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National Statistics
Publication, Part of

Health Survey for England 2019 [NS]

Official statistics, National statistics, Survey
Publication Date:
Geographic Coverage:
England
Geographical Granularity:
Country, Regions, Strategic Health Authorities
Date Range:
01 Jan 2019 to 31 Dec 2019

Main Findings

This section presents main findings from the Health Survey for England (HSE) 2019. More detailed findings can be found in the relevant topic reports, attached to the overview page.

Overweight and Obesity

Background

Obesity is a major public health problem in England and globally. In adults, overweight and obesity are associated with life-limiting conditions, such as type 2 diabetes, cardiovascular disease, and some cancers as well as osteoarthritis.

Successive governments have introduced several initiatives to tackle obesity in England.

Overweight and obesity in adults

The prevalence of overweight and obesity is indicated by body mass index (BMI) as a measure of general obesity, and/or waist circumference as a measure of abdominal obesity.

BMI, defined as weight in kilograms divided by the square of the height in metres (kg/m2) was calculated to group people into the following categories:

BMI BMI category
Less than 18.5 Underweight
18.5 to less than 25 Normal
25 to less than 30 Overweight, not obese
30 or more Obese, including morbidly obese
40 or more Morbidly obese

Waist circumference is measured, and categorised into desirable, high and very high, by sex-specific thresholds:

Description Men's waist circumference (cm) Women's waist circumference (cm)
Desirable Less than 94 Less than 80
High 94-102 80-88
Very high More than 102 More than 88

 

Prevalence of overweight and obesity in adults

27% of men and 29% of women were obese. Around two thirds of adults were overweight or obese, this was more prevalent among men (68%) than women (60%).

Obesity increased with age from 13% of adults aged between 16 and 24, to 36% of those aged 65 to 74. It was lower among adults aged 75 and over (26%).

Graph showing prevalence of obesity increased with age up to 75

Deprivation level is based on Index of Multiple Deprivation (IMD) quintiles. For further information see section 8.7 of the HSE Methods report.

Adults living in the most deprived areas were the most likely to be obese. This difference was particularly pronounced for women, where 39% of women in the most deprived areas were obese, compared with 22% in the least deprived areas.

Graph showing obesity more prevalent in most deprived areas

Prevalence of very high waist circumference

59% of men and 69% of women had a higher than desirable waist circumference. This proportion increased broadly in line with age, from 29% of adults aged 16 to 24, to 83% of those aged 75 and over.

Graph showing proportion of adults with high waist circumference increased with age

Overweight and obesity in children (aged 2 to 15)

Estimates of child overweight and obesity are based on data from the 2018 and 2019 surveys combined.

Assessment of a child’s weight status compares the actual BMI with BMI centiles on published growth charts, using sex and age in six-month bands. The UK National BMI centiles give the BMI threshold, separately for boys and girls for each age, above which a child is considered overweight or obese.

Prevalence of overweight and obesity in children

Most children aged between 2 and 15 were neither overweight nor obese: 69% of boys and 73% of girls were normal weight. However, 18% of boys and 13% of girls were obese.

 

Obesity increased with age, though in a different way for boys and girls.

Graph showing percentage of obese children generally increased with age

Children’s obesity was closely associated with their parent’s BMI status. While 7% of children with mothers who were neither overweight nor obese were obese themselves, 27% of children with an obese mother were obese.

8% of children with fathers who were neither overweight nor obese were obese themselves, while 23% of those with obese fathers were obese.

Graph showing that children with an obese parent were more likely to be obese

Eating Disorders

Background

An eating disorder is related to having an unhealthy attitude towards food. This can involve eating too much or too little, being obsessed with weight or body shape, changes in mood, excessive exercise, having strict habits or routines around food or purging after eating.

Having an eating disorder is linked to long term health implications and can occur alongside mental health conditions. Often an eating disorder is one of several conditions that is having a significant impact upon individuals and their quality of life.

The following questions were administered to all HSE 2019 participants aged 16 and over as part of a self-completion questionnaire. In this publication, a positive screening for a possible eating disorder is defined as a score of two or more ‘Yes’ answers.

During the last year…

 

…have you lost more than one stone in a 3 month period?

Yes/No

…have you made yourself be sick because you felt uncomfortably full?

Yes/No

…did you worry you had lost control over how much you eat?

Yes/No

…did you believe yourself to be fat when others said you were too thin?

Yes/No

…would you say food dominated your life?

Yes/No

Participants were also asked whether their feelings about food interfered with their ability to work, meet personal responsibilities and/or enjoy a social life.

