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Research Findings: Understanding health

As well as the six themes outlined in Research Findings, the Twenty-07 Study has been employed over the last 20 years to explore different aspects of people’s health and how they relate to each other.  The Twenty-07 Study has very rich information on people’s health over time enabling us to develop our understanding of health.

Our findings about people’s health to date can be grouped into four broad areas:

Descriptions of health and changes in health over time

Changes in weight and waistlines over 9 years in a Scottish population
During the period 1991-2000 we found a large increase in the prevalence of overweight and obesity among middle and older cohorts of the Twenty-07 Study.  Women were no more likely than men to put on weight and neither a person’s social class affect the change in their weight over time.  We found that people in early middle age (39-48 years) seem to put on more weight more quickly than older people (59-68 years), but the waistlines of older people seem to be bigger.

Blood pressure in young Scots
Changes in blood pressure between 15 and 18 years were related to changes in body weight and body mass index, but not height.  This pattern reflects the well known relation between growth and blood pressure in adolescents.  Weaker associations were found in female adolescents than males because growth had stopped between 15 and 18 years.  Birth weight was found to be negatively associated with systolic blood pressure changes between 15 and 18.

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Understanding of people’s use of health services

Practical and moral dilemmas in living with chronic illness

We found that people in their early 50s living with long-term illness use a variety of techniques in managing their symptoms from taking medication to using support from social networks such as friends, family, and work colleagues.  However, trying to maintain valued roles in the social aspects of their lives and trying to lead a ‘normal life’ often took priority over symptom management leading to stresses and moral dilemmas.

Why do some people consult a GP more often than others?
People with poorer social circumstances who visit a GP more often are likely to do so because of higher levels of health needs, and not simply because they have a greater ‘readiness’ to consult a GP for whatever reason.

Someone to talk to?  The role of loneliness in the frequency of GP consultations
Respondents who said they felt lonely ‘most of the time’ or ‘often’, had twice as many consultations with their GP in the previous year compared with those who ‘rarely’ or ‘never’ felt lonely.

Accounts of disagreements with doctors
Understanding patients’ perceptions of healthcare is important to both practitioners and public health researchers to identify ways of improving services.  We identified some of the actions patients have taken when faced with a disagreement with a doctor.  We found that people were more likely to discontinue treatment if their own health was at the centre of the disagreement, but more likely to seek a second opinion or challenge the GP’s opinion when the problem concerned the health of a family member.  Where the nature the disagreement related to patient-doctor communication style, no action was likely to be taken.  However, where diagnosis or treatment was the issue, seeking a second opinion or challenging the GP was the most likely course of action.

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People’s own understandings of ill health and its causes

What factors do people consider important for health?

When rating factors that influence health and illness, people (regardless of sociodemographic differences) recognised the need to take personal responsibility for their health and the role of the physical and social environments in influencing health.

Are rich or poor people more likely to become ill?
Using data collected from the localities sample we found that those most at risk of poor health may be less likely to acknowledge health inequalities between the rich and poor living in Glasgow.

Are men or women more likely to become ill?
Both males and females tended to over-estimate the risks of illness for their own sex than for the opposite sex.  Males think that men are fitter and females think women are more athletic.  Females were less likely than males to think that men were at greater risk of heart disease, and accidents.  Furthermore, males were less likely than females to think that women were at greater risk of mental illness.

Are those with a family-history of heart disease more likely to adopt healthier lifestyles?
People with a family history of heart disease are more likely to see themselves as ‘at risk’ of heart disease and are generally more aware about the influence of behavioural risk factors on the development of the disease.  These people are much less likely to smoke and more likely take on board health promotion messages such as eating a healthy diet and taking regular exercise. 

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Relationship between different dimensions of health

Obesity a risk factor for lower joint pain

People in their late 50s who are obese experienced more joint pain of the lower limbs whereas smoking and alcohol consumption did not appear to be linked with joint pain in any joints. 

Diagnosis alone is not enough to predict ill health
It would appear that diagnosis alone is not enough to predict poor health of those people in their late 50s.  Measures that include both frequency of pain associated with long-term illness, and self-reported health, may be better predictors of physical disability.  Simple diagnosis may mask important associations between certain conditions and physical disability.


Summary papers...