1

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MenWomen

Black

Caribbean

Black

African

Indian

Pakistani

Bangladeshi

IrishChinese

9.3.3 Type of fruit and vegetables consumed by minority ethnic group

Informants were asked about their consumption of individual food items in the previous 24hours. This included questions about the consumption of vegetables (fresh, raw, tinned andfrozen), vegetables in composites, salads, pulses, fresh fruit, dried fruit, fruit in compositesand fruit juice. Summary measures were created to take into account total consumption offruit and vegetables (including portions or parts of portions). These summary measuresincluded 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 9.5shows consumption levels by age, and table 9.6 shows the mean number of portionsconsumed for each individual food item.

Vegetable consumption among men

In the general population 67% of men had consumed fresh, raw, tinned or frozenvegetables, vegetables in composites or salad in the previous 24 hours. In all minorityethnic groups apart from the Irish, two thirds or more men had eaten these types ofvegetables, 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 ofvegetables (ranging from 5% among Irish men to 38% among Bangladeshi men). Chineseand Pakistani men were more likely to report eating fresh, raw, tinned and frozen vegetablesthan 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 highestamong Chinese and Indian men (both 2.2 portions per day), and Chinese men alsoconsumed more portions of vegetables i.e. fresh, raw, tinned and frozen varieties (1.6portions per day) than all other minority ethnic groups (0.5-0.8 portions per day) and thegeneral population (0.7 portions per day).

The proportion consuming pulses was higher among men of Indian origin (55%) than otherminority ethnic groups. A lower proportion of Chinese men consumed pulses (23%) thanother 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 fruitand fruit in composites in the last 24 hours. Consumption of any type of fruit was higheramong Chinese and Pakistani men (both 73%) than other minority ethnic groups and thegeneral population. The mean daily number of portions of fruit consumed was also highestamong Pakistani men (2.5 portions per day, compared with 2.0 – 2.3 portions among otherminority 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 ofChinese men (70%) consumed fresh fruit than men in Black Caribbean, Black African andIrish groups (60-62%), and men in the general population (58%). Fresh fruit consumptionwas significantly lower among men in the general population (58%) than among Pakistani,Bangladeshi and Chinese men. Frozen fruit was the least commonly consumed (rangingfrom 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


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Vegetable consumption among women

Patterns of consumption of fruit and vegetables were broadly similar between men andwomen. In the general population 74% of women had eaten fresh, raw, tinned or frozenvegetables, vegetables in composites or salad in the previous 24 hours. At a slightly higherlevel than men, 70% or more of women in all minority ethnic groups had eaten anyvegetables. Mean portions of total vegetables consumed were highest among women ofChinese 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 ethnicgroups.

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 higherproportion of Chinese women (82%) consumed fresh, raw, tinned and frozen vegetablesthan all other minority ethnic groups (43%-62%) and the general population (56%).Vegetables in composites were the least commonly consumed (ranging from 7% amongwomen in the general population to 35% among Bangladeshi women).

Similarly to men, the proportion of women who had eaten pulses was significantly higheramong informants of Indian origin (54%) than other minority groups (24%-42%) and thegeneral population (30%). As with men, the lowest levels of consumption were foundamong 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 eachgroup. Within minority ethnic groups a higher proportion of Chinese women (83%) ate freshfruit (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 amongwomen than men (83% and 70%, respectively). This difference between the sexes was notsignificant 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 generalpopulation and of Black Caribbean origin, and among men of Chinese, Pakistani and Irishorigin. Fruit consumption increased with age among men and women in most of theminority ethnic groups, though not among Black African, Pakistani and Bangladeshiwomen. Table 9.5

9.4 Fat intake

9.4.1 Fat intake by minority ethnic group

As a measure of fat intake, mean fat scores have been calculated, based on consumption ofcertain foods, as described in section 9.2.2, and this measure is used to compare groups ofinformants. Informants were also classified as having low, medium and high fat scores. Thegeneral population data are taken from the 2003 survey, since these questions wereincluded 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 ethnicgroups, with a mean fat score of 24.3, and 72% having a low fat score, 22% a medium fatscore 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 BlackAfrican 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 thesedifferences.


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Fat intake among women

Patterns of fat intake among women in the general population were different from men. Themean fat score, at 21.2, was significantly lower than the score for men in the generalpopulation, 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 minorityethnic groups, Irish women were the most similar (mean fat score 20.5), while women in allother groups had lower fat scores. Indian and Black Caribbean women had the lowestmean fat scores (17.3, 17.9). Risk ratios, adjusting for the different age profiles among eachminority ethnic group, confirmed that Indian and Black Caribbean women had low riskratios compared with the general population (0.81 and 0.84, respectively), and that thosewith Bangladeshi backgrounds also had a low fat intake compared with the generalpopulation (0.84).

The difference in fat intake between men and women in the general population was alsoapparent among the Black Caribbean, Bangladeshi and Irish groups, with lower mean fatscores, 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 andChinese 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 generalpopulation 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 35-54 (26.1 to 23.9) and a further but smaller decrease in fat score among those aged 55 andover (to 23.1). There was the same pattern among men and women with Black Caribbeanand Indian backgrounds and Irish men, where sample sizes were sufficient to provide datafor those aged 55 and over. Among women in the general population, the differencebetween 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 andover. 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, sinceadjustments for energy requirement were made in 1999, and the scores were calculateddifferently.

9.5 Use of salt in cooking and at the table

9.5.1 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 inminority ethnic groups (from 74% among Black African men to 95% among Bangladeshimen). 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 withouttasting the food first. Thus there were slight differences in salt use at the table, with men inthe general population and Irish men more likely to report that they generally add saltwithout tasting (24% and 23%) than other groups (6% to 15%) apart from Bangladeshimen. More Chinese and Black Caribbean men said that they rarely or never add salt at thetable (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 usein cooking was higher for women in minority ethnic groups (ranging from 69% among BlackCaribbean 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 thegeneral population (46%). Use of salt at the table also followed a similar pattern to men,


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with more women in the general population and Irish women generally adding salt withouttasting (15% and 16%, respectively) than Black Caribbean, Black African, Indian or Chinesewomen (5% to 9% ), and more Black Caribbean and Chinese women rarely or never addingsalt (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 overdue 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 amongthose aged 55 and over than among other age groups (60%, compared with 56% amongmen aged 16-34, and 52% among men aged 35-54). There were varying levels of use of saltin cooking across the different minority ethnic groups, as noted above, but little variationaccording to age within the minority ethnic groups.

Salt use in cooking showed more variation by age among women. Mirroring the pattern formen in the general population, more women in the general population aged 55 and overreported 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 and35-54 among both Black Caribbean women (61% and 75%, respectively) and Bangladeshiwomen (87% and 97%). There was higher prevalence of using salt in cooking amongChinese 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 generalpopulation and there was similarly little variation by age in most of the ethnic minoritygroups. Among Black Caribbean, Black African and Bangladeshi men, there was aconsistent, though not statistically significant difference in salt use at the table betweenthose aged 16-34 and 35-54: more of the younger than older informants reported that theytasted food and occasionally added salt, while more of the older group than the youngergroup reported that they rarely or never added salt at the table. This pattern was alsoapparent among Black Caribbean and Black African and women, and in these instancessignificantly more of those aged 35-54 than those aged 16-34 reported that they rarely ornever 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 informantsare 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 incooking, in 1999 and 2004.

Between 1999 and 2004, there was a reduction in the proportion of men who used salt incooking among those from Chinese and Irish backgrounds, though little change amongother groups. The proportion of women who used salt in cooking decreased slightly overthe same period in all minority ethnic groups, with the greatest differences among Chinese,Irish, Black Caribbean and Pakistani women.


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Use of salt in cooking in 2004 and 1999, by sex

Black Caribbean Indian Pakistani Bangladeshi Chinese Irish

Men

2004 77 93 93 95 82 45

1999 83 95 96 97 94 66

Women

2004 69 92 88 91 75 46

1999 81 97 97 98 94 59

Salt use at the table also decreased between 1999 and 2004 among adults in most minorityethnic groups. There were marked changes in the balance between the proportion of adultswho add salt to food at the table, or rarely or never add salt. The inset table below showsthe proportion of men and women who add salt to food at the table, whether generallywithout tasting, or generally or occasionally after tasting.

Between 1999 and 2004, the proportion of adults who add salt at the table decreasedamong Irish and Indian men and women, and among Pakistani men. There was little changein use of salt at the table among Bangladeshi and Black Caribbean groups.

Although use of salt in cooking was already lower among Irish informants than among otherminority ethnic groups in 1999, it is among the Irish community that there has been themost 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 someevidence of reduced use of salt in 2004, either in cooking (among Pakistani and Chinesewomen), or at the table (among Indian men and women, and Pakistani men). There appearsto have been little change among the Bangladeshi group, where use of salt in cookingremained consistently high between 1999 and 2004. Table 9.12

9.5.3 Use of salt by equivalised household income

Among the general population, for both men and women, those in the lower tertile forequivalised household income were the most likely to add salt during cooking, but therewas little variation across the tertiles in patterns of salt use at the table. There was a similarpattern among Irish men and women for salt in cooking, and among this group there wasalso a difference for table use, with more in the highest income tertile reporting that theyrarely 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 Caribbeanwomen in the lowest income tertile than the highest (77% and 62%, respectively), andfewer Black African women in the lowest tertile rarely or never used salt at the tablecompared with those in the highest tertile (34% and 58%, respectively). Among Indian menand women, there was no comparable gradient of salt use across the income groups. It isnot possible to comment on other minority ethnic groups due to small base sizes. Table 9.13


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 informationsee: 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 jointWHO/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).


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Use of salt at the table in 2004 and 1999, by sex

Black Caribbean Indian Pakistani Bangladeshi Chinese Irish

Men

2004 51 53 53 61 50 57

1999 49 64 64 59 56 73

Women

2004 36 50 54 62 47 55

1999 37 59 59 58 56 66

8 Henderson L, Gregory J, Irving K, Swann G. The National Diet and Nutrition Survey: Adults aged 19 to 64years. 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 inBritain. 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 toreduce dietary salt in adults. British Medical Journal, 2002, 325:628

12 Salt and Health. Food Standards Agency, 2003. See Food Standards Agency website for furtherinformation: 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 DINEmethod 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.

16 In 2004, fat scores were derived in a different way from 1999 so direct comparisons between 2004 and1999 data are not possible.


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276 HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 9: EATING HABITS

Tables

9.1 Fruit and vegetable consumption, by minorityethnic group and sex

9.2 Fruit and vegetable consumption, by age withinminority ethnic group and sex

9.3 Fruit and vegetable consumption, byequivalised household income tertile withinminority ethnic group and sex

9.4 Type of fruit and vegetable consumption, byminority ethnic group and sex

9.5 Type of fruit and vegetable consumption, by agewithin minority ethnic group and sex

9.6 Mean fruit and vegetable consumption, by fooditem, minority ethnic group and sex

9.7 Fat intake, by minority ethnic group and sex

9.8 Fat intake, by age within minority ethnic groupand sex

9.9 Fat intake, by equivalised household incometertile 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 groupand sex

9.12 Comparison of salt use, in 2004 and 1999, byage within minority ethnic group and sex

9.13 Use of salt, by equivalised household incometertile within minority ethnic group and sex


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Table 9.1

Fruit and vegetable consumption, by minority ethnic group and sex


Portions per day Minority ethnic group Generalpopulation


MenObserved %

None 8 8 4 4 6 3 11 8

Less than 1 portion 2 3 2 3 2 3 3 4

1 portion or more but less than 2 portions 16 16 13 13 14 9 18 16

2 portions or more but less than 3 portions 16 16 15 14 17 15 14 19



5 portions or more 32 31 37 33 32 36 26 23

Mean portions consumed 3.9 3.7 4.2 4.3 3.8 4.4 3.6 3.3


Median 3.3 3.3 4.0 4.0 3.7 3.8 3.0 3.0


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

WomenObserved %

None 7 5 3 4 5 1 5 6






5 portions or more 31 32 36 32 28 42 32 27



Median 3.3 3.7 4.0 3.7 3.2 4.3 3.5 3.3


Consumed 5 or more portions 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

Bases (weighted)

Men 479 377 903 422 178 151 1776 46178

Women 675 476 1067 499 208 163 2369 48719

Bases (unweighted)

Men 412 390 550 432 411 348 497 2878

Women 652 469 634 508 478 375 656 3825


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Table 9.2

Fruit and vegetable consumption, by age within minority ethnic group and sex


Portions per day Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

None 10 7 6 8 11 5 5 7






5 portions or more 20 33 44 32 21 35 37 31



Median 2.7 3.3 4.0 3.3 2.3 3.7 4.0 3.3

Black African

None 11 4 [5] 8 7 3 [-] 5

Less than 1 portion 4 3 [2] 3 2 1 [-] 2

1 portion or more but less than 2 portions 19 15 [6] 16 18 16 [21] 18

2 portions or more but less than 3 portions 14 17 [17] 16 15 14 [17] 14



5 portions or more 23 35 [49] 31 29 35 [38] 32

Mean portions consumed 3.1 4.0 [4.9] 3.7 3.5 4.0 [3.9] 3.8


Median 3.0 3.7 [4.7] 3.3 3.5 4.0 [4.0] 3.7

Indian

None 5 4 5 4 4 2 2 3






5 portions or more 30 39 45 37 28 37 50 36



Median 3.7 4.0 4.4 4.0 3.5 3.8 4.9 4.0

Pakistani

None 6 2 3 4 3 5 2 4






5 portions or more 29 37 40 33 33 30 32 32



Median 3.5 4.0 4.2 4.0 3.7 3.7 4.1 3.7

Continued…


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Table 9.2 continued


Portions per day Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Bangladeshi

None 5 5 [8] 6 4 5 8 5

Less than 1 portion 3 3 [-] 2 5 3 9 5

1 portion or more but less than 2 portions 15 14 [6] 14 14 13 15 14

2 portions or more but less than 3 portions 18 13 [21] 17 20 16 12 18



5 portions or more 36 26 [30] 32 29 27 21 28

Mean portions consumed 3.9 3.7 [3.8] 3.8 3.6 3.7 3.2 3.6

Standard error of the mean 0.22 0.22 [0.30] 0.19 0.17 0.21 0.35 0.15

Median 3.9 3.6 [4.0] 3.7 3.0 3.7 3.0 3.2

Chinese

None 5 3 - 3 2 1 - 1

Less than 1 portion 5 3 - 3 1 - 6 1





5 portions or more 34 34 45 36 40 43 48 42



Median 3.3 4.0 4.6 3.8 4.3 4.3 4.7 4.3

Irish

None 15 13 6 11 7 4 5 5






5 portions or more 25 21 32 26 33 30 34 32



Median 2.0 3.2 3.3 3.0 3.7 3.5 3.5 3.5

General population

None 12 8 4 8 10 5 3 6






5 portions or more 18 22 29 23 21 29 30 27



Median 2.3 3.0 3.5 3.0 2.7 3.3 3.5 3.3

Continued…


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Table 9.2 continued


Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Bases (weighted)

Black Caribbean 140 196 143 479 219 292 165 675

Black African 179 159 40 377 240 198 37 476

Indian 327 384 192 903 408 466 193 1067

Pakistani 205 153 64 422 276 161 62 499

Bangladeshi 92 65 21 178 135 51 21 208

Chinese 74 50 27 151 63 78 22 163

Irish 412 678 686 1776 497 1038 833 2369


Bases (unweighted)

Black Caribbean 121 166 125 412 200 290 162 652

Black African 179 172 39 390 235 190 44 469

Indian 201 231 118 550 240 275 119 634

Pakistani 222 145 65 432 279 164 65 508

Bangladeshi 212 150 49 411 310 118 50 478

Chinese 172 118 58 348 148 176 51 375

Irish 114 194 189 497 149 275 232 656



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Table 9.3

Fruit and vegetable consumption, by equivalised household incometertile within minority ethnic group and sex


Portions per day Equivalised household income tertile



Consumed 5 or more portions 41 28 27 42 28 20

Mean portions consumed 4.6 3.7 3.4 4.8 3.6 3.3


Black African




Indian




Pakistani

Consumed 5 or more portions [32] 36 31 [44] 36 26

Mean portions consumed [4.9] 4.6 3.9 [4.8] 4.3 3.6

Standard error of the mean 0.69 0.37 0.25 [0.54] 0.29 0.25

Bangladeshi

Consumed 5 or more portions a 51 30 a 37 31

Mean portions consumed 4.0 4.6 3.8 a 3.9 3.6

Standard error of the mean 0.52 0.29 0.26 a 0.34 0.25

Chinese

Consumed 5 or more portions 40 39 [43] 47 34 51

Mean portions consumed 4.6 4.9 [4.4] 5.1 4.7 5.1


Irish




General population




Standardised risk ratiosConsumed 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


Indian 1.91 1.76 1.56 1.70 1.20 1.14


Pakistani [1.21] 1.76 1.43 [1.39] 1.37 0.98

Standard error of risk ratio [0.35] 0.29 0.21 [0.37] 0.20 0.18

Bangladeshi 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




a Results are not shown because of small bases. Continued…..


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Table 9.3 continued




Bases (weighted)

Black Caribbean 152 115 106 156 188 179

Black African 113 89 90 123 115 153

Indian 264 241 150 305 287 203

Pakistani 55 119 137 56 134 168


Chinese 44 36 21 52 34 24

Irish 833 398 270 1040 568 347


Bases (unweighted)

Black Caribbean 123 90 96 148 163 179

Black African 104 105 94 102 123 150

Indian 159 155 97 179 173 126

Pakistani 47 114 155 46 135 176

Bangladeshi 19 89 171 23 101 191

Chinese 105 77 49 120 74 58

Irish 207 122 89 257 163 123




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Table 9.4

Type of fruit and vegetables consumed, by minority ethnic group and sex


Food item Minority ethnic group Generalpopulation


% % % % % % % %

MenTotal fruit and vegetables 92 92 96 96 94 97 89 92

Total vegetables (excludes pulses) 66 69 81 73 82 86 64 67

Total fruit (excludes fruit juice) 64 63 69 73 66 73 66 64

Vegetables 54 54 57 74 59 78 51 52

Pulses 41 38 55 32 36 23 39 34

Salad 28 28 45 46 39 25 26 27

Vegetables in composites 8 9 25 23 38 9 5 7

Fresh fruit 62 60 64 68 65 70 62 58

Fruit in composites 5 5 3 6 1 5 7 7

Dried fruit 7 6 14 10 5 7 8 8

Frozen fruit 2 2 1 3 1 2 6 4

Fruit juice 57 58 40 50 52 38 37 41

WomenTotal fruit and vegetables 93 95 97 96 95 99 95 94



Vegetables 54 58 62 43 60 82 55 56

Pulses 33 39 54 42 34 24 31 30

Salad 36 30 47 45 35 30 38 36


Fresh fruit 64 63 70 69 65 83 71 67


Dried fruit 9 7 15 7 5 10 13 12

Frozen fruit 3 3 3 2 1 1 4 5

Fruit juice 51 62 44 51 46 36 41 43

Bases (weighted)

Men 479 377 903 422 178 151 1776 46178

Women 675 476 1067 499 208 163 2369 48719

Bases (unweighted)

Men 412 390 550 432 411 348 497 2878

Women 652 469 634 508 478 375 656 3825


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Table 9.5

Type of fruit and vegetables consumed, by age within minority ethnic group and sex


Type of fruit and Age groupvegetable

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

Total fruit and vegetables 90 93 94 92 89 95 95 93



Vegetables 42 62 56 54 45 53 66 54

Pulses 31 43 47 41 30 34 34 33

Salad 23 28 33 28 32 39 36 36


Fresh fruit 49 59 79 62 47 66 81 64

Fruit in composites 6 8 - 5 3 5 4 4

Dried fruit 6 8 6 7 9 9 9 9

Frozen fruit 3 0 3 2 4 3 2 3

Fruit juice 53 56 62 57 57 50 46 51

Black African

Total fruit and vegetables 89 96 [95] 92 93 97 [100] 95

Total vegetables (excludes pulses) 66 71 [74] 69 71 76 [75] 73

Total fruit (excludes fruit juice) 58 64 [81] 63 63 72 [75] 68

Vegetables 54 54 [54] 54 55 62 [63] 58

Pulses 29 46 [44] 38 39 42 [25] 39

Salad 23 31 [34] 28 30 31 [28] 30

Vegetables in composites 7 10 [13] 9 14 12 [7] 13

Fresh fruit 55 64 [69] 60 58 69 [68] 63

Fruit in composites 9 1 [8] 5 4 5 [6] 5

Dried fruit 3 6 [16] 6 7 6 [7] 7

Frozen fruit 1 2 [6] 2 4 3 [-] 3

Fruit juice 59 58 [56] 58 66 61 [49] 62

Indian




Vegetables 52 57 64 57 56 64 67 62

Pulses 54 51 62 55 52 54 59 54

Salad 37 48 52 45 45 49 45 47


Fresh fruit 56 67 71 64 63 74 76 70


Dried fruit 9 16 19 14 11 15 22 15

Frozen fruit 0 1 2 1 2 4 2 3

Fruit juice 49 36 34 40 50 37 46 44

Continued…..


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Table 9.5 continued



Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Pakistani




Vegetables 36 41 58 41 41 38 63 43

Pulses 28 31 48 32 43 41 40 42

Salad 38 51 58 46 42 52 43 45


Fresh fruit 60 73 81 68 66 72 70 69


Dried fruit 9 11 12 10 5 12 5 7

Frozen fruit 2 4 2 3 3 2 1 2

Fruit juice 50 51 48 50 55 46 44 51

Bangladeshi

Total fruit and vegetables 95 95 [92] 94 96 95 92 95

Total vegetables (excludes pulses) 82 82 [78] 82 80 81 88 82

Total fruit (excludes fruit juice) 64 64 [81] 66 64 76 67 67

Vegetables 61 58 [55] 59 59 58 64 60

Pulses 35 37 [38] 36 36 34 25 34

Salad 38 38 [48] 39 36 36 34 35

Vegetables in composites 38 38 [41] 38 34 40 36 35

Fresh fruit 64 62 [81] 65 61 74 67 65

Fruit in composites 1 2 [-] 1 1 - - 1

Dried fruit 3 7 [4] 5 5 7 1 5

Frozen fruit 1 1 [-] 1 1 2 - 1

Fruit juice 62 45 [31] 52 50 39 32 46

Chinese




Vegetables 74 82 83 78 79 83 88 82

Pulses 22 23 28 23 26 25 19 24

Salad 25 24 27 25 27 32 29 30


Fresh fruit 59 78 88 70 74 88 91 83


Dried fruit 5 6 11 7 11 11 7 10

Frozen fruit 1 3 4 2 - 2 3 1

Fruit juice 42 31 40 38 41 35 25 36

Continued…..


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Table 9.5 continued



Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Irish




Vegetables 40 51 58 51 51 50 64 55

Pulses 37 34 44 39 27 33 31 31

Salad 15 32 27 26 42 41 32 38


Fresh fruit 47 61 71 62 65 71 76 71


Dried fruit 6 6 10 8 8 13 16 13

Frozen fruit 4 5 8 6 6 3 5 4

Fruit juice 37 37 38 37 48 39 40 41

General population




Vegetables 44 50 63 52 47 56 62 56

Pulses 30 34 38 34 26 31 34 30

Salad 25 29 26 27 33 40 34 36


Fresh fruit 46 59 71 58 55 68 76 67


Dried fruit 5 8 11 8 8 12 16 12

Frozen fruit 2 3 9 4 2 3 9 5

Fruit juice 45 39 40 41 48 42 41 43

Bases (weighted)

Black Caribbean 140 196 143 479 219 292 165 675

Black African 179 159 40 377 240 198 37 476

Indian 327 384 192 903 408 466 193 1067

Pakistani 205 153 64 422 276 161 62 499

Bangladeshi 92 65 21 178 135 51 21 208

Chinese 74 50 27 151 63 78 22 163

Irish 412 678 686 1776 497 1038 833 2369


Bases (unweighted)

Black Caribbean 121 166 125 412 200 290 162 652

Black African 179 172 39 390 235 190 44 469

Indian 201 231 118 550 240 275 119 634

Pakistani 222 145 65 432 279 164 65 508

Bangladeshi 212 150 49 411 310 118 50 478

Chinese 172 118 58 348 148 176 51 375

Irish 114 194 189 497 149 275 232 656



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Table 9.6

Mean fruit and vegetable consumption, by food item, minority ethnic group and sex


Portions per day Minority ethnic group Generalpopulation


MenTotal fruit and vegetables 3.9 3.7 4.2 4.3 3.8 4.4 3.6 3.3


Total vegetables and salads 1.6 1.6 2.2 1.7 1.9 2.2 1.5 1.4


Total fruit (excludes fruit juice) 2.3 2.1 2.1 2.5 2.0 2.2 2.1 1.9


Vegetables 0.7 0.8 0.8 0.5 0.7 1.6 0.8 0.7


Pulses 0.4 0.4 0.5 0.3 0.3 0.2 0.3 0.3


Salad 0.3 0.3 0.5 0.6 0.4 0.3 0.3 0.3


Vegetables in composites 0.1 0.1 0.4 0.3 0.5 0.1 0.1 0.1


Fresh fruit 1.6 1.4 1.5 1.8 1.4 1.7 1.5 1.3


Fruit in composites 0.1 0.1 0.0 0.1 0.0 0.1 0.1 0.1


Dried fruit 0.1 0.1 0.1 0.1 0.0 0.1 0.1 0.1


Frozen fruit 0.0 0.0 0.0 0.1 0.0 0.0 0.1 0.0


Fruit juice 0.6 0.6 0.4 0.5 0.5 0.4 0.4 0.4


WomenTotal fruit and vegetables 3.9 3.8 4.4 4.0 3.6 4.9 3.9 3.6


Total vegetables and salads 1.5 1.6 2.1 1.7 1.7 2.4 1.4 1.4


Total fruit (excludes fruit juice) 2.4 2.2 2.3 2.3 1.9 2.5 2.4 2.2


Vegetables 0.7 0.7 0.8 0.5 0.6 1.6 0.7 0.7


Pulses 0.3 0.3 0.5 0.4 0.3 0.2 0.2 0.2


Salad 0.4 0.3 0.5 0.6 0.4 0.3 0.4 0.4


Vegetables in composites 0.1 0.2 0.3 0.3 0.4 0.2 0.1 0.1


Fresh fruit 1.7 1.5 1.6 1.6 1.3 2.0 1.7 1.5


Fruit in composites 0.0 0.1 0.0 0.1 0.0 0.0 0.1 0.1


Dried fruit 0.1 0.1 0.1 0.1 0.0 0.1 0.1 0.1


Frozen fruit 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0


Fruit juice 0.5 0.6 0.4 0.5 0.5 0.4 0.4 0.4


Continued…..


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Table 9.6 continued




Bases (weighted)

Men 479 377 903 422 178 151 1776 46178

Women 675 476 1067 499 208 163 2369 48719

Bases (unweighted)

Men 412 390 550 432 411 348 497 2878

Women 652 469 634 508 508 375 656 3825

Table 9.7

Fat intake, by minority ethnic group and sex


Fat score Minority ethnic group Generalpopulation

Black Black (2003)


MenObserved %

Low fat 82 86 89 80 83 86 77 72

Medium fat 14 10 10 16 12 13 19 22

High fat 5 4 1 4 5 0 4 6

Mean fat score 20.8 20.1 18.6 20.9 22.6 20.4 23.5 24.3

Standard error of mean 0.82 0.75 0.51 0.87 0.86 0.73 0.70 0.16


Mean fat score 0.85 0.82 0.76 0.84 0.89 0.80 0.98 1


WomenObserved %

Low fat 89 82 94 87 88 84 84 84

Medium fat 11 14 5 11 10 15 15 14

High fat 1 4 1 2 3 1 1 3

Mean fat score 17.9 19.6 17.3 20.0 18.9 18.9 20.5 21.2



Mean fat score 0.84 0.92 0.81 0.91 0.84 0.90 1.00 1


Bases (weighted):

Men 210 149 392 173 62 69 817 5144

Women 286 215 459 201 88 72 1044 5511

Bases (unweighted):

Men 186 145 281 175 113 168 293 4742

Women 277 186 321 214 150 178 382 5928


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Table 9.8

Fat intake, by age within minority ethnic group and sex


Fat score Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

Low fat 66 94 86 82 81 90 98 89

Medium fat 26 5 10 14 19 9 2 11

High fat 8 2 4 5 0 1 - 1

Mean fat score 24.4 19.4 18.3 20.8 21.1 17.1 14.0 17.9


Black African

Low fat 81 93 a 86 82 80 a 82

Medium fat 12 6 a 10 16 12 a 14

High fat 8 1 a 4 2 8 a 4

Mean fat score 21.4 18.3 a 20.1 20.4 19.1 a 19.6

Standard error of mean 1.27 0.91 a 0.75 0.85 1.20 a 0.92

Indian

Low fat 81 90 97 89 91 95 98 94

Medium fat 16 9 3 10 6 5 2 5

High fat 3 1 - 1 3 - - 1

Mean fat score 21.9 18.2 14.2 18.6 19.6 16.5 13.7 17.3


Pakistani

Low fat 77 84 a 80 82 91 a 87

Medium fat 20 12 a 16 15 6 a 11

High fat 4 5 a 4 2 3 a 2

Mean fat score 22.7 20.0 a 20.9 21.6 19.3 a 20.0


Bangladeshi

Low fat [71] [92] a 83 85 [91] a 88

Medium fat [21] [5] a 12 11 [9] a 10

High fat [9] [3] a 5 4 [-] a 3

Mean fat score [26.3] [20.1] a 22.6 20.7 [16.0] a 18.9

Standard error of mean [1.49] [1.08] a 0.86 0.90 [1.34] a 0.78

Chinese

Low fat 76 96 a 86 74 91 a 84

Medium fat 23 4 a 13 24 9 a 15

High fat 1 - a 0 2 - a 1

Mean fat score 22.9 17.6 a 20.4 21.7 17.7 a 18.9


Irish

Low fat 72 75 83 77 86 86 81 84

Medium fat 21 21 14 19 14 14 17 15

High fat 7 4 3 4 0 0 2 1

Mean fat score 25.7 23.6 21.9 23.5 21.0 20.2 20.5 20.5



Low fat 66 75 76 72 82 86 83 84

Medium fat 25 21 20 22 15 12 14 14

High fat 9 4 4 6 3 2 3 3

Mean fat score 26.1 23.9 23.1 24.3 22.0 20.6 20.9 21.2


a Results not shown because of small bases. Continued…


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Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Bases (weighted)

Black Caribbean 74 76 60 210 104 121 62 286

Black African 73 63 14 149 112 91 12 215

Indian 139 161 92 392 185 209 65 459

Pakistani 81 66 25 173 103 75 22 201

Bangladeshi 29 24 8 62 57 25 6 88

Chinese 35 22 11 69 27 37 8 72

Irish 184 355 278 817 223 450 371 1044


Bases (unweighted)

Black Caribbean 56 75 55 186 88 125 64 277

Black African 60 71 14 145 93 82 11 186

Indian 89 125 67 281 124 146 51 321

Pakistani 81 66 28 175 112 77 25 214

Bangladeshi 48 49 16 113 97 42 11 150

Chinese 79 62 27 168 65 93 20 178

Irish 61 130 102 293 77 162 143 382




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Table 9.9

Fat intake, by equivalised household income tertile within minorityethnic group and sex


Fat score Equivalised household income tertile



Low fat 84 76 [77] 95 92 88

Medium fat 11 22 [13] 5 7 12

High fat 5 2 [10] - 1 0

Mean fat score 20.8 21.4 [22.4] 17.7 16.8 18.3

Standard error of mean 1.52 1.78 [2.24] 0.83 1.22 1.28

Black African

Low fat 94 [89] [74] 93 [80] 74

Medium fat 6 [9] [13] 5 [15] 19

High fat - [2] [13] 2 [5] 7

Mean fat score 17.3 [20.4] [23.5] 17.7 [19.7] 21.0

Standard error of mean 0.95 [1.45] [1.76] 1.14 [1.93] 1.86

Indian

Low fat 90 87 88 95 97 93

Medium fat 10 11 10 3 3 7

High fat - 2 1 1 - -

Mean fat score 18.7 18.5 18.1 17.1 16.8 18.0

Standard error of mean 0.82 1.12 1.01 0.77 0.71 0.96

Pakistani

Low fat a 87 76 a 92 88

Medium fat a 10 20 a 8 8

High fat a 3 4 a 0 3

Mean fat score a 20.3 20.5 a 19.6 19.5

Standard error of mean a 1.42 1.27 a 1.03 1.09

Bangladeshi

Low fat a a 87 a a 93

Medium fat a a 11 a a 7

High fat a a 3 a a -

Mean fat score a a 21.2 a a 18.3

Standard error of mean a a 1.32 a a 0.90

Chinese

Low fat 84 [89] a 76 [88] a

Medium fat 14 [11] a 23 [12] a

High fat 1 [-] a 1 [ -] a

Mean fat score 19.8 [20.9] a 21.0 [17.8] a

Standard error of mean 1.18 [1.24] a 1.70 [1.90] a

Irish

Low fat 75 81 [79] 84 85 80

Medium fat 20 13 [16] 16 14 17

High fat 4 6 [5] 0 1 2

Mean fat score 24.2 22.9 [23.2] 20.2 20.6 20.4

Standard error of mean 0.93 1.71 [1.58] 0.72 0.77 1.30

General Population (2003)

Low fat 74 69 73 86 81 82

Medium fat 21 24 19 12 15 15

High fat 5 6 7 2 3 4

Mean fat score 24.2 24.9 24.0 20.7 21.8 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…..


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Table 9.9 continued


Fat score Equivalised household income tertile


Standardised risk ratiosMean fat score

Black Caribbean 0.82 0.93 [0.90] 0.82 0.82 0.82


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


Pakistani a 0.81 0.83 a 0.86 0.89


Bangladeshi a a 0.86 a a 0.77

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


General population (2003) 0.99 1.03 0.99 0.98 1.03 1.02


Bases (weighted)


Black African 60 30 41 61 48 76

Indian 116 118 75 144 133 103

Pakistani 22 60 59 22 66 70


Chinese 25 16 8 31 12 10

Irish 443 208 87 472 285 148


Bases (unweighted)


Black African 53 34 39 50 47 63

Indian 84 87 56 100 91 73

Pakistani 20 61 65 20 68 80


Chinese 66 39 18 76 30 26

Irish 142 79 44 169 104 66




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Table 9.10

Use of salt, by minority ethnic group and sex


Adds salt to fooda,b Minority ethnic group Generalpopulation

Black Black (2003)


MenObserved %

Adds salt during cooking 77 74 93 93 95 82 45 56

Generally adds salt at table, without tasting 9 10 6 15 17 10 23 24

Tastes, generally adds salt at table 18 16 14 13 16 11 19 14

Tastes, occasionally adds salt at table 24 31 32 25 28 29 15 24

Rarely, or never, adds salt at table 49 43 47 47 39 50 43 38


Adds salt during cooking 1.38 1.38 1.69 1.69 1.73 1.42 0.83 1


WomenObserved %







Adds salt during cooking 1.33 1.60 1.78 1.70 1.79 1.49 0.87 1


Bases (weighted)c

Men 230 171 435 196 73 74 870 5455

Women 332 245 523 229 103 77 1134 5814

Bases (unweighted)c

Men 208 157 309 199 134 179 312 5022

Women 321 212 370 242 178 191 413 6255

a Adds salt during cooking, or adds salt to food at table b Excludes salt alternativec 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.