Prevalence of eating disorders among adults

In 2019, 16% of adults aged 16 and over (19% of women and 13% of men) screened positive for a possible eating disorder. This included 4% (5% of women and 3% of men) who reported that their feelings about food had interfered with their ability to work, meet personal responsibilities or enjoy a social life.

Graph showing women more likely to report feelings about food having a negative impact

The proportion of adults aged 16 and over who screened positive for a possible eating disorder increased as household income decreased.

Graph showing proportion of adults screening positive increased as household income decreased

Smoking

Background

Adults aged 25 and over were asked about their smoking behaviour within the face-to-face interview.  For those aged 16 to 17, information about smoking was collected through a self-completion questionnaire. At the interviewer’s discretion, those aged 18 to 24 could answer the smoking questions either through the face-to face interview or through the self-completion questionnaire.

In 2017, the government published Towards a smoke-free generation: a tobacco control plan.  This sets out a five-year plan to reduce the harms of smoking. It includes a target to reduce adult smoking to 12% or less by the end of 2022.

Department of Health. Towards a smoke-free generation: a tobacco control plan for England. DH, London, 2011. www.gov.uk/government/publications/towards-a-smoke-free-generation-tobacco-control-plan-for-england 

Smoking among adults

In 2019, the proportion of adults who smoked was 16% (18% men and 15% women). The proportion of adults who stated they currently smoke cigarettes was highest among adults aged under 35.

Graph showing cigarette smoking was highest among under 35s

In 2019, 6% of all adults were defined as current e-cigarette users. As with cigarette smoking, men were more likely to be current e-cigarette users (7% of men and 5% of women).

Current smokers were more likely to have tried or currently smoke e-cigarettes compared to those who have never smoked. 15% of current smokers also currently used e-cigarettes as did 13% of ex-regular smokers, but only 1% of those who had never smoked cigarettes.

Graph showing current and ex-smokers were more likely to have used e-cigarettes

Smoking among children (aged 8 to 15)

Children aged between 8 and 15 were asked questions about smoking within a self-completion questionnaire.

Whether children have ever smoked a cigarette

In 2019, 4% of children aged 8 to 15 reported that they had ever smoked a cigarette. Among 13 to 15 year olds, 10% reported they had ever smoked a cigarette.

In 2019, more children had ever used an e-cigarette or vaping device than had smoked a tobacco cigarette. 9% of children aged 8 to 15 had ever used an e-cigarette or vaping device. 

Association with parent’s smoking status

Children’s smoking status was associated with their parent’s smoking status. Children whose mothers were current or former cigarette smokers were more likely to have ever tried smoking a cigarette (9% and 8% respectively) than children whose mother never regularly smoked (1%).    

A similar pattern was seen among children based on their father’s smoking status. Among children whose fathers were current or former cigarette smokers, 5% had tried smoking a cigarette themselves, compared to 2% of children whose father had never regularly smoked.

Association with parent’s smoking status is based on data from HSE 2018 and 2019 combined.

Graph showing children were more likely to smoke if their parents were smokers or ex-smokers

Alcohol Consumption

Background

Adults aged 25 and over were asked about their drinking behaviour within the face-to-face interview.  For those aged 16 to 17, information about drinking was collected through a self-completion questionnaire. At the interviewer’s discretion, those aged 18 to 24 could answer the drinking questions either through the face-to face interview or through the self-completion questionnaire.

Alcohol has been identified as a causal factor in many medical conditions, including cancers, cirrhosis of the liver, high blood pressure and depression.  The Chief Medical Officer’s guidelines advise  that men and women should not regularly, (defined as most weeks), drink more than 14 units per week. Drinking at this level is considered to be ‘low risk’, and adults who regularly drink up to this amount are advised to spread their drinking over three or more days.

Alcohol consumption in adults

57% of adults (53% of men and 62% of women) drank at levels which put them at lower risk of alcohol-related harm, that is, 14 units or less in the last week.

Drinking at increasing or higher risk was most prevalent among those aged 55 to 64, (39%  of men  and 20% of women).

Graph showing proportion of those who drank 5 days or more in last week increased with age up to 75

Alcohol consumption in children

in 2009, the Department of Health published guidance from the Chief Medical Officer of England on alcohol consumption by children and young people.  This included a recommendation that children under the age of 15 do not drink any alcohol at all and that alcohol consumption for 15 to 17 year olds should be under the supervision of a parent or carer.

The prevalence of children aged 8 to 15 reporting ever having had a proper alcoholic drink has declined from a peak of 45% in 2003 to 15% in 2019.

Graph showing decline in proportion of children who had drunk alcohol from 1999 to 2019

In 2019, 35% of children aged 13 to 15 had ever drunk alcohol, compared with 9% aged 11 to 12 and 1% aged 8 to 10.

