Trends in socioeconomic inequalities in behavioural non-communicable disease risk factors: analysis of repeated cross-sectional health surveys in England between 2003 and 2019

Background Previous studies have shown that those in lower socioeconomic positions (SEPs) generally have higher levels of behavioural non-communicable disease (NCD) risk factors. However, there are limited studies examining recent trends in inequalities. This study examined trends in socioeconomic inequalities in NCD behavioural risk factors and their co-occurrence in England from 2003–19. Methods This time-trend analysis of repeated cross-sectional data from the Health Survey for England examined the relative index of inequalities (RII) and slope index of inequalities (SII) in four NCD behavioural risk factors: smoking; drinking above recommended limits; insufficient fruit and vegetables consumption; and physical inactivity. Findings Prevalence of risk factors has reduced over time, however, this has not been consistent across SEPs. Absolute and relative inequalities increased for physical inactivity; relative inequalities also increased for smoking; for insufficient fruit and vegetable consumption, the trends in inequalities depended on SEPs measure. Those in lower SEPs experienced persistent socioeconomic inequalities and clustering of behavioural risk factors. In contrast, those in higher SEPs had higher prevalence of excessive alcohol consumption; this inequality widened over the study period. Interpretation Inequalities in smoking and physical inactivity are persisting or widening. The pattern of higher drinking in higher SEPs obscure the fact that the greatest burden of alcohol-related harm falls on lower SEPs. Policy attention is required to tackle increasing inequalities in smoking prevalence, low fruit and vegetable consumption and physical inactivity, and to reduce alcohol harm..

Summary boxes Section 1: What is already known on this topic • Those in lower socio-economic positions (SEPs) have generally higher levels of behavioural non-communicable disease (NCD) risk factors than those in higher SEPs. • Behavioural NCD risk factors tend to co-occur. • Whilst levels of some behavioural risk factors have been declining over the past decade it is unclear how this has occurred across SEPs and whether inequalities are widening or narrowing over time. Section 2: What this study adds • From 2003–2019, prevalence of smoking, excessive alcohol consumption, low fruit and vegetable consumption, and physical inactivity declined, however social-economic inequalities widened for smoking and physical inactivity. • On both relative and absolute scales, social-economic inequalities for low fruit and vegetable consumption narrowed across neighbourhood deprivation and income for women but widened across educational level for men, suggesting differential effects by sex and SEPs. • Those in lower SEPs had a higher prevalence of having two or more behavioural risk factors; this remained stable over the time-period..

Medienart:	E-Artikel

Erscheinungsjahr:	2023
Erschienen:	2023

Enthalten in:	Zur Gesamtaufnahme - volume:23
Enthalten in:	BMC public health - 23(2023), 1 vom: 28. Juli

Sprache:	Englisch

Beteiligte Personen:	Ogunlayi, Fatai [VerfasserIn] Coleman, Paul C. [VerfasserIn] Fat, Linda Ng [VerfasserIn] Mindell, Jennifer S. [VerfasserIn] Oyebode, Oyinlola [VerfasserIn]

Links:	Volltext [kostenfrei]

Themen:	England Health inequalities Health policy Healthcare disparities Public health

Anmerkungen:	© The Author(s) 2023

doi:	10.1186/s12889-023-16275-6

funding:
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PPN (Katalog-ID):	SPR052554961