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Table 9.11

Use of salt, by age within minority ethnic group and sex


Adds salt to foodb,c Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean






Black African

Adds salt during cooking 73 73 a 74 79 88 a 83

Generally adds salt at table, without tasting 10 9 a 10 11 6 a 9

Tastes, generally adds salt at table 17 18 a 16 21 14 a 17

Tastes, occasionally adds salt at table 39 29 a 31 32 26 a 29

Rarely, or never, adds salt at table 34 44 a 43 37 54 a 45

Indian






Pakistani

Adds salt during cooking 96 92 [88] 93 88 89 [87] 88

Generally adds salt at table, without tasting 18 9 [16] 15 13 14 [4] 12

Tastes, generally adds salt at table 13 15 [9] 13 19 21 [28] 21

Tastes, occasionally adds salt at table 27 27 [15] 25 23 18 [24] 22

Rarely, or never, adds salt at table 42 49 [60] 47 45 47 [44] 46

Bangladeshi

Adds salt during cooking 95 93 a 95 87 97 a 91

Generally adds salt at table, without tasting 16 21 a 17 9 15 a 11

Tastes, generally adds salt at table 18 11 a 16 20 25 a 21

Tastes, occasionally adds salt at table 30 25 a 28 32 24 a 30

Rarely, or never, adds salt at table 36 43 a 39 39 36 a 38

Chinese

Adds salt during cooking 86 78 [76] 82 84 69 a 75

Generally adds salt at table, without tasting 11 10 [7] 10 5 6 a 7

Tastes, generally adds salt at table 9 11 [18] 11 19 13 a 15

Tastes, occasionally adds salt at table 29 33 [23] 29 31 23 a 25

Rarely, or never, adds salt at table 52 46 [52] 50 45 57 a 53

Irish












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Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Bases (weighted)d

Black Caribbean 76 83 71 230 114 144 74 332

Black African 85 69 17 171 125 103 16 245

Indian 146 179 110 435 201 241 82 523

Pakistani 97 70 29 196 118 84 27 229

Bangladeshi 36 27 10 73 65 31 7 103

Chinese 39 23 12 74 29 40 8 77

Irish 194 360 316 870 227 478 429 1134


Bases (unweighted)d

Black Caribbean 59 83 66 208 96 149 76 321

Black African 67 75 15 157 106 91 15 212

Indian 94 137 78 309 136 169 65 370

Pakistani 97 70 32 199 126 86 30 242

Bangladeshi 60 55 19 134 112 53 13 178

Chinese 85 64 30 179 70 101 20 191

Irish 64 133 115 312 79 175 159 413


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.


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Table 9.12

Comparison of salt use, in 2004 and 1999 by age within minority ethnic groupand sex


Use of saltb,c Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Black Caribbean

2004


Generally adds salt, without tasting 12 12 3 9 7 4 3 5

Tastes, generally adds salt 16 17 21 18 7 7 19 10

Tastes, occasionally adds salt 30 22 20 24 30 16 15 21

Rarely, or never, adds salt 43 50 56 49 55 72 63 64

1999






Basesd

Bases 2004 (weighted) 76 83 71 230 114 144 74 332

Bases 2004 (unweighted) 59 83 66 208 96 149 76 321

Bases 1999 (weighted) 98 62 86 245 134 142 77 353


Indian

2004






1999






Basesd

Bases 2004 (weighted) 146 179 110 435 201 241 82 523


Bases 1999 (weighted) 159 197 84 441 175 184 70 428


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.

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Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Pakistani

2004


Generally adds salt, without tasting 18 9 [16] 15 13 14 [4] 12

Tastes, generally adds salt 13 15 [9] 13 19 21 [28] 21

Tastes, occasionally adds salt 27 27 [15] 25 23 18 [24] 22

Rarely, or never, adds salt 42 49 [60] 47 45 47 [44] 46

1999


Generally adds salt, without tasting 17 15 [11] 16 12 10 [14] 12

Tastes, generally adds salt 21 26 [16] 23 19 19 [20] 19

Tastes, occasionally adds salt 26 25 [19] 25 30 29 [13] 28

Rarely, or never, adds salt 36 34 [54] 37 39 42 [53] 41

Basesd

Bases 2004 (weighted) 97 70 29 196 118 84 27 229


Bases 1999 (weighted) 110 84 26 220 146 71 19 236


Bangladeshi

2004

Adds salt during cooking 95 93 c 95 87 97 c 91

Generally adds salt, without tasting 16 21 c 17 9 15 c 11

Tastes, generally adds salt 18 11 c 16 20 25 c 21

Tastes, occasionally adds salt 30 25 c 28 32 24 c 30

Rarely, or never, adds salt 36 43 c 39 39 36 c 38

1999

Adds salt during cooking 96 99 97 97 98 98 a 98

Generally adds salt, without tasting 15 15 9 13 19 7 a 15

Tastes, generally adds salt 22 15 7 16 22 20 a 20

Tastes, occasionally adds salt 29 29 33 30 22 25 a 23

Rarely, or never, adds salt 34 41 50 40 7 49 a 42

Basesd

Bases 2004 (weighted) 86 27 10 73 65 31 7 103


Bases 1999 (weighted) 33 20 18 72 49 19 7 75



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Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

% % % % % % % %

Chinese

2004

Adds salt during cooking 86 78 [76] 82 84 69 c 75

Generally adds salt, without tasting 11 10 [7] 10 5 6 c 7

Tastes, generally adds salt 9 11 [18] 11 19 13 c 15

Tastes, occasionally adds salt 29 33 [23] 29 31 23 c 25

Rarely, or never, adds salt 52 46 [52] 50 45 57 c 53

1999

Adds salt during cooking 89 97 [92] 94 94 95 91 94

Generally adds salt, without tasting 11 10 [5] 9 4 6 10 6

Tastes, generally adds salt 9 23 [9] 16 12 16 15 15

Tastes, occasionally adds salt 31 30 [33] 31 43 34 23 35

Rarely, or never, adds salt 49 37 [54] 44 40 44 53 44

Basesd

Bases 2004 (weighted) 39 23 12 74 29 40 8 77


Bases 1999 (weighted) 19 31 12 62 21 48 10 80


Irish

2004






1999






Basesd

Bases 2004 (weighted) 194 360 316 870 227 478 429 1134


Bases 1999 (weighted) 277 568 331 1176 471 699 421 1591




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Table 9.13

Use of salt, by equivalised household income tertile within minorityethnic group and sex


Use of saltb,c Equivalised household income tertile



Adds salt during cooking 65 82 [83] 62 65 77

Generally adds salt at table, without tasting 11 6 [17] 2 9 7

Tastes, generally adds salt at table 16 29 [7] 6 11 8

Tastes, occasionally adds salt at table 27 25 [23] 23 18 19

Rarely, or never, adds salt at table 45 40 [54] 70 63 66

Black African

Adds salt during cooking 75 [78] [60] 86 84 80

Generally adds salt at table, without tasting 7 [9] [18] 7 13 10

Tastes, generally adds salt at table 11 [10] [28] 4 19 27

Tastes, occasionally adds salt at table 45 [18] [23] 30 26 29

Rarely, or never, adds salt at table 37 [63] [32] 58 42 34

Indian

Adds salt during cooking 93 94 91 89 94 88

Generally adds salt at table, without tasting 4 8 7 6 12 11

Tastes, generally adds salt at table 15 11 19 11 10 17

Tastes, occasionally adds salt at table 42 23 31 32 27 27

Rarely, or never, adds salt at table 38 58 43 51 51 44

Pakistani

Adds salt during cooking a 93 93 a 91 86

Generally adds salt at table, without tasting a 10 19 a 8 20

Tastes, generally adds salt at table a 22 7 a 22 21

Tastes, occasionally adds salt at table a 15 31 a 19 23

Rarely, or never, adds salt at table a 53 42 a 50 36

Bangladeshi

Adds salt during cooking a [95] 94 a [89] 90

Generally adds salt at table, without tasting a [26] 19 a [23] 12

Tastes, generally adds salt at table a [14] 15 a [21] 22

Tastes, occasionally adds salt at table a [26] 24 a [14] 31

Rarely, or never, adds salt at table a [34] 42 a [42] 36

Chinese

Adds salt during cooking 80 [74] a 70 [75] a

Generally adds salt at table, without tasting 6 [8] a 2 [9] a

Tastes, generally adds salt at table 10 [13] a 23 [3] a

Tastes, occasionally adds salt at table 28 [30] a 19 [48] a

Rarely, or never, adds salt at table 55 [49] a 55 [40] a

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. 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. Continued…


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Use of saltb,c Equivalised household income tertile


Standardised risk ratiosAdds salt during cooking

Black Caribbean 1.16 1.47 [1.53] 1.14 1.22 1.51


Black African 1.47 [1.43] [1.09] 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


Pakistani a 1.72 1.70 a 1.76 1.67


Bangladeshi a [1.76] 1.73 a [1.77] 1.82


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


General population (2003) 0.95 1.00 1.18 0.96 0.98 1.14


Bases (weighted)d


Black African 68 34 44 65 63 82

Indian 118 123 89 152 149 122

Pakistani 24 70 67 24 69 80


Chinese 25 17 10 32 13 11

Irish 452 224 100 493 316 171


Bases (unweighted)d


Black African 57 36 41 52 59 69

Indian 85 91 65 106 103 88

Pakistani 22 68 76 22 72 92

Bangladeshi 7 30 60 10 32 80

Chinese 67 40 23 79 32 29

Irish 147 84 48 175 115 76


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.

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HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES 301

Blood analytes

Emanuela Falaschetti & Moushumi Chaudhury

Analytes from non-fasting blood sample

Blood samples were taken only from minority ethnic groups in HSE 2004, socomparisons 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 significantafter age standardisation. Age-standardised risk ratios, comparing each minorityethnic 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 ratio0.86) than in the general population.

● The prevalence of low HDL-cholesterol (<1.0 mmol/l) was significantly higher than inthe general population in Pakistani (risk ratio 3.00) and Bangladeshi men (2.82) andBangladeshi women (4.64). The age-standardised risk ratio for the prevalence of lowHDL-cholesterol was significantly lower than 1 in Black African men (0.31).

● The prevalence of elevated levels of C-reactive protein was high for Pakistaniinformants (risk ratio 1.64 in men and 1.50 in women). Chinese women were less likelythan 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 groupsbetween 1999 and 2004 except for Pakistani men, in whom a significant increase wasfound in the proportion of informants with high levels (from 14% in 1999 to 29% in2004).

● 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 Pakistaniwomen 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 groupsand in the general population, except Black Caribbean and Bangladeshi men andChinese men and women.

● The prevalence of anaemia was very low among men, ranging from 0% in Chinese andIrish men to 4.4% in Black Caribbean men. Anaemia was more common amongwomen: it was lowest in Chinese (7.3%) and Irish (5.7%) women but otherwise rangedfrom 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 anyminority ethnic group except for Pakistani women. The prevalence of anaemiadecreased in Black Caribbean women (to 16.4% in 2004 from 25.5% in 1999) and inPakistani women (to 20.5% from 30.3%).

● The prevalence of low ferritin (levels between the cut-offs for the bottom quintile of thegeneral population in 1998) was higher among Indian men (33%) than the other ethnic

10Summary

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302 HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES

groups, with a low prevalence among Chinese men (3%). Among women, prevalenceof low ferritin was higher in South Asian groups (Indian 48%, Pakistani 38% andBangladeshi women 29%) than in Black Caribbean (19%), Chinese (14%) or Irishwomen (14%).

● Between 1999 and 2004, mean ferritin increased significantly in Pakistani and Irishmen, and in Black Caribbean and Bangladeshi women.

● The age-standardised prevalence of high glycated haemoglobin (≥7%) wasconsiderably raised in Bangladeshi men (risk ratio 5.16) and women (6.20) andPakistani 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 waslower in 2004 than in 1999 in each minority ethnic group and in the general population.

Analytes from fasting blood sample

Fasting blood samples were not taken from adults under 35 before 2004, so forcomparison with the general population (in 2003), summary results are those for adultsaged 35 and over.

● Among males aged 35 and over, no significant difference was found in age-standardised mean or prevalence of raised LDL-cholesterol (≥3 mmol/l) betweenminority ethnic groups and the general population (risk ratios not different from 1).Chinese women showed a standardised risk ratio significantly lower than 1 for bothmean 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 LDL-cholesterol, from 49% to 68%.

● Black Caribbean and Black African men and women, Irish men, and Chinese womenaged 35 and over had lower mean triglyceride levels than the general population afterage 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 commonamong Pakistani men (62%) than men in the general population, although afterstandardisation 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 raisedtriglyceride levels decreased among Black Caribbean and Irish men between the twoyears.

● Age-standardised mean fasting glucose levels were not significantly different betweenminority ethnic groups and the general population among male informants. Amongwomen, Pakistani informants had a higher mean glucose level (risk ratio 1.21).

● There was a significant decrease in glucose levels from 1999 to 2004 in all minorityethnic groups in both sexes, except among Pakistani and Bangladeshi men andwomen, for whom the bases were too small to allow comparison.

10.1 Introduction

This chapter presents findings on blood analytes from a non-fasting and a fasting bloodsample collected from seven minority ethnic groups - Black Caribbean, Black African,Indian, Pakistani, Bangladeshi, Chinese, and Irish - during the HSE 2004 nurse visit. Thegeneral population data presented are from HSE 2003, as the general population did notreceive a nurse visit in 2004.

Measurements taken on the non-fasting blood samples were total and HDL- cholesterol, C-reactive protein, fibrinogen, haemoglobin, ferritin, and glycated haemoglobin. LDL-cholesterol, triglycerides, and glucose were measured on the fasting blood samples. Foreach 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 wherepossible. 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 andpercentage 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), whilefor the other minority ethnic groups the percentage ranged from 58% in Chinese men to67% in Black Caribbean and Pakistani men. Among women, response rates were slightlylower than among men. They were above 70% only in Irish women (78%) and women in thegeneral 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, wereineligible (because on anticoagulants or were pregnant), or the nurse was unable to obtain asample from them. Section 6.3 in Volume 2 gives more details of response rates to thedifferent stages of the survey. Table 10.1

Among non-fasting blood sample analytes, there was a lower proportion of valid fibrinogenand haemoglobin samples analysed than for the other analytes in each ethnic group.

Table 10.2All those aged 16 and over in minority ethnic groups were eligible to give a fasting bloodsample in HSE 2004. The proportion of informants providing fasting blood samples waslow, ranging from 23% of Bangladeshi men to 46% of Irish men (compared with 59% ofmen in the general population), and from 18% of Bangladeshi women to 50% of Irishwomen (compared with 60% of women in the general population). However, fasting bloodsamples were sought from (all) adults aged 16 and over from minority ethnic groups in 2004who had a nurse visit, but only from (a random sample of) adults aged 35 and over in thegeneral 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 inlarge confidence intervals. In some groups, the samples have been judged too small fordata to be shown in the tables. Consequently, tables by income are not presented in thischapter. Where the response rate is low, there is also a possibility that those who do notprovide blood have different characteristics from those who do. Some caution is thereforenecessary 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 ispresent in cell membranes and is used to form steroid hormones and bile acids. Some ismade in the liver and some is obtained from the diet. Blood levels depend to a large extenton 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 ofatheroma in arteries, narrowing or blocking them, limiting blood supply to that part of thebody. Reducing total cholesterol levels with drugs, particularly statins, significantly reducesthe risks of developing or dying from ischaemic heart disease (IHD) in people with existingdisease (secondary prevention)2,3 and in those without (primary prevention)4 withoutincreasing risks of other diseases. This report uses high risk level thresholds as defined inthe 1998 Joint British Recommendations on prevention of coronary heart disease in clinicalpractice,5 to facilitate comparisons with HSE 1999. Revised recommendations (JBS 2) werepublished in 2005. These recommended an optimal level for total cholesterol of <4.0 mmol/lin those with established cardiovascular disease (CVD), people with diabetes, or those athigh risk of developing CVD (10 year risk ≥20%) but recommended retaining 5.0 mmol/l asan audit standard.6

Results from HSE 1999 showed that mean total cholesterol was generally lower in minorityethnic groups than in the general population, except for Indian and Irish men. Prevalence ofraised cholesterol was lower than in the general population in Black Caribbean, Pakistaniand 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 section10.10); VLDL-cholesterol (rich in triglycerides, see section 10.11); and HDL-cholesterol.HDL- (High Density Lipoprotein-) cholesterol is protective against IHD. Physiologically, therole of HDL-cholesterol is to transport excess cholesterol from peripheral tissues to the liverfor excretion. It may also reduce the risk of thrombosis by inhibiting platelet activation andaggregation.8 The link between low levels of HDL-cholesterol and an increased risk of IHD iswell established.9 Recommendations to manage low HDL-cholesterol in clinical practicewere set up by a panel of international experts in 2002.10 The cut-off point of ≥1.0 mmol/l isthe recommended goal to be achieved for patients with CVD, and those who are at high riskof the disease.

Both animal and epidemiological studies have suggested that raising the level of HDL-cholesterol may prevent the development of atherosclerosis.11 Lifestyle modifications whichlead 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 greatestin those with the highest HDL levels.11 A number of ‘lipid-lowering’ drugs increase HDLlevels 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 levelswere lower in the Pakistani and Bangladeshi populations and in Indian women, but werehigher than the general population in Black Caribbean men.7

Tables presenting cholesterol data in this chapter include informants who reported takinglipid-lowering drugs.

10.3.2 Total cholesterol and HDL-cholesterol, by minority ethnic group

Among men, mean total cholesterol was lower in Black Caribbean, Black African andChinese informants (5.1 mmol/l) than the general population (5.5 mmol/l); this remainedafter age standardisation. Age-standardised risk ratios are used to take account ofdifferences in the age profile of different minority ethnic groups (see chapter 1, section1.6.5). Risk ratios in these three minority ethnic groups were 0.93, 0.95 and 0.96respectively.

Among women, mean total cholesterol levels were higher in the general population and Irishinformants (5.6 mmol/l in each) than among women in other ethnic groups, but after agestandardisation, the risk ratio in Black African and Bangladeshi women was not significantlydifferent from the general population. No significant sex differences were observed withinthe minority ethnic groups for mean total cholesterol. Mean total cholesterol increased withage in both sexes.

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The prevalence of high total cholesterol (≥5.0 mmol/l) was significantly lower among BlackCaribbean (51%) and Pakistani (55%) men than among Irish men (67%) and men in thegeneral population (66%), but after age standardisation, only Black Caribbean men had arisk ratio significantly below 1 (0.82). Irish women and women in the general population hadgreater 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 BlackAfrican women. Nevertheless, after age standardisation, only Indian women had astandardised risk ratio significantly lower than 1 (0.86).

Mean HDL-cholesterol was generally higher in women than in men in each minority ethnicgroup 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) menthan among men in the general population (1.4 mmol/l). Black African, Indian and Pakistaniwomen (each 1.4 mmol/l) and Bangladeshi women (1.2 mmol/l) had lower mean HDL-cholesterol 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 bothsexes.

Apart from Chinese informants, prevalence of low HDL-cholesterol (<1.0 mmol/l) wasconsiderably 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) andBangladeshi (19.5% of men and 8.1% of women) than in the general population (6.3% ofmen and 1.9% of women). After standardisation, the risk ratio for the prevalence of lowHDL-cholesterol was significantly higher than 1 only in Pakistani men (3.00) andBangladeshi men (2.82) and women (4.64), while it was significantly lower than 1 in BlackAfrican men (0.31). Table 10.3, Figure 10A

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 differedlittle in 2004 from those seen in 1999.

Pakistani and Bangladeshi men and women and Black Caribbean women showed anincrease in mean total cholesterol from 1999 to 2004. Due to this rise, the differences inmean total cholesterol between the minority ethnic groups and the general populationreduced 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 responseto tissue injury, including that caused by infection, trauma, malignant disease and chronicinflammatory conditions.16 CRP levels are positively associated with the risk of myocardialinfarction (heart attack),17 stroke,18 peripheral arterial disease,17 and cognitive disorders,including dementia.18 CRP is associated with impaired endothelial function and is positivelycorrelated with smoking, BMI, and impaired lung function.19

CRP levels increase with age20 and are higher in women than men both in the generalpopulation16 and in minority ethnic groups.7,21 There is an inverse relationship between CRPlevels and income20 but no general relationship with social class.7 Black adults in Americahave higher CRP levels than white.21 CRP levels are higher in South Asian populations andlower in African-Caribbean groups than Europeans in the UK.15 Compared with the generalpopulation, high CRP levels were more prevalent in Pakistani women in HSE 1999 and wereless 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 to1,000mg/l during the acute phase response to injury or inflammation. Distribution istherefore not normal, being skewed to the left, as only small numbers of individuals in thegeneral population have such high levels at any one time. Both the arithmetic mean and themedian are therefore presented in the tables.

There are no population-based thresholds for CRP in the general population or for minorityethnic groups. For this report, the definition for the proportion of informants with the highestlevels was set as those with C-reactive protein levels >3.6 mg/l in men and >5.2 mg/l inwomen, to correspond with the sex-specific thresholds for the top quintile in the 2003general population. However, for comparison with 1999, the quintile distribution from 1998general 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 to4.7 mg/l and 4.0 mg/l in Pakistani men and women, respectively. There were no statisticallysignificant 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 (3.1mg/l). Mean C-reactive protein increased with age in all the groups.

After age standardisation, Chinese informants showed lower C-reactive protein levels thanthe 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 inChinese men (7%) and women (3%), with standardised risk ratio significantly lower only forwomen (0.33). Pakistani informants were significantly more likely to have a high level of C-reactive protein (30% of men, 24% of women, risk ratios 1.64 and 1.50 respectively).

Tables 10.6, 10.7

10.4.2 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 similarpatterns between the different ethnic groups. The only significant increase was found in theproportion 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 isstrongly and independently associated with cardiovascular risk.22 Raised fibrinogen is amajor risk factor for ischaemic heart disease, stroke, hypertension, and cancer.23,24,25


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Fibrinogen levels increase with age and are higher in women than men;7,20 no ethnicdifferences 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 2.6g/l) than the other minority ethnic groups (mean 2.8 g/l to 2.9 g/l). Chinese women had lowerfibrinogen levels (mean 2.7 g/l) than women in the other minority ethnic groups. After agestandardisation, Black Caribbean men and Chinese women had lower mean fibrinogenlevels than the general population (standardised ratio 0.95, 0.91 respectively), whilePakistani 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 thanin 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 andin the general population, except in Black Caribbean and Bangladeshi men and Chinesemen and women. The increase was considerable in most groups, with increases of 0.4 g/l inPakistani men and women and Bangladeshi women.

Since the levels of fibrinogen rose in some ethnic groups but not others between 1999 and2004, the general pattern between the minority ethnic groups was different in 2004 fromthat seen in 1999. No difference between the ethnic groups was found in 1999. In 2004, thestandardised risk ratios were significantly lower than 1 in Black Caribbean men and Chinesewomen. Table 10.9

10.6 Haemoglobin

10.6.1 Introduction

Haemoglobin, an iron-containing protein in red blood cells, carries oxygen from the lungs tothe rest of the body. Low levels of haemoglobin can be caused by blood loss, dietarydeficiencies, or problems with producing haemoglobin (such as sickle cell disease), leadingto anaemia. Certain physiological adjustments can also lead to a low haemoglobin. Raisedlevels (polycythaemia or erythrocytosis) can also occur in response to physiologicalchanges or disease.

Mean haemoglobin levels are higher in men than women, due to menstrual blood loss inwomen of childbearing age. HSE 1999 found that anaemia was a little more common inPakistani men and about three times higher in Black Caribbean, Indian, Pakistani andBangladeshi women than in the general population.7

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 Africanwomen to 13.5 g/dl in Irish women. Mean haemoglobin was lower in women than in men ineach minority ethnic group. Haemoglobin was not measured in HSE 2003, so nocomparisons have been made with the general population and risk ratios are not presentedin 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, rangingfrom 0% in Chinese and Irish informants to 4.4% in Black Caribbean men. Anaemia wasmuch 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 Caribbeanwomen to 29.0% in Indian women. Table 10.10, Figure 10B


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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 haemoglobinfrom 12.4 g/dl in 1999 to 13.0 g/dl in 2004, mean haemoglobin did not change between1999 and 2004, showing similar patterns between the different ethnic groups.

The prevalence of anaemia decreased in Black Caribbean women (to 16.4% in 2004 from25.5% 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 withthe amount of iron stored in the body. Low ferritin levels indicate iron-deficiency. Plasmaferritin levels can be raised by iron overload, liver disease, infections, inflammation, andmalignancy. This report focuses on prevalence of low ferritin levels. Low ferritin levels werefound more commonly in HSE 1999 than in Indian and Pakistani men and women andBangladeshi women in the general population.7

10.7.2 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) informantsand highest in Chinese informants (220.7 ng/ml). Among women, it was lowest in Indianinformants (33.8 ng/ml) and highest in Chinese informants (79.3 ng/ml). Ferritin was notmeasured in HSE 2003, so no comparisons have been made with the general populationand risk ratios are not presented in table 10.12.

The prevalence of low ferritin (levels equivalent to the bottom quintile of the generalpopulation in 1998) among Indian men was higher (33%) than among any other ethnicgroup, with a very low prevalence among Chinese men (3%). Among women, theproportion with low ferritin ranged from 14% in Chinese informants to 48% in Indianinformants. Prevalence of low ferritin was higher in Indian, Pakistani and Bangladeshiwomen than in Black Caribbean, Chinese or Irish women.

Among women, mean ferritin increased with age in most minority ethnic groups but thepattern was less clear among men. Tables 10.12, 10.13


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Mean ferritin increased in almost every group between 1999 and 2004 but the rise wasstatistically significant only in Pakistani and Irish men, and in Black Caribbean andBangladeshi women. Pakistani men and Bangladeshi women also showed a decrease inthe proportion of informants with ferritin in the bottom quintile. Overall patterns between thedifferent 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 thepreceding three months. It is used to monitor control of blood sugar in diabetics: high levelsindicate individuals at higher risk of micro- and macro-vascular complications. It has alsobeen 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 isnot surprising that glycated haemoglobin levels were higher in these groups, and also inChinese 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 inthe general population (5.3% in both sexes), with the exception of Chinese and Irish menand women and Black African women. There was no gender difference in mean glycatedhaemoglobin, which increased with age in both sexes. After age standardisation, meanlevels in Indian, Pakistani and Bangladeshi men and women, Black African men, and BlackCaribbean 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 generalpopulation (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, thelikelihood of high glycated haemoglobin was significantly raised in Bangladeshi men (riskratio 5.16) and women (6.20) and Pakistani women (6.39) and significantly lower in Irish menand 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

With the exception of Pakistani and Irish women, mean glycated haemoglobin levels ineach 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 ethnicgroups 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 post-prandial samples being transiently raised. Analysis of these substances was therefore madeon 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 thereforeneeded when interpreting the results; results have been commented on in the text belowonly when there were at least 50 informants in the group or where the difference wasstatistically significant, even allowing for the small base. General population comparisonsare made with results from HSE 2003, in which fasting blood samples were requested onlyfrom a random sample of informants aged 35 and over.


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10.10 LDL-cholesterol

10.10.1 Introduction

Low-density lipoprotein (LDL), the predominant form of cholesterol in the blood, is thecomplex of fat and protein that transports cholesterol into the blood from the liver. WhereasHDL-cholesterol is protective against cardiovascular disease, LDL-cholesterol is the maincause of fatty deposits (atheromatous plaques) on the walls of the arteries (‘narrowing of thearteries’). 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 Healthand Clinical Excellence) has recommended the use of statins for prevention ofcardiovascular disease in adults who have a 20% or greater 10-year risk of developingcardiovascular disease.30

Although there is no definite threshold below which LDL-cholesterol is not associated withlower risk of cardiovascular disease,31 the current Department of Health recommendation isfor LDL-cholesterol to be below 3.0 mmol/l in people at high risk of cardiovasculardisease.32 In this report, an LDL-cholesterol level of 3.0 mmol/l or above is referred to as‘high’.

In HSE 1999, prevalence of high LDL-cholesterol was higher in Indian and Irish men andwomen and Black Caribbean and Chinese men, while levels were slightly lower in Pakistanimen and women, Bangladeshi men, and Black Caribbean and Chinese women, than ininformants in the general population.7 Other studies have also found lower levels of LDL-cholesterol in the Bangladeshi population.33,34 There is no information available about theeffectiveness of statins or the effects of cholesterol-lowering in most minority ethnicgroups30 but one study has found greater effectiveness of statin treatment in Black thanwhite participants, although LDL-cholesterol levels are generally lower in the Blackpopulation.15

10.10.2 LDL-cholesterol, by minority ethnic group

Among men aged 16 and over, Indian informants had the highest mean LDL-cholesterollevel (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 Chineseinformants (2.7 mmol/l). It was highest in Irish informants (3.5 mmol/l), being significantlyhigher than in any other minority ethnic group. LDL-cholesterol levels were higher in Indianand Chinese men than in women from the same ethnic group.


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The prevalence of high LDL-cholesterol levels (≥3.0 mmol/l) among males aged 16 and overin minority ethnic groups ranged from 56% in Black African to 68% in Indian and Irish menand 72% in Bangladeshi men. However, caution is needed for this last result because ofsmall numbers. The proportion with raised LDL-cholesterol was significantly lower inChinese 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 inBlack Caribbean to 3.7 mmol/l in Indian men. Only Black Caribbean men (61%), BlackAfrican women (52%) and Chinese women (46%) had significantly lower prevalence ofraised LDL-cholesterol than the general population (77% of men, 74% of women).However, after age standardisation, no significant difference was found between minorityethnic groups and the general population among men. Among women, Chinese womenshowed a risk ratio significantly lower than 1 for both mean and prevalence of raised LDL-cholesterol (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 forinformants aged 35 and over, as fasting blood samples were not taken from informantsunder 35 in HSE before 2004. Consequently the bases in most groups are too small tocomment 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 LDL-cholesterol, and from 49% to 68% in the prevalence of raised LDL-cholesterol. Table 10.17

10.11 Triglycerides


Triglycerides, comprising fatty acids and glycerol, are formed in the intestine from dietaryfat. They appear in the blood after fat-containing meals. Triglyceride levels are inverselyrelated to HDL-cholesterol but raised triglyceride levels, which are associated withdiabetes, are also independently associated with cardiovascular disease.35

High serum triglyceride levels are found more commonly in Bangladeshi men andwomen.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 generallylower in Black adults.15

10.11.2 Triglycerides, by minority ethnic group

Among men aged 16 and over, Indian, Pakistani, Bangladeshi and Irish informants hadhigher mean triglycerides than the other minority ethnic groups. Pakistani and Bangladeshimen also had higher prevalence of raised triglycerides (52% and 53%) than any other ethnicgroup. A similar pattern was found among women: Indian, Pakistani, Bangladeshi and Irishinformants had higher mean triglycerides and higher prevalence of raised triglycerides thanBlack Caribbean and Black African informants.

Black Caribbean and Black African men and women, Irish men, and Chinese women aged35 and over had lower mean triglyceride levels than the general population, confirmed afterage standardisation.

Black Caribbean and Black African men and women aged 35 and over also had lowerprevalence of raised triglycerides (≥1.6 mmol/l) (Black Caribbean: 14% of both men andwomen; 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 and29% women) groups. However, raised triglycerides was more common among Pakistanimen (62%) than among men in the general population. After age standardisation, the risk


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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 menthan 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 amongIrish men and women, Black Caribbean and Indian men, and Chinese women. BlackCaribbean and Irish men also showed a decrease in the prevalence of raised triglyceridelevels. The pattern between the ethnic groups changed between the two years as thedifferences between the minority ethnic groups and the general population reduced: Irishmen and Indian men, and Chinese women had significantly higher triglycerides than thegeneral population in 1999 but not in 2004. Table 10.19

10.12 Glucose


Glucose (‘blood sugar’) is a source of energy for tissue cells, and the only source of energyfor some types of cell. Blood levels are regulated by the liver, which removes glucose aftermeals 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 ofcardiovascular disease.39 The UK uses the WHO guidelines level for diagnosing diabetes: afasting glucose of 7.0 mmol/l or above.40 Mean fasting glucose and the prevalence of raisedlevels both increase with age.20 Type 2 diabetes is much more common in Black Caribbeanand South Asian groups.41 Both mean fasting glucose and prevalence of raised levels werehigher in Asian populations than the general population in England in HSE 1999; prevalenceof 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 menand women to 5.6 mmol/l in Black African men and 6.0 mmol/l in Pakistani women. Theprevalence of raised glucose ranged from 2.3% in Chinese men to 9.7% in Black Africanmen, and from 0% in Chinese women to 9.9% in Pakistani women. (Prevalence of raisedglucose was 10.2% in Bangladeshi women but the base size was small.)

Irish men aged 35 and over had lower mean glucose (5.1 mmol/l) than general populationmen (5.3 mmol/l) but after age standardisation the risk ratio was not significantly differentfrom 1. Among women aged 35 and over, after age standardisation, only Pakistaniinformants 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 (≥7mmol/l) (16.2% and 12.0% respectively) than men in the general population (5.1%), thoughnumbers of Black African informants were small. After age standardisation, no significantdifference was found in the prevalence of raised glucose between any minority ethnic groupand the general population in men or women. Table 10.20

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 ethnicgroups in both sexes, with the exception of Pakistani and Bangladeshi men and women, forwhom the bases were too small to enable comparison. The pattern between ethnic groupsdid not change over time. Table 10.21


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2 Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol-lowering in 4444patients 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 loweringwith 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 withhypercholesterolemia. N Engl J Med 1995; 333:1301-1308.

5 Wood DA, Durrington P, Poulter N, et al. Joint British recommendations on prevention of coronary heartdisease in clinical practice. Heart. 1998; 80:S1-29.