Providing Care for Family and Friends

Background

Social care is the provision of help with personal care and domestic tasks to help enable individuals to live as independently as possible. This support can take the form of formal care arranged and paid for, by the local authority, privately paid-for care, or unpaid care provided by family, friends or another voluntary source.

Unpaid carers provide a crucial role in social care, as well as wider society, with an ageing population and increasing pressure on social care services meaning that more people rely on them. Recent policies, such as the Carers Action Plan 2018-2020, highlight the important role played by unpaid carers, as well as recognising the impact caring might have on them. The Carers Action Plan recognises that, whilst providing care can be rewarding and can have a great impact on the people they care for, caring can negatively impact the carer’s own finances, relationships, and health.

Adults providing care

In 2019, 17% of adults provided unpaid help or support to at least one person with long-term mental or physical health problems, disabilities or problems related to old age.

The proportions of men and women providing care to at least one person were highest among men aged 65 to 74 (19%) and women aged 55 to 64 (34%)

Graph showing men aged 65-74 and women aged 55-64 were more likely to provide care

In 2019, over half (55%) of those providing care received no help or support. This was most prevalent among people aged 65 and over (64%).

Graph showing people aged 65 and over were more likely to receive no help or support
Graph showing those in lower income houses were more likely to report financial difficulties

Women were more likely than men to report health impacts of providing care:  including feeling tired (41% of men and 27% of women) a general feeling of stress (36% of men and 25% of women), and disturbed sleep (30% of women and 21% of men).

Adults' Health

Hypertension

Hypertension (persistent high blood pressure) is an important public health challenge worldwide because of its high prevalence and the associated risk of cardiovascular (circulatory) diseases (CVD).

Lifestyle changes such as reducing alcohol consumption, increasing physical activity and weight loss if overweight can reduce blood pressure; these changes, together with smoking cessation and improved diet, can further reduce CVD risk. These may be followed by drug treatment.

Untreated hypertension is defined for this report as a systolic blood pressure (SBP) at or above 140mmHg and/or diastolic blood pressure (DBP) at or above 90mmHg where the participant is not currently taking medication for blood pressure. 

In 2019, 14% of men and 11% of women had untreated hypertension (high blood pressure). The proportion of those with untreated hypertension was highest at an earlier age among men than women. Among men this proportion was highest among those aged 55 to 64 (22%). Among women, this proportion increased with age, being highest among those aged 65 and over (19%).

Graph showing untreated hypertension was highest among men aged 55-64 and women aged 65 and over

After age is taken into account, the proportion of adults with untreated hypertension was highest in the North West (17%), and North East (16%), and lowest in London, Yorkshire & the Humber and the South East (10%).

Graph showing untreated hypertension lowest in London and highest in the North West

Cholesterol

Cholesterol is a fatty substance (also referred to as a lipid) found in the blood and is needed by the body to function. High cholesterol is a significant risk factor for cardiovascular (circulatory) diseases (CVD), including narrowing of the arteries (atherosclerosis), heart attack, and stroke.

In HSE, cholesterol levels were measured via blood samples taken at the nurse visit. Raised total cholesterol is defined as total cholesterol equal to or greater than 5mmol/L.

From 1998 to 2019 there has been a decline in the proportion of adults with raised total cholesterol from 66% to 40% among men, and from 67% to 45% among women.

The below graph represents the years in which cholesterol testing was carried out within the HSE.

Graph showing prevalence of raised total cholesterol decreased between 1998 and 2019

Use of Health Care Services

Background

General practitioners (GPs) are usually the first point of patient contact in the National Health Service (NHS). The services that GPs provide to their registered list of patients include consultation, treatment and onward referral for investigation or specialist advice. GPs may also provide extended primary care services, such as prevention, screening, and some diagnostic services. GPs also help to ensure effective co-ordination of care for their patients, including with other NHS services, social care, and health services outside the NHS.

Service use in adults

69% of men and 82% of women had talked to or visited a GP in the last 12 months. This proportion increased with age, especially among men. 57% of men and 78% of women aged 16 to 24 reported having talked to or visited a GP in the last 12 months compared with 85% of men and 87% of women aged 75 years and over

Graph showing a higher proportion of women across all age groups saw a GP in the last 12 months

84% said they had consulted their GP solely for a physical health problem, 5% for a mental health, nervous or emotional problem only and 11% had consulted for both types of problem in the last 12 months

Graph showing people were most likely to consult a GP for a physical problem

In 2019, almost 1 in 5 (19%) of those who provided unpaid care reported experiencing financial difficulties due to their caring responsibility. Those in lower income households were more likely to report financial difficulties as a result of providing care.

Last edited: 14 December 2020 4:17 pm