Sociodemographic determinants of multiple unhealthy behaviours

Abstract

Background: Although behaviours regarded as unhealthy are widespread, behaving in an unhealthy manner in several respects is relatively uncommon. However, people with multiple unhealthy behaviours exist and their number is larger than expected if the behaviours were not related to each other. The aim of this study was to examine sociodemographic determinants of multiple unhealthy behaviours, with special reference to independent and combined effects of the determinants. Methods : Data on unhealthy behaviours were derived from nationwide surveys among Finnish adults. The mean number of unhealthy behaviours practised on a daily basis and the probability of reporting three or four of these behaviours was examined across sociodemographic groups.

Results: Age, educational level and marital status predicted reporting of three or four unhealthy behaviours. Interactions were observed between education and age in both genders as well as between marital status and age in men and educational level and living area in women. Mean numbers of unhealthy behaviours showed similar patterns to having three or four unhealthy behaviours but few differences between the means were statistically significant and there were no interactions. Conclusion: The influence of each sociodemographic determinant on multiple unhealthy behaviours was relatively independent from the other sociodemographic determinants. As the effect of these determinants tends to be cumulative, engaging in multiple unhealthy behaviours is common in population subgroups with several unfavourable characteristics. In health promotion initiatives special attention should be paid to such population groups and their social circumstances.

Keywords

alcohol drinking exercise food habits health behaviour smoking socioeconomic factors.

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References

Berkman L. , Breslow L. Health and ways of living. The Alameda County Study. Oxford : Oxford University Press, 1983.

Segovia J. , Bartlett RF , Edwards AC Health status and health practices: Alameda and beyond. Int J Epidemiol 1991; 20: 259—63.

Luoto R. , Prättälä R. , Uutela A. , Puska P. Impact of unhealthy behaviors on cardiovascular mortality in Finland, 1978—1993 . Prev Med 1998; 27: 93—100.

Meng L. , Maskarinec G. , Lee J. , Kolonel LN Lifestyle factors and chronic diseases: application of a composite risk index . Prev Med 1999; 29: 296—304.

Rose G. The strategy of preventive medicine. Oxford: Oxford University Press, 1992.

Aromaa A. , Koskinen S. , Huttunen J. Health in Finland. Helsinki: National Public Health Institute and Ministry of Social Affairs and Health , 1999.

Helakorpi S. , Uutela A. , Prättälä R. , Puska P. Health behaviour and health among the Finnish adult population, spring 1999 . Helsinki: National Public Health Institute, 1999.

Lahelma E. , Rahkonen O. , Berg MA , et al. Changes in health status and health behaviour among Finnish adults 1978—1993. Scand J Work Environ Health 1997; 23: 85—90.

Ahlström S. Women's use of alcohol. In: Simpura J , editor. Finnish drinking habits. Results from interview surveys held in 1968, 1976 and 1984. Helsinki: Finnish Foundation for Alcohol Studies, vol. 35, 1987: 109—34.

10.

Blaxter M. Health and lifestyles. London: Tavistock/ Routledge , 1990.

11.

Patterson RE , Haines PS , Popkin BM Health lifestyle patterns of U.S. adults. Prev Med 1994; 23: 453—60.

12.

Karisto A. , Prättälä R. , Berg MA The good, the bad and the ugly. Differences and changes in health related lifestyles. In: Kjaernes U , Holm L , Ekström M , Füsso E , Prättälä R , editors. Regulating markets — regulating people. On food and nutrition policy. Oslo: Novus, 1993: 185—204.

13.

Prättälä R. , Karisto A. , Berg MA Consistency and variation in unhealthy behaviour among Finnish men, 1982—1990. Soc Sci Med 1994; 39: 115—22.

14.

Laaksonen M. , Prättälä R. , Karisto A. Patterns of unhealthy behaviour in Finland . Eur J Public Health 2001; 11: 294—300.

15.

Pantzar M. Terveellisyystietoisuus — pysyvä kulttuurimuutos kulutus-Suomessa. (Health consciousness — permanent cultural change in consumerist Finland) . Kotitalous 1992; 10: 4—8.