6 British Cardiac Society, British Hypertension Society, Diabetes UK, HEART UK, Primary CareCardiovascular Society, The Stroke Association. JBS 2: Joint British Societies’ guidelines on preventionof 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 forEngland: 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 andits 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 ofcoronary heart disease risk. The PROCAM experience and pathophysiological implications for reversecholesterol 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 physicalactivity 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: thenational 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 andselected 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 researchwith 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 acommunity 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, cognitivedisorders, and depression in the general population: systematic review and meta-analysis. Lancet Neurol2005; 4:371-380.

19 Danesh J, Whincup PH, Walker M. Low-grade inflammation and coronary heart disease: new prospectivestudies 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 CollCardiol. 2005 46:464-469.

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 FraminghamStudy. 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 specifichistocytological composition and complications of atherosclerotic carotid plagues in patients affected bytransient ischemic attacks. Circulation, 2000; 1017:744-750.

26 McCance DR, Hanson RL, Charles M-A, et al. Comparison of tests for glycated haemoglobin and fastingand two hour plasma glucose concentrations as diagnostic methods of diabetes. BMJ. 1994; 308:1323-1328.


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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 RiskFactor Intervention Trial. Diabetes Care. 1993; 16:434-444.

28 Heart Protection Study Collaborative Group. Effect of cholesterol-lowering with simvastatin on strokeand other major vascular events in 20,536 people with cerebrovascular disease or other high-riskconditions. 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 inpopulation 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 coronaryrisk 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 incoronary 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 whatcost--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. JBone 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 inmen 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 WHOconsultation. Part 1: Diagnosis and classification of diabetes mellitus. WHO, Department of Non-communicable Disease Surveillance, Geneva, 1999 (WHO/NCD/99.2).

41 Aspinall P, Jacobson B. Ethnic disparities in health and health care: A focused review of the evidence andselected examples of good practice. London Health Observatory, London, 2004.


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HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 10: BLOOD ANALYTES 315

10.20 Glucose, by minority ethnic group and sex

10.21 Comparison of glucose in 2004 and 1999, byminority ethnic group and sex

Tables

10.1 Response to non-fasting and fasting bloodsamples, by minority ethnic group and sex

10.2 Percentages providing valid samples for eachanalyte, by minority ethnic group and sex

10.3 Total cholesterol and HDL-cholesterol, byminority ethnic group and sex

10.4 Comparison of total cholesterol in 2004 and1999, by age within minority ethnic group andsex

10.5 Comparison of HDL-cholesterol in 2004 and1999, by age within minority ethnic group andsex

10.6 C-reactive protein, by minority ethnic group andsex

10.7 Comparison of C-reactive protein in 2004 and1999, by age within minority ethnic group andsex

10.8 Fibrinogen, by minority ethnic group and sex

10.9 Comparison of fibrinogen, in 2004 and 1999, byage 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 agewithin minority ethnic group and sex

10.14 Glycated haemoglobin, by minority ethnicgroup and sex

10.15 Comparison of glycated haemoglobin in 2004and 1999, by age within minority ethnic groupand sex

10.16 LDL-cholesterol, by minority ethnic group andsex

10.17 Comparison of LDL-cholesterol in 2004 and1999, 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


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Table 10.1

Response to non-fasting and fasting blood samples, by minority ethnic group and sex


Whether blood Minority ethnic group Generalobtained population

Black Black (2003)a


% % % % % % % %

MenNon-fasting blood obtained 67 66 77 67 60 58 77 77

Consent given, no fasting blood obtained 3 7 2 5 3 5 4 3

Ineligibleb 8 2 4 3 1 2 6 5

Refused 22 26 16 25 36 35 12 15

Fasting blood obtainedc 40 39 39 39 23 38 46 59


Ineligible for fasting blood 8 2 4 3 1 2 6 5

Refused fasting blood 51 58 54 58 72 59 46 22

WomenNon-fasting blood obtained 64 56 67 56 53 57 78 72

Consent given, no blood obtained 5 6 8 4 10 5 4 5

Ineligibleb 4 7 6 13 5 5 4 7

Refused 26 31 19 26 31 34 14 16

Fasting blood obtainedc 41 35 41 24 18 39 50 60


Ineligible for fasting blood 4 7 6 13 5 5 4 5

Refused fasting blood 52 54 52 61 70 56 45 23

Bases (unweighted)

Non-fasting blood

Men 218 165 316 208 143 183 320 5086

Women 327 216 382 260 185 199 418 6322

Fasting blood

Men 218 165 316 208 143 183 320 659

Women 327 216 382 260 185 199 418 800

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

and over in the general population in 2003.


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Table 10.2

Percentages providing valid samples for each analyte, by minority ethnic group and sex


Valid blood samples Minority ethnic group Generalobtained population

Black Black (2003)a


% % % % % % % %

MenNon-fasting blood obtained

Total cholesterol 65 64 75 67 60 53 75 74

HDL-cholesterol 65 64 75 67 60 53 75 74

C-reactive protein 65 64 74 67 60 53 75 74

Fibrinogen 60 51 73 63 57 54 75 73

Haemoglobin 54 59 62 58 51 46 64 63

Ferritin 64 63 74 65 57 54 73 c

Glycated haemoglobin 64 64 74 66 60 53 74 c

Fasting blood obtainedb

LDL-cholesterol 36 38 35 34 21 35 42 51

Triglycerides 35 38 34 34 19 35 41 49

Glucose 38 39 39 38 22 37 44 58

WomenNon-fasting blood obtained

Total cholesterol 62 54 66 56 51 55 77 70

HDL-cholesterol 62 54 66 56 51 55 77 70

C-reactive protein 62 54 65 56 51 55 77 69

Fibrinogen 57 44 64 54 52 55 75 69

Haemoglobin 56 50 60 46 44 50 66 59

Ferritin 62 51 62 52 48 53 76 c

Glycated haemoglobin 62 52 63 53 47 53 77 c

Fasting blood obtainedb

LDL-cholesterol 36 33 38 20 16 38 46 53

Triglycerides 36 33 38 20 16 38 46 52

Glucose 40 34 41 24 18 37 49 57

Bases (unweighted)

Non-fasting blood

Men 218 165 316 208 143 183 320 5086

Women 327 216 382 260 185 199 418 6322

Fasting bloodb

Men 218 165 316 208 143 183 320 659

Women 327 216 382 260 185 199 418 800

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.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 2004

Total cholesterol/HDL- Minority ethnic group Generalcholesterol (mmol/l) population

Black Black (2003)a


MenTotal cholesterol

Observed

Mean 5.1 5.1 5.3 5.3 5.3 5.1 5.4 5.5


% ≥5.0 mmol/l 51 55 60 55 60 60 67 66


Mean total cholesterol: ratio of means 0.93 0.95 0.98 0.98 0.97 0.96 0.99 1


% ≥5.0 mmol/l (risk ratio) 0.82 0.87 0.94 0.90 0.93 1.05 1.02 1


HDL- cholesterol

Observed

Mean 1.4 1.4 1.3 1.2 1.1 1.3 1.4 1.4


% <1.0 mmol/l 3.6 2.1 11.0 19.8 19.5 7.7 5.1 6.3




% <1.0 mmol/l (risk ratio) 0.60 0.31 1.61 3.00 2.82 2.23 0.65 1


WomenTotal cholesterol

Observed

Mean 5.2 4.8 5.1 5.1 5.1 5.1 5.6 5.6


% ≥5.0 mmol/l 56 44 53 53 55 52 67 67




% ≥5.0 mmol/l (risk ratio) 0.88 0.92 0.86 0.92 0.98 0.90 0.85 1


HDL- cholesterol

Observed

Mean 1.6 1.4 1.4 1.4 1.2 1.7 1.6 1.6


% <1.0 mmol/l 1.3 3.1 3.9 5.6 8.1 1.3 1.8 1.9




% <1.0 mmol/l (risk ratio) 0.54 1.07 1.82 2.68 4.64 0.54 0.94 1


Bases (weighted)

Men 139 109 267 123 44 39 510 4020

Women 199 142 304 148 64 48 675 4249

Bases (unweighted)

Men 137 103 234 137 87 101 244 3814

Women 195 118 256 143 98 108 300 4460



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Table 10.4

Comparison of total cholesterol in 2004 and 1999, by age within minorityethnic group and sexa

Aged 16 and over with valid total cholesterol measurement 2004, 1999

Total cholesterol Age group(mmol/l)

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ 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 [32] 69 [48] 51 [32] 58 [83] 56

1999

Mean 4.6 5.3 5.3 5.0 4.5 4.9 5.8 4.9


% ≥5.0 mmol/l 31 62 68 52 27 44 80 45

Indian

2004

Mean 5.1 5.7 5.0 5.3 4.6 5.2 [5.8 ] 5.1

Standard error of the mean 0.17 0.11 0.18 0.10 0.10 0.09 [0.17 ] 0.07

% ≥5.0 mmol/l 45 75 52 60 29 64 [82] 53

1999

Mean 4.8 5.7 5.6 5.4 4.6 5.1 5.6 5.0


% ≥5.0 mmol/l 41 72 74 62 35 52 76 50

Pakistani

2004

Mean 5.0 5.7 [5.2] 5.3 4.9 5.3 b 5.1

Standard error of the mean 0.15 0.15 [0.24] 0.10 0.08 0.14 b 0.08

% ≥5.0 mmol/l 49 66 [49] 55 44 61 b 53

1999

Mean 4.7 5.3 [5.1] 5.0 4.5 5.1 b 4.8


% ≥5.0 mmol/l 35 62 [63] 49 28 57 b 41

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 [51] [68] b 60 43 [72] b 55

1999

Mean 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 32 64 [62] 48 24 [53] b 36

Chinese

2004

Mean [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

% ≥5.0 mmol/l [46] [78] b 60 [42] 59 b 52

1999

Mean [4.5] 5.4 [5.4] 5.1 [4.6] 5.0 b 5.1

Standard error of the mean [0.14] 0.10 [0.21] 0.08 [0.14] 0.08 b 0.07

% ≥5.0 mmol/l [19] 72 [67] 56 [29] 51 b 49

Continued…



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.

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.


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Aged 16 and over with valid total cholesterol measurement 2004, 1999

Total cholesterol Age group(mmol/l)

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Irish

2004

Mean 5.2 5.5 5.5 5.4 [4.6] 5.5 6.2 5.6

Standard error of the mean 0.15 0.12 0.16 0.08 [0.20] 0.11 0.19 0.10

% ≥5.0 mmol/l 62 71 66 67 [29] 67 84 67

1999

Mean 4.9 5.6 5.5 5.4 4.7 5.4 6.1 5.4


% ≥5.0 mmol/l 40 77 72 68 34 62 91 63

General population

2003c

Mean 4.9 5.8 5.6 5.5 4.8 5.6 6.2 5.6


% ≥5.0 mmol/l 45 79 72 66 43 69 85 67

1998d

Mean 4.9 5.6 5.7 5.5 4.8 5.4 6.3 5.6


% ≥5.0 mmol/l 41 74 78 66 39 66 90 67

Bases (weighted)

Black Caribbean 2004 46 52 41 139 66 86 48 199

Black Caribbean 1999 80 54 68 201 88 113 50 252

Indian 2004 85 119 62 267 116 147 41 304

Indian 1999 123 173 61 357 132 162 59 353

Pakistani 2004 53 45 25 123 79 52 17 148

Pakistani 1999 88 67 22 177 96 54 13 162

Bangladeshi 2004 21 18 6 44 39 18 6 64

Bangladeshi 1999 26 15 12 53 29 11 3 43

Chinese 2004 20 13 5 39 23 22 3 48

Chinese 1999 14 24 9 47 13 35 7 56

Irish 2004 130 191 189 510 125 277 273 675

Irish 1999 211 454 282 947 302 597 365 1264



Bases (unweighted)

Black Caribbean 2004 38 59 40 137 47 99 49 195

Black Caribbean 1999 110 79 96 285 131 167 70 368

Indian 2004 65 117 52 234 82 133 41 256

Indian 1999 129 185 65 379 136 176 64 376

Pakistani 2004 59 51 27 137 70 55 18 143

Pakistani 1999 149 115 37 301 164 94 23 281

Bangladeshi 2004 37 38 12 87 56 32 10 98

Bangladeshi 1999 103 56 39 198 114 49 13 176

Chinese 2004 44 41 16 101 43 57 8 108

Chinese 1999 45 73 31 149 41 110 24 175

Irish 2004 57 100 87 244 49 126 125 300

Irish 1999 71 151 104 326 107 197 135 439








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Table 10.5

Comparison of HDL-cholesterol in 2004 and 1999, by age within minorityethnic group and sexa

Aged 16 and over with valid HDL-cholesterol measurement 2004, 1999

HDL-cholesterol Age group(mmol/l)

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Black Caribbean

2004

Mean [1.4] 1.4 [1.4] 1.4 [1.5] 1.6 [1.6] 1.6


% <1.0 mmol/l [10.0] 0.6 [-] 3.6 [3.9] - [-] 1.3

1999

Mean 1.5 1.4 1.5 1.5 1.6 1.6 1.6 1.6


% <1.0 mmol/l 9.1 10.9 8.5 9.4 3.9 3.9 0.3 3.2

Indian

2004

Mean 1.3 1.3 1.2 1.3 1.4 1.4 [1.5 ] 1.4

Standard error of the mean 0.03 0.04 0.05 0.02 0.03 0.03 [0.03 ] 0.02

% <1.0 mmol/l 6.5 12.2 15.1 11.0 5.1 3.4 [2.2] 3.9

1999

Mean 1.3 1.2 1.3 1.3 1.5 1.4 1.4 1.4


% <1.0 mmol/l 15.2 20.5 20.6 18.7 3.6 10.3 17.1 8.9

Pakistani

2004

Mean 1.2 1.2 [1.1] 1.2 1.3 1.4 b 1.4


% <1.0 mmol/l 20.7 15.4 [26.2] 19.8 4.8 8.5 b 5.6

1999

Mean 1.2 1.1 [1.1] 1.1 1.4 1.3 b 1.4


% <1.0 mmol/l 24.5 34.5 [21.5] 27.9 13.1 14.0 b 13.1

Bangladeshi

2004

Mean [1.1] [1.1] b 1.1 1.2 [1.2] b 1.2


% <1.0 mmol/l [20.3] [18.1] b 19.5 7.4 [4.8] b 8.1

1999

Mean 1.1 1.0 [1.0] 1.1 1.4 [1.1] b 1.3


% <1.0 mmol/l 28.8 57.0 [58.0] 43.4 14.3 [31.2] b 18.5

Chinese

2004

Mean [1.3] [1.4] b 1.3 [1.7] 1.7 b 1.7


% <1.0 mmol/l [1.9] [4.9] b 7.7 [-] 2.9 b 1.3

1999

Mean [1.3] 1.4 [1.2] 1.3 [1.6] 1.6 b 1.6


% <1.0 mmol/l [11.2] 14.4 [20.4] 14.6 [4.3] 5.2 b 4.9

Continued…






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Aged 16 and over with valid HDL-cholesterol measurement 2004, 1999

HDL-cholesterol Age group(mmol/l)

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Irish

2004

Mean 1.3 1.4 1.4 1.4 [1.4] 1.6 1.7 1.6


% <1.0 mmol/l 4.8 1.0 9.5 5.1 [4.2] 1.7 0.9 1.8

1999

Mean 1.3 1.3 1.4 1.3 1.6 1.6 1.6 1.6


% <1.0 mmol/l 19.7 18.1 19.0 18.7 5.4 4.7 3.6 4.6

General population

2003c

Mean 1.4 1.4 1.4 1.4 1.6 1.6 1.7 1.6


% <1.0 mmol/l 6.7 5.7 6.6 6.3 2.6 2.0 1.3 1.9

1998d

Mean 1.3 1.3 1.3 1.3 1.5 1.6 1.6 1.6


% <1.0 mmol/l 4.3 6.5 6.1 16.9 1.4 2.1 1.8 5.4

Bases (weighted)

Black Caribbean 2004 46 52 41 139 66 86 48 199

Black Caribbean 1999 80 54 68 201 88 113 50 252

Indian 2004 85 119 62 267 116 147 41 304

Indian 1999 123 173 61 357 132 162 59 353

Pakistani 2004 53 45 25 123 79 52 17 148

Pakistani 1999 88 67 22 177 96 54 13 162

Bangladeshi 2004 21 18 6 44 39 18 6 64

Bangladeshi 1999 26 15 12 53 29 11 3 43

Chinese 2004 20 13 5 39 23 22 3 48

Chinese 1999 14 24 9 47 13 35 7 56

Irish 2004 130 191 189 510 125 277 273 675

Irish 1999 211 454 282 947 302 597 365 1264



Bases (unweighted)

Black Caribbean 2004 38 59 40 137 47 99 49 195

Black Caribbean 1999 110 79 96 285 131 167 70 368

Indian 2004 65 117 52 234 82 133 41 256

Indian 1999 129 185 65 379 136 176 64 376

Pakistani 2004 59 51 27 137 70 55 18 143

Pakistani 1999 149 115 37 301 164 94 23 281

Bangladeshi 2004 37 38 12 87 56 32 10 98

Bangladeshi 1999 103 56 39 198 114 49 13 176

Chinese 2004 44 41 16 101 43 57 8 108

Chinese 1999 45 73 31 149 41 110 24 175

Irish 2004 57 100 87 244 49 126 125 300

Irish 1999 71 151 104 326 107 197 135 439








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Table 10.6

C-reactive protein, by minority ethnic group and sex

Aged 16 and over with valid C-reactive protein measurement 2004

C-reactive protein Minority ethnic group General(mg/l) population

Black Black (2003)a


MenObserved

Mean (mg/l) 2.2 2.9 2.8 4.7 3.8 1.3 2.9 3.1


% ≤0.5b 27 37 23 18 26 51 22 23

% 0.6-0.9 23 18 17 13 19 12 16 17

% 1.0-1.7 14 16 21 22 11 20 14 20

% 1.8-3.6 22 13 20 17 25 11 31 20

% >3.6 14 16 19 30 19 7 18 20


Mean CRP: ratio of means 0.68 0.98 0.89 1.66 1.15 0.59 0.85 1


% >3.6mg/l (risk ratio)c 0.79 0.89 1.00 1.64 1.00 0.67 0.76 1


WomenObserved

Mean (mg/l) 2.7 3.5 3.3 4.0 4.2 1.2 3.1 3.8


% ≤0.5b 30 31 25 13 13 56 18 20

% 0.6-1.2 24 17 21 17 11 22 23 20

% 1.3-2.6 13 21 21 20 28 10 24 21

% 2.7-5.2 18 10 16 26 30 9 19 20

% >5.2 15 20 16 24 18 3 16 20


Mean CRP: ratio of means 0.73 0.97 0.99 1.24 1.10 0.54 0.76 1


% >5.2mg/l (risk ratio)c 0.79 1.08 0.93 1.50 0.98 0.33 0.87 1


Bases (weighted)

Men 139 109 266 123 44 39 506 3999

Women 200 142 301 148 64 48 675 4230

Bases (unweighted)

Men 137 103 233 137 87 101 243 3789

Women 195 118 255 143 98 108 300 4442

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.c These values correspond to the top quintile in the general population in the 2003 survey.


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Table 10.7

Comparison of C-reactive protein in 2004 and 1999, by age within minorityethnic group and sexa

Aged 16 and over with valid C-reactive protein measurement 2004, 1999

C-reactive protein (mg/l) Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Black Caribbean

2004

Mean [1.5] 2.4 [2.7] 2.2 [1.8] 2.5 [4.5] 2.7


% >3.7 (men), > 4.9 (women)b [9] 16 [17] 14 [15] 11 [28] 16

1999

Mean 1.4 1.8 4.2 2.5 1.9 2.6 4.8 2.8


% >3.7 (men), > 4.9 (women)b 6 13 25 15 9 11 30 15

Indian

2004

Mean 1.9 2.6 4.4 2.8 3.0 3.1 [4.7] 3.3


% >3.7 (men), > 4.9 (women)b 11 18 24 17 13 18 [21] 17

1999

Mean 1.9 3.7 4.2 3.2 2.5 3.4 5.2 3.4


% >3.7 (men), > 4.9 (women)b 10 21 29 19 13 19 28 19

Pakistani

2004

Mean 4.9 4.1 c 4.7 3.4 3.9 c 4.0


% >3.7 (men), > 4.9 (women)b 27 28 c 29 25 25 c 28

1999

Mean 2.7 2.3 [3.0] 2.6 2.8 5.3 c 4.0


% >3.7 (men), > 4.9 (women)b 10 16 [24] 14 16 44 c 29

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 [14] [22] c 19 25 [27] c 23

1999

Mean 1.4 3.2 [3.8] 2.5 2.1 4.4 c 3.1


% >3.7 (men), > 4.9 (women)b 7 21 [23] 15 11 21 c 16

Chinese

2004

Mean [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

% >3.7 (men), > 4.9 (women)b [4] [2] c 7 [2] 3 c 3

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

% >3.7 (men), > 4.9 (women)b [9] 2 [18] 7 [17] 3 c 7

Continued…

a Black Africans were includedin the 2004 survey but not in1999, and are thereforeexcluded from thiscomparative table.

b These values correspond tothe top quintile in the generalpopulation 1998 forcomparison with 1999 data.

c Results are not shownbecause of small bases.

d Comparative data for thegeneral population are notavailable on this topic fromthe 2004 survey, so datahave been taken from the2003 survey, which wasweighted for non-response.The 2004 survey is weightedfor differential selectionprobabilities and for non-response.

e Comparative data for thegeneral population are notavailable on this topic fromthe 1999 survey, so datahave been taken from the1998 survey, in which noweighting was involved.


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Aged 16 and over with valid C-reactive protein measurement 2004, 1999

C-reactive protein (mg/l) Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Irish

2004

Mean 1.7 2.3 4.2 2.9 [2.6] 2.5 4.0 3.1


% >3.7 (men), > 4.9 (women)b 5 11 32 17 [20] 10 26 18

1999

Mean 1.8 2.8 4.1 3.0 2.8 3.7 4.9 3.9


% >3.7 (men), > 4.9 (women)b 12 17 31 20 18 20 22 20

General population

2003c

Mean 2.3 2.7 4.2 3.1 3.2 3.4 4.8 3.8


% >3.7 (men), > 4.9 (women)b 12 17 29 19 18 19 27 21

1998d

Mean 1.9 2.2 4.8 3.0 3.0 3.0 4.6 3.6


% >3.7 (men), > 4.9 (women)b 10 15 33 20 15 16 27 20

Bases (weighted)

Black Caribbean 2004 46 52 41 139 67 86 48 200

Black Caribbean 1999 79 53 69 201 86 111 56 252

Indian 2004 85 118 62 266 112 148 41 301

Indian 1999 120 178 67 365 128 165 59 353

Pakistani 2004 53 45 25 123 79 52 17 148

Pakistani 1999 86 67 25 178 97 53 14 164

Bangladeshi 2004 21 18 6 44 39 18 6 64

Bangladeshi 1999 25 15 14 53 28 13 3 44

Chinese 2004 20 13 5 39 23 22 3 48

Chinese 1999 13 23 9 45 13 35 7 54

Irish 2004 130 188 189 506 125 277 273 675

Irish 1999 208 466 292 965 291 597 376 1264


General population (1998) e e e e e e e e

Bases (unweighted)

Black Caribbean 2004 38 59 40 137 47 99 49 195

Black Caribbean 1999 110 78 97 285 128 163 77 368

Indian 2004 65 116 52 233 80 134 41 255

Indian 1999 125 190 72 387 134 176 64 374

Pakistani 2004 59 51 27 137 70 55 18 143

Pakistani 1999 146 116 42 304 164 93 25 282

Bangladeshi 2004 37 38 12 87 56 32 10 98

Bangladeshi 1999 101 54 44 199 110 52 14 176

Chinese 2004 44 41 16 101 43 57 8 108

Chinese 1999 42 69 30 141 38 108 24 170

Irish 2004 57 99 87 243 49 126 125 300

Irish 1999 71 154 107 332 104 197 139 440



a Black Africans were includedin the 2004 survey but not in1999, and are thereforeexcluded from thiscomparative table.

b These values correspond tothe top quintile in the generalpopulation 1998 forcomparison with 1999 data.

c Results are not shownbecause of small bases.

d Comparative data for thegeneral population are notavailable on this topic fromthe 2004 survey, so datahave been taken from the2003 survey, which wasweighted for non-response.The 2004 survey is weightedfor differential selectionprobabilities and for non-response.

e Comparative data for thegeneral population are notavailable on this topic fromthe 1999 survey, so datahave been taken from the1998 survey, in which noweighting was involved.


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Table 10.8

Fibrinogen, by minority ethnic group and sex

Aged 16 and over with valid fibrinogen measurement 2004

Fibrinogen (g/l) Minority ethnic group Generalpopulation

Black Black (2003)a


MenObserved (g/l)

Mean 2.6 2.6 2.8 2.9 2.8 2.6 2.9 2.8


Median 2.6 2.5 2.7 2.8 2.8 2.4 2.8 2.7

10th percentile 1.9 1.9 2.1 2.0 2.0 1.8 2.1 2.0

90th percentile 3.4 3.5 3.6 3.8 3.9 3.4 3.9 3.7


Mean fibrinogen: ratio of means 0.95 0.96 1.01 1.06 1.07 0.95 1.04 1


WomenObserved (g/l)

Mean 3.0 3.0 3.0 3.2 3.2 2.7 3.0 3.1


Median 3.0 3.0 2.9 3.2 3.1 2.6 3.0 3.0

10th percentile 2.2 2.2 2.2 2.4 2.3 2.0 2.2 2.2

90th percentile 4.0 3.9 3.8 4.2 4.3 3.6 3.9 4.0


Mean fibrinogen: ratio of means 1.01 1.02 1.01 1.12 1.07 0.91 1.00 1


Bases (weighted)

Men 114 98 220 105 37 34 431 3435

Women 180 133 279 124 55 44 582 3629

Bases (unweighted)

Men 115 98 194 119 73 89 210 3194

Women 170 109 231 120 83 99 266 3779



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Table 10.9

Comparison of fibrinogen in 2004 and 1999, by age within minority ethnicgroup and sexa

Aged 16 and over with valid fibrinogen measurement 2004, 1999

Fibrinogen (g/l) Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ 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 [2.3] 2.8 b 2.6 [2.7] 3.0 b 3.0

1999

Mean 2.3 2.4 2.9 2.5 2.6 2.7 3.0 2.7


Median 2.2 2.4 2.9 2.4 2.5 2.6 2.9 2.6

Indian

2004

Mean 2.6 2.7 b 2.8 2.9 2.9 [3.4] 3.0

Standard error of the mean 0.06 0.05 b 0.04 0.08 0.06 [0.15] 0.05

Median 2.5 2.7 b 2.7 2.8 2.9 [3.3] 2.9

1999

Mean 2.3 2.5 2.8 2.5 2.5 2.7 3.3 2.7


Median 2.1 2.4 2.6 2.4 2.4 2.7 3.0 2.7

Pakistani

2004

Mean 2.8 [2.9] b 2.9 3.1 [3.2] b 3.2

Standard error of the mean 0.12 [0.11] b 0.08 0.10 [0.09] b 0.07

Median 2.6 [2.9] b 2.8 3.1 [3.2] b 3.2

1999

Mean 2.4 2.6 [3.0] 2.5 2.7 2.8 b 2.8


Median 2.3 2.5 [3.0] 2.4 2.7 2.8 b 2.7

Bangladeshi

2004

Mean [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 [2.7] b b 2.8 3.0 b b 3.1

1999

Mean 2.3 2.7 [3.0] 2.6 2.5 [3.0] b 2.8


Median 2.2 2.6 [2.7] 2.5 2.5 [2.9] b 2.7

Chinese

2004

Mean [2.4] [2.7] b 2.6 [2.6] 2.7 b 2.7


Median [2.3] [2.7] b 2.4 [2.5] 2.7 b 2.6

1999

Mean [2.4] 2.6 b 2.6 [2.8] 2.6 b 2.7

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

Continued…






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Aged 16 and over with valid fibrinogen measurement 2004, 1999

Fibrinogen (g/l) Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Irish

2004

Mean 2.7 2.8 3.2 2.9 2.9 3.0 3.3 3.0


Median 2.6 2.7 3.2 2.8 2.8 3.0 3.1 3.0

1999

Mean 2.3 2.6 3.0 2.7 2.6 2.8 3.0 2.8


Median 2.3 2.5 3.0 2.5 2.5 2.7 3.0 2.7

General population

2003c

Mean 2.5 2.8 3.2 2.8 2.9 3.0 3.4 3.1


Median 2.4 2.7 3.1 2.7 2.8 2.9 3.3 3.0

1998d

Mean 2.3 2.5 3.0 2.6 2.6 2.7 3.0 2.8


Median 2.2 2.4 2.9 2.5 2.5 2.6 3.0 2.7

Bases (weighted)

Black Caribbean 2004 41 50 23 114 65 84 31 180

Black Caribbean 1999 74 49 54 177 80 102 42 223

Indian 2004 85 101 34 220 112 137 30 279

Indian 1999 114 152 53 319 121 146 47 315

Pakistani 2004 50 41 14 105 72 46 6 124

Pakistani 1999 82 65 20 167 88 46 10 145

Bangladeshi 2004 21 13 4 37 39 14 3 55

Bangladeshi 1999 24 15 10 48 26 11 3 41

Chinese 2004 18 13 3 34 22 21 2 44

Chinese 1999 13 21 7 42 11 30 6 47

Irish 2004 127 168 136 431 115 270 196 582

Irish 1999 201 447 255 903 274 543 330 1147



Bases (unweighted)

Black Caribbean 2004 34 56 25 115 45 96 29 170

Black Caribbean 1999 102 72 77 251 115 150 58 323

Indian 2004 63 102 29 194 80 121 30 231

Indian 1999 121 163 57 341 127 159 51 337

Pakistani 2004 58 46 15 119 67 47 6 120

Pakistani 1999 139 113 33 285 151 82 18 251

Bangladeshi 2004 37 29 7 73 55 24 4 83

Bangladeshi 1999 96 52 32 180 104 44 13 161

Chinese 2004 41 38 10 89 40 54 5 99

Chinese 1999 43 63 25 131 33 94 20 147

Irish 2004 57 90 63 210 48 125 93 266

Irish 1999 67 146 91 304 98 176 117 391








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Table 10.10

Haemoglobin, by minority ethnic group and sexa

Aged 16 and over with valid haemoglobin measurement 2004

Haemoglobin Minority ethnic group(g/dl)


MenMean (g/dl) 14.5 14.8 14.8 15.2 15.2 15.1 14.9


% <12.0 g/dl (low) 4.4 2.1 1.9 2.3 1.5 - -

WomenMean (g/dl) 12.9 12.5 12.6 13.0 12.7 13.2 13.5


% <12.0 g/dl (low) 16.4 25.8 29.0 20.5 22.5 7.3 5.7

Bases (weighted)

Men 138 107 266 120 42 40 494

Women 199 136 289 140 59 47 669

Bases (unweighted)

Men 134 102 233 136 84 103 239

Women 194 113 241 136 92 105 301

a Haemoglobin was not measured in 2003 so general population data are not presented in this table.


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Table 10.11

Comparison of haemoglobin in 2004 and 1999, by age within minorityethnic group and sexa

Aged 16 and over with valid haemoglobin measurement 2004, 1999

Haemoglobin (g/dl) Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Black Caribbean

2004

Mean [14.6] 14.6 [14.2] 14.5 [12.9] 12.8 12.9 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) [9.0] - [4.7] 4.4 [11.2] 19.3 18.3 16.4

1999

Mean 14.6 14.5 14.0 14.4 12.5 12.5 12.7 12.5


% <12.0 g/dl (low) - - 5.6 1.9 29.8 25.7 18.3 25.5

Indian

2004

Mean 15.3 14.8 14.1 14.8 12.6 12.6 [12.7] 12.6


% <12.0 g/dl (low) 1.8 2.3 1.2 1.9 25.4 30.0 [36.8] 29.0

1999

Mean 15.0 14.8 14.3 14.8 12.4 12.4 13.1 12.5


% <12.0 g/dl (low) - 0.4 4.1 0.9 36.2 32.9 12.1 30.7

Pakistani

2004

Mean 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) - - b 2.3 18.2 23.9 b 20.5

1999

Mean 15.1 15.2 [14.0] 15.0 12.4 12.3 b 12.4


% <12.0 g/dl (low) 3.0 - [10.7] 2.9 31.6 29.6 b 30.3

Bangladeshi

2004

Mean [15.7] [15.2] b 15.2 12.6 b b 12.7

Standard error of the mean [0.17] [0.23] b 0.16 0.22 b b 0.17

% <12.0 g/dl (low) - - b 1.5 21.3 b b 22.5

1999

Mean 15.4 14.9 [14.3] 15.0 12.7 [12.1] b 12.5


% <12.0 g/dl (low) - - [1.4] 0.3 21.0 [54.0] b 28.3

Chinese

2004

Mean [15.2] [15.2] b 15.1 [13.2] 13.1 b 13.2


% <12.0 g/dl (low) - - b - [2.3] 13.1 b 7.3

1999

Mean [15.4] 15.0 [14.7] 15.1 [13.3] 12.9 b 13.1


% <12.0 g/dl (low) [-] 0.9 [2.5] 0.9 [14.5] 16.1 b 13.5

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. Continued…


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Aged 16 and over with valid haemoglobin measurement 2004, 1999

Haemoglobin (g/dl) Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Irish

2004

Mean 15.3 15.0 14.6 14.9 [13.4] 13.3 13.7 13.5


% <12.0 g/dl (low) - - - - [8.5] 5.7 4.4 5.7

1999

Mean 15.2 14.9 14.7 14.9 13.1 13.2 13.3 13.2


% <12.0 g/dl (low) - 0.2 0.6 0.3 7.4 11.2 8.2 9.4

Bases (weighted)

Black Caribbean 2004 47 52 39 138 65 86 48 199

Black Caribbean 1999 80 54 68 203 86 109 55 251

Indian 2004 88 117 61 266 113 140 36 289

Indian 1999 123 179 66 368 125 160 56 341

Pakistani 2004 54 44 23 120 74 50 15 140

Pakistani 1999 88 68 25 181 95 51 13 159

Bangladeshi 2004 26 15 13 55 27 11 3 41

Bangladeshi 1999 19 17 6 42 37 16 6 59

Chinese 2004 14 25 9 48 13 34 8 54

Chinese 1999 21 13 5 40 23 22 2 47

Irish 2004 213 480 284 977 310 605 390 1305

Irish 1999 130 189 175 494 127 275 268 669

Bases (unweighted)

Black Caribbean 2004 39 59 36 134 46 99 49 194

Black Caribbean 1999 110 80 96 286 128 160 76 364

Indian 2004 66 116 51 233 79 125 37 241

Indian 1999 129 192 72 393 129 172 60 361

Pakistani 2004 61 49 26 136 67 52 17 136

Pakistani 1999 150 117 40 307 161 88 23 272

Bangladeshi 2004 36 37 11 84 55 28 9 92

Bangladeshi 1999 102 57 43 202 107 41 13 161

Chinese 2004 46 41 16 103 42 57 6 105

Chinese 1999 46 73 31 150 39 106 26 171

Irish 2004 57 100 82 239 49 128 124 301

Irish 1999 72 158 104 334 109 200 142 451

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.



