UKHLS Consultation Launch, 19/06/07, RSS Health Outcomes and Health Related Behaviour Scott Weich Dieter Wolke University of Warwick

UKHLS Consultation Launch, 19/06/07, RSS

Health Outcomes and Health Related Behaviour

Scott WeichDieter Wolke

University of Warwick


Opportunities

• Address questions at the interface between social science and biomedical research, including gene x environment effects.

• Longitudinal design, household recruitment and sample size make UKHLS uniquely suited to studying

- Transitions across entire lifespan (inc pre-conception)- Effects of household and family- Ethnic differences

• Chance to study well-being as well as pathology, and to describe & understand causes and consequences of positive health states

• Linkage to NHS IT networks and routine data sources?


The importance of studying households: variance in GHQ-12 scores

Prevalence of CMD (GHQ score ? 3) GHQ score (continuous measure)

Variance (se) p %variance Variance (se) p %variance

Model 1 (null)

Individual 3.29a 91.1 20.37 (0.43) <0.001 84.7 (81.2-88.2)

Household 0.29 (0.065) <0.001 8.0 (4.5-11.6) 3.47 (0.37) <0.001 14.4 (11.4-17.5)

Ward 0.03 (0.022) 0.21 0.8 (0.0-1.9) 0.22 (0.11) 0.046 0.9 (0.01-1.8)

Model 2†

Individual 3.29a 93.4 18.14 (0.38) <0.001 89.2 (85.6-92.9)

Household 0.23 (0.070) 0.001 6.5 (2.5-9.8) 2.09 (0.31) <0.001 10.3 (7.3-13.3)

Ward 0.002 (0.022) 0.91 0.05 (0.0-1.3) 0.13 (0.08) 0.21 0.5 (0.0-1.3)


Challenges

• Limited questionnaire space and interview time• Respondent fatigue• Interviewer training and equipment costs for

even basic physical data collection• No funding beyond core measures• Non-participation in invasive procedures, and

particular challenges associated eg with fasting samples

• Optimum measurement frequency unclear• Huge range of potential health measures


BHPS Measures• Disability (defined by receipt of benefits)• Health limits housework/stairs/dressing/walking• Health limits work• Registered as disabled• Self-rated health• Checklist of 12 + 1 health problems (up to 4) • 12-item General Health Questionnaire• GP consultations: count• Accidents• Admissions to hospital• Check-ups• Smoking


Core Measures: Initial UKHLS FocusBody compositionImportance of describing & understanding recent (and worsening) obesity epidemic;Factors that enable or prevent lifestyle change;Height, weight, waist & hip circumferences

Mental health and well-beingGlobally, depression major cause of DALYs;Major cause of health care seeking in primary care;Major cause of time lost from work;Great interest in epidemiology of (mental) well-being


Non-Core Measures?

• Genotyping• Cardiovascular health: BP, heart rate, ECG• Metabolic health: glucose, lipids, cholesterol (fasting?)• Psychosis and Personality Disorder• Early indicators of cognitive decline• HPA axis and autonomic nervous system markers (endophenotypes)• Inflammatory markers

Documents

UKHLS Consultation Launch, 19/06/07, RSS Health Outcomes and Health Related Behaviour Scott Weich Dieter Wolke University of Warwick