Research Findings: Understanding health: People’s own understandings of ill health and its causes Summary Papers

What factors do people consider important for health?

Understanding how people rate factors that influence health and illness is important for health professionals dealing with patients and for public health strategies in preventing disease and promoting healthier lifestyles. 

We asked respondents in all three cohorts from the Localities sample from the Twenty-07 Study their views on what influences health (habits, self-care, the environment, family relationships, the ‘person you are’, money and luck).

As shown in Figure 1 above, habits, self-care and the environment were regarded as very important.  Family relationships, the ‘person you are’, and money were believed to be less important.  Luck was considered the least important factor. Responses supported current public health research knowledge and widespread views for the need to take personal responsibility for health and about the role of the physical and social environment in influencing health.  Socio-demographic differences were less marked than might originally be suggested in other studies of specific social groups.  However we did find that older people and those in more disadvantaged social classes were more likely to view money and family relationships as being important for health. Older people and those in the more affluent locality thought that ‘the person you are’ was important in influencing health.

Macintyre, S., L. McKay, et al. (2006). "Lay concepts of the relative importance of different determinants of illness: are there major socio-demographic variations?" Health Education Research 21: 731-739.
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Are rich or poor people more likely to become ill?

A small number of earlier in-depth studies carried out in the UK suggested that people from disadvantaged social class or from disadvantaged neighbourhoods are less likely than people from more socially advantaged backgrounds to agree that people living in poverty had worse health. 

We asked respondents from all three cohorts in the locality sample who were more likely to have accidents, cancer, heart disease, mental illness, to be fitter, and to live longer:  the rich, the poor or both equally. 

We found that people in disadvantaged circumstances were equally or less likely than people from affluent backgrounds to say that poorer people had worse health than richer people or that richer people live longer.  Our findings add further support to the notion that those most at risk of ill health may be less likely to acknowledge health inequalities between the rich and poor living in Glasgow.

Macintyre, S., L. McKay, et al. (2005). "Are rich people or poor people more likely to be ill?  Lay perceptions, by social class and neighbourhood, of inequalities in health." Social Science & Medicine 60(2): 313-317.
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Are men or women more likely to become ill?

Many differences in the health of men and women are known to exist.  However, little is known about people’s beliefs about patterns of health between men and women.

Here, we asked people from all three age cohorts in the localities sample from the Twenty-07 Study whether men, women or both equally, were more likely to have accidents, cancer, heart disease, mental illness, to be fitter, and to live longer. 

We found that females were less likely than males to agree that men were at greater risk of heart disease, and accidents than women.  Furthermore, males were less likely than females to agree that women were at greater risk of mental illness.  Both males and females tended to think risks were higher for their own gender.

Macintyre, S., L. McKay, et al. (2005). "Who is more likely to experience common disorders: men, women, or both equally?  Lay perceptions in the West of Scotland." International Journal of Epidemiology 34: 461-466.
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Are those with a family history of heart disease more likely to adopt healthier lifestyles?

Heart disease is a major cause of long-term illness and early death, and is strongly linked to lifestyle behaviours such as lack of exercise, poor diet, smoking and heavy drinking.  Reducing heart-disease prone behaviour and gaining a more detailed understanding of the complexity of barriers to changing behaviour remains a priority for public health and health promotion strategies.  A person’s attitudes and beliefs towards family-related disease are common and thought to play an important part when making decisions about their own lifestyles. 

In this study we followed data from all three age cohorts from the Twenty-07 Study over an 8 year period 1987/88 to 1995/96.  We asked people about the health and deaths of family members, their attitudes towards illness and health weaknesses that run in their own family, and if they felt they were at greater risk of developing heart disease which has in turn affected their own lifestyle. 

Around 40% of the sample had some kind of family history of illness and 20% a family history specific to heart disease.  We found perceptions of family history of heart disease were very strongly related to the number of relatives who had ever the disease.  We also found that people with a family history of heart disease are more likely to see themselves as ‘at risk’ of heart disease and appear to be generally aware about the influence of behavioural risk factors on the development of the disease.  We found 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.

Hunt, K., C. Davison, et al. (2000). "Are perceptions of a family history of heart disease related to health-related attitudes and behaviours?" Health Education Research: Theory and Practice 15: 131-143.
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