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Table 10.12

Ferritin, by minority ethnic group and sexa

Aged 16 and over with valid ferritin measurement 2004

Ferritin Minority ethnic group(ng/ml)


MenMean 134.0 137.1 91.3 124.5 100.0 220.7 159.9


Median 109.3 109.4 65.0 101.1 90.0 195.8 126.4

% <lowest quintile threshold 17 15 33 16 19 3 16

WomenMean 64.0 53.6 33.8 43.5 56.9 79.3 75.0


Median 46.0 35.9 22.0 27.0 36.4 49.3 52.0

% <lowest quintile threshold 19 24 48 38 29 14 14

Bases (weighted)

Men 136 107 266 122 44 39 502

Women 197 139 292 141 58 47 675

Bases (unweighted)

Men 134 103 233 136 86 101 243

Women 193 115 245 136 90 105 299

a Ferritin was not measured in 2003 so comparisons with the general population are not presented in this table.


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Table 10.13

Comparison of ferritin in 2004 and 1999, by age within minority ethnicgroup and sexa

Aged 16 and over with valid ferritin measurement 2004, 1999

Ferritin (ng/ml) Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Black Caribbean

2004

Mean [133.9] 152.2 [111.5] 134.0 [44.6] 61.9 [93.5] 64.0


Median [102.0] 136.0 [85.0] 109.3 [32.6] 43.0 [78.0] 46.0

% <lowest quintile value [18] 12 [21] 17 [29] 19 [5] 19

1999

Mean 89.1 117.7 140.7 114.3 33.4 46.2 98.4 53.2


Median 77.4 85.6 117.0 90.1 28.4 34.3 76.0 37.0

% <lowest quintile value 31 23 19 25 34 26 3 24

Indian

2004

Mean 89.2 105.3 67.3 91.3 21.9 36.1 [60.2] 33.8


Median 65.0 66.0 50.0 65.0 17.0 25.0 [28.6] 22.0

% <lowest quintile value 31 27 48 33 64 39 [32] 48

1999

Mean 81.3 90.7 71.7 84.2 24.8 31.4 58.9 33.5


Median 66.0 67.7 61.3 65.5 21.0 22.0 48.1 23.0


Pakistani

2004

Mean 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 87.0 135.5 b 101.1 23.0 27.0 b 27.0

% <lowest quintile value 16 12 b 16 41 38 b 38

1999

Mean 71.1 104.7 [86.6] 86.0 31.9 38.3 b 36.9


Median 62.0 91.4 [70.1] 69.8 21.0 23.0 b 22.0

% <lowest quintile value 35 20 [27] 28 49 47 b 46

Bangladeshi

2004

Mean [107.6] [108.1] b 100.0 35.8 b b 56.9

Standard error of the mean [10.45] [8.16] b 6.85 3.99 b b 10.20

Median [104.6] [104.2] b 90.0 29.6 b b 36.4

% <lowest quintile value [13] [16] b 19 34 b b 29

1999

Mean 86.2 118.8 [85.0] 94.8 32.5 [35.1] b 34.0


Median 67.6 99.0 [87.5] 78.1 22.0 [23.2] b 23.0

% <lowest quintile value 25 7 [33] 22 44 [46] b 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. Continued…


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Aged 16 and over with valid ferritin measurement 2004, 1999

Ferritin (ng/ml) Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Chinese

2004

Mean [176.1] [266.9] b 220.7 [64.3] 90.1 113.3 79.3

Standard error of the mean [17.33] [23.96] b 13.95 [7.22] 16.05 27.78 8.60

Median [164.8] [252.2] b 195.8 [49.3] 40.8 112.7 49.3

% <lowest quintile value [4] [2] b 3 [9] 21 14

1999

Mean [145.5] 214.4 [207.5] 193.4 [53.8] 68.0 b 74.7


Median [101.7] 185.5 [184.6] 157.8 [49.5] 46.0 b 52.0

% <lowest quintile value [14] 6 [11] 9 [19] 19 b 16

Irish

2004

Mean 139.8 151.7 182.8 159.9 [43.3] 51.3 113.8 75.0


Median 129.0 110.3 157.0 126.4 [35.0] 43.2 78.0 52.0

% <lowest quintile value 14 14 19 16 [10] 19 11 14

1999

Mean 123.1 138.3 127.0 131.6 37.7 56.8 89.8 61.8


Median 95.0 107.1 104.0 103.0 29.2 44.8 60.4 43.0


Bases (weighted)

Black Caribbean 2004 46 50 40 136 64 86 48 197

Black Caribbean 1999 79 53 68 199 85 108 54 247

Indian 2004 85 119 61 266 113 142 38 292

Indian 1999 121 180 63 365 125 159 55 339

Pakistani 2004 53 45 23 122 76 50 15 141

Pakistani 1999 86 67 25 178 93 49 13 155

Bangladeshi 2004 21 18 6 44 36 16 6 58

Bangladeshi 1999 25 15 13 53 25 11 2 38

Chinese 2004 20 13 5 39 23 21 3 47

Chinese 1999 13 25 9 47 13 33 7 54

Irish 2004 130 189 183 502 125 277 273 675

Irish 1999 213 459 279 951 309 588 372 1269

Bases (unweighted)

Black Caribbean 2004 38 58 38 134 45 99 49 193

Black Caribbean 1999 109 78 96 283 127 157 75 359

Indian 2004 65 117 51 233 79 128 38 245

Indian 1999 127 191 69 387 129 171 58 358

Pakistani 2004 59 51 26 136 67 52 17 136

Pakistani 1999 147 116 41 304 158 83 24 265

Bangladeshi 2004 37 38 11 86 53 28 9 90

Bangladeshi 1999 103 53 43 199 100 43 10 153

Chinese 2004 44 41 16 101 42 55 8 105

Chinese 1999 44 73 31 148 41 104 25 170

Irish 2004 57 101 85 243 48 126 125 299

Irish 1999 72 151 103 326 108 193 137 438

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.



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Table 10.14

Glycated haemoglobin, by minority ethnic group and sex

Aged 16 and over with valid glycated haemoglobin measurement 2004

Glycated haemoglobin (%) Minority ethnic group Generalpopulation

Black Black (2003)a


MenObserved

Mean 5.5 5.5 5.5 5.7 5.8 5.3 5.3 5.3


% ≥7% 3.4 4.7 6.4 6.5 10.7 2.9 1.9 2.8


Mean haemoglobin: ratio of means 1.04 1.06 1.05 1.09 1.12 1.04 0.99 1


% ≥7% (risk ratio) 1.49 2.99 2.38 3.12 5.16 1.45 0.44 1


WomenObserved

Mean 5.5 5.3 5.5 5.6 5.5 5.3 5.2 5.3


% ≥7% 4.9 2.7 2.6 7.0 6.9 1.5 0.9 2.4


Mean haemoglobin: ratio of means 1.05 1.03 1.05 1.12 1.10 1.01 0.99 1


% ≥7% (risk ratio) 2.33 0.76 1.27 6.39 6.20 0.64 0.36 1


Bases (weighted)

Men 127 87 262 117 42 40 506 3985

Women 180 117 296 144 64 49 664 4199

Bases (unweighted)

Men 122 82 229 129 84 103 242 3782

Women 177 100 249 140 99 109 301 4417



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Table 10.15

Comparison of glycated haemoglobin in 2004 and 1999, by age withinminority ethnic group and sexa

Aged 16 and over with valid glycated haemoglobin measurement 2004, 1999

Glycated Age grouphaemoglobin (%)

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Black Caribbean

2004

Mean [5.1] 5.4 [6.1] 5.5 [5.2] 5.2 [6.3] 5.5


1999

Mean 5.3 5.7 6.8 5.9 5.2 5.6 6.8 5.7


Indian

2004

Mean 5.2 5.6 [6.0] 5.5 5.2 5.6 [5.8] 5.5


1999

Mean 5.3 6.0 6.5 5.9 5.3 5.7 6.6 5.7


Pakistani

2004

Mean 5.3 [5.8] b 5.7 5.2 5.6 b 5.6

Standard error of the mean 0.05 [0.21] b 0.10 0.05 0.11 b 0.09

1999

Mean 5.3 5.9 [7.2] 5.8 5.3 6.0 b 5.7


Bangladeshi

2004

Mean [5.3] [5.8] b 5.8 5.3 [5.7] b 5.5


1999

Mean 5.4 6.4 [7.4] 6.2 5.5 [6.1] b 5.8


Chinese

2004

Mean [5.1] [5.5] b 5.3 [5.1] 5.4 b 5.3


1999

Mean [5.4] 5.7 [6.7] 5.8 [5.5] 5.6 b 5.8


Irish

2004

Mean 5.1 5.2 5.5 5.3 [5.0] 5.2 5.4 5.2


1999

Mean 5.1 5.3 5.9 5.5 4.9 5.1 5.5 5.2


General population

2003c

Mean 5.0 5.3 5.6 5.3 5.0 5.2 5.6 5.3


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…

a Black Africans were included in the2004 survey but not in 1999, and aretherefore excluded from thiscomparative table.

b Results are not shown because ofsmall bases.

c Comparative data for the generalpopulation are not available on thistopic from the 2004 survey, so datahave been taken from the 2003survey, which was weighted for non-response. The 2004 survey isweighted for differential selectionprobabilities and for non-response.

d Blood sample not collected under age35 in the general population 1999.


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Aged 16 and over with valid glycated haemoglobin measurement 2004, 1999

Age group

Men WomenAll All

16-34 35-54 55+ men 16-34 35-54 55+ women

Black Caribbean 2004 36 53 33 122 40 91 46 177

Black Caribbean 1999 109 80 99 288 127 161 78 366

Indian 2004 66 113 50 229 81 128 40 249

Indian 1999 125 193 77 395 134 181 65 380

Pakistani 2004 56 47 26 129 69 54 17 140

Pakistani 1999 149 119 41 309 165 92 24 281

Bangladeshi 2004 36 37 11 84 57 32 10 99

Bangladeshi 1999 101 56 42 199 111 49 14 174

Chinese 2004 46 41 16 103 43 59 7 109

Chinese 1999 47 72 31 150 39 109 26 174

Irish 2004 57 99 86 242 49 127 125 301

Irish 1999 71 157 108 336 107 200 143 450


General population (1999) d 128 111 239 d 179 133 312

a Black Africans were included in the 2004 survey but not in 1999, and are therefore excluded from thiscomparative 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 fordifferential selection probabilities and for non-response.

d Blood sample not collected under age 35 in the general population 1999.


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Table 10.16

LDL-cholesterol, by minority ethnic group and sex

Aged 16 and over with valid LDL-cholesterol measurement 2004

LDL-cholesterol (mmol/l) Minority ethnic group Generalpopulation

Black Black (2003)a


MenObserved

Age 16+

Mean 3.2 3.1 3.6 3.3 [3.3] 3.1 3.4 c

Standard error of the mean 0.13 0.16 0.10 0.11 [0.15] 0.10 0.12 c

% ≥3 mmol/l 57 56 68 59 [72] 63 68 c

Age 35+

Mean 3.3 [3.4] 3.7 [3.5] b [3.5] 3.4 3.6

Standard error of the mean 0.17 [0.15] 0.1 [0.16] b [0.13] 0.13 0.05

% ≥3 mmol/l 61 [75] 76 [77] b [84] 73 77


Age 35+

Mean LDL-cholesterol: ratio of means 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 1


WomenObserved

Age 16+

Mean 3.2 2.9 3.1 3.0 [3.2] 2.7 3.5 c


% ≥3 mmol/l 60 48 55 50 [72] 30 67 c

Age 35+

Mean 3.4 [3.1] 3.3 b b [3.0] 3.6 3.6

Standard error of the mean 0.12 [0.19] 0.1 b b [0.12] 0.12 0.05

% ≥3 mmol/l 68 [52] 68 b b [46] 73 74


Age 35+

Mean LDL-cholesterol: ratio of means 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 1


Bases (weighted)

Age 16+

Men 75 65 120 61 14 26 275 c

Women 116 87 179 50 20 33 401 c

Age 35+

Men 55 39 80 33 7 11 215 290

Women 77 42 105 23 7 19 328 351

Bases (unweighted)

Age 16+

Men 78 60 112 69 31 63 137 c

Women 109 67 145 53 33 71 172 c

Age 35+

Men 57 42 80 36 15 32 112 332

Women 82 36 94 25 12 46 144 429

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.


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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 2004

LDL-cholesterol Minority ethnic group General(mmol/l) population

Black (2003)c

Caribbean Indian Pakistani Bangladeshi Chinese Irish

Men2004

Mean 3.3 3.7 [3.5] d [3.5] 3.4 3.6

Standard error of the mean 0.17 0.10 [0.16] d [0.13] 0.13 0.05

% ≥3 mmol/l 61 76 [77] d [84] 73 77

1999

Mean 3.3 3.5 3.2 [3.3] 3.4 3.5 3.5

Standard error of the mean 0.09 0.07 0.08 [0.11] 0.10 0.07 0.09

% ≥3 mmol/l 67 66 63 [61] 75 70 71

WomenObserved

2004

Mean 3.4 3.3 d d [3.0] 3.6 3.6

Standard error of the mean 0.12 0.10 d d [0.12] 0.12 0.05

% ≥3 mmol/l 68 68 d d [46] 73 74

1999

Mean 3.1 3.1 3.0 d 2.9 3.4 3.5

Standard error of the mean 0.08 0.06 0.08 d 0.09 0.06 0.11

% ≥3 mmol/l 49 57 47 d 45 65 61

Bases (weighted)

Men 2004 55 80 33 7 11 215 290

Men 1999 79 147 57 14 24 469 13635

Women 2004 77 105 23 7 19 328 351

Women 1999 111 151 40 7 30 639 18761

Bases (unweighted)

Men 2004 57 80 36 15 32 112 332

Men 1999 108 157 95 47 73 167 161

Women 2004 82 94 25 12 46 144 429

Women 1999 159 162 72 28 92 222 215

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 non-response.

d Results are not shown because of small bases.


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Table 10.18

Triglycerides, by minority ethnic group and sex

Aged 16 and over with valid triglycerides measurement 2004

Triglycerides (mmol/l) Minority ethnic group Generalpopulation

Black Black (2003)a


MenObserved

Age 16+

Mean 1.1 1.1 1.7 1.8 [2.0] 1.3 1.6 c


% ≥1.6 mmol/l 14 18 36 52 [53] 25 37 c

Age 35+

Mean 1.2 [1.2] 1.7 [2.1] b [1.6] 1.5 1.8

Standard error of the mean 0.06 [0.10] 0.12 [0.21] b [0.15] 0.10 0.08

% ≥1.6 mmol/l 14 [18] 42 [62] b [40] 36 41


Age 35+

Mean triglyceride: ratio of means 0.67 [0.70] 0.99 [1.20] b [0.87] 0.84 1


% ≥1.6 mmol/l (risk ratio) 0.32 [0.45] 1.05 [1.47] b [0.98] 0.82 1


WomenObserved

Age 16+

Mean 1.0 0.8 1.2 1.3 [1.5] 1.1 1.2 c


% ≥1.6 mmol/l 9 3 23 26 [43] 15 24 c

Age 35+

Mean 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

% ≥1.6 mmol/l 14 [4] 29 b b [16] 25 31


Age 35+

Mean triglyceride: ratio of means 0.84 [0.78] 1.06 b b [0.86] 0.91 1


% ≥1.6 mmol/l (risk ratio) 0.59 [0.11] 1.28 b b [0.70] 0.73 1


Bases (weighted)

Age 16+

Men 75 65 125 62 15 26 277 c

Women 116 87 180 50 20 33 402 c

Age 35+

Men 55 39 84 35 8 11 216 304

Women 77 42 106 23 7 19 329 352

Bases (unweighted)

Age 16+

Men 79 60 117 71 33 63 139 c

Women 109 67 146 53 34 71 173 c

Age 35+

Men 57 42 84 38 17 32 113 347

Women 82 36 95 25 13 46 145 431

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.


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Table 10.19

Comparison of triglycerides in 2004 and 1999, by minority ethnic group and sexa

Aged 35 and over with valid triglycerides measurementb 2004

Triglycerides Minority ethnic group General(mmol/l) population

Black (2003)c


Men2004

Mean 1.2 1.7 [2.1] d [1.6] 1.5 1.8


% ≥1.6 mmol/l 14 42 [62] d [40] 36 41

1999

Mean 1.5 2.3 2.1 2.5 1.6 2.1 1.7


% ≥1.6 mmol/l 28 53 61 64 33 51 35

WomenObserved

2004

Mean 1.1 1.4 d d [1.1] 1.3 1.4

Standard error of the mean 0.06 0.09 d d [0.07] 0.07 0.04

% ≥1.6 mmol/l 14 29 d d [16] 25 31

1999

Mean 1.1 1.5 1.6 [2.0] 1.5 1.5 1.4


% ≥1.6 mmol/l 18 34 45 [64] 28 30 31

Bases (weighted)

Men 2004 55 84 35 8 11 216 304

Men 1999 89 176 63 17 25 544 15557

Women 2004 77 106 23 7 19 329 352

Women 1999 121 166 42 9 33 740 20527

Bases (unweighted)

Men 2004 57 84 38 17 32 113 347

Men 1999 124 187 108 60 77 191 181

Women 2004 82 95 25 13 46 145 431

Women 1999 174 179 77 35 101 258 237





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Table 10.20

Glucose, by minority ethnic group and sex

Aged 16 and over with valid glucose measurement 2004

Glucose (mmol/l) Minority ethnic group Generalpopulation

Black Black (2003)a


% % % % % % % %

MenObserved

Age 16+

Mean 5.0 5.6 5.3 5.5 [5.2] 4.8 5.0 b

Standard error of the mean 0.14 0.38 0.13 0.27 [0.28] 0.12 0.07 b

% ≥7 mmol/l 2.7 9.7 8.2 5.7 [4.2] 2.3 2.9 b

Age 35+

Mean 5.1 [6.3] 5.5 [6.0] c [5.2] 5.1 5.3

Standard error of the mean 0.17 [0.59] 0.17 [0.43] c [0.22] 0.08 0.06

% ≥7 mmol/l 3.7 [16.2] 12.0 [9.5] c [5.3] 3.6 5.1


Age 35+

Mean glucose: ratio of means 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 1


WomenObserved

Age 16+

Mean 5.0 4.9 5.0 6.0 [5.2] 4.8 5.0 b

Standard error of the mean 0.12 0.22 0.09 0.62 [0.39] 0.05 0.07 b

% ≥7 mmol/l 3.5 2.9 2.5 9.9 [10.2] - 1.8 b

Age 35+

Mean 5.2 [5.2] 5.2 [5.9] c [5.0] 5.0 5.1

Standard error of the mean 0.16 [0.42] 0.14 [0.41] c [0.06] 0.08 0.05

% ≥7 mmol/l 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


% ≥7 mmol/l (risk ratio) 3.51 [1.35] 2.15 [11.80] c [0.00] 1.40 1


Bases (weighted)

Age 16+

Men 80 66 139 68 16 27 298 b

Women 128 91 191 61 22 32 424 b

Age 35+

Men 59 40 95 41 9 12 240 349

Women 84 44 115 32 7 19 350 384

Bases (unweighted)

Age 16+

Men 84 61 129 78 36 68 151 b

Women 123 72 157 63 37 70 183 b

Age 35+

Men 62 43 94 45 20 36 125 389

Women 93 39 104 35 15 46 154 465

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.


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Table 10.21

Comparison of glucose in 2004 and 1999, by minority ethnic group and sexa

Aged 35 and over with valid glucose measurementb 2004

Glucose (mmol/l) Minority ethnic group Generalpopulation

Black (2003)c


Men2004

Mean 5.1 5.5 [6.0] d [5.2] 5.1 5.3


% ≥7 mmol/l 3.7 12.0 [9.5] d [5.3] 3.6 5.1

1999

Mean 6.2 6.3 6.3 6.9 6.3 5.9 5.8


% ≥7 mmol/l 16.6 19.0 18.7 41.7 17.2 10.9 11.3

WomenObserved

2004

Mean 5.2 5.2 [5.9] d [5.0] 5.0 5.1


% ≥7 mmol/l 5.3 4.1 [14.7] d [-] 2.2 2.4

1999

Mean 5.7 5.9 6.2 [6.0] 5.7 5.3 5.3


% ≥7 mmol/l 9.2 10.5 17.3 [10.4] 9.1 6.0 3.0

Bases (weighted)

Men 2004 59 95 41 9 12 240 349

Men 1999 92 186 67 19 25 569 15718

Women 2004 84 115 32 7 19 350 384

Women 1999 126 168 43 10 33 763 21323

Bases (unweighted)

Men 2004 62 94 45 20 36 125 389

Men 1999 127 197 115 62 76 199 184

Women 2004 93 104 35 15 46 154 465

Women 1999 182 178 80 38 102 261 241




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HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES 345

Complementary andalternative medicinesand therapies (CAM)

Richard Boreham

● Among the general population, 33% of women had used any of the 24 listedcomplementary or alternative medicines (CAM) in the last 12 months, compared with21% of men.

● Women were also more likely than men to have used a CAM practitioner in the last 12months (23% compared with 14%).

● The most popular CAM used in the last 12 months among the general population weremassage 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 werethe least likely. In total, 47% of Chinese women had used any CAM in the last 12months compared with 4% of Bangladeshi women, and 33% of women in the generalpopulation. Equivalent figures for men were Chinese (30%), general population (21%)and Bangladeshi (6%). These differences were mostly due to higher use of Chinesemedicine among Chinese people.

● Younger people in the general population were more likely to use CAM - 22% of menaged 16-34 and 23% of men aged 35-54 had done so in the last 12 months comparedwith 16% of men aged 55 and over. Equivalent figures for women were 34%, 40% and25%.

● Prevalence of having used CAM in the last 12 months was higher among men andwomen in the general population with higher incomes. Among men, those in thehighest income tertile had a risk ratio of 1.61 compared with a risk ratio of 0.57 forthose in the lowest income tertile. Among women the equivalent risk ratios were 1.16and 0.61 respectively.

● There were no relationships between age or income and using CAM among thedifferent minority ethnic groups, although small sample sizes in older age groups andhigher income groups make it difficult to determine whether such relationships exist.

11Summary

11.1 Introduction and measures

Complementary and alternative medicines and therapies (CAM) were introduced as a coremodule in 2004 in order to measure national prevalence of use of CAMs for the first time onHSE. The CAM module was interviewer administered via CAPI and was asked of adultsaged 16 and over. For each of 24 different medicines or therapies, participants were askedwhether they had ever used it, whether they had used it in the last year and whether theyhad consulted a practitioner about it in the last year. The CAM module was introduced inApril 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 ofthe 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% ofmen) and osteopathy (11% of women, 11% of men). Women in the general population weresignificantly more likely than men to have ever used each individual CAM (for CAM withprevalence greater than 0.5%), with the exception of osteopathy, chiropractic and Chinesemedicine.

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% ofwomen and 40% of men in the general population. These differences were mostly due tohigher use of Chinese medicine and acupuncture among Chinese people. Among women,52% of Chinese informants had ever used Chinese medicine (compared with 4% of thegeneral population), and 22% of Chinese women had ever used acupuncture (comparedwith 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 usedChinese 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 generalpopulation (2% and 1% respectively). The same patterns for Chinese Medicine andacupuncture 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 24listed CAM, compared with 51% and 40% among women and men in the generalpopulation, respectively. The only CAM where rates of use among Bangladeshi men andwomen were similar to the general population was homeopathy – 8% of Bangladeshi menand women had ever used homeopathy, compared with 6% of men and 11% of women inthe general population. The same pattern was seen for age-standardised risk ratios.

Table 11.1, Figure 11AAmong women, those from Black Caribbean (40%), Indian (36%), Black African (32%),Pakistani (25%) and Bangladeshi (15%) groups were less likely than those in the generalpopulation to have ever used CAM (51%) and these differences were still significant afterage 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 thesedifferences were still significant after age standardisation. Although Black Caribbean menand Black African men also appeared to be less likely than men in the general population tohave ever used CAM, these differences were not significant once the data were age-standardised. The prevalence of ever using CAM among Irish men and women was similarto that of the general population. Table 11.1, Figure 11A

Ayurvedic medicine was much more prevalent among Indian women and men than amongany other ethnic group – 7% of Indian women and 10% of Indian men had ever usedAyurvedic medicine compared with less than 0.5% of men and of women in the generalpopulation. Table 11.1

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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 the24 listed complementary or alternative medicines (CAM) in the last 12 months (33% ofwomen compared with 21% of men). The most popular CAM used in the last 12 monthswere massage therapy (10% of women and 6% of men) and aromatherapy (11% ofwomen, 3% of men) – these were also the CAM with the highest prevalence of having everbeen used. The next most popular CAM used in the last 12 months were relaxationtechniques (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 andosteopathy were the next most popular.

As with the measure of ever having used CAM, Chinese men and women were the mostlikely ethnic group to have used CAM in the last 12 months. Overall 47% of Chinese womenand 30% of Chinese men had used CAM in the last 12 months, compared with 33% ofwomen and 21% of men in the general population. These differences were mostly due tohigher use of Chinese medicine and acupuncture among Chinese people. Among women,31% of Chinese informants had used Chinese medicine in the last 12 months comparedwith 2% of the general population, and 13% of Chinese women had used acupuncture inthe last 12 months, compared with 3% of women in the general population. The onlydifference in prevalence of use of specific CAM in the last 12 months among men wasChinese medicine (19% of Chinese men compared with 1% of men in the generalpopulation).

Bangladeshi men and women were the least likely ethnic group to have used CAM in thelast 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 CAMin 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 generalpopulation to have used CAM in the last 12 months (33%), and these differences were stillsignificant after age standardisation. The differences between these minority ethnic groupsand 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 347Cop

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Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

Ever used any CAM, by minority ethnic group

Men Women

Ris

k ra

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, lo

gar

ithm

ic s

cale

Figure 11A

2.0

0.5


0.1

1.0

10.0

Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

2.0

0.5

0.1

1.0

10.0

likely than men in the general population (21%) to have used CAM in the last 12 monthswhere 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 anyother ethnic group – 4% of Indian women and men had used Ayurvedic medicine in the last12 months, compared with less than 0.5% of men and of women in the general population.

Table 11.2Among the general population prevalence of using CAM in the last 12 months was loweramong older respondents. Among men in the general population, 16% of those aged 55and over had used CAM in the last 12 months, compared with 23% of those aged 35-54and 22% of those aged 16-34. Among women the equivalent percentages were 25%, 40%and 34%. Table 11.3, Figure 11C


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Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

Used any CAM in last 12 months, by minority ethnic group

Men WomenR

isk

rati

o, l

og

arit

hmic

sca

le

Figure 11B

2.0

0.5


Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

0.01

0.1

1.0

10.0

2.0

0.5

0.01

0.1

1.0

10.0

Whether used CAM in last 12 months, by sex and age Base: General population aged 16 and over

Per

cent

Figure 11C

0

10

20

30

40

MenWomen

Age group

16-34 35-54 55+

It is difficult to determine whether the same age differences existed among minority ethnicgroups 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 therelationship between use of CAM and age. Among women, there was no relationshipbetween 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 amongthose aged 16-34, whereas among Black Caribbean and Irish men prevalence was lowestamong 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 washigher 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 0.57for those in the lowest income tertile. Among women in the general population theequivalent risk ratios were 1.16 and 0.61 respectively. Table 11.4, Figure 11D

There were no significant relationships between income and using CAM in the last 12months among either men or women from any of the minority ethnic groups. However, itshould be borne in mind that the sample sizes for comparing income tertiles within sex andethnic group were small, and only a very strong relationship between income and CAMwould be identifiable. Table 11.4

11.4 Consulted a CAM practitioner in last 12 months

As with the other measures of use of CAM, among the general population, women weremore likely than men to have consulted a practitioner for any of the 24 listed CAM in the last12 months (23% of women compared with 14% of men). Prevalence levels for havingconsulted a practitioner for individual CAMs were relatively low, with the most popular beingmassage 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 12months, where massage therapy and aromatherapy were the most popular.

Bangladeshi men and women were the least likely ethnic group to have consulted a CAMpractitioner in the last 12 months. In total 3% of Bangladeshi women and 3% ofBangladeshi men had consulted a CAM practitioner in the last 12 months, compared with


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Highest tertile

Middle tertile

Lowest tertile

Used CAM in last 12 months, by equivalised household income tertile Base: General population aged 16 and over

Ris

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Figure 11D


0.1

1.0

10.0

Men Women

2.0

0.5

Highest tertile

Middle tertile

Lowest tertile

23% and 14% among women and men in the general population, respectively. Thisrelationship was still significant after age standardisation. Table 11.5, Figure 11E

Black African men and women were also less likely than men and women in the generalpopulation to have consulted a CAM practitioner in the last 12 months. In total, 9% of BlackAfrican women and 8% of Black African men had consulted a CAM practitioner in the last12 months, compared with 23% of women and 14% of men in the general population.

Unlike differences in the use of CAM between Chinese informants and the generalpopulation, there was no difference between Chinese men and women and theircounterparts in the general population in prevalence of having consulted any CAMpractitioner in the last 12 months. However, Chinese women were more likely than womenin the general population to have consulted a practitioner of Chinese medicine in the last 12months (12% and 1% respectively) and there was a similar pattern among men (7% and1% respectively).