16.

Fox J. Applied regression analysis, linear models, and related methods. Thousand Oaks, CA: Sage, 1997.

17.

Hosmer DW , Lemeshow S. Applied logistic regression. New York: Wiley, 1989.

18.

Wingard DL , Berkman LF , Brand RJ A multivariate analysis of health-related practices: a nine-year mortality follow-up of the Alameda County Study. Am J Epidemiol 1982; 116: 765—75.

19.

Theobald H. , Bygren LO , Carstensen J. , Engfeldt P.

Validity of two questions on alcohol use in a health survey questionnaire. Scand

J Public Health 1999; 27: 73—7.

20.

Svardsudd K.

Moderate alcohol consumption and cardiovascular disease: is there evidence for a preventive effect?

Alcohol Clin Exp Res 1998; 22: S307—314.

21.

Wannamethee SG , Shaper AG Alcohol, coronary heart disease and stroke: an examination of the J-shaped curve. Neuroepidemiology 1998; 17: 288—95.

22.

Simpura J. , Leppänen K. , Metso L. , Mustonen H. , Österberg E. Paljonko Suomi juo? Alkoholin kokonaiskulutustason selvittäminen vaikeutunut (How much do Finns drink? Increasing problems in determining the level of aggregate alcohol consumption). Alkoholipolitiikka 1997; 62: 101—12.

23.

Slater CH , Linder SH A reassessment of the additive scoring of health practices. Med Care 1988; 26: 1216—27.

24.

Dean K. , Salem N. Detecting measurement confounding in epidemiological research: construct validity in scaling risk behaviours: based on a population sample in Minnesota, USA . J Epidemiol Community Health 1998; 52: 195—9.

25.

Brock BM , Haefner DP , Noble DS Alameda County redux: replication in Michigan. Prev Med 1988; 17: 483—95.

26.

Rotevatn S. , Akslen LA , Bjelke E. Lifestyle and mortality among Norwegian men . Prev Med 1989; 18: 433—43.

27.

Pomerleau J. , Pederson LL , Ostbye T. , Speechley M. , Speechley KN Health behaviours and socio-economic status in Ontario, Canada. Eur J Epidemiol 1997; 13: 613—22.

28.

Galambos NL , Tilton-Weaver LC Multiple-risk behaviour in adolescents and young adults. Health Rep 1998; 10: 9—20.

29.

Pill R. , Peters TJ , Robling MR Social class and preventive health behaviour: a British example. J Epidemiol Community Health 1995; 49: 28—32.

30.

Blacconiere MJ , Oleckno WA Health-promoting behaviours in public health: testing the health promotion model. J R Soc Health 1999; 119: 11—16.

31.

Martelin T. Tupakointitapojen kehitys Suomessa haastattelu- ja kyselytutkimusten valossa (Development of smoking habits according to survey data in Finland) . Helsinki: Lääkintöhallitus . Terveyskasvatus. Tutkimukset 1984/1, 1984.

32.

Laaksonen M. , Uutela A. , Vartiainen E. , Jousilahti P. , Helakorpi S. , Puska P. Development of smoking by birth cohort in the adult population in eastern Finland 1972—97 . Tob Control 1999; 8: 161—8.

33.

Mustonen H. , Metso L. , Paakkanen P. , Simpura J. , Kaivonurmi M. Finnish drinking habits 1968, 1976, 1984, 1992 and 1996: tables and publications based on Finnish drinking habit surveys . Helsinki: STAKES, 1999.

34.

Hu YR , Goldman N. Mortality differentials by marital status: an international comparison . Demography 1990; 27: 233—50.

35.

Burman B. , Margolin G. Analysis of the association between marital relationships and health problems: an interactional perspective. Psychol Bull 1992; 112: 39—63.

36.

Joung I. , Stronks K. , van de Mheen H. , Mackenbach J. Health behaviours explain part of the differences in self-reported health associated with partner/marital status in The Netherlands. J Epidemiol Community Health 1995; 49: 482—8.

37.

Umberson D. Gender, marital status and the social control of health behavior. Soc Sci Med 1992; 34: 907—17.