For men and women in Black Caribbean, Indian and Pakistani ethnic groups, it was lessclear whether there were significant differences in having consulted a CAM practitioner inthe last 12 months compared with their counterparts in the general population. Before agestandardisation 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 CAMpractitioner in the last 12 months. However, after age standardisation, differences were stillsignificant for women in all these groups, but only Indian men were significantly differentfrom men in the general population. Table 11.5


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Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

Consulted any CAM practitioner in last 12 months, by minority ethnic group

Men Women

Ris

k ra

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ithm

ic s

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Figure 11E

2.0

0.5


Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

0.01

0.1

1.0

10.0

2.0

0.5

0.01

0.1

1.0

10.0

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

This chapter has presented analysis of three CAM measures: ever used, used in the last 12months and consulted a practitioner in the last 12 months. These three measures areobviously inter-related, and thus patterns by minority ethnic groups seen for one measurewere usually present in the other measures. Where there were differences in patternsbetween the different measure, this can mostly be explained by relationships between everused, 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 CAMthat had used it in the last 12 months varied considerably for different CAM. Among thosewho had ever used meditation/visualisation, 65% had done so in the last 12 months andthe equivalent figure for massage therapy was 62%. In contrast, 19% of those who hadever used hypnotherapy had used it in the last year, and equivalent figures for acupunctureand shiatsu were 27% and 28% respectively. Table 11.6, Figure 11F

There was also substantial variation by CAM in the proportion that had seen a practitioneramong those who had used each CAM in the last 12 months. The CAM where people weremost 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 inthe last 12 months and equivalent figures were 97% for osteopathy and 94% foracupuncture. The CAM where people were least likely to have seen a practitioner wereherbal medicine (37% of those who had used herbal medicine in the last 12 months hadseen a practitioner in the last 12 months), aromatherapy (45%) and meditation/visualisation(46%). Table 11.7, Figure 11G


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Whether used individual CAM in the last 12 months Base: General population aged 16 and over who had ever used individual CAM

Figure 11F

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

Percent


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Whether consulted individual CAM practitioner in the last 12 months Base: General population aged 16 and over who had ever used individual CAM

Figure 11G

Percent

0 10 20 30 40 50 60 70 80 90 100

Chiropractic

Osteopathy

Acupuncture

Reflexology

Reiki

Massage therapy

Spiritual healing

Chinese medicine

Homeopathy

Relaxation techniques

Meditation/visualisation

Aromatherapy

Herbal medicine

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HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 11: COMPLEMENTARY AND ALTERNATIVE MEDICINES 353

Tables

11.1 Whether ever used CAM, by minority ethnicgroup and sex

11.2 Whether used CAM in the last 12 months, byminority ethnic group and sex

11.3 Whether used CAM in the last 12 months, byage within minority ethnic group and sex

11.4 Whether used CAM in the last 12 months, byequivalised household income tertile withinminority ethnic group and sex

11.5 Whether used CAM practitioner in the last 12months, by minority ethnic group and sex

11.6 Whether used individual CAM in the last 12months, among those who had ever usedindividual CAM

11.7 Whether consulted individual CAM practitionerin the last 12 months, among those who hadused individual CAM practitioner in the last 12months


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Table 11.1

Whether ever used CAM, by minority ethnic group and sex


Ever used CAM Minority ethnic group Generalpopulation


MenObserved %

Massage therapy 9 7 8 6 0 10 13 10

Aromatherapy 4 4 2 2 0 4 7 6

Acupuncture 7 5 7 4 2 15 8 9

Osteopathy 3 1 3 2 - 7 12 11

Herbal medicine 8 14 8 4 3 5 6 7

Relaxation techniques 5 5 3 2 - 5 5 7

Chiropractic 1 2 2 2 - 5 2 8

Homeopathy 5 3 8 9 8 5 5 6

Reflexology 3 1 4 1 1 7 5 4

Meditation/visualisation 4 2 4 0 - 5 3 3

Healing / spiritual healing 4 4 2 1 - 1 2 3

Hypnotherapy 1 - 2 0 - 1 2 3

Chinese medicine 4 4 4 3 2 44 1 3

Reiki 0 1 3 1 - 3 1 2

Shiatsu - - 0 1 - 3 2 1

Crystal therapy - 1 1 - - 1 2 1

Nutritional therapy - 1 1 - - 1 - 1

Kinesiology - - 1 - - - 0 1

Dowsing 0 1 - - - - 0 0

Naturopathy 1 - - - - - 0 0

Ayurvedic medicine 1 - 10 0 - 0 - 0

Iridology - 1 - 1 - - 0 0

Unani medicine 0 - 1 - 0 - - 0

MegaVit - - - - - - - -

Used any CAM 29 29 29 22 14 55 36 40


Massage therapy 0.87 0.55 0.65 0.52 0.03 0.94 1.41 1

Standard error 0.22 0.15 0.20 0.16 0.03 0.25 0.28

Aromatherapy 0.78 0.52 0.37 0.46 0.05 0.65 1.24 1

Standard error 0.31 0.21 0.17 0.32 0.05 0.25 0.34

Herbal medicine 1.33 2.17 1.20 0.45 0.92 0.79 0.88 1

Standard error 0.34 0.59 0.31 0.17 0.42 0.27 0.32

Acupuncture 1.01 0.49 0.72 0.40 0.36 1.78 0.83 1

Standard error 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 1

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 1

Standard error 0.09 0.11 0.10 0.11 0.09 0.12 0.11

Bases (weighted) 331 245 548 228 107 78 1187 31588


Continued…


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Ever used CAM Minority ethnic group Generalpopulation


WomenObserved %

Massage therapy 15 9 11 10 2 16 16 17

Aromatherapy 13 7 6 5 0 11 21 18

Acupuncture 8 3 8 6 3 22 15 13

Osteopathy 6 2 2 1 - 5 13 11

Herbal medicine 13 15 6 7 3 11 12 12


Chiropractic 6 0 3 1 - 5 7 9

Homeopathy 6 3 11 8 8 6 11 11

Reflexology 10 4 8 3 0 10 16 12

Meditation/visualisation 4 4 5 1 0 5 7 5

Healing / spiritual healing 3 4 3 2 0 2 6 5

Hypnotherapy 2 0 3 0 - 1 6 5


Reiki 1 2 6 1 - 2 5 5

Shiatsu 2 1 1 0 0 7 4 2

Crystal therapy 0 0 2 0 - 3 2 2

Nutritional therapy 1 1 3 1 - 2 1 2

Kinesiology 0 1 1 - - 2 1 1

Dowsing - 0 1 - - 1 0 1

Naturopathy 1 - 2 - - 0 0 1

Ayurvedic medicine 1 - 7 0 0 0 0 0

Iridology - 1 1 - - 1 - 1

Unani medicine 0 - - - - - - -

MegaVit - - - - - - - -

Used any CAM 40 32 36 25 15 64 52 51


Massage therapy 0.86 0.55 0.55 0.64 0.06 0.78 0.88 1

Standard error 0.14 0.14 0.10 0.14 0.04 0.14 0.18

Aromatherapy 0.68 0.32 0.29 0.24 0.01 0.52 1.14 1

Standard error 0.12 0.10 0.07 0.07 0.01 0.12 0.19

Herbal medicine 1.01 1.14 0.41 0.53 0.35 0.89 1.05 1

Standard error 0.19 0.23 0.13 0.14 0.13 0.20 0.25

Acupuncture 0.62 0.32 0.63 0.64 0.39 1.72 1.14 1

Standard error 0.13 0.11 0.12 0.19 0.16 0.27 0.21


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 1

Standard error 0.06 0.07 0.07 0.07 0.05 0.07 0.08

Bases (weighted) 439 308 647 285 121 94 1497 33736



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Table 11.2

Whether used CAM in the last 12 months, by minority ethnic group and sex


Used CAM in last Minority ethnic group General12 months population


MenObserved %





Reflexology 1 1 3 - 0 2 2 2

Osteopathy 1 0 1 2 - 1 1 3

Homeopathy 2 0 4 5 2 2 1 2

Meditation/visualisation 3 2 4 0 - 4 1 2

Acupuncture 2 1 2 2 1 3 3 2

Chiropractic 0 2 1 - - 1 0 2

Spiritual healing 3 4 1 0 - - 1 1

Reiki 0 1 2 - - - 1 1


Crystal therapy - 1 1 - - - 1 0

Hypnotherapy 0 - 1 - - 0 1 1

Nutritional therapy - 0 0 - - - - 0

Shiatsu - - - 1 - 2 1 0

Kinesiology - - - - - - - 0

Dowsing 0 - - - - - - 0

Naturopathy 0 - - - - - 0 0

Iridology - - - - - - - 0

Ayurvedic medicine - - 4 0 - 0 - 0

Unani medicine - - - - - - - -

Megavit - - - - - - - -

Used any CAM 17 16 19 14 6 30 20 21


Massage therapy 0.78 0.65 0.54 0.55 0.05 0.74 1.33 1

Standard error 0.24 0.22 0.20 0.20 0.05 0.26 0.33

Aromatherapy 0.73 0.68 0.52 0.58 0.09 0.33 1.34 1

Standard error 0.45 0.34 0.28 0.56 0.10 0.18 0.49

Herbal medicine 1.41 1.67 1.16 0.64 0.68 0.44 1.24 1

Standard error 0.48 0.92 0.36 0.31 0.27 0.26 0.64

Acupuncture 1.21 0.29 0.78 0.67 0.43 1.25 1.24 1

Standard error 0.70 0.21 0.33 0.32 0.26 0.61 0.52


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 1

Standard error 0.15 0.18 0.15 0.17 0.07 0.20 0.19

Bases (weighted) 331 245 548 228 107 78 1187 31588


Continued…


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Used CAM in last Minority ethnic group General12 months population


WomenObserved %






Osteopathy 1 - 1 0 - 3 5 4

Homeopathy 2 1 5 4 2 2 4 4


Acupuncture 1 1 3 2 0 13 4 3

Chiropractic 2 - 1 1 - 2 1 3

Spiritual healing 1 3 2 2 0 1 4 2

Reiki 0 1 4 1 - 0 3 2


Crystal therapy - 0 1 0 - 2 1 1

Hypnotherapy 0 - 1 0 - 1 1 1

Nutritional therapy 1 1 2 1 - 1 0 1

Shiatsu 1 0 - 0 - 3 3 1

Kinesiology - 1 1 - - 2 - 1

Dowsing - 0 - - - - - 0

Naturopathy - - - - - 0 - 0

Iridology - 0 - - - 1 - 0

Ayurvedic medicine 1 - 4 - - 0 - 0


Megavit - - - - - - - -

Used any CAM 26 19 24 17 4 47 30 33


Massage therapy 0.94 0.69 0.68 0.84 0.07 0.91 0.99 1

Standard error 0.18 0.20 0.14 0.21 0.05 0.20 0.27

Aromatherapy 0.63 0.42 0.32 0.32 0.01 0.63 1.20 1

Standard error 0.13 0.15 0.09 0.11 0.01 0.16 0.27

Herbal medicine 1.03 0.93 0.44 0.48 0.06 0.75 1.26 1

Standard error 0.27 0.27 0.15 0.17 0.04 0.23 0.40

Acupuncture 0.26 0.56 0.82 1.34 0.06 3.13 1.03 1

Standard error 0.16 0.30 0.29 0.64 0.06 0.75 0.46


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 1

Standard error 0.08 0.10 0.08 0.10 0.04 0.13 0.12

Bases (weighted) 439 308 647 285 121 94 1497 33736



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Table 11.3

Whether used CAM in the last 12 months, by age within minority ethnicgroup and sex


Used CAM in last Age group12 months

Men Women16-34 35-54 55+ Total 16-34 35-54 55+ Total

% % % % % % % %

Black Caribbean


Aromatherapy 3 3 - 2 6 13 2 8

Relaxation techniques 5 3 2 3 4 7 1 4


Reflexology 2 1 - 1 4 6 3 5

Osteopathy 2 0 - 1 - 2 2 1

Homeopathy 6 0 1 2 0 5 0 2

Meditation/visualisation 7 2 - 3 4 2 3 3

Acupuncture 6 1 1 2 - - 3 1

Chiropractic - 0 - 0 0 3 2 2

Spiritual healing 4 4 1 3 0 2 - 1

Reiki - 1 - 0 - 1 - 0

Chinese medicine - 3 1 1 2 2 3 2

Crystal therapy - - - - - - - -

Hypnotherapy - 1 - 0 - 0 - 0

Nutritional therapy - - - - 1 0 1 1

Shiatsu - - - - 1 1 - 1

Kinesiology - - - - - - - -

Dowsing - - 1 0 - - - -

Naturopathy - - 1 0 - - - -

Iridology - - - - - - - -

Ayurvedic medicine - - - - - 2 - 1


Megavit - - - - - - - -

Used any CAM 26 17 9 17 23 32 23 26

Bases (weighted) 93 139 98 331 148 168 123 439




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% % % % % % % %

Black African

Massage therapy 3 7 a 5 5 8 [10] 7

Aromatherapy 6 1 a 3 1 11 [-] 5

Relaxation techniques 2 3 a 3 4 9 [3] 6

Herbal medicine 3 4 a 3 5 10 [2] 7

Reflexology 1 1 a 1 1 2 [3] 1

Osteopathy - 1 a 0 - - [-] -

Homeopathy - 0 a 0 0 2 [-] 1

Meditation/visualisation 1 4 a 2 0 2 [5] 1

Acupuncture - 2 a 1 0 3 [2] 1

Chiropractic 2 1 a 2 - - [-] -

Spiritual healing 4 4 a 4 2 6 [-] 3

Reiki - 1 a 1 0 2 [-] 1

Chinese medicine 0 5 a 2 1 2 [-] 1

Crystal therapy 1 - a 1 0 - [-] 0

Hypnotherapy - - a - - - [-] -

Nutritional therapy 1 - a 0 2 - [-] 1

Shiatsu - - a - - 1 [-] 0

Kinesiology - - a - - 1 [-] 1

Dowsing - - a - 0 - [-] 0

Naturopathy - - a - - - [-] -

Iridology - - a - 1 - [-] 0

Ayurvedic medicine - - a - - - [-] -

Unani medicine - - a - - - [-] -

Megavit - - a - - - [-] -

Used any CAM 14 17 a 16 12 29 [16] 19

Bases (weighted) 120 105 20 245 153 127 27 308




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% % % % % % % %

Indian


Aromatherapy 3 2 - 2 4 5 - 4




Osteopathy 2 - 3 1 1 1 1 1

Homeopathy 3 6 2 4 5 5 5 5



Chiropractic - 1 - 1 2 1 - 1

Spiritual healing - 2 - 1 1 3 2 2

Reiki 6 1 - 2 3 4 9 4

Chinese medicine 2 1 1 1 - 1 1 1

Crystal therapy 1 1 - 1 1 2 1 1

Hypnotherapy - 1 - 1 1 - 2 1

Nutritional therapy - 1 - 0 - 2 4 2

Shiatsu - - - - - - - -

Kinesiology - - - - - 1 - 1

Dowsing - - - - - - - -

Naturopathy - - - - - - - -

Iridology - - - - - - - -

Ayurvedic medicine 1 7 5 4 5 4 4 4


Megavit - - - - - - - -

Used any CAM 12 22 24 19 23 23 26 24

Bases (weighted) 192 247 109 548 236 296 116 647




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% % % % % % % %

Pakistani

Massage therapy 1 7 a 4 6 15 a 9

Aromatherapy 0 - a 1 5 5 a 5

Relaxation techniques 2 - a 1 3 1 a 2

Herbal medicine 4 1 a 2 5 5 a 4

Reflexology - - a - 3 1 a 2

Osteopathy 1 2 a 2 1 - a 0

Homeopathy 2 8 a 5 3 6 a 4

Meditation/visualisation 1 - a 0 1 1 a 1

Acupuncture 0 4 a 2 1 4 a 2

Chiropractic - - a - - 4 a 1

Spiritual healing 1 - a 0 1 1 a 2

Reiki - - a - 0 1 a 1

Chinese medicine - 1 a 0 - 2 a 2

Crystal therapy - - a - - 1 a 0

Hypnotherapy - - a - 0 - a 0

Nutritional therapy - - a - 1 - a 1

Shiatsu 1 - a 1 0 - a 0

Kinesiology - - a - - - a -

Dowsing - - a - - - a -

Naturopathy - - a - - - a -

Iridology - - a - - - a -

Ayurvedic medicine 0 - a 0 - - a -

Unani medicine - - a - - - a -

Megavit - - a - - - a -

Used any CAM 10 17 a 14 13 24 a 17

Bases (weighted) 114 91 23 228 177 89 19 285




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% % % % % % % %

Bangladeshi

Massage therapy 1 - [-] 0 1 - [3] 1

Aromatherapy 1 - [-] 0 0 - [-] 0

Relaxation techniques - - [-] - - - [-] -

Herbal medicine 1 5 [-] 2 1 - [-] 1

Reflexology - 1 [-] 0 - - [2] 0

Osteopathy - - [-] - - - [-] -

Homeopathy 2 3 [2] 2 2 - [3] 2

Meditation/visualisation - - [-] - 1 - [-] 0

Acupuncture 1 1 [-] 1 1 - [-] 0

Chiropractic - - [-] - - - [-] -

Spiritual healing - - [-] - - 1 [-] 0

Reiki - - [-] - - - [-] -

Chinese medicine 1 - [-] 0 1 - [-] 0

Crystal therapy - - [-] - - - [-] -

Hypnotherapy - - [-] - - - [-] -

Nutritional therapy - - [-] - - - [-] -

Shiatsu - - [-] - - - [-] -

Kinesiology - - [-] - - - [-] -

Dowsing - - [-] - - - [-] -

Naturopathy - - [-] - - - [-] -

Iridology - - [-] - - - [-] -

Ayurvedic medicine - - [-] - - - [-] -

Unani medicine - - [-] - - - [-] -

Megavit - - [-] - - - [-] -

Used any CAM 6 9 [2] 6 5 1 [5] 4

Bases (weighted) 59 34 14 107 80 29 13 121




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% % % % % % % %

Chinese

Massage therapy 5 6 [3] 5 15 12 a 11

Aromatherapy 2 1 [-] 1 13 6 a 8

Relaxation techniques 3 4 [-] 3 3 5 a 4

Herbal medicine 1 3 [-] 2 7 7 a 6

Reflexology 4 1 [3] 2 10 3 a 5

Osteopathy 1 1 [-] 1 2 3 a 3

Homeopathy 2 1 [3] 2 4 2 a 2

Meditation/visualisation 5 4 [-] 4 4 3 a 3

Acupuncture 2 4 [6] 3 7 19 a 13

Chiropractic - 1 [3] 1 1 1 a 2

Spiritual healing - - [-] - 2 2 a 1

Reiki - - [-] - - 1 a 0

Chinese medicine 20 20 [19] 19 26 37 a 31

Crystal therapy - - [-] - 3 1 a 2

Hypnotherapy 1 - [-] 0 2 - a 1

Nutritional therapy - - [-] - 1 2 a 1

Shiatsu 3 0 [-] 2 2 5 a 3

Kinesiology - - [-] - 2 2 a 2

Dowsing - - [-] - - - a -

Naturopathy - - [-] - - 1 a 0

Iridology - - [-] - 2 - a 1

Ayurvedic medicine 1 - [-] 0 1 - a 0

Unani medicine - - [-] - - - a -

Megavit - - [-] - - - a -

Used any CAM 28 33 [27] 30 47 51 a 47

Bases (weighted) 32 31 15 78 34 49 11 94




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% % % % % % % %

Irish


Aromatherapy 4 8 1 4 13 20 5 13




Osteopathy 4 1 - 1 - 8 5 5

Homeopathy 2 1 1 1 6 5 3 4



Chiropractic - 0 1 0 2 1 1 1

Spiritual healing 1 2 1 1 5 5 - 4

Reiki 2 1 - 1 5 3 1 3

Chinese medicine 2 1 - 1 1 3 2 2

Crystal therapy - 2 1 1 2 2 - 1

Hypnotherapy 2 1 0 1 0 2 - 1

Nutritional therapy - - - - - - 1 0

Shiatsu 1 2 - 1 3 2 3 3

Kinesiology - - - - - - - -

Dowsing - - - - - - - -

Naturopathy 1 - - 0 - - - -

Iridology - - - - - - - -

Ayurvedic medicine - - - - - - - -


Megavit - - - - - - - -

Used any CAM 26 29 6 20 27 38 22 30

Bases (weighted) 278 448 462 1187 292 672 533 1497




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% % % % % % % %

General population


Aromatherapy 4 4 2 3 12 14 6 11




Osteopathy 2 5 2 3 3 4 3 4

Homeopathy 1 3 2 2 4 6 3 4



Chiropractic 1 3 2 2 1 4 3 3

Spiritual healing 0 2 1 1 3 3 2 2

Reiki 1 1 0 1 3 3 2 2


Crystal therapy 1 0 0 0 1 2 0 1

Hypnotherapy 1 0 0 1 1 1 1 1

Nutritional therapy 0 0 0 0 0 1 1 1

Shiatsu 1 0 - 0 0 1 0 1

Kinesiology - 0 0 0 0 1 1 1

Dowsing 0 - - 0 0 0 1 0

Naturopathy 0 - 0 0 0 0 0 0

Iridology - 0 0 0 - 0 0 0

Ayurvedic medicine - 0 0 0 - 0 - 0


Megavit - - - - - - - -

Used any CAM 22 23 16 21 34 40 25 33

Bases (weighted) 9968 11428 10191 31588 10183 11706 11848 33736




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Table 11.4

Whether used CAM in the last 12 months, by equivalisedhousehold income tertile within minority ethnic group and sex


Used CAM in last Equivalised household income tertile12 months


% % % % % %

Black Caribbean

Observed %

Massage therapy 8 2 6 15 11 8

Aromatherapy 6 - 1 10 8 9

Relaxation techniques 5 2 5 5 5 3

Herbal medicine 5 1 9 13 10 5

Reflexology 1 - - 10 5 -

Osteopathy 2 - - 3 - -

Homeopathy 6 - 2 7 - -

Meditation/visualisation 3 - 1 5 - 3

Acupuncture 5 - - - 1 1

Chiropractic 0 - - 1 3 4

Spiritual healing 3 2 2 1 2 1

Reiki 0 - - - 2 -

Chinese medicine 2 2 - 4 1 3

Crystal therapy - - - - - -

Hypnotherapy - 1 - 1 - -

Nutritional therapy - - - 1 1 0

Shiatsu - - - - - -

Kinesiology - - - - - -

Dowsing - - 1 - - -

Naturopathy - - 1 - - -

Iridology - - - - - -

Ayurvedic medicine - - - 3 - -

Unani medicine - - - - - -

Megavit - - - - - -

Used any CAM 73 93 84 62 74 77


Massage therapy 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) 110 82 61 103 112 111


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% % % % % %

Black African

Observed %


Aromatherapy - - 4 4 13 1



Reflexology - 1 - 1 3 1

Osteopathy - 1 - - - -

Homeopathy 1 - 0 - 3 0

Meditation/visualisation - 1 7 2 1 1

Acupuncture 2 - 1 3 - 1

Chiropractic 2 3 - - - -


Reiki - 3 - 2 2 1

Chinese medicine 4 3 0 1 2 2

Crystal therapy - - 3 - - 1

Hypnotherapy - - - - - -

Nutritional therapy 1 - - - - 2

Shiatsu - - - - 1 -

Kinesiology - - - 2 - -

Dowsing - - - - - 1

Naturopathy - - - - - -

Iridology - - - 1 - -

Ayurvedic medicine - - - - - -


Megavit - - - - - -

Used any CAM 88 89 83 79 79 86


Massage therapy 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


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

Bases (weighted) 74 59 57 85 72 96


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% % % % % %

Indian

Observed %


Aromatherapy 2 1 - 6 2 3



Reflexology 0 2 6 7 2 3

Osteopathy - - 2 - - 1

Homeopathy 2 4 4 5 4 4

Meditation/visualisation 3 3 2 4 1 1

Acupuncture 2 3 2 4 - 1

Chiropractic - 1 - 1 - -

Spiritual healing 1 1 - 2 1 3

Reiki - 1 - 3 3 8

Chinese medicine - 1 - 1 - -

Crystal therapy - 1 - 1 2 -

Hypnotherapy 2 - - - 1 3

Nutritional therapy - 1 - 1 - -

Shiatsu - - - - - -


Dowsing - - - - - -

Naturopathy - - - - - -


Ayurvedic medicine 6 5 7 6 2 -


Megavit - - - - - -

Used any CAM 82 86 79 72 82 79


Massage therapy 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


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) 141 150 88 196 176 100


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% % % % % %

Pakistani

Observed %

Massage therapy [8] [2] 5 [14] 5 11

Aromatherapy [-] [0] 2 [7] 4 5

Relaxation techniques [-] [5] - [10] 2 -

Herbal medicine [1] [7] 2 [7] 8 4

Reflexology [-] [-] - [7] 2 2

Osteopathy [4] [-] 2 [-] - -

Homeopathy [4] [6] 3 [3] 8 2

Meditation/visualisation [-] [2] - [3] 2 -

Acupuncture [1] [2] 3 [3] 6 -

Chiropractic [-] [-] - [3] - 1

Spiritual healing [-] [2] - [-] 1 -

Reiki [-] [-] - [3] 0 -

Chinese medicine [-] [-] 1 [-] 5 -

Crystal therapy [-] [-] - [3] - -

Hypnotherapy [-] [-] - [-] 0 -

Nutritional therapy [-] [-] - [4] - -

Shiatsu [3] [-] 0 [-] - 0

Kinesiology [-] [-] - [-] - -

Dowsing [-] [-] - [-] - -

Naturopathy [-] [-] - [-] - -

Iridology [-] [-] - [-] - -

Ayurvedic medicine [1] [-] - [-] - -

Unani medicine [-] [-] - [-] - -

Megavit [-] [-] - [-] - -

Used any CAM [87] [84] 84 [80] 79 85


Massage therapy [1.04] [0.18] 0.74 [1.36] 1.33 0.85

Standard error [0.72] [0.12] 0.36 [0.64] 0.73 0.32

Aromatherapy [0.00] [0.07] 0.88 [0.63] 0.34 0.31

Standard error [0.00] [0.08] 0.88 [0.44] 0.24 0.22

Herbal medicine [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 [0.48] [1.20] 0.83 [1.43] 2.79 0.00

Chinese medicine [0.00] [0.00] 0.67 [0.00] 7.77 0.00

Standard error [0.00] [0.00] 0.68 [0.00] 4.83 0.00

Any CAM [0.50] [0.70] 0.83 [0.65] 0.87 0.37

Standard error [0.27] [0.24] 0.25 [0.26] 0.22 0.12

Bases (weighted) 37 54 79 40 66 100


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% % % % % %

Bangladeshi

Observed %

Massage therapy a - - a - 1

Aromatherapy a - - a - 1

Relaxation techniques a - - a - -

Herbal medicine a 6 - a - 1

Reflexology a - - a - -

Osteopathy a - - a - -

Homeopathy a 6 1 a 4 1

Meditation/visualisation a - - a - 1

Acupuncture a 1 - a - -

Chiropractic a - - a - -

Spiritual healing a - - a 1 -

Reiki a - - a - -

Chinese medicine a 1 - a 1 -

Crystal therapy a - - a - -

Hypnotherapy a - - a - -

Nutritional therapy a - - a - -

Shiatsu a - - a - -

Kinesiology a - - a - -

Dowsing a - - a - -

Naturopathy a - - a - -

Iridology a - - a - -

Ayurvedic medicine a - - a - -

Unani medicine a - - a - -

Megavit a - - a - -

Used any CAM a 90 99 a 95 97


Massage therapy 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


Herbal medicine a 1.99 0.00 a 0.00 0.07


Acupuncture a 0.49 0.00 a 0.00 0.00


Chinese medicine a 0.74 0.00 a 0.47 0.00


Any CAM a 0.52 0.05 a 0.13 0.05


Bases (weighted) 5 29 43 7 31 50



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% % % % % %

Chinese

Observed %

Massage therapy 3 [6] a 17 [6] a

Aromatherapy 1 [3] a 10 [5] a

Relaxation techniques 3 [8] a 8 [-] a

Herbal medicine 2 [1] a 9 [8] a

Reflexology 3 [6] a 10 [3] a

Osteopathy 2 [-] a 3 [4] a

Homeopathy 5 [1] a 1 [1] a

Meditation/visualisation 5 [8] a 5 [3] a

Acupuncture 6 [6] a 14 [14] a

Chiropractic 2 [-] a 4 [-] a

Spiritual healing - [-] a 3 [2] a

Reiki - [-] a 1 [-] a

Chinese medicine 29 [6] a 39 [31] a

Crystal therapy - [-] a 3 [-] a

Hypnotherapy - [1] a 2 [-] a

Nutritional therapy - [-] a 2 [-] a

Shiatsu 3 [1] a 4 [-] a

Kinesiology - [-] a 3 [-] a

Dowsing - [-] a - [-] a

Naturopathy - [-] a 1 [-] a

Iridology - [-] a 2 [-] a

Ayurvedic medicine - [1] a 1 [-] a

Unani medicine - [-] a - [-] a

Megavit - [-] a - [-] a

Used any CAM 56 [77] a 46 [50] a


Massage therapy 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


Herbal medicine 0.33 [0.42] a 0.85 [0.48] a


Acupuncture 3.40 [1.83] a 3.68 [1.68] a


Chinese medicine 21.36 [2.53] a 21.76 [5.18] a


Any CAM 2.13 [0.29] a 1.64 [0.22] a


Bases (weighted) 25 20 7 35 19 11



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% % % % % %

Irish

Observed %


Aromatherapy 5 4 2 20 12 3

Relaxation techniques 3 4 - 11 6 8

Herbal medicine 5 - 2 14 4 3

Reflexology 2 2 3 10 5 -

Osteopathy 2 - - 6 7 3

Homeopathy 0 1 - 5 7 3

Meditation/visualisation 0 3 - 9 7 -

Acupuncture 1 7 2 7 2 3

Chiropractic 1 - - 2 0 1

Spiritual healing 2 1 - 4 4 4

Reiki - 2 - 4 4 -

Chinese medicine 1 1 - 4 0 -

Crystal therapy 2 1 - 2 - 1

Hypnotherapy 1 0 1 0 3 -

Nutritional therapy - - - 0 - -

Shiatsu 1 - 1 6 - -


Dowsing - - - - - -

Naturopathy - - 2 - - -


Ayurvedic medicine - - - - - -


Megavit - - - - - -

Used any CAM 76 82 93 57 76 84


Massage therapy 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


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) 571 271 160 645 381 214


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% % % % % %

General population

Observed %


Aromatherapy 4 2 2 16 7 7



Reflexology 2 1 1 7 3 1

Osteopathy 4 3 0 4 2 1

Homeopathy 3 1 - 6 3 2

Meditation/visualisation 2 2 3 4 4 2

Acupuncture 2 1 3 4 2 3

Chiropractic 3 2 0 3 2 1


Reiki 1 1 - 4 1 2

Chinese medicine 2 0 2 2 1 1

Crystal therapy 1 - - 2 1 1

Hypnotherapy 0 0 1 1 1 0

Nutritional therapy 1 0 - 1 0 1

Shiatsu 0 0 - 1 0 -

Kinesiology 0 0 - 1 0 -

Dowsing 0 - - 1 0 -

Naturopathy 0 - 0 1 0 -

Iridology - 0 - 0 0 -

Ayurvedic medicine 0 - - 0 0 -


Megavit - - - - - -

Used any CAM 76 82 88 59 71 79


Massage therapy 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


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

Bases (weighted) 15166 7980 3579 13698 9955 4485



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Table 11.5

Whether used CAM practitioner in the last 12 months, by minority ethnic group and sex


Used CAM Minority ethnic group Generalpractitioner in last population12 months Black Black


MenObserved %

Massage therapy 4 4 3 3 - 4 6 5

Osteopathy 1 0 1 2 - 1 1 3

Aromatherapy 1 - 1 1 0 1 1 1

Reflexology 1 1 2 - 0 2 2 2



Chiropractic 0 2 1 - - 1 0 2


Homeopathy 2 0 3 2 2 1 0 1

Healing / spiritual healing 1 1 1 - - - 1 1

Reiki 0 1 1 - - - 1 0

Meditation/visualisation 1 - 1 - - 1 0 1


Hypnotherapy - - 1 - - 0 1 0

Nutritional therapy - - - - - - - 0

Crystal therapy - 1 - - - - 1 0

Kinesiology - - - - - - - 0

Shiatsu - - - 1 - 1 1 0

Iridology - - - - - - - 0

Dowsing 0 - - - - - - -

Naturopathy - - - - - - 0 0

Ayurvedic medicine - - 1 - - - - 0


MegaVit - - - - - - - -

Used any CAM 10 8 11 11 3 16 15 14


Massage therapy 0.74 0.73 0.42 0.43 0.00 0.80 1.24 1

Standard error 0.28 0.26 0.21 0.20 0.00 0.28 0.38

Aromatherapy 0.81 0.00 0.70 1.88 0.30 0.72 0.79 1

Standard error 0.63 0.00 0.72 1.85 0.31 0.52 0.56

Herbal medicine 1.46 0.14 0.35 0.04 0.00 0.79 1.55 1

Standard error 0.87 0.15 0.26 0.04 0.00 0.53 0.90

Acupuncture 0.89 1.34 1.18 1.11 0.82 0.91 0.74 1

Standard error 0.53 0.99 0.70 0.83 0.59 0.64 0.47


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 1

Standard error 0.19 0.12 0.16 0.23 0.07 0.19 0.24

Bases (weighted) 331 245 548 228 107 78 1187 31588


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Used CAM Minority ethnic group Generalpractitioner in last population12 months Black Black


WomenObserved %


Osteopathy 1 - 1 0 - 3 5 4




Acupuncture 1 1 2 2 0 12 4 3

Chiropractic 2 - 1 1 - 1 1 3


Homeopathy 1 1 4 4 2 2 3 3

Healing / spiritual healing 0 1 0 0 - 1 2 2

Reiki 0 0 3 1 - - 3 2



Hypnotherapy 0 - 1 - - 1 1 1

Nutritional therapy 1 - 1 - - 1 - 0

Crystal therapy - 0 0 0 - 2 0 1

Kinesiology - - - - - 2 - 0

Shiatsu 1 - - - - 3 3 0

Iridology - 0 - - - 1 - 0

Dowsing - - - - - - - 0

Naturopathy - - - - - 0 - 0

Ayurvedic medicine 1 - 2 - - 0 - 0


MegaVit - - - - - - - -

Used any CAM 15 9 17 12 3 30 22 23


Massage therapy 0.76 0.63 0.61 0.67 0.07 1.10 1.09 1

Standard error 0.18 0.20 0.15 0.25 0.04 0.25 0.34

Aromatherapy 0.66 0.38 0.31 0.33 0.02 0.72 1.27 1

Standard error 0.19 0.20 0.13 0.16 0.02 0.27 0.49

Herbal medicine 0.56 0.32 0.22 0.26 0.00 0.29 1.17 1

Standard error 0.22 0.18 0.12 0.16 0.00 0.18 0.59

Acupuncture 0.65 0.61 0.36 0.63 0.07 0.88 1.46 1

Standard error 0.28 0.31 0.18 0.26 0.07 0.37 0.83


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 1

Standard error 0.09 0.09 0.11 0.14 0.05 0.17 0.14

Bases (weighted) 439 308 647 285 121 94 1497 33736



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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 2004

CAMa Used in Weighted Unweightedlast 12 bases bases

months

Meditation/visualisation % 65 2792 204

Massage therapy % 62 8743 627

Aromatherapy % 58 7974 600

Crystal therapy % 58 948 74

Relaxation techniques % 58 6230 454

Nutritional therapy % 57 715 54

Herbal medicine % 55 6417 474

Reiki % 48 2207 160

Spiritual healing % 45 2589 188

Reflexology % 42 5352 399

Chinese medicine % 40 2252 151

Homeopathy % 39 5466 402

Kinesiology % 37 699 55

Osteopathy % 31 7067 513

Chiropractic % 30 5477 411

Shiatsu % 28 965 71

Acupuncture % 27 7127 540

Hypnotherapy % 19 2464 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 thelast 12 months, among those who had used individualCAM in the last 12 months

General population aged 16 and over who had ever used individual CAM in last 12 months 2004

CAMa Consulted Weighted Unweightedpractitioner bases bases

in last 12months

Chiropractic % 99 1622 119

Osteopathy % 97 2205 155

Acupuncture % 94 1942 144

Reflexology % 86 2269 162

Reiki % 80 1042 75

Massage therapy % 78 5445 388

Spiritual healing % 72 1171 86

Chinese medicine % 61 894 60

Homeopathy % 54 2150 162

Relaxation techniques % 54 3591 265

Meditation/visualisation % 46 1826 137

Aromatherapy % 45 4643 343

Herbal medicine % 37 3513 267

a Only CAM where 50 or more participants had used them in the last 12 months are shown in the table.

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HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH 377

Children’s health

Elizabeth Fuller

General health (ages 0 to 15)

● Irish and Black Caribbean boys and girls and Chinese boys reported similar levels oflongstanding illness to children in the general population. Children in all other minorityethnic groups were less likely than the general population to report a longstandingillness. The prevalence of limiting longstanding illness differed less between groups.

● Children in most minority ethnic groups were less likely than were children in thegeneral population to report acute sickness within the past two weeks. The prevalenceof acute sickness among Irish boys and girls and Pakistani boys was similar to theprevalence in the general population.

● Children in all groups were very likely to rate their general health as ‘good’ or ‘verygood’. In most minority ethnic groups the proportions who reported this were similar tothe proportions in the general population (93% of boys and girls). Smaller proportionsof Bangladeshi boys (86%) and Black Caribbean girls (89%) reported ‘good’ or ‘verygood’ general health.

Psychosocial health (ages 4 to 15)

● The prevalence of emotional, behavioural or relationship difficulties, as indicated by ahigh total deviance score on the Strengths and Difficulties Questionnaire, was notsignificantly different among children in most minority ethnic groups and the generalpopulation. The exceptions were Chinese boys and Black African girls, who were lesslikely to obtain a score above the ‘problem’ threshold.

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 girlswas similar to the prevalence within the general population. Experience of wheezingwas less prevalent among children in other minority ethnic groups. In all groups, boyswere more likely than girls to have ever wheezed, although the difference was notsignificant for Black Caribbean, Indian and Irish children.

● After controlling for age and height, mean FEV1 (forced expiratory volume in the firstsecond) was similar among Black Caribbean and Irish boys and boys in the generalpopulation. The mean FEV1 for boys in other minority ethnic groups, and for girls in allminority 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 Irishboys, and Black Caribbean and Irish girls were as likely to have smoked cigarettes aschildren in the general population. Children in other minority groups were less likely tohave smoked.

Drinking alcohol (ages 8 to 15)

● 45% of boys and 40% of girls in the general population had drunk alcohol at least

12Summary

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378 HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

once. Children in most minority ethnic groups were less likely than the generalpopulation to have ever had an alcoholic drink. This was particularly so for Pakistaniand 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 hadtried alcohol were similar to the proportions in the general population, and Irish girlswere 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 forchildren in minority ethnic groups and the general population. Mean diastolic bloodpressure (DBP) did not differ significantly between groups, except for Indian, Pakistaniand Bangladeshi boys and Black African girls. Children in these groups had highermean 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. Comparedwith boys in the general population, Black Caribbean boys were taller on average andChinese boys were shorter on average. Black Caribbean and Black African girls weretaller on average than girls in the general population, and Bangladeshi girls wereshorter on average.

● For most minority ethnic groups, the average weight was similar to children in thegeneral population, once age had been controlled for. Black Caribbean, Black Africanand Pakistani boys were heavier on average than boys in the general population. BlackCaribbean and Black African girls were heavier on average than girls in the generalpopulation.

● Black African boys were more likely to be obese than boys in the 2004 generalpopulation. 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 generalpopulation to have exercised at the levels recommended by government (at least onehour every day). Children in other minority ethnic groups were less likely than childrenin the general population to have been active at the recommended levels.

Fruit and vegetable consumption (ages 5 to 15)

● Children in most minority ethnic groups were more likely than the general population toeat the recommended five or more portions a day of fruit and vegetables. Theproportions of Chinese boys, Bangladeshi girls and Irish boys and girls who ate five ormore portions were not significantly different from the general population. The averageconsumption of fruit and vegetables among children in minority ethnic groups rangedfrom 2.8 portions for Irish boys to 3.6 portions for Chinese girls. Children in the generalpopulation ate fewer portions: boys ate an average of 2.5 portions, girls ate an averageof 2.6 portions.

12.1 Introduction

12.1.1 Background

This chapter focuses on the health of children aged 15 and under from seven minorityethnic groups: Black Caribbean, Black African, Indian, Pakistani, Bangladeshi, Chinese andIrish, along with a comparison sample of children in the general population. The HealthSurvey for England (HSE) has covered children aged 2 to 15 since 1995, and in 2001 theage 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 representativesurvey 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 anydetailed analysis of children’s health. Surveys in 1997 and 2002 used boosted samples ofchildren, and the reports from those years presented aggregated data from more than onesurvey year, to enable a full analysis of children’s health. However, these boosted samplesof children were not large enough to provide separate results on the health of minorityethnic children. The Health Surveys of 1999 and 2004 boosted samples of people fromminority 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 nursevisit; consequently it did not include sufficient numbers of children for comparisons to bedrawn with those from minority ethnic groups. Within this chapter, findings for minorityethnic 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 importantexceptions. The 1999 survey did not include children aged under 2, so the comparisons arelimited to those aged 2 to 15. Also, Black Africans were not included in the boosted samplein 1999, so no comparisons can be made.

Further information about the sample, including response rates among children for thestages 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);

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 personalinterview, self-completion questionnaires and measurements carried out by interviewersand 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 answereddirectly. There were some exceptions to this. The Strengths and Difficulties Questionnaire(SDQ) was completed by parents about their children aged 4 to 15. Questions aboutsmoking 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 mostmeasurements can be found in the relevant chapters covering adults’ health. Exceptions tothis are the measurement of lung function, which was not carried out on adults, andquestions covering cigarette smoking, drinking alcohol and physical activity where thequestions are worded differently. Details of the measures used are given in the relevantsections 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 thischapter 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 inthis 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 differencesbetween groups may be influenced by differences in their age profiles. The tables show keycomparisons with the general population in the form of risk ratios; again these are notgenerally age-standardised. Where measures are strongly related to age, data arepresented within age categories (smoking and drinking behaviour, obesity and overweight)or age-adjusted regression coefficients are shown (lung function, blood pressure, heightand weight). The latter are derived using linear regression models; the regressioncoefficients are equivalent to age-standardised absolute differences in the means for eachminority ethnic group compared with the general population. The regression models forlung function and blood pressure also incorporate height, and these regression coefficientsare standardised for height as well as age. For further information about risk ratios andlinear regression models, see the Glossary in volume 2 of HSE 2004, Health Survey forEngland 2004: Methodology and Documentation.

12.2 General health

12.2.1 Longstanding illness and limiting longstanding illness

All informants were asked whether they had any longstanding illness, disability or infirmitythat had troubled them over a period of time, or was likely to trouble them over a period oftime. Those who said they had were asked about the nature of the illness and also whetherit limited their activities in any way.

Within minority ethnic groups, the proportion of children aged 15 or under who reported alongstanding illness ranged from 11% of Black African boys to 23% of Irish boys, and from7% of Black African girls to 22% of Black Caribbean girls. In the general population 24% ofboys and 20% of girls reported such an illness. Black Caribbean and Irish boys and girlsand Chinese boys were as likely as children in the general population to report longstandingillness; 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 longstandingillness said that it limited their activities. Within minority ethnic groups, the proportionsreporting a limiting longstanding illness ranged from 5% of Black African and Bangladeshiboys to 10% of Chinese boys, and from 2% of Black African girls to 8% of Black Caribbeangirls. 8% of boys and 7% of girls in the general population reported a limiting longstandingillness. In most minority ethnic groups boys had similar levels of limiting longstanding illnessas boys in the general population; only Bangladeshi boys were less likely to report this. Incontrast, only Black Caribbean and Pakistani girls reported similar levels of limitinglongstanding illness to girls in the general population; girls in most minority ethnic groupswere 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 between1999 and 2004 shown in Table 12.2 shows children aged 2 to 15 for both years. Levels oflongstanding illness and limiting longstanding illness observed in 1999 were similar to thoserecorded in 2004 for most minority ethnic groups. Among Indian and Irish girls, theprevalence of longstanding illness in 2004 was lower than in 1999, and the prevalence oflimiting longstanding illness had fallen in the same period among Bangladeshi and Irishgirls. 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 broadcategories corresponding as far as possible to the chapter headings of the Tenth Revisionof 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 therespiratory system, skin complaints and mental disorders.

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 Bangladeshiboys to 157 per 1000 among Black Caribbean boys; the corresponding figure for boys inthe general population was 123 per 1000. Among girls in minority ethnic groups theprevalence was lower, ranging from 38 per 1000 among Black African girls to 118 per 1000among 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 from9 per 1000 among Black Caribbean boys to 45 per 1000 among Indian boys, and from 16per 1000 among Indian girls to 71 per 1000 among Black Caribbean girls. In the generalpopulation, the prevalence of skin complaints was 45 per 1000 for boys and 43 per 1000 forgirls.

The prevalence of mental disorders among boys in minority ethnic groups ranged from 7per 1000 among Indian boys to 43 per 1000 among Irish boys. The prevalence was muchlower among girls, and no Indian or Chinese girls reported mental disorders. Among girls inother minority ethnic groups, the prevalence ranged from 2 per 1000 among Black Africangirls to 23 per 1000 among Irish girls. Within the general population the prevalence ofmental 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 causedthe child to cut down on anything usually done about the house, at school or during freetime. Severity was measured by the number of days on which activities were affected byillness or injury in this way.

The proportions of children aged 15 or under who had suffered from acute sickness in thelast two weeks ranged from 4% of Chinese boys to 12% of Irish boys, and from 4% ofBangladeshi 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


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Rate per thousand of most commonly reported types of illness, by minority ethnic group and sex


(2001-2002)

% % % % % % % %

Boys


Skin complaints 9 20 45 22 29 32 38 45


Girls


Skin complaints 71 18 16 51 22 19 36 43

Mental disorders 11 2 - 11 3 - 23 10

children in the general population (13% of both boys and girls). Most children who reportedacute 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 thegeneral population to have suffered acute sickness in the last two weeks (generalpopulation 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 wereinclined to rate their health as ‘good’ or ‘very good’, ranging from 86% of Bangladeshi boysto 94% of Black African, Indian and Irish boys, and from 89% of Black Caribbean girls to97% 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 andgirls). The exceptions were Bangladeshi boys and Black Caribbean girls, who were lesslikely 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 minorityethnic 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 ofchildren in minority ethnic groups who were taking prescribed medicines ranged from 9% ofChinese boys to 24% of Pakistani boys, and from 10% of Black African girls to 22% ofBangladeshi girls. Chinese boys and Black African girls were less likely than children in thegeneral population to be taking prescribed medicines; for other groups the proportionstaking prescribed medicines were similar to the proportion doing so in the generalpopulation (20% of boys and 19% of girls). Table 12.8

The prevalence of taking prescribed medicine among children aged 2 to 15 in minorityethnic groups was broadly similar in 1999 and 2004. The proportion of Chinese boys takingprescribed medicines was lower in 2004 than in 1999; other differences between the twoyears were not significant. Table 12.9

12.3 Psychosocial health

12.3.1 General Health Questionnaire (GHQ12)

The General Health Questionnaire (GHQ12), a 12-question scale designed to assesspsychological health, was included in the self-completion questionnaire for children aged13 to 15.4 The GHQ12 has been used successfully with young people aged 13 or over, but isnot recommended for use with younger children. A high score (4 or more) is used as thethreshold to identify informants with possible psychiatric disorder. However, too fewchildren in any of the minority ethnic groups completed the GHQ12 for reliable comparisonsto be made between groups. Among the general population, girls were more likely thanboys 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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score is derived from the sum of scores on the first four scales. Threshold scores reportedhere are as recommended by the author of the SDQ, and the scoring system is outlined in anote at the end of this chapter.6

The SDQ correlates highly with other measures of behavioural and emotional problems inchildhood such as the Rutter questionnaire5 and the Child Behaviour Checklist.7 It has theadvantages of being shorter and including some focus on positive behaviour (the prosocialbehaviour scale).5,7 The SDQ is currently available in more than 40 languages, but, as withthe GHQ, its validity for cross-cultural comparisons is uncertain, particularly when these arebased on different language versions of the questionnaire.

The SDQ was administered in a self-completion booklet to parents, who responded abouttheir children aged 4 to 15.

The prevalence of emotional and behavioural problems, as measured by a high totaldeviance score (17+), is shown in the table below and ranged from 3% of Chinese boys to21% 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 girlswere less likely to score above the problem threshold (17+) on the total deviance score. Theprevalence rates of problem scores among other groups were not significantly differentfrom the general population.

In the general population higher proportions of boys than girls had a high SDQ score. Thiswas also true for Black Caribbean children. Differences between boys and girls amongBangladeshi, Black African, Indian and Irish children were not statistically significant.

Table 12.11The likelihood of ‘problem’ scores on the SDQ subscales was, on the whole, notsignificantly different among minority groups compared with the general population. Thesmall samples of Chinese boys and girls showed comparatively low risks of problem scoresfor emotional symptoms and conduct problems. Black African and Indian boys were lesslikely than boys in the general population to have problem scores for hyperactivity. Amonggirls, Black African and Indian girls were also less likely than girls in the general populationto score in the high (problem) range for hyperactivity. Only one group, Pakistani girls, wasmore likely than the general population to have problems in any of the subscales, with arelatively high risk of peer problems.

As noted, apparent differences in the prevalence of problem scores should be treated withcaution. This is underlined by comparisons of SDQ scores from 2004 with those recorded in1999. Taking the two years together, there are no indications of significant differencesbetween children in different minority ethnic groups when analysing the prevalence ofemotional and behavioural problems indicated by the SDQ and its subscales. Table 12.12

12.4 Respiratory symptoms and lung function


Asthma is one of the most common chronic childhood diseases, and its prevalence inBritain is amongst the highest in the world.8,9 Like other industrialised nations, the UK saw arise in the prevalence of asthma among children over several decades, levelling off in themid-1990s. The causes of this rise are still largely unexplained; a range of epidemiologicalstudies 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


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Proportion of children with high SDQ total scores, by minority ethnic group and sex

Black Black General Caribbean African Indian Pakistani Bangladeshi Chinesea Irish population

(2001-2002)

% % % % % % % %

Boys 21 9 9 11 17 [3] 13 12

Girls 6 3 6 12 9 [6] 10 8a

Percentages shown in square brackets are based on fewer than 50 cases.

prevalence was due in some part to changes in diagnostic practice.8,10 Since the mid-1990sprevalence trends have been less clear.8,9,11,12 There is evidence that the prevalence ofasthma and associated respiratory symptoms among children in Britain differs betweenethnic groups.1,13

All children aged under 16 (or their parents) were asked about any respiratory symptomsthey had experienced: wheezing or whistling in the chest at any time, wheezing when theydidn’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 medicaldiagnosis.8 Informants were also asked whether they had ever had asthma diagnosed by adoctor.

The nurse visit included a measure of lung function for children aged 7 to 15 (uniquelyamong 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 toethnicity for both adults and children, but validated algorithms to correct for thesedifferences 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 thisinstrument, the manufacturer reports the accuracy of volume measurement as +/-3% or +/-0.5 litres, whichever is greater, and of flow measurement as +/-5%. The measurementtechnique involves a maximum inspiration followed by a forced expiration for as long aspossible into the instrument. After a demonstration by the nurse, children were asked tocarry out the test up to five times, to allow for practice and with the aim of achieving at leastthree technically satisfactory measures. The data here are based on the highest values fromany technically successful test for each of the three parameters, FEV1, FVC and PEF, andthe values for each informant may not come from the same test. Full details of the methodsused can be found in volume 2 of HSE 2004, Health Survey for England 2004: Methodology& Documentation.

12.4.2 Respiratory symptoms and doctor-diagnosed asthma

Among children in minority ethnic groups, the proportions who had ever experiencedwheezing or whistling in the chest ranged from 16% of Bangladeshi boys to 39% of BlackCaribbean boys, and from 8% of Bangladeshi girls to 33% of Black Caribbean girls. In mostminority ethnic groups, children were less likely than those in the general population to haveever wheezed. The exceptions were Black Caribbean, Irish and Chinese boys and BlackCaribbean and Irish girls, among whom the proportions who had ever wheezed were similarto 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 notsignificant 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’thave a cold) and to have been breathless when wheezing (26% experienced eachsymptom), and Bangladeshi boys were the least likely to have experienced thesesymptoms (7% experienced each symptom). Among girls, Black Caribbean girls were mostlikely to have experienced these symptoms (15% had wheezed without a cold, 16% hadbeen breathless when wheezing). Bangladeshi and Black African girls were least likely tohave wheezed when they didn’t have a cold (3% and 4% respectively) and to have beenbreathless when wheezing (4% of girls in both groups).

The proportions of children who had wheezed in the last 12 months ranged from 11% ofBangladeshi boys to 27% of Black Caribbean boys, and from 6% of Bangladeshi girls to21% of Black Caribbean and Irish girls. Bangladeshi boys and Black African, Bangladeshiand Chinese girls were less likely than children in the general population to have wheezedwithin the last 12 months. Table 12.13

Black Caribbean boys were more likely than boys in the general population to have hadasthma diagnosed by a doctor (30% compared with 23%). Doctor-diagnosed asthma was


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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, theproportion 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 asthmawas similar to that found among girls in the general population.

Among the general population and most minority ethnic groups, boys were more likely thangirls to be diagnosed with asthma. The exceptions to this were Indian, Irish and Chinesechildren, where the differences between the sexes were not statistically significant.

Table 12.13, Figure 12A

In 1999, the pattern of prevalence of respiratory symptoms was broadly similar to thatfound 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 reportedhaving wheezed in the last 12 months. In the case of Black African and Chinese boys andBlack African, Indian, Bangladeshi and Chinese girls, the subsamples are too small toreport the findings. Where figures are shown, any apparent differences are not statisticallysignificant.

In all groups, the majority of children who had experienced wheezing in the last 12 monthshad no more than three attacks in the year (on average one or less every three months). Aminority 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 betreated with caution). A minority in each group reported adverse effects from wheezingattacks, such disturbed sleep at least once a week, difficulty in speaking during attacks orinterference with daily activities. Table 12.15

12.4.4 Lung function

Lung function is strongly related to height and age among children, and the analysisincludes regression coefficients adjusted for age and height, allowing comparisons to bemade between mean values measured for each group regardless of age profile. (Theregression coefficient shows the difference between the mean for that group and the meanfor the general population once age and height have been controlled for.) For furtherinformation about age and height standardisation using linear regression models, see theGlossary in volume 2 of HSE 2004, Health Survey for England 2004: Methodology andDocumentation.


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Prevalence of having wheezed in the last 12 months, by sex and minority ethnic group

Per

cent

Figure 12A

0

5

10

15

20

25

30

BoysGirls

Black

Caribbean

Black

African

Indian

Pakistani

Bangladeshi

IrishChinese

General

population

The sample of Chinese boys from whom valid lung function measures were obtained wastoo small to analyse. Otherwise, among minority ethnic groups, mean FEV1 (forcedexpiratory volume in the first second) ranged from 1.85 litres for Bangladeshi boys to 2.53litres for Irish boys, and from 1.80 litres for Bangladeshi girls to 2.23 for Black Caribbeangirls. 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 thegeneral population. For boys in other minority ethnic groups, and girls in all minority ethnicgroups, 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 from2.26 litres for Bangladeshi boys to 3.11 litres for Black Caribbean boys, and from 2.04 litresfor Bangladeshi girls to 2.66 litres for Black Caribbean girls. In the general population meanFVC was 2.88 litres for boys and 2.61 litres for girls. As with FEV1, once age and height hadbeen taken into account, Black African, Indian, Pakistani and Bangladeshi boys had loweraverage 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 254l/min for Bangladeshi boys to 327 l/min for Pakistani and Irish boys, and from 251 l/minamong Bangladeshi girls to 313 l/min for Black Caribbean girls. Among the generalpopulation mean peak flow was 322 l/min for boys and 303 l/min for girls. After adjustmentfor age and height, mean peak flow was lower than for the general population among Indianand Bangladeshi boys and Black Africa, Indian, Pakistani, Bangladeshi and Irish girls.

Table 12.18

12.5 Cigarette smoking


Questions about smoking were included in the self-completion questionnaires for childrenaged 8 to 15, a mode designed to allow a measure of privacy to encourage children to behonest about behaviour of which their parents might disapprove. Children were askedwhether they had ever smoked a cigarette ‘even if it was only a puff or two’. Those who hadsmoked were asked when they first tried smoking, whether they still smoked and, if they didsmoke, how often they did so and how many cigarettes they had smoked in the last week.

HSE has asked about children’s smoking behaviour since 1995. Similar questions are askedin 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 surveycollects data using a self-completion questionnaire administered in schools. Comparison ofthe two surveys suggests that children under-report their smoking behaviour in HSE andother surveys completed within the family home, compared with SDD and other surveyscarried out at school.19 Because SDD includes relatively small samples of children fromminority ethnic groups, and categorises ethnicity differently from HSE, it is not possible tocompare smoking prevalence rates measured by these two surveys in 2004. However SDDand other surveys indicate that children’s smoking patterns vary between different ethnicgroups.20,21

12.5.2 Self-reported cigarette smoking

Among children in minority ethnic groups aged 8 to 15, the proportion who had eversmoked ranged from 1% of Indian boys to 16% of Black Caribbean boys, and from 5% ofBangladeshi and Pakistani girls to 23% of Irish girls. In the general population, 18% of boysand 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 truefor girls in all groups except for Irish and Black Caribbean girls. Table 12.19


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The patterns of smoking were generally similar to those reported by minority ethnic childrenin 1999, when Black Caribbean and Irish boys and girls were also most likely to reporthaving ever smoked cigarettes. Table 12.23

No Indian or Chinese children and no Bangladeshi girls reported that they currentlysmoked, and the samples were too small for reliable conclusions to be drawn about therelative proportions of children within other different minority ethnic groups who currentlysmoked. Tables 12.19, 12.20, Figure 12B

Smoking behaviour among children is strongly linked to age. The bases for individualminority ethnic groups are too small for reliable comparisons between age groups, butoverall experience of smoking tended to be lower among children aged 8 to 10 than amongthose aged 11 to 15 in all groups. Among children in minority ethnic groups, none aged 8 to10 reported being a current smoker, and the proportions who had ever tried smoking weregenerally very small. Consequently, reliable conclusions cannot be drawn about the relativeprevalence rates of smoking within different minority ethnic groups, since the data have notbeen age-standardised (see Section 12.1.3). Since smoking behaviour among childrenaged 8 to 15 is highly related to age, apparent differences between groups may be theproduct of different age profiles. Tables 12.21, 12.22

12.6 Drinking alcohol


Questions about drinking alcohol were included in the self-completion questionnaire forchildren aged 8 to 15. As with questions about smoking, this was to allow children torespond to these questions privately, with the aim of encouraging frankness in reportingbehaviour which parents might not know about and might disapprove of. Children wereasked two initial questions (see below) about whether they had ever drunk alcohol. Thosewho answered yes to either of these questions were asked how old they were when theyfirst had an alcoholic drink, how often they usually drank alcohol and when they had lastdrunk alcohol. Older children (aged 13 to 15) who had drunk alcohol in the last week wereasked 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 HSE1998. Similar questions are asked in the survey of smoking, drinking and drug use amongyoung people in England (SDD), carried out annually among children aged 11 to 15 insecondary schools.22 The latter survey collects data using a self-completion questionnaireadministered in schools. As with smoking, comparison of the two surveys suggests thatchildren under-report their drinking behaviour in HSE and other surveys completed within


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Prevalence of ever having smoked a cigarette, by sex and minority ethnic group

Per

cent

Figure 12B

0

5

10

15

20

25

BoysGirls

Black

Caribbean

Black

African

Indian

Pakistani

Bangladeshi

IrishChinese

General

population

the family home, compared with SDD and other surveys carried out at school. To attempt tocompensate for this under-reporting, HSE uses a different approach to measure how manychildren 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 answerno to this are also asked ‘Have you ever drunk alcopops (such as Bacardi Breezer, SmirnoffIce, WKD, Hooch etc)?’. The use of this follow-up question in 2002 increased the proportionof children who reported that they had drunk alcohol so that it was closer to the proportionrecorded by SDD.23 Because SDD includes relatively small samples of children fromminority ethnic groups, and categorises ethnicity differently from HSE, it is not possible tocarry out a comparison of drinking prevalence rates measured by these two surveys in2004. However, evidence from these and other surveys suggest that there are differencesbetween ethnic groups in children’s experience of alcohol. 20,21 The analysis below isrestricted to whether children had ever drunk alcohol. Given the small sizes of thesubsamples of children in minority ethnic groups, it is not possible to analyse their drinkingbehaviour in more detail. As noted above (Section 12.1.3), the data have not been age-standardised and – since drinking behaviour among children is highly related to age –apparent differences between groups may be the product of different age profiles.

12.6.2 The prevalence of drinking alcohol

The proportions of children aged 8 to 15 in minority ethnic groups who had ever drunkalcohol varied widely. Bangladeshi and Pakistani children were much less likely thanchildren in other groups to have drunk alcohol. Among boys, the prevalence of having everdrunk 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. Formost groups, the proportion of boys or girls who had drunk alcohol was lower than theproportion who had done so in the general population (45% of boys, 40% of girls). Theexceptions were Black Caribbean and Irish boys and Black Caribbean girls, among whomthe prevalence of having drunk alcohol was similar to that in the general population; andIrish girls, among whom the prevalence of ever having drunk alcohol was higher than thegeneral population.

Within the general population, boys were more likely than girls to have drunk alcohol. Noneof the minority groups showed significant differences between the sexes.

Table 12.24, Figure 12C

Among children, the likelihood of having tried alcohol is strongly related to age. It is notpossible to make reliable comparisons between older and younger children within minorityethnic 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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Prevalence of ever having drunk alcohol, by sex and minority ethnic group

Per

cent

Figure 12C

0

10

20

30

40

50

60

BoysGirls

Black

Caribbean

Black

African

Indian

Pakistani

Bangladeshi

IrishChinese

General

population

girls, with no Bangladeshi girls of this age reporting that they had drunk alcohol. (In thegeneral 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 twoquestions: ‘Have you ever had a proper alcoholic drink, not just a sip? Please don’t countdrinks 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 drinkingalcohol among children based on the first question with the prevalence based on bothquestions. Among Pakistani and Bangladeshi children there is very little difference. Amongother groups, including the alcopops responses increases the prevalence rates by up to 16percentage points. This matched the findings of HSE 2002, where the use of both questionsalso 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

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 similarpatterns: Irish and Black Caribbean children were most likely to have drunk alcohol, andvery few Pakistani or Bangladeshi children said that they had ever had an alcoholic drink. In2004 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 notsignificant. Table 12.26

12.7 Blood pressure


The blood pressure of children aged 5 to 15 has been measured every year for HSE since1995. 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 pressurein HSE. Previously, measurements had been taken using the Dinamap 8100. In HSE 2003 anew oscillometric automated device, the Omron HEM 907, replaced the Dinamap, whichhad become obsolete. A calibration study for HSE 2003 provided suitable regressionequations to derive predicted Omron readings from Dinamap readings and vice versa. Forthis report, the Dinamap values obtained in 1999, 2001 and 2002 were converted intoOmron 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: Dinamap = 1.025*OmronSystolic blood pressure for girls: Dinamap = 1.040*OmronDiastolic blood pressure for boys: Dinamap = 0.934*OmronDiastolic blood pressure for girls: Dinamap = 0.915*Omron.

Blood pressure is known to have a stronger relationship with age, height and weight inchildren 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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Reported experience of drinking in response to alcohol questions, by minority ethnic group and sex (aged 8 to 15)

Black Black General Caribbean African Indian Pakistani Bangladeshi Chinesea Irish population

(2001-2002)

% % % % % % % %

Boys

One question 33 17 5 1 1 19 35 37

Two questions 38 24 13 1 1 29 43 45

Girls

One question 26 15 8 3 3 [6] 38 31

Two questions 35 23 17 4 3 [21] 54 40

aPercentages shown in square brackets are based on fewer than 50 cases.

age and height specific.24,25 The analysis below shows regression coefficients adjusted forage and height, allowing comparisons to be made between mean values for each group,regardless of age profiles. (The regression coefficient shows the difference between themean for that group and the mean for the general population once age and height havebeen controlled for.)

12.7.2 Systolic blood pressure

Among children in minority ethnic groups, mean systolic blood pressure (SBP) ranged from105.2mmHg for Chinese boys to 112.2mmHg for Pakistani boys, and from 102.9mmHg forBangladeshi girls to 110.7mmHg for Black Caribbean girls. Mean SBP among children inthe general population was 108.7mmHg for boys and 106.7mmHg for girls. Regressioncoefficients, controlling for age and height, have been calculated to allow comparison withthe general population. For mean SBP, there were no significant differences betweenchildren 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 65.9mmHgfor Bangladeshi boys, and from 62.7mmHg for Irish girls to 68.2mmHg for Black Africangirls. 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 thegeneral population. Table 12.28

12.8 Anthropometric measures


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 ofheight in metres (kg/m2). For a description of the methods used to measure heights andweights see Chapter 6, Section 6.1.2. Both height and weight are strongly age-relatedamong children, and comparisons between groups have been made using age-adjustedregression coefficients, which control for differences in their age profiles. (The regressioncoefficient shows the difference between the mean for that group and the mean for thegeneral population once age has been controlled for.)

The proportion of children who were overweight or obese has been calculated using the UKnational BMI percentiles classification. Using 1990 reference data compiled from a numberof sources as the baseline, and adjusted for age and sex, the threshold for overweight wasdefined as the 85th percentile and the threshold for obesity is the 95th percentile.26 Thisclassification was used in the analysis of HSE data published in 2005 on trends in obesityamong 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 thegeneral population, they may not be appropriate measures to use in assessing obesity andoverweight among children in minority ethnic groups. There is considerable debate aboutthe applicability of definitions of overweight and obesity across ethnic groups for adults andchildren (see Chapter 6, Section 6.1.1). Evidence suggests that, for a given BMI, theaverage proportion of body fat differs between ethnic groups, and that thresholds foroverweight and obesity may be lower among Asian populations and higher among those ofAfrican descent. The issue is further complicated among children by differences betweengroups 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 havebeen increasing since 1990, the comparison with an earlier year may overestimate thedifferences in 2004 between minority ethnic groups with higher mean BMIs and the general


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population (and underestimate those with lower mean BMIs). This issue is discussed inSection 12.8.4.

12.8.2 Height

Mean height among children in minority ethnic groups ranged from 128.7cm for BlackAfrican boys to 140.6cm for Black Caribbean boys, and from 127.5cm for Bangladeshi girlsto 134.0cm for Black Caribbean girls. However, as noted above, height is strongly related toage among children, so age-adjusted regression coefficients have been calculated to allowcomparison with the general population, controlling for the different age profiles of theminority ethnic groups. The age-adjusted regression coefficients show that, on average, themean height of Black Caribbean boys was 3.9cm more than the mean height of boys in thegeneral population and the mean height of Chinese boys was 1.7cm less. Compared withthe mean height of girls in the general population, the mean heights of Black Caribbean andBlack African girls were greater (by 1.8cm and 3.8cm respectively) and the mean height ofBangladeshi girls was less (by 2.1cm). Table 12.29

A similar pattern of difference was seen in 1999. However, in 1999, the mean heights ofBangladeshi boys and Indian and Chinese girls were less than the average for the generalpopulation, 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 boysto 39.6kg for Black Caribbean boys, and from 30.9kg for Bangladeshi girls to 38.9kg forBlack Caribbean girls. As with height, weight is strongly related to age, so age-adjustedregression coefficients have been calculated for each group. These show that, havingcontrolled for age, the mean weights of Black Caribbean, Black African and Pakistani boyswere greater than the mean weight of boys in the general population (by 3.7kg, 2.0kg and1.6kg respectively). Among girls, the mean weights of Black Caribbean and Black Africangirls were greater than the mean weight of girls in the general population (by 3.9kg and4.0kg respectively). Table 12.30

In 1999, after controlling for age, Black Caribbean girls, but not boys, were also heavier onaverage than girls in the general population. Children in several minority ethnic groups werelighter on average than boys or girls in the general population: Bangladeshi boys andIndian, Bangladeshi and Chinese girls (data not shown).1

12.8.4 Body mass index (BMI)

Among children in minority ethnic groups, mean BMI ranged from 17.7 for Indian boys to19.3 for Black Caribbean boys, and from 18.1 for Pakistani girls to 20.0 for Black Caribbeangirls.

As noted above, the definitions of overweight and obesity used here are based on the age-specific national BMI percentiles. Among minority ethnic groups, the prevalence ofoverweight (including obesity) ranged from 22% of Chinese boys to 42% of Black Africanboys, and from 25% of Pakistani girls to 42% of Black Caribbean girls. 30% of boys and31% of girls in the 2002 general population were overweight or obese. Black African andPakistani boys and Black Caribbean and Black African girls had an increased risk of beingoverweight or obese compared with the 2002 general population. Chinese boys were lesslikely than boys in the general population to be overweight or obese. The remainder of thissection focuses on the prevalence of obesity.

Among children in minority ethnic groups, the proportions who were obese ranged from14% of Indian and Chinese boys to 31% of Black African boys, and from 12% of Chinesegirls 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 andgirls and Pakistani boys were more likely than boys and girls in the general population to beobese. Table 12.31, Figure 12D


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Obesity among younger children has become a focus of government concern. The 2004Public Service Agreements (PSAs) include the objective, shared by the Department ofHealth, the Department for Education and Skills and the Department of Culture, Media andSport, of ‘halting the year-on-year rise in obesity among children under 11 by 2010 in thecontext of a broader strategy to tackle obesity in the population as a whole’.31 In the 2002general population sample, 15% of boys and 15% of girls aged 2 to 10 were obese. Amongminority ethnic groups the proportions of obese children aged 2 to 10 in 2004 ranged from13% 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 childrenin this age group who were obese ranged from 13% of Chinese boys to 31% of Pakistaniboys, and from 15% of Bangladeshi girls to 37% of Black Caribbean girls. Although itseems likely that – as with the general population – the proportion of obese children ishigher in the older age group, the minority ethnic group subsamples were too small forreliable comparisons to be made. Table 12.32

Because the proportions of overweight and obese children in the general population haverisen in recent years, comparisons with the 2002 general population will tend tooverestimate differences between the general population and groups with higher levels ofoverweight and obesity. The table below compares the proportions of obese children inminority ethnic groups with the 2004 general population.


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Prevalence of overweight and obesity among children aged 2 to 15, by minority ethnic group

Per

cent

Per

cent

Figure 12D

0

5

10

15

20

25

30

35

40

45

OverweightObese

Black

Caribbean

Black

African

Indian

Pakistani

Bangladeshi

IrishChinese

General

population

Black

Caribbean

Black

African

Indian

Pakistani

Bangladeshi

IrishChinese

General

population

Boys

0

5

10

15

20

25

30

35

40

45Girls

In 2004, 19% of boys and 18% of girls in the general population were obese. Theprevalence of obesity in most minority ethnic groups was not significantly different; onlyBlack 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 ofobesity 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


HSE has collected information on children’s physical activity since 1997, using differentquestions from those used for adults. Although there have been some changes in thequestions in successive surveys, those used in 2004 are consistent with those used in 1999and 2002, the years used for comparison in this chapter.

In 2004 this information was collected in the face-to-face interview with parents of childrenaged 2 to 12, and directly from children aged 13 to 15. Questions referred to the previousseven days and asked for details of specific activities, although not those done as part ofthe school curriculum. ‘Sports and exercise’ included organised sports and activities suchas swimming, gymnastics, football or athletics. ‘Active play’ was less formal, defined ashaving 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 for15 minutes or more. Weekdays and weekends were asked about separately, including thenumber 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 recallerror, 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 toconstruct an accurate account of their child’s activities. In any case, children’s activity maybe difficult to quantify, given that it is typically made up of short and sporadic bouts ratherthan sustained episodes. Finally parents and older children might have been influenced bysocial desirability in their responses.

For further discussion of the methodology of this section, including the limitations of self-report as a means of measuring physical activity, see Chapter 4, Section 4.2.1 in the 2002HSE report.32

12.9.2 Participation in different activities in the last week

Participation in different types of physical activity varied between groups. Overall, walkingand 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


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Obesity among children in 2004, by minority ethnic group, sex and age

Black Black General Caribbean African Indian Pakistani Bangladeshia Chinesea Irish population

% % % % % % % %

Boys

Aged 2 to 10 27 32 13 21 24 [15] 20 16

Aged 11 to 15 29 [27] 16 31 19 [13] 28 24

Aged 2 to 15 28 31 14 25 22 14 22 19

Girls

Aged 2 to 10 21 28 16 11 21 13 13 13

Aged 11 to 15 37 [24] 28 22 [15] a 21 27

Aged 2 to 15 27 27 21 15 20 12 16 18a

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.

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 andBangladeshi 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 of8.0 hours for Chinese boys to 12.9 hours for Irish boys, compared with 14.2 hours for boysin the general population. The average amount of time spent in physical activity among girlsin minority ethnic groups ranged from 6.9 hours for Pakistani girls to 10.2 for Irish girls. Themean 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% ofPakistani 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 wereless 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 of4.1 days for Chinese girls to 5.4 days for Bangladeshi boys). The average time in a weekspent 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 playranged from 77% of Chinese boys to 91% of Irish boys, and from 74% of Bangladeshi girlsto 88% of Irish girls. Indian, Bangladeshi and Chinese boys and Black Caribbean, BlackAfrican, Indian and Bangladeshi girls were less likely to have done any active play thanchildren 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). Chineseboys played, on average, on fewer days (3.1) than boys in other groups. In most minorityethnic groups, the mean number of days on which girls had taken part in active play waslower 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 anaverage of 7.8 hours, girls 6.4 hours in active play.

Sports and exercise

The questions on exercise excluded activities undertaken as part of the school curriculumand thus participation in sports and types of organised exercise is likely to beunderrepresented for many of these children, most of whom are of school age. TheGovernment’s 2004 target for sporting activity was for 75% of school children to bespending a minimum of two hours per week on high quality physical exercise and schoolsport within and beyond the curriculum by 2006. At the time they estimated that this wasprovided by about a quarter of schools at Key Stage 1, two-fifths at Key Stage 2 and a thirdat Key Stages 3 and 4. However, it should be noted that these estimates were for schoolprovision, not for the take-up by pupils.33,34

There were considerable differences between minority ethnic groups in the proportion ofboys and girls who had taken part in sport or organised exercise in the last week, rangingfrom 48% of Pakistani boys to 71% of Black Caribbean boys, and from 23% of Pakistanigirls 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 minorityethnic 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 andIrish children.


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The average number of days on which children participated in sport and exercise rangedfrom 2.0 days for Pakistani boys to 2.7 days for Black Caribbean boys, and from 1.0 daysfor Pakistani girls to 1.7 days for Black African girls. The time spent on these activitiesranged from a mean of 0.7 hours (Pakistani girls) to 3.2 hours (Black Caribbean boys). In thegeneral 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 least15 minutes ranged from 23% of Bangladeshi boys to 37% of Indian boys, and from 24% ofChinese 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 andexercise, girls in the general population and in most minority ethnic groups were more likelythan boys to have done housework or gardening in the last week, but this was not soamong Chinese children.

The mean number of days on which children did housework or gardening ranged from 0.4days for Chinese boys to 0.9 days for Indian boys, and from 0.4 days for Chinese girls to 1.9days for Indian girls. The mean number of hours ranged from 0.2 hours (Chinese boys andgirls) to 1.1 hours (Indian, Pakistani, Bangladeshi and Irish girls). Boys in the generalpopulation did an average of 0.5 hours housework and gardening, girls an average of 0.6hours. Table 12.34

12.9.3 Levels of activity

The government has recommended that young people aged between 5 and 18 should dosome physical activity of at least moderate intensity for at least one hour every day; and thatinactive young people should do some activity of at least moderate intensity for at least halfan hour (30 minutes) a day. In line with these guidelines, the amount of activity children haddone in the last week was summarised into three categories. The recommendation of atleast 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 eachday of the week, was classified as ‘medium’ level activity. Activity for less time, or on fewerthan seven days a week, was classified as ‘low’ level activity.

With the exception of Pakistani boys and Irish boys and girls, children in minority ethnicgroups were less likely than the general population to have done the recommended level ofactivity. Additionally, in most groups, girls were less likely than boys to have done a highlevel of activity, though the proportions of boys and girls who did a high level of activity weresimilar among Black Caribbean, Chinese and Irish children. Chinese boys (38%) were muchless 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% ofIndian 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% ofPakistani girls to 60% of Irish girls, and 61% of girls in the general population. Irish andBlack Caribbean girls were more likely than girls in other minority ethnic groups to havedone 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 thepreceding 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 andfrom 24% of Irish girls to 46% of Indian girls. Among the general population thecorresponding proportions were 17% of boys and 23% of girls. Table 12.35

Questions about exercise were asked in 1999, although the summary exercise levels werenot presented in the report. Although the questionnaires were comparable, apparentdifferences between the findings should be treated with caution, given the small samplesizes.

In each minority ethnic group the proportions of children who reported high levels of activity


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in 1999 and 2004 were not significantly different, except for Black Caribbean boys, amongwhom 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


Information about fruit and vegetable consumption was collected during the face-to-faceinterview, 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 the24 hours ending at midnight before the interview). For details of the methodology seeChapter 9, Section 9.2.1.

As the data are based on self-reported information, there may be some variation in the wayinformants interpreted the definitions. Additionally responses may have been subject torecall error or influenced by the social desirability of responses. Informants may have foundit difficult to assess accurately the amount of fruit or vegetables consumed in compositeitems, such as fruit pies or vegetable chilli. Finally, parents might not always have anaccurate knowledge of what their child had eaten, for example during the school day, orwhen visiting friends.

The analysis below reflects the government recommendation that everyone should eat atleast five portions of fruit and vegetables a day, a level of consumption which is known tosignificantly reduce the risks of cardiovascular disease and many cancers. The NHS ‘5 aday’ campaign was launched in 2000, and during 2004 the School Fruit and VegetableScheme was extended to all children aged 4 to 6 in English primary schools. Since autumn2004 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 rangedfrom 15% of Chinese boys to 22% of Indian and Bangladeshi boys, and from 12% of Irishgirls to 24% of Chinese girls. In most minority ethnic groups, the proportion of childreneating 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 Irishboys or for Bangladeshi and Irish girls. Table 12.37, Figure 12F


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Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

Proportion doing recommended amount of exercise, by minority ethnic group

Boys Girls

Ris

k ra

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, lo

gar

ithm

ic s

cale

Figure 12E

2.0

0.5


0.10

1.0

10.0

Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

2.0

0.5

0.10

1.0

10.0

Mean consumption among minority ethnic groups ranged from 2.8 portions by Irish boys to3.4 portions by Indian boys, and from 2.9 portions by Irish and Black Caribbean girls to 3.6portions by Chinese girls. Again, these levels were generally higher than the averageconsumption 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 from2% of Black African boys to 11% of Irish boys, and from 1% of Chinese girls to 9% of BlackCaribbean and Bangladeshi girls. Compared with boys (12%) and girls (8%) in the generalpopulation, Black Caribbean, Indian and Chinese boys (8%, 5% and 4% respectively), andChinese and Pakistani girls (1% and 2%) were less likely to have eaten no fruit orvegetables. Table 12.37


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. TheStationery Office, London, 2001.

2 Sproston K, Primatesta P (eds). Health Survey for England 2002: The Health of Children and YoungPeople. Volume 3: Methodology and Documentation. The Stationery Office, London 2003.

3 The International Classification of Diseases and Related Health Problems (Tenth Revision). World HealthOrganisation, Geneva, 1992.

4 Goldberg D, Williams OA. Users’ guide to the General Health Questionnaire. NFER-Nelson, London,1988.

5 Goodman R. The Strengths and Difficulties Questionnaire: a research note. Journal of Child Psychologyand Psychiatry 1997; 38:581-6.

6 The SDQ measures 25 attributes: ten strengths, fourteen difficulties and one neutral item. The 25 SDQitems 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 thesum of the scores on the five relevant items, ranging from 0 to 10. The total deviance score derived fromthe sum of four scales, excluding the prosocial behaviour scale, and ranges from 0 to 40. Each score hasbeen 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. Formore 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 BehaviourChecklist: 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 youngpeople. Office for National Statistics, London 2004. www.statistics.gov.uk/children.


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Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

Proportion eating 5+ portions of fruit and vegetables, by minority ethnic group

Boys Girls

Ris

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, lo

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Figure 12F

2.0

0.5


0.10

1.0

10.0

Black Caribbean

Black African

Indian

Pakistani

Bangladeshi

IrishChinese

2.0

0.5

0.10

1.0

10.0

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 MedicalJournal 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 England2002: The Health of Children and Young People. Volume 1: Findings. The Stationery Office, London2003.

13 Netuveli G, Hurwitz B, Levy M et al. Ethnic variations in UK asthma frequency, morbidity, and health-service 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 studyin 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 inchildhood. Thorax 1987; 42:542-8.

17 Whittaker AL, Sutton AJ, Beardsmore CS. Are ethnic differences in lung function explained by chestsize? 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 thesurvey of Smoking among secondary school children.

19 Wardle H, Hedges B, Chapter 1: Cigarette smoking in Sproston K, Primatesta P (eds). Health Survey forEngland 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 SocialCare 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 Londonadolescents. Ethnicity and Health 2001; 6(1):51-7.

22 Questions about drinking alcohol were first included in the survey of smoking, drinking and drug useamong young people in England in 1988.

23 Erens B, Chapter 2: Alcohol consumption in Sproston K, Primatesta P (eds). Health Survey for England2002: The Health of Children and Young People. Volume 1: Findings. The Stationery Office, London2003.

24 Voors AW, Webber LS, Frerichs RR, Berenson GS. Body height and body mass as determinants of basalblood 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 Diseasein Childhood 1995; 73:25-9

27 Wardle H (ed). Obesity among children under 11. 2004http://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 ofAfrican or Indian descent in Trinidad and Tobago. International Journal of Epidemiology 2001; 30:989-98.

30 Daniels SR, Khoury PR, Morrison JA. The utility of Body Mass Index as a measure of body fatness inchildren and adolescents: differences by race and gender. Pediatrics 1997; 99(6):804-7.

31 This and other departmental Public Service Agreements can be found at http://www.hm-treasury.gov.uk/media//70320/sr04_psa_ch3.pdf .

32 Stamatakis E, Chapter 4: Physical activity in Sproston K, Primatesta P (eds). Health Survey for England2002: The Health of Children and Young People. Volume 1: Findings. The Stationery Office, London2003.

33 Department for Education and Skills/Department for Culture, Media and Sport. Learning through PE andSport. 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, networksof 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 partnershipschools met the target of at least two hours sport a day (http://www.teachernet.gov.uk/_doc/9045/2004-


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05SchholSportSurveyReport.doc). However it is unlikely that these schools are typical of all schools inEngland, 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 relationshipto health. 2004. http://www.dh.gov.uk/assetRoot/04/08/09/81/04080981.pdf .

36 See http://www.5aday.nhs.uk/sfvs/default.aspx.


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400 HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH

12.15 Severity of childen’s respiratory symptoms andimpact on everyday life in the last twelvemonths, by minority ethnic group and sex

12.16 Forced expiratory volume in the first second(FEV1), by minority ethnic group and sex

12.17 Forced vital capacity (FVC), by minority ethnicgroup and sex

12.18 Peak expiratory flow (PEF), by minority ethnicgroup and sex

12.19 Children’s self-reported experience of smokingcigarettes, by minority ethnic group and sex

12.20 Children’s self-reported frequency of smokingcigarettes, by minority ethnic group and sex

12.21 Children’s self-reported experience of smokingcigarettes, by age within minority ethnic groupand sex

12.22 Children’s self-reported frequency of smokingcigarettes, by age within minority ethnic groupand sex

12.23 Comparison of children’s self-reportedexperience of smoking cigarettes in 2004 and1999, by age within minority ethnic group andsex

12.24 Children’s self-reported experience of drinkingalcohol, by minority ethnic group and sex

12.25 Children’s self-reported experience of drinkingalcohol, by age within minority ethnic group andsex

12.26 Children’s self-reported experience of drinkingalcohol in 2004 and 1999, by age within minorityethnic group and sex

12.27 Children’s systolic blood pressure (SBP), byminority ethnic group and sex

12.28 Children’s diastolic blood pressure (DBP), byminority ethnic group and sex

12.29 Children’s height, by minority ethnic group andsex

12.30 Children’s weight, by minority ethnic group andsex

Tables

12.1 Self-reported longstanding illness and limitinglongstanding illness among children, byminority ethnic group and sex

12.2 Comparison of self-reported longstandingillness and limiting longstanding illness amongchildren in 2004 and 1999, by minority ethnicgroup and sex

12.3 Type of longstanding illness (rate per 1000)among children, by minority ethnic group andsex

12.4 Self-reported acute sickness in last two weeksamong children, by minority ethnic group andsex

12.5 Comparison of self-reported acute sickness inthe last two weeks among children in 2004 and1999, 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 healthamong children in 2004 and 1999, by minorityethnic group and sex

12.8 Children’s use of prescribed medicines, byminority ethnic group and sex

12.9 Comparison of children’s use of prescribedmedicines in 2004 and 1999, by minority ethnicgroup and sex

12.10 General Health Questionnaire (GHQ12) scoreamong children, by minority ethnic group andsex

12.11 Strengths and Difficulties Questionnaire (SDQ)score, by minority ethnic group and sex

12.12 Comparison of Strengths and DifficultiesQuestionnaire (SDQ) scores in 2004 and 1999,by minority ethnic group and sex

12.13 Children’s respiratory symptoms and doctor-diagnosed asthma, by minority ethnic groupand sex

12.14 Comparison of children’s respiratory symptomsand doctor-diagnosed asthma in 2004 and1999, by minority ethnic group and sex

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HSE 2004 | VOL 1: MINORITY ETHNIC GROUPS | 12: CHILDREN’S HEALTH 401

12.31 Children’s body mass index (BMI) and theprevalence of overweight and obesity, byminority ethnic group and sex

12.32 Children’s body mass index (BMI) and theprevalence of overweight and obesity, by agewithin minority ethnic group and sex

12.33 Comparison of children’s body mass index(BMI) and the prevalence of overweight andobesity in 2004 and 1999, by minority ethnicgroup and sex

12.34 Summary of children’s participation in differentactivities in the last week, by minority ethnicgroup and sex

12.35 Summary of children’s activity levels, byminority ethnic group and sex

12.36 Comparison of children’s activity levels in 2004and 1999, by minority ethnic group and sex

12.37 Children’s consumption of fruit and vegetables,by minority ethnic group and sex


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Table 12.1

Self-reported longstanding illness and limiting longstanding illness among children, by minority ethnic group and sex

Aged 0-15 2004

Longstanding illness Minority ethnic group Generaland limiting populationlongstanding illness Black Black (2001-2002)


BoysObserved %


Any longstanding illness 21 11 18 18 14 17 23 24

Risk ratios



Any longstanding illness 0.89 0.46 0.73 0.76 0.56 0.72 0.94 1


GirlsObserved %


Any longstanding illness 22 7 9 13 10 13 17 20

Risk ratios



Any longstanding illness 1.14 0.35 0.46 0.67 0.50 0.65 0.86 1


Bases (weighted)

Boys 322 269 391 354 133 53 935 6936

Girls 264 283 319 319 136 52 979 6863

Bases (unweighted)

Boys 262 253 241 313 290 123 225 6066

Girls 223 266 185 287 277 112 241 5992


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Table 12.2

Comparison of self-reported longstanding illness and limiting longstandingillness among children in 2004 and 1999, by minority ethnic groupa and sex

Aged 2-15b 2004, 1999

Longstanding illness Minority ethnic groupand limitinglongstanding illness Black


% % % % % %

Boys2004

Limiting longstanding illness 9 7 8 5 12 6

Any longstanding illness 23 20 18 14 20 24

1999



Girls2004



1999



Bases (weighted)

Boys 2004 275 340 312 114 47 803

Boys 1999 207 275 243 106 43 852

Girls 2004 234 290 280 114 46 857

Girls1999 217 209 245 98 42 894

Bases (unweighted)

Boys 2004 226 209 272 244 110 195

Boys 1999 300 268 397 385 138 270

Girls 2004 203 170 249 229 99 204

Girls 1999 312 203 393 357 126 265


b The sample in 1999 included children aged between 2 and 15. In 2004 the sample included all children from birth. For the 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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Table 12.3

Type of longstanding illness (rate per 1000) among children, by minority ethnic group and sex

Aged 0-15 2004

Condition group Minority ethnic group General(ICD categories)a population

Black Black (2001-2002)


BoysI Infectious disease - - 10 4 3 - - 1

II Neoplasms & benign growths 2 - - - - - - 1

III Endocrine & metabolic 9 2 9 1 4 5 1 5

IV Blood & related organs 14 - - 12 - - 3 3

V Mental disorders 13 20 7 8 10 8 43 27

VI Nervous system 25 6 11 14 13 - 8 16

VI Eye complaints - 3 11 6 8 16 29 10

VI Ear complaints 17 8 20 4 3 8 6 18

VII Heart & circulatory system 5 8 11 - 4 8 1 5

VIII Respiratory system 157 69 101 96 60 127 136 123

IX Digestive system 4 8 19 15 7 - 3 18

X Genito-urinary system 5 - - 10 14 - 6 9

XII Skin complaints 9 20 45 22 29 32 38 45

XIII Musculoskeletal system 4 15 - 7 4 16 2 16

Other complaints - - - 4 - - - 3

GirlsI Infectious disease - 3 - - - - 3 1

II Neoplasms & benign growths - - - - - - - 1

III Endocrine & metabolic - - - - 3 - 3 6

IV Blood & related organs 12 6 - 7 10 - 3 5

V Mental disorders 11 2 - 11 3 - 23 10

VI Nervous system - - 4 9 7 - 4 10

VI Eye complaints 5 2 7 - - 8 9 8

VI Ear complaints 18 5 3 5 2 - 7 14

VII Heart & circulatory system 8 - 7 - - - 6 5

VIII Respiratory system 118 38 71 55 41 63 91 99

IX Digestive system 21 - 3 10 12 - 20 14

X Genito-urinary system 7 - 4 - - - 3 6

XII Skin complaints 71 18 16 51 22 19 36 43

XIII Musculoskeletal system 18 - 9 17 - 30 10 13

Other complaints - - - 4 9 8 3 1

Bases (weighted)

Boys 322 269 391 354 133 53 935 6936

Girls 264 283 319 319 136 52 979 6863

Bases (unweighted)

Boys 262 253 241 313 290 123 225 6066

Girls 223 266 185 287 277 112 241 5992

a ICD categories as in The International Classification of Diseases and Related Health problems (Tenth Revision). World Health Organisation, Geneva, 1992.


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Table 12.4

Self-reported acute sickness in last two weeks among children, by minority ethnic group and sex

Aged 0-15 2004

Acute sickness in Minority ethnic group Generallast two weeks population



BoysObserved %

Had acute sickness 7 5 7 11 6 4 12 13

1-3 days 5 2 3 5 3 2 6 7

4-6 days 0 2 2 2 1 2 2 3

7-13 days 1 - 1 2 1 - 3 2

2 weeks 1 1 0 2 1 - 1 1

Risk ratios

Acute sickness in last 2 weeks 0.53 0.36 0.53 0.86 0.46 0.33 0.90 1


GirlsObserved %

Had acute sickness 6 5 7 7 4 5 11 13

1-3 days 3 2 5 3 2 3 6 8

4-6 days 1 2 1 2 1 - 4 2

7-13 days - 1 1 1 - 1 1 2

2 weeks 2 - - 0 0 - 0 1

Risk ratios

Acute sickness in last 2 weeks 0.45 0.35 0.57 0.53 0.29 0.37 0.89 1


Bases (weighted)

Boys 322 269 391 354 133 53 935 6937

Girls 264 283 319 319 136 52 979 6861

Bases (unweighted)

Boys 262 253 241 313 290 123 225 6067

Girls 223 266 185 287 277 112 241 5990


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Table 12.5

Comparison of self-reported acute sickness in the last two weeks amongchildren in 2004 and 1999, by minority ethnic groupa and sex

Aged 2-15b 2004, 1999

Acute sickness in the Minority ethnic grouplast two weeks


% % % % % %

Boys2004

Had acute sickness in last 2 weeks 7 7 12 5 4 12

1999


Girls2004


1999


Bases (weighted)

Boys 2004 275 340 312 114 47 803

Boys 1999 207 275 243 106 43 852

Girls 2004 234 290 280 114 46 857

Girls1999 217 209 244 98 42 894

Bases (unweighted)

Boys 2004 226 209 272 244 110 195

Boys 1999 300 268 397 385 138 270

Girls 2004 203 170 249 229 99 204

Girls 1999 312 203 392 357 126 265




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Table 12.6

Self-assessed general health among children, by minority ethnic group and sex

Aged 0-15 2004

Self-assessed Minority ethnic group Generalgeneral health population



BoysObserved %

Very good 52 58 55 47 39 49 64 57

Good 39 36 39 46 47 43 29 36

Very good/good 91 94 94 92 86 92 94 93

Fair 9 5 6 7 10 7 6 7

Bad - 1 0 0 4 1 0 1

Very bad - 0 - 0 - - 0 0

Bad/very bad - 1 0 1 4 1 1 1

Risk ratios

Good/very good 0.98 1.02 1.01 1.00 0.93 0.99 1.01 1


Bad/very bad - 1.03 0.45 0.62 4.39 1.68 0.93 1

Standard error of the ratio - 0.77 0.46 0.47 1.57 1.23 0.56

GirlsObserved %

Very good 46 53 55 50 37 47 67 57

Good 43 41 41 41 56 49 28 35

Very good/good 89 95 96 91 94 97 95 93

Fair 10 5 4 8 5 3 5 6

Bad 1 0 0 0 1 - 0 1

Very bad - - - 0 - - - 0

Bad/very bad 1 0 0 1 1 - 0 1

Risk ratios

Good/very good 0.96 1.02 1.03 0.98 1.01 1.04 1.02 1


Bad/very bad 1.26 0.17 0.41 0.70 0.75 - 0.29 1

Standard error of the ratio 0.72 0.17 0.40 0.48 0.44 - 0.26

Bases (weighted)

Boys 321 269 391 354 133 53 935 6937

Girls 264 283 319 316 136 52 979 6862

Bases (unweighted)

Boys 261 253 241 313 290 123 225 6067

Girls 223 266 185 285 277 112 241 5991


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Table 12.7

Comparison of self-assessed general health among children in 2004 and 1999, by minority ethnic groupa and sex

Aged 2-15b 2004,1999

Self-assessed Minority ethnic groupgeneral health


% % % % % %

Boys2004

Good/very good 91 93 93 86 91 95

Fair 9 7 7 10 7 5

Bad/very bad - 0 0 4 2 1

1999

Good/very good 88 89 87 84 91 94

Fair 11 10 11 14 7 6


Girls2004

Good/very good 90 95 91 94 97 94

Fair 9 4 8 6 3 6

Bad/very bad 1 0 1 1 - 0

1999

Good/very good 90 87 92 89 91 91

Fair 9 12 6 9 9 7


Bases (weighted)

Boys 2004 274 228 340 312 114 47

Boys 1999 207 275 243 106 43 852

Girls 2004 234 226 290 277 114 46

Girls1999 217 209 244 98 42 894

Bases (unweighted)

Boys 2004 225 212 209 272 244 110

Boys 1999 300 268 397 385 138 270

Girls 2004 203 211 170 247 229 99

Girls 1999 312 203 392 357 126 265


b The sample in 1999 included children aged between 2 and 15. In 2004 the sample included all children from birth. For the purposes of comparison, the 2004 figures in this table are based on children aged 2-15 and may differ fromhose shown elsewhere in this report.


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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 Generalpopulation



BoysObserved %

Taking any prescribed medicine 21 14 20 24 16 9 19 20

1 prescribed medicine 6 10 7 14 7 6 11 10

2 prescribed medicines 9 3 11 8 5 2 6 7

3 prescribed medicines 1 0 - 2 1 2 - 2

4 or more prescribed medicines 5 0 1 1 3 - 1 1

Risk ratios

Any prescribed medicine 1.08 0.73 1.00 1.22 0.84 0.46 0.96 1


GirlsObserved %

Taking any prescribed medicine 18 10 16 12 22 20 18 19

1 prescribed medicine 8 7 8 6 13 14 11 9

2 prescribed medicines 8 2 8 4 7 4 5 7

3 prescribed medicines 1 2 - 0 - 3 2 2

4 or more prescribed medicines 1 -- 1 1 2 - - 1

Risk ratios

Any prescribed medicine 0.97 0.56 0.85 0.65 1.18 1.08 0.95 1


Bases (weighted)

Boys 159 142 209 171 69 26 447 5769

Girls 139 141 150 168 65 27 468 5715

Bases (unweighted)

Boys 120 121 155 175 115 67 140 5033

Girls 119 123 108 169 104 68 159 4989


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Table 12.9

Comparison of children’s use of prescribed medicines in 2004 and 1999, by minority ethnic groupa and sex

Aged 2-15b 2004, 1999

Use of prescribed medicines Minority ethnic group


% % % % % %

Boys2004

Taking any prescribed medicine 19 21 22 14 11 17

1999


Girls2004


1999


Bases (weighted)

Boys 2004 135 181 145 58 22 397

Boys 1999 148 208 170 58 35 690

Girls 2004 121 137 147 50 24 418

Girls1999 161 160 169 52 31 755

Bases (unweighted)

Boys 2004 106 134 147 95 59 122

Boys 1999 216 199 279 219 113 206

Girls 2004 106 100 146 79 59 137

Girls 1999 236 157 268 194 92 208




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Table 12.10

General Health Questionnaire (GHQ12) score among children, by minority ethnic group and sex

Aged 13-15 2004




BoysObserved %

0 [64] a [67] [66] [69] a [77] 62

1-3 [30] a [22] [30] [20] a [18] 30

4+ [7] a [11] [4] [10] a [5] 7

Risk ratios

High score (4+) [0.89] a [1.48] [0.52] [1.41] a [0.71] 1

Standard error of the ratio [0.63] a [0.74] [0.40] [0.78] a [0.45]

GirlsObserved %

0 [42] [59] [60] [62] [69] a [62] 56

1-3 [37] [38] [32] [31] [23] a [33] 31

4+ [20] [4] [8] [7] [8] a [5] 13

Risk ratios

High score (4+) [1.59] [0.30] [0.62] [0.53] [0.66] a [0.41] 1

Standard error of the ratio [0.69] [0.21] [0.44] [0.30] [0.50] a [0.23]

Bases (weighted)

Boys 45 24 52 50 16 10 128 1189

Girls 42 32 48 34 17 8 137 1187

Bases (unweighted)

Boys 35 23 36 40 33 25 34 1070

Girls 31 31 30 32 31 17 36 1071



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Table 12.11

Strengths and Difficulties Questionnaire (SDQ) score, by minority ethnic group and sex

Aged 4-15 2004

SDQ score Minority ethnic group Generalpopulation



BoysObserved %

Total deviance scorea

0-13 68 85 81 69 73 [86] 76 80

14-16 11 6 9 20 10 [10] 11 9

17-40 21 9 9 11 17 [3] 13 12

Emotional symptoms score

0-3 76 83 81 77 76 [94] 76 84

4 16 10 9 9 5 [2] 9 7

5-10 7 7 10 14 19 [4] 15 10

Conduct problems score

0-2 65 67 72 67 71 [89] 73 72

3 10 19 13 13 12 [6] 16 13

4-10 26 14 15 20 17 [5] 10 15

Hyperactivity score

0-5 67 81 79 68 74 [79] 77 72

6 5 10 11 14 10 [7] 12 10

7-10 28 9 10 17 16 [14] 11 18

Peer problems score

0-2 62 75 64 59 65 [74] 81 75

3 16 16 20 20 16 [11] 7 11

4-10 22 10 16 21 19 [16] 12 14

Prosocial behaviour score

6-10 85 83 85 86 89 [81] 93 89

5 8 5 9 9 4 [7] 6 6

0-4 7 12 6 5 7 [12] 1 5


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 1


Conduct problems score 4-10 1.71 0.94 0.97 1.35 1.12 [0.36] 0.70 1


Hyperactivity score 7-10 1.53 0.49 0.55 0.97 0.85 [0.76] 0.61 1


Peer problems score 4-10 1.59 0.69 1.17 1.57 1.35 [1.13] 0.87 1


Prosocial behaviour score 0-4 1.44 2.49 1.20 0.97 1.44 [2.46] 0.16 1


Bases

Boys (weighted) 119 78 167 118 29 21 444 3461

Boys (unweighted) 87 71 109 95 62 48 100 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 …


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Aged 4-15 2004

SDQ score Minority ethnic group Generalpopulation



GirlsObserved %


0-13 81 92 84 74 80 [85] 88 84

14-16 12 5 10 15 11 [10] 1 9

17-40 6 3 6 12 9 [6] 10 8

Emotional symptoms score

0-3 72 87 74 61 68 [77] 75 79

4 9 6 12 13 13 [12] 6 9

5-10 19 7 14 27 19 [11] 18 12

Conduct problems score

0-2 74 88 81 68 67 [75] 74 76

3 15 5 12 9 24 [21] 13 12

4-10 11 8 7 23 9 [4] 12 12

Hyperactivity score

0-5 81 92 90 83 89 [85] 86 85

6 8 6 6 4 3 [12] 9 6

7-10 10 2 4 13 8 [4] 5 9

Peer problems score

0-2 78 76 72 55 69 [70] 83 78

3 11 18 12 24 17 [18] 7 11

4-10 11 7 16 21 13 [12] 10 11

Prosocial behaviour score

6-10 94 95 95 90 94 [90] 91 93

5 4 2 2 6 4 [8] 1 4

0-4 2 2 2 3 2 [2] 7 3


Mean 8.6 6.8 8.4 10.3 9.3 7.8 7.7 8.1


Median 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


Emotional symptoms score 5-10 1.56 0.61 1.25 2.14 1.54 0.93 1.53 1


Conduct problems score 4-10 0.98 0.67 0.60 1.93 0.79 0.34 1.05 1


Hyperactivity score 7-10 1.16 0.25 0.45 1.42 0.89 0.42 0.56 1


Peer problems score 4-10 1.00 0.60 1.52 1.88 1.21 1.07 0.93 1


Prosocial behaviour score 0-4 0.73 0.81 0.88 1.23 0.62 0.84 2.78 1


Bases

Girls (weighted) 104 93 140 115 29 23 489 3339

Girls (unweighted) 81 77 85 90 54 49 112 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).


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Table 12.12

Comparison of Strengths and Difficulties Questionnaire (SDQ) scores in 2004 and 1999, by minority ethnic groupa and sex

Aged 4-15 2004, 1999

SDQ score Minority ethnic group


% % % % % %

Boys2004

Total deviance score 17-40b 21 9 11 17 [3] 13

Emotional symptoms score 5-10 7 10 14 19 [4] 15

Conduct problems score 4-10 26 15 20 17 [5] 10

Hyperactivity score 7-10 28 10 17 16 [14] 11

Peer problems score 4-10 22 16 21 19 [16] 12

Prosocial behaviour score 0-4 7 6 5 7 [12] 1

1999

Total deviance score 17-40b 14 15 22 13 11 8

Emotional symptoms score 5-10 13 15 22 11 14 5

Conduct problems score 4-10 20 16 21 15 17 17

Hyperactivity score 7-10 21 19 11 15 17 24

Peer problems score 4-10 13 24 26 24 15 10

Prosocial behaviour score 0-4 2 4 5 16 8 2

Girls2004

Total deviance score 17-40b 6 6 12 9 [6] 10

Emotional symptoms score 5-10 19 14 27 19 [11] 18

Conduct problems score 4-10 11 7 23 9 [4] 12

Hyperactivity score 7-10 10 4 13 8 [4] 5

Peer problems score 4-10 11 16 21 13 [12] 10

Prosocial behaviour score 0-4 2 2 3 2 [2] 7

1999

Total deviance score 17-40b 12 16 17 12 8 14

Emotional symptoms score 5-10 18 21 26 20 15 15

Conduct problems score 4-10 12 15 16 16 18 18

Hyperactivity score 7-10 11 11 7 6 4 8

Peer problems score 4-10 16 16 20 27 11 9

Prosocial behaviour score 0-4 2 5 3 13 6 2

Bases (weighted)

Boys 2004 119 167 118 29 21 444

Boys 1999 121 173 128 45 30 588

Girls 2004 104 140 115 29 23 489

Girls1999 129 136 135 41 29 630

Bases (unweighted)

Boys 2004 87 109 95 62 48 100

Boys 1999 174 163 204 171 98 168

Girls 2004 81 85 90 54 49 112

Girls 1999 189 133 208 148 84 174


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).


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Table 12.13

Children’s respiratory symptoms and doctor-diagnosed asthma, by minority ethnic group and sex

Aged 0-15 2004

Respiratory symptoms Minority ethnic group Generaland asthma population



BoysObserved %

Ever wheezed 39 20 23 22 16 30 29 36

Wheezed without a cold 26 10 11 12 7 16 14 22

Breathless when wheezing 26 8 10 9 7 14 15 16

Wheezed in last 12 months 27 13 15 15 11 15 13 20

Doctor-diagnosed asthma 30 17 18 13 12 21 20 23

Risk ratios

Wheezed in last 12 months 1.37 0.67 0.76 0.79 0.54 0.76 0.67 1


Doctor-diagnosed asthma 1.33 0.74 0.81 0.56 0.52 0.92 0.90 1


GirlsObserved %

Ever wheezed 33 12 19 15 8 14 27 29

Wheezed without a cold 15 4 8 8 3 9 10 16

Breathless when wheezing 16 4 10 5 4 10 13 13

Wheezed in last 12 months 21 8 13 13 6 9 21 17

Doctor-diagnosed asthma 21 9 16 8 7 15 14 18

Risk ratios

Wheezed in last 12 months 1.27 0.47 0.80 0.77 0.36 0.53 1.27 1


Doctor-diagnosed asthma 1.21 0.50 0.90 0.44 0.37 0.85 0.82 1


Bases (weighted)

Boys 321 269 384 354 133 53 935 6937

Girls 262 282 316 318 136 52 979 6864

Bases (unweighted)

Boys 260 253 238 313 290 123 225 6067

Girls 220 265 184 285 277 112 241 5993


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Table 12.14

Comparison of children’s respiratory symptoms and doctor-diagnosed asthmain 2004 and 1999, by minority ethnic groupa and sex

Aged 2-15b 2004, 1999

Respiratory symptoms Minority ethnic groupand asthma


% % % % % %

Boys2004

Ever wheezed 40 25 21 16 34 31

Wheezed without a cold 28 12 11 7 18 14

Breathless when wheezing 28 11 10 8 16 17

Wheezed in last 12 months 27 15 13 10 17 12

Doctor-diagnosed asthma 33 21 14 13 24 22

1999

Ever wheezed 41 25 24 18 26 37





Girls2004

Ever wheezed 33 20 13 9 15 26





1999

Ever wheezed 32 23 15 11 17 34





Bases (weighted)

Boys 2004 273 335 312 114 47 803

Boys 1999 206 275 243 105 43 827

Girls 2004 233 287 278 114 46 857

Girls1999 217 209 245 98 42 888

Bases (unweighted)

Boys 2004 224 207 272 244 110 195

Boys 1999 298 268 397 384 138 267

Girls 2004 200 169 247 229 99 204

Girls 1999 312 203 393 358 126 264




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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 2004

Respiratory symptoms Minority ethnic group Generalpopulation



BoysNumber of wheezing attacks in the last twelve months

1-3 57 a [63] 63 [76] a [51] 68

4-12 40 a [37] 24 [12] a [20] 23

More than 12 3 a [-] 13 [12] a [29] 8

Sleep disturbed once or more a week 9 a [-] 24 [32] a [35] 20

Speech limitedb,c 22 a a [20] a a a 15

Interfered with daily activitiesd 28 a [32] 34 [30] a [41] 57

GirlsNumber of wheezing attacks in the last twelve months

1-3 [67] a a [65] a a [67] 69

4-12 [18] a a [19] a a [27] 23

More than 12 [15] a a [16] a a [6] 8

Sleep disturbed once or more a week [34] a a [19] a a [11] 20

Speech limitedb,c [8] a a [24] a a [29] 15

Interfered with daily activitiesd [43] a a [31] a a [54] 57

Bases (weighted)

Boys 86 35 57 55 14 8 122 1360

Girls 55 22 42 41 8 5 206 1140

Bases (unweighted)

Boys 62 28 32 50 33 18 32 1197

Girls 45 18 26 37 16 10 45 993

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’.c Not asked about those aged under 2.d Interfered ‘a little’, ‘quite a bit’ or ‘a lot’.


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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 2004

FEV1 (litres) Minority ethnic group Generalpopulation



BoysObserved

Mean 2.41 [2.24] 2.20 2.37 [1.85] a 2.53 2.46

Standard error of the mean 0.25 [0.14] 0.09 0.11 [0.12] a 0.17 0.02

Median 2.02 [2.13] 2.03 2.43 [1.69] a 2.20 2.23

Age and height adjusted

Regression coefficientb -0.22 [-0.34] -0.24 -0.26 [-0.29] a 0.05 0

Standard error of the coefficient 0.21 [0.09] 0.06 0.07 [0.05] a 0.07

GirlsObserved

Mean [2.23] [2.11] 1.98 2.07 [1.80] [2.17] 2.21 2.29

Standard error of the mean [0.14] [0.12] 0.11 0.13 [0.08] [0.11] 0.10 0.02

Median [2.15] [2.19] 1.98 2.00 [1.83] [2.13] 2.14 2.19


Regression coefficientb [-0.26] [-0.39] -0.26 -0.17 [-0.34] [0.00] -0.11 0

Standard error of the coefficient [0.06] [0.05] 0.04 0.05 [0.10] [0.05] 0.05

Bases (weighted)

Boys 72 42 92 63 23 11 206 3020

Girls 60 48 79 53 24 13 202 2948

Bases (unweighted)

Boys 51 40 69 60 38 29 61 2638

Girls 49 38 57 53 34 30 67 2556

a Results are not shown because of small bases.b Equivalent to absolute difference in mean FEV1, adjusted for height and age, compared with the general population. The reference value for the general

population is consequently 0.


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Table 12.17

Forced vital capacity (FVC), by minority ethnic group and sex


FVC (litres) Minority ethnic group Generalpopulation



BoysObserved

Mean 3.11 [2.91] 2.63 2.75 [2.26] a 2.96 2.88


Median 2.68 [2.49] 2.36 2.75 [2.08] a 2.63 2.65


Regression coefficientb 0.04 [-0.12] -0.23 -0.32 [-0.25] a 0.05 0


GirlsObserved

Mean [2.66] [2.58] 2.58 2.37 [2.04] [2.54] 2.61 2.61


Median [2.57] [2.59] 2.45 2.35 [1.99] [2.53] 2.43 2.52


Regression coefficientb [-0.17] [-0.26] 0.03 -0.18 [-0.40] [0.07] -0.03 0


Bases (weighted)

Boys 72 42 92 63 23 11 206 3020

Girls 60 48 79 53 24 13 202 2948

Bases (unweighted)

Boys 51 40 69 60 38 29 61 2638

Girls 49 38 57 53 34 30 67 2556

a Results are not shown because of small bases.b Equivalent to absolute difference in mean FVC1, adjusted for height and age, compared with the general population. The reference value for the general



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Table 12.18

Peak expiratory flow (PEF), by minority ethnic group and sex


PEF (l.min-1) Minority ethnic group Generalpopulation



BoysObserved

Mean 321 [309] 301 327 [254] a 327 322


Median 300 [285] 292 329 [242] a 290 298


Regression coefficientb -18.57 [-27.05] -18.71 -15.40 [-28.59] a 0.40 0


GirlsObserved

Mean [313] [282] 260 267 [251] [286] 266 303


Median [302] [268] 263 249 [240] [285] 256 295


Regression coefficientb [-13.52] [-43.67] -37.64 -30.92 [-36.51] [-2.60] -39.10 0


Bases (weighted)

Boys 72 42 92 63 23 11 206 3020

Girls 60 48 79 53 24 13 202 2948

Bases (unweighted)

Boys 51 40 69 60 38 29 61 2638

Girls 49 38 57 53 34 30 67 2556

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



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Table 12.19

Children’s self-reported experience of smoking cigarettes, by minority ethnic group and sex

Aged 8-15 2004

Experience of smoking Minority ethnic group Generalcigarettes population



BoysObserved %

Has never smoked cigarettes 84 88 99 89 90 94 87 82

Has ever smoked 16 12 1 11 10 6 13 18

Has smoked, but does not do so now 15 7 1 8 7 6 8 14

Current smoker 2 5 - 3 3 - 5 4

Risk ratios

Has ever smoked 0.89 0.65 0.08 0.59 0.53 0.32 0.73 1


Current smoker 0.45 1.35 - 0.81 0.69 - 1.30 1

Standard error of the ratio 0.34 1.31 - 0.58 0.47 - 0.76

GirlsObserved %

Has never smoked cigarettes 83 91 93 95 95 [98] 77 81

Has ever smoked 17 9 7 5 5 [2] 23 19

Has smoked, but does not do so now 11 8 7 3 5 [2] 15 15

Current smoker 6 1 - 2 - [-] 8 4

Risk ratios

Has ever smoked 0.90 0.49 0.38 0.25 0.27 [0.11] 1.25 1


Current smoker 1.47 0.21 - 0.50 - - 2.03 1

Standard error of the ratio 1.03 0.21 - 0.36 - - 1.00

Bases (weighted)

Boys 117 71 168 142 46 24 391 3298

Girls 111 81 147 120 41 21 372 3282

Bases (unweighted)

Boys 91 68 109 121 96 57 93 2887

Girls 89 76 86 103 76 46 89 2859


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Table 12.20

Children’s self-reported frequency of smoking cigarettes, by minority ethnic group and sex

Aged 8-15 2004

Frequency of smoking Minority ethnic group Generalcigarettes population



% % % % % % % %

BoysDoesn’t smoke 98 95 100 97 97 100 95 96

Smokes less than once a week 0 - - 2 - - 2 1

Smokes once a week or more 1 5 - 1 3 - 3 2

GirlsDoesn’t smoke 94 99 100 98 100 [100] 92 96

Smokes less than once a week 2 1 - - - [-] 1 1

Smokes once a week or more 4 - - 2 - [-] 8 3

Bases (weighted)

Boys 117 71 168 142 46 24 391 3298

Girls 111 81 147 120 41 21 372 3282

Bases (unweighted)

Boys 91 68 109 121 96 57 93 2887

Girls 89 76 86 103 76 46 89 2859


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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 Age groupcigarettes

Boys GirlsAll All

8-10 11-15 boys 8-10 11-15 girls

% % % % % %

Black Caribbean

Ever smoked [10] 20 16 [-] 26 17

Currently smokes [-] 3 2 [-] 9 6

Black African

Ever smoked a [15] 12 a 14 9

Currently smokes a [9] 5 a 1 1

Indian

Ever smoked - 3 1 a 9 7

Currently smokes - - - a - -

Pakistani

Ever smoked [3] 15 11 [3] 6 5

Currently smokes [-] 5 3 [-] 3 2

Bangladeshi

Ever smoked [-] 16 10 [-] [8] 5

Currently smokes [-] 4 3 [-] [-] -

Chinese

Ever smoked a [8] 6 a a [2]

Currently smokes a [-] - a a [-]

Irish

Ever smoked [1] 24 13 a 33 23

Currently smokes [-] 9 5 a 12 8

General population (2001-2002)

Ever smoked 5 26 18 4 27 19

Currently smokes 0 6 4 - 6 4

Bases (weighted)


Black African 30 41 71 29 52 81

Indian 78 89 168 49 98 147

Pakistani 53 89 142 47 73 120

Bangladeshi 18 28 46 17 24 41

Chinese 6 19 24 9 12 21

Irish 176 215 391 111 261 372

General population (2001-2002) 1227 2072 3298 1234 2047 3282

Bases (unweighted)


Black African 29 39 68 26 50 76

Indian 50 59 109 28 58 86

Pakistani 48 73 121 41 62 103

Bangladeshi 36 60 96 31 45 76

Chinese 12 45 57 18 28 46

Irish 36 57 93 21 68 89




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Table 12.22

Children’s self-reported frequency of smoking cigarettes, by age within minority ethnic group and sex

Aged 8-15 2004

Frequency of smoking Age groupcigarettes

Boys GirlsAll All

8-10 11-15 boys 8-10 11-15 girls

% % % % % %

Black Caribbean

Doesn't smoke cigarettes [100] 97 98 [100] 91 94

Smokes less than once a week [-] 1 0 [-] 3 2

Smokes once a week or more often [-] 2 1 [-] 6 4

Black African

Doesn't smoke cigarettes a [91] 95 a 99 99

Smokes less than once a week a [-] - a 1 1

Smokes once a week or more often a [9] 5 a - -

Indian

Doesn't smoke cigarettes 100 100 100 a 100 100

Smokes less than once a week - - - a - -

Smokes once a week or more often - - - a - -

Pakistani

Doesn't smoke cigarettes [100] 95 97 [100] 97 98

Smokes less than once a week [-] 3 2 [-] - -

Smokes once a week or more often [-] 2 1 [-] 3 2

Bangladeshi

Doesn't smoke cigarettes 100 96 97 [100] [100] 100

Smokes less than once a week [-] - - [-] [-]

Smokes once a week or more often [-] 4 3 [-] [-]

Chinese

Doesn't smoke cigarettes a [91] 95 a a [100]

Smokes less than once a week a [3] 2 a a [-]

Smokes once a week or more often a [6] 3 a a [-]

Irish

Doesn't smoke cigarettes [100] 96 98 a 88 92

Smokes less than once a week [-] 1 1 a 1 1

Smokes once a week or more often [-] 2 1 a 11 8


Doesn't smoke cigarettes 100 94 96 100 94 96

Smokes less than once a week 0 2 1 - 2 1

Smokes once a week or more often - 4 2 - 5 3

Bases (weighted)


Black African 30 41 71 29 52 81

Indian 78 89 168 49 98 147

Pakistani 53 89 142 47 73 120

Bangladeshi 18 28 46 17 24 41

Chinese 6 19 24 9 12 21

Irish 176 215 391 111 261 372


Bases (unweighted)


Black African 29 39 68 26 50 76

Indian 50 59 109 28 58 86

Pakistani 48 73 121 41 62 103

Bangladeshi 36 60 96 31 45 76

Chinese 12 45 57 18 28 46

Irish 36 57 93 21 68 89

General population (2001-2002) 1051 1836 2887 1041 1818 2859a Results are not shown because of small bases.


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Table 12.23

Comparison of children’s self-reported experience ofsmoking in 2004 and 1999, by age within minorityethnic groupa and sex

Aged 8-15 2004, 1999

Experience of Age groupsmoking

Boys GirlscigarettesAll All

8-10 11-15 boys 8-10 11-15 girls

% % % % % %

2004

Black Caribbean

Ever smoked [10] 20 16 [-] 26 17

Current smoker [-] 3 2 [-] 9 6

Indian

Ever smoked - 3 1 b 9 7

Current smoker - - - b - -

Pakistani

Ever smoked [3] 15 11 [3] 6 5

Current smoker [-] 5 3 [-] 3 2

Bangladeshi

Ever smoked [-] 16 10 [-] [8] 5

Current smoker [-] 4 3 [-] [-] -

Chinese

Ever smoked b [8] 6 b b [2]

Current smoker b [-] - b b [-]

Irish

Ever smoked [1] 24 13 b 33 23

Current smoker [-] 9 5 b 12 8

1999

Black Caribbean

Ever smoked 9 31 21 5 34 21

Current smoker 1 4 2 0 7 4

Indian

Ever smoked [1] 15 10 [0] 12 7

Current smoker [0] 5 3 [0] 0 0

Pakistani

Ever smoked 2 16 10 0 8 5


Bangladeshi

Ever smoked 0 13 8 [0] 1 1

Current smoker 0 1 0 [0] 0 0

Chinese

Ever smoked b 7 6 b [4] 3

Current smoker b [4] 3 b [0] 0

Irish

Ever smoked 15 31 25 2 46 30



b Results are not shown because of small bases. Continued …


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Aged 8-15 2004, 1999

Age group

Boys GirlsAll All

8-10 11-15 boys 8-10 11-15 girls

Bases (weighted)

2004


Indian 78 89 168 49 98 147

Pakistani 53 89 142 47 73 120

Bangladeshi 18 28 46 17 24 41

Chinese 6 19 24 9 12 21

Irish 176 215 391 111 261 372

1999


Indian 48 96 144 44 72 116

Pakistani 36 53 89 40 80 119

Bangladeshi 15 28 43 13 28 41

Chinese 8 15 23 6 17 23

Irish 172 278 450 165 281 445

Bases (unweighted)

2004


Indian 50 59 109 28 58 86

Pakistani 48 73 121 41 62 103

Bangladeshi 36 60 96 31 45 76

Chinese 12 45 57 18 28 46

Irish 36 57 93 21 68 89

1999


Indian 45 93 138 48 60 108

Pakistani 58 87 145 62 128 190

Bangladeshi 51 110 161 46 98 144

Chinese 26 50 76 17 49 66

Irish 52 84 136 54 76 130


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Table 12.24

Children’s self-reported experience of drinking alcohol, by minority ethnic group and sex

Aged 8-15 2004

Experience of drinking Minority ethnic group Generalalcohola population



BoysObserved %

Has had an alcoholic drink 38 24 13 1 1 29 43 45

Has not had an alcoholic drink 62 76 87 99 99 71 57 55

Risk ratios

Has had an alcoholic drink 0.87 0.53 0.29 0.02 0.02 0.66 0.97 1


GirlsObserved %

Has had an alcoholic drink 35 23 17 4 3 [21] 54 40

Has not had an alcoholic drink 65 77 83 96 97 [79] 46 60

Risk ratios

Has had an alcoholic drink 0.89 0.58 0.44 0.09 0.07 [0.53] 1.37 1


Bases (weighted)

Boys 121 72 172 146 46 24 393 3327

Girls 112 83 152 121 41 21 378 3313

Bases (unweighted)

Boys 94 68 112 124 97 57 93 2910

Girls 90 78 87 103 76 46 92 2883

a Includes children who say that they have not had an alcoholic drink but that they have drunk alcopops.


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Table 12.25

Children’s self-reported experience of drinking alcohol, by age within minority ethnic group and sex

Aged 8-15 2004

Ever drunk alcoholb Age group

Boys GirlsAll All

8-10 11-15 boys 8-10 11-15 girls

% % % % % %

Black Caribbean [10] 55 38 [5] 52 35

Black African [11] [34] 24 a 35 23

Indian 1 23 13 a 20 17

Pakistani [-] 1 1 [6] 2 4

Bangladeshi [-] 2 1 [7] [-] 3

Chinese a [35] 29 a a [21]

Irish [25] 58 43 a 75 54


Bases (weighted)


Black African 32 41 72 29 55 83

Indian 80 92 172 54 98 152

Pakistani 53 93 146 48 73 121

Bangladeshi 18 28 46 17 24 41

Chinese 6 19 24 9 12 21

Irish 177 215 393 117 261 378


Bases (unweighted)


Black African 30 38 68 26 52 78

Indian 51 61 112 29 58 87

Pakistani 48 76 124 41 62 103

Bangladeshi 37 60 97 30 46 76

Chinese 12 45 57 18 28 46

Irish 36 57 93 24 68 92


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.


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Table 12.26

Children’s self-reported experience of drinking alcoholin 2004 and 1999, by age within minority ethnic groupa

and sex

Aged 8-15 2004, 1999

Ever drunk Age groupalcoholb

Boys GirlsAll All

8-10 11-15 boys 8-10 11-15 girls

% % % % % %

2004c

Black Caribbean [10] 55 38 [5] 52 35

Indian 1 23 13 a 20 17

Pakistani [-] 1 1 [6] 2 4

Bangladeshi [-] 2 1 [7] [-] 3

Chinese b [35] 29 b b [21]

Irish [25] 58 43 b 75 54

1999d


Indian [6] 18 14 [1] 14 9

Pakistani - 1 1 2 2 2

Bangladeshi - 2 1 [3] 1 1

Chinese b 25 19 6 [17] 14

Irish 20 49 38 9 58 40

Bases (weighted)

2004


Indian 80 92 172 54 98 152

Pakistani 53 93 146 48 73 121

Bangladeshi 18 28 46 17 24 41

Chinese 6 19 24 9 12 21

Irish 177 215 393 117 261 378

1999


Indian 47 96 143 44 72 116

Pakistani 37 53 89 39 79 118

Bangladeshi 15 28 42 13 27 41

Chinese 8 15 23 6 17 23

Irish 172 278 450 165 281 445

Bases (unweighted)

2004


Indian 51 61 112 29 58 87

Pakistani 48 76 124 41 62 103

Bangladeshi 37 60 97 30 46 76

Chinese 12 45 57 18 28 46

Irish 36 57 93 24 68 92

1999


Indian 44 93 137 48 60 108

Pakistani 59 86 145 61 128 189

Bangladeshi 51 108 159 45 97 142

Chinese 26 50 76 17 49 66

Irish 52 84 136 54 76 130


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.


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Table 12.27

Children’s systolic blood pressure (SBP), by minority ethnic group and sex

Aged 5-15 with valid BP and height measurements 2004

Systolic blood pressure Minority ethnic group General(mmHg) population

Black Black (2001-

Caribbean African Indian Pakistani Bangladeshi Chinese Irish 2002)a

BoysObserved

Mean SBP 108.9 [109.6] 109.2 112.2 [109.6] [105.2] 108.4 108.7

Standard error of the mean 1.86 [1.48] 1.30 1.15 [1.83] [2.15] 1.64 0.21

90th percentile 124.8 [123.5] 121.7 123.5 [129.6] [122.2] 121.5 122.0

Age and height standardised

Regression coefficientb -1.24 [1.54] -0.11 1.29 [2.23] [-2.58] -0.79 0

Standard error of the coefficient 1.64 [1.50] 1.40 1.04 [1.80] [1.85] 1.63

GirlsObserved

Mean SBP 110.7 [108.1] 107.8 106.2 [102.9] [106.0] 105.8 106.7


90th percentile 128.7 [120.5] 120.0 122.3 [118.9] [123.9] 115.0 120.13


Regression coefficientb 2.45 [1.12] 0.60 -0.04 [-2.92] [-0.64] -0.81 0


Bases (weighted)

Boys 83 59 97 70 18 13 181 3347

Girls 63 52 85 85 22 13 189 3366

Bases (unweighted)

Boys 58 45 75 66 30 34 56 2911

Girls 50 37 64 77 32 32 63 2915

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 general population is consequently 0.


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Table 12.28

Children’s diastolic blood pressure (DBP), by minority ethnic group and sex

Aged 5-15 with valid BP and height measurements 2004

Diastolic blood pressure Minority ethnic group General(mmHg) population

Black Black (2001-

Caribbean African Indian Pakistani Bangladeshi Chinese Irish 2002)a

BoysObserved

Mean DBP 62.2 [63.1] 64.9 64.9 [65.9] [62.1] 61.3 61.5


90th percentile 77.5 [84.0] 76.5 75.3 [79.1] [77.1] 73.0 73.3


Regression coefficientb 0.63 [1.63] 3.42 3.38 [4.42] [0.65] -0.18 0


GirlsObserved

Mean DBP 64.3 [68.2] 65.2 65.1 [65.1] [64.4] 62.7 63.5


90th percentile 80.0 [80.0] 78.4 78.0 [78.8] [76.1] 71.0 76.0


Regression coefficientb 0.71 [4.74] 1.71 1.73 [1.82] [0.99] -0.69 0


Bases (weighted)

Boys 83 59 97 70 18 13 181 3347

Girls 63 52 85 85 22 13 189 3366

Bases (unweighted)

Boys 58 45 75 66 30 34 56 2911

Girls 50 37 64 77 32 32 63 2915

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 general population is consequently 0.


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Table 12.29

Children’s height, by minority ethnic group and sex

Aged 2-15 with a valid height measurement 2004

Height (cm) Minority ethnic group Generalpopulation



BoysObserved

Mean 140.6 128.7 131.8 132.9 131.5 136.0 132.2 134.7


Age adjusted

Regression coefficient 3.9 0.1 -0.5 0.1 -1.2 -1.7 -1.0 0

Standard error of the coefficient 0.70 0.91 0.58 0.61 0.72 0.75 0.82

GirlsObserved

Mean 134.0 131.8 132.7 128.4 127.5 128.7 132.7 133.0


Age adjusted

Regression coefficient 1.8 3.8 -0.3 -1.1 -2.1 -1.1 0.9 0


Bases (weighted)

Boys 199 181 292 257 87 40 701 5556

Girls 181 172 256 239 85 41 694 5510

Bases (unweighted)

Boys 156 167 179 214 186 93 168 4838

Girls 146 150 149 202 168 85 168 4786


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Table 12.30

Children’s weight, by minority ethnic group and sex

Aged 2-15 with a valid weight measurement 2004

Weight (kg) Minority ethnic group Generalpopulation



BoysObserved

Mean 39.6 33.0 32.2 35.5 32.9 36.0 33.9 35.0


Age adjusted

Regression coefficient 3.7 2.0 -1.1 1.6 -0.7 -1.1 -0.2 0


GirlsObserved

Mean 38.9 35.2 35.5 31.7 30.9 32.2 35.8 34.9


Age adjusted

Regression coefficient 3.9 4.0 0.4 -1.2 -1.3 -1.2 1.1 0


Bases (weighted)

Boys 196 180 294 260 87 40 705 5568

Girls 178 176 260 242 88 41 681 5511

Bases (unweighted)

Boys 150 168 180 217 185 91 164 4847

Girls 143 158 151 206 175 85 164 4785


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Table 12.31

Children’s body mass index (BMI) and the prevalence of overweight and obesity, by minority ethnicgroup and sex

Aged 2-15 with valid height and weight measurements 2004

BMI (kg/m2) and BMI Minority ethnic group Generalstatus population



BoysObserved %

Mean 19.3 19.0 17.7 18.8 18.2 18.4 18.3 18.3


Median 18.4 17.8 16.9 17.6 17.5 17.5 17.2 17.4

% overweighta,b 11 11 12 14 12 8 10 14

% obesea,b 28 31 14 25 22 14 22 16

% overweight including obese 39 42 26 39 34 22 32 30

Risk ratios

Obese 1.7 1.9 0.8 1.5 1.3 0.8 1.4 1


Overweight and obese 1.3 1.4 0.8 1.3 1.1 0.7 1.1 1


GirlsObserved %

Mean 20.0 19.6 18.9 18.1 18.5 18.2 18.9 18.7


Median 18.6 18.6 17.7 16.9 17.6 17.8 17.9 17.6

% overweighta,b 15 13 11 10 14 22 16 15

% obesea,b 27 27 21 15 20 12 16 16

% overweight including obese 42 40 31 25 33 34 32 31

Risk ratios

Obese 1.7 1.7 1.3 0.9 1.2 0.8 1.0 1


Overweight and obese 1.4 1.3 1.0 0.8 1.1 1.1 1.0 1


Bases (weighted)

Boys 190 173 285 255 85 39 694 5442

Girls 173 168 256 239 84 41 681 5381

Bases (unweighted)

Boys 147 161 176 213 182 90 162 4740

Girls 139 147 149 202 165 85 163 4672

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.

b Categories are independent, i.e. overweight does not include those who are obese.


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Table 12.32

Children’s body mass index (BMI) and the prevalence of overweight and obesity among children, by age within minorityethnic group and sex


BMI (kg/m2) and BMI status Age group

Boys GirlsAll All

2-10 11-15 boys 2-10 11-15 girls

Black Caribbean

Mean 17.8 21.7 19.3 18.2 23.0 20.0


% overweightb,c 6 19 11 11 22 15

% obeseb,c 27 29 28 21 37 27

% overweight including obese 33 48 39 32 59 42

Black African

Mean 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 14 [4] 11 15 [9] 13

% obeseb,c 32 [27] 31 28 [24] 27

% overweight including obese 46 [31] 42 43 [33] 40

Indian

Mean 16.9 19.4 17.7 17.1 21.7 18.9


Overweightb,c 13 9 12 13 7 11

Obeseb,c 13 16 14 16 28 21

Overweight including obese 26 26 26 29 35 31

Pakistani

Mean 17.5 21. 1 18.8 16.6 21.3 18.1


% overweightb,c 14 14 14 10 11 10

% obeseb,c 21 31 25 11 22 15


Bangladeshi

Mean 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

Overweightb,c 9 18 12 11 [20] 14

Obeseb,c 24 19 22 21 [15] 20

Overweight including obese 33 37 34 33 [35] 33

Chinese

Mean [17.0] [19.8] 18.4 17.0 a 18.2

Standard error of the mean [0.28] [0.73] 0.41 0.31 a 0.34

% overweightb,c [4] [12] 8 21 a 22

% obeseb,c [15] [13] 14 13 a 12

% overweight including obese [19] [25] 22 34 a 34

Irish

Mean 17.2 20.8 18.3 17.1 21.8 18.9


% overweightb,c 9 12 10 12 21 16

% obeseb,c 20 28 22 13 21 16



Mean 17.1 20.3 18.3 17.3 21.2 18.7


% overweightb,c 14 14 14 13 16 14

% obeseb,c 15 19 16 15 19 16


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 …


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Age group

Boys GirlsAll All

2-10 11-15 boys 2-10 11-15 girls

Bases (weighted)

Black Caribbean 118 72 190 109 63 173

Black African 128 45 173 117 51 168

Indian 200 85 285 155 101 256

Pakistani 163 93 255 165 74 239

Bangladeshi 57 28 85 62 22 84

Chinese 20 19 39 27 13 41

Irish 475 219 694 423 258 681


Bases (unweighted)


Black African 117 44 161 100 47 147

Indian 119 57 176 90 59 149

Pakistani 139 74 213 141 61 202

Bangladeshi 123 59 182 125 40 165

Chinese 45 45 90 56 29 85

Irish 106 56 162 97 66 163


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.


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Table 12.33

Comparison of children’s body mass index (BMI) and the prevalence ofoverweight and obesity in 2004 and 1999, by minority ethnic groupa and sex

Aged 2-15 with valid height and weight measurements 2004, 1999

BMI (kg/m2) and BMI Minority ethnic groupstatus


Boys2004

Mean 19.3 17.7 18.8 18.2 18.4 18.3


% overweightb,c 11 12 14 12 8 10

% obeseb,c 28 14 25 22 14 22


1999

Mean 18.2 18.4 17.8 17.1 17.8 17.9


% overweightb,c 14 11 14 11 5 13

% obeseb,c 16 21 19 12 13 15


Girls2004

Mean 20.0 18.9 18.1 18.5 18.2 18.9


% overweightb,c 15 11 10 14 22 16

% obeseb,c 27 21 15 20 12 16


1999

Mean 19.1 18.1 18.4 17.8 17.7 18.2


% overweightb,c 13 10 11 9 11 16

% obeseb,c 21 16 18 13 7 14


Bases (weighted)

Boys 2004 190 285 255 85 39 694

Boys 1999 173 226 204 77 39 719

Girls 2004 173 256 239 84 41 681

Girls1999 194 192 210 68 38 805

Bases (unweighted)

Boys 2004 147 176 213 182 90 162

Boys 1999 247 221 327 286 124 230

Girls 2004 139 149 202 165 85 163

Girls 1999 275 183 333 244 115 235


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.


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Table 12.34

Summary of children’s participation in different activities in the last week, by minority ethnic group and sex

Aged 2-15 2004

Summary of participationa Minority ethnic group Generalin different activities in populationthe last week Black Black (2002)b


BoysSports and exercise

% who participated 71 54 60 48 49 63 68 59

Risk ratios 1.21 0.93 1.02 0.82 0.84 1.07 1.16 1




Mean number of hours 3.2 2.4 2.4 2.5 1.7 1.8 2.5 2.4


Active play


Risk ratios 0.93 0.95 0.90 0.96 0.88 0.83 0.99 1






Walkingc


Risk ratios 1.01 1.00 1.04 0.97 1.03 0.99 1.06 1






Housework and gardeningd,e


Risk ratios 0.92 0.91 1.23 1.00 0.78 0.79 1.11 1






Any physical activity


Risk ratios 1.00 1.00 0.99 1.00 0.97 1.00 1.01 1






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. Continued….


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Aged 2-15 2004


Black Black (2002)b


Bases (weighted)f

Boys (all activities except housework) 272 227 340 311 113 47 802 4201

Boys (housework/gardening) 156 97 190 173 61 29 438 2440

Bases (unweighted)f

Boys (all activities except housework) 223 211 209 269 242 109 194 3629

Boys (housework/gardening) 131 95 123 146 128 67 105 2113



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Aged 2-15 2004

Summary of participationa Minority ethnic group Generalin different activities in populationthe last week Black Black (2002)b


GirlsSports and exercise


Risk ratios 0.86 0.91 0.82 0.41 0.59 1.10 1.11 1






Active play


Risk ratios 0.90 0.91 0.86 0.92 0.86 0.98 1.02 1






Walkingc


Risk ratios 1.00 1.01 1.01 0.92 0.98 0.97 1.03 1

Standard error of ratio 0.03 0.03 0.03 0.04 0.03 0.04 0.03





Housework and gardeningd,e


Risk ratios 1.23 1.05 1.58 1.17 1.02 0.64 1.43 1






Any physical activity


Risk ratios 0.98 0.98 0.96 0.99 0.95 1.01 0.99 1








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Aged 2-15 2004


Black Black (2002)b


Bases (weighted)f

Girls (all activities except housework) 233 225 288 277 114 45 856 4058

Girls (housework/gardening) 137 103 171 141 58 24 465 2341

Bases (unweighted)f

Girls (all activities except housework) 200 209 169 246 229 97 203 3504

Girls (housework/gardening) 118 98 98 121 109 54 111 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.e Questions about housework and gardening were not asked of children aged 2-7. f Bases for individual activities may vary.


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Table 12.35

Summary of children’s activity levels, by minority ethnic group and sex

Aged 2-15 2004

Activity levels in the Minority ethnic group Generallast weeka population

Black Black (2002)b


BoysObserved %

High 59 55 53 60 57 38 68 69

Medium 19 13 18 16 16 19 17 13

Low 21 30 27 22 24 42 14 16

No activity recorded in last week 1 1 2 1 4 1 0 1

Risk ratios

High level of physical activity 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

GirlsObserved %

High 52 38 40 36 41 38 60 61

Medium 16 25 14 21 24 19 16 16

Low 29 35 41 40 30 43 23 22

No activity recorded in last week 3 3 5 2 6 - 2 1

Risk ratios

High level of physical activity 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

Bases (weighted)

Boys 272 227 340 311 113 47 802 4186

Girls 233 225 288 277 114 45 856 4043

Bases (unweighted)

Boys 223 211 209 269 242 109 194 3618

Girls 200 209 169 246 229 97 203 3491

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.

b Exercise questions were not asked in 2001, and the general population figures are based on 2002 only.


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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 Minority ethnic grouptwo weeksb


Boys2004

High 59 53 60 57 38 68

Medium 19 18 16 16 19 17

Low 21 27 22 24 42 14

No activity recorded in last week 1 2 1 4 1 0

1999

High 72 61 55 46 50 67

Medium 12 14 19 19 21 15

Low 13 23 20 33 26 15


Girls2004

High 52 40 36 41 38 60

Medium 16 14 21 24 19 16

Low 29 41 40 30 43 23

No activity recorded in last week 3 5 2 6 - 2

1999

High 52 42 42 24 31 63

Medium 19 23 23 28 26 16

Low 27 31 31 44 42 19


Bases (weighted)

Boys 2004 272 340 311 113 47 802

Boys 1999 207 275 243 106 43 852

Girls 2004 233 288 277 114 45 856

Girls1999 217 209 245 98 42 894

Bases (unweighted)

Boys 2004 223 209 269 242 109 194

Boys 1999 300 268 397 385 138 270

Girls 2004 200 209 269 242 109 194

Girls 1999 312 203 393 358 126 265


b Activity levels are defined as follows: high = active on all seven days for an average of 60+ minutes per day; medium = activeon 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.


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Table 12.37

Children’s consumption of fruit and vegetables, by minority ethnic group and sex

Aged 5-15 2004

Fruit and vegetable Minority ethnic group Generalconsumption population(portions per day) Black Black (2001-2002)


BoysObserved %

None 8 2 5 10 10 4 11 12


1 portion or more but less than 2 21 17 18 20 23 15 17 25

2 portions or more but less than 3 21 27 17 20 18 28 20 23





7 portions or more but less than 8 5 2 4 3 1 - 3 1

8 or more portions 1 3 6 3 2 6 1 2

5 portions or more 19 18 22 19 22 15 16 11

Mean 3.0 3.3 3.4 3.0 3.1 3.3 2.8 2.5


Median 2.7 2.9 3.0 2.7 2.7 2.9 2.3 2.0

Risk ratios

Eats 5 or more portions a day 1.68 1.54 1.96 1.62 1.88 1.28 1.38 1


GirlsObserved %

None 9 7 6 2 9 1 7 8


1 portion or more but less than 2 25 19 17 28 16 13 15 25







8 or more portions 2 2 4 3 3 3 2 2

5 portions or more 19 20 18 16 21 24 12 12

Mean 2.9 3.2 3.1 3.0 3.3 3.6 2.9 2.6


Median 2.7 2.8 2.7 2.7 3.3 3.2 2.7 2.3

Risk ratios

Eats 5 or more portions a day 1.64 1.74 1.55 1.39 1.84 2.12 1.02 1


Bases (weighted)

Boys 212 159 262 229 85 39 617 4905

Girls 186 164 228 205 82 33 654 4839

Bases (unweighted)

Boys 178 154 166 196 184 91 147 4260

Girls 160 148 132 177 156 74 157 4178

health survey for 2004 - lemosandcrane.co.uk statistics - health... · 5 alcohol consumption...

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