The Scottish Health Survey-Scottish Morbidity Record Linked Datasets: Introduction to a new resource...
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Transcript of The Scottish Health Survey-Scottish Morbidity Record Linked Datasets: Introduction to a new resource...
The Scottish Health Survey-Scottish Morbidity Record Linked Datasets:Introduction to a new resource
Peter Craig
Chief Scientist Office
Outline
• The Scottish Health Surveys
• The Scottish Morbidity Record Linked Datasets
• The SHS-SMR Linked Datasets
• Examples
• Further information and access to the data
The Scottish Health Surveys
• Aims: to measure the health of the Scottish population, and to monitor changes in health, with a particular emphasis on cardiovascular disease and its risk factors
• Three surveys carried out so far, in 1995-6, 1998-9 and 2003-4, and a fourth in progress
SHS - Design
• Repeated cross-sectional survey, using a stratified, clustered random probability sample of individuals living in private households
• Covers the whole of mainland Scotland plus the larger inhabited islands
• Two-stage data-gathering: interview followed by a nurse visit
SHS - contentHealth: self-assessed general health, limiting longstanding illness, acute sickness; CVD and use of health services; respiratory health; asthma; accidents; food poisoning; use of dental services; psychosocial health (GHQ, SDQ*), health-related quality of life (SF-12)*
Health behaviours: physical activity; eating habits; smoking; drinking; use of prescribed drugs, contraceptive pill, vitamin supplements and NRT; immunisations*; breastfeeding*; exposure to environmental tobacco smoke
Measurements: height (length, demispan), weight; blood pressure; waist, hip, mid-upper arm circumference; salivary cotinine; blood analytes (total and HDL cholesterol, C-reactive protein, total and house dust mite specific IgE, etc.); urinary sodium*†, ECG*†
*2003 only †subsample only
SHS - Content
Household characteristics: size, composition, relationships; tenure, car ownership; receipt of state benefits; income*; economic status/occupation of household reference person*; Carstairs score; SIMD*
Individual characteristics: age, sex; economic status, occupation; education (age left FTE, highest qualification); ethnic background, religion*; parental social class*; parental history of CVD
*2003 only
SHS - changes
• Content extended: household income; parental social class; fruit and vegetable consumption; HRQoL; SDQ; urinary sodium; ECG
• Age range extended from 16-64 (1995) to 2-74 (1998) to all ages (2003)
• Design modified– 1995, 1998 one adult per household interviewed– 2003 interviews attempted with all adults
SHS – non-response and weighting
1995 1998 2003
Household - - 67
Individual interview
81 76 60
Nurse visit 71 63 40
SHS – non-response and weighting
Weights• 1995, 1998 – single interview weight to take account of
– disproportionate sampling within health regions– differing probabilities of selection within households of different
sizes and within multi-occupied addresses– differential non-response
• 2003 – interview, nurse visit and blood weights to take account of– disproportionate sampling within health regions– differing probabilities of selection within multi-occupied
addresses– differential non-response at each stage of data-gathering
The SMR Linked Datasets
• Records of hospital episodes (date of admission and discharge, diagnosis, etc.) linked to provide individual patient-based records
• Contains information on acute and psychiatric hospital episodes, cancer registrations and deaths in Scotland from 1981-present
SHS-SMR Linked Datasets
SHS Survey data + encrypted serial number
Names, postcodes, DoBs + encrypted serial number
National Centre for Social Research
SMR01 data + encrypted serial number
SHS Survey data + SMR01 data
SHS-SMR Linked Datasets
• Currently include hospital episodes and deaths up to Sept 2006 and cancer registrations to December 2004– Minimum datasets contain all survey data plus
summary of SMR data – freely available– Full datasets contain survey data plus
specified fields from the SMR01 catalogue – available subject to PAC approval
The ‘minimum datasets’
• All survey data for respondents who consent to linkage
• Summary of SMR data– Death: date, cause– Psychiatric admissions: total number; date and
diagnosis of 1st admission– Cancer registrations: total number; date and diagnosis
of 1st registration for a range of sites– Cardiovascular disease: total numbers of AMI, CHD,
stroke, angiography, PCTA, and CABG admissions; date of 1st admission for each cause
• Emigration status
SHS-SMR Linked Datasets
1995 1998 2003
Cases 7363 8305 10470
Cancer registrations 560 755 500
Cancer registrations post survey 389 455 70
CHD admissions 367 531 441
CHD admissions post survey 291 330 121
Psych hospital admissions 260 300 167
Psych hosp. admissions post survey 147 140 35
Deaths 442 618 208
Deprivation quintile
Hazard ratio
Lower CI
Upper CI
P value
Highest 1.00
2 1.33 0.99 1.79 0.058
3 1.48 1.11 1.96 0.007
4 1.73 1.29 2.32 0.000
Lowest 1.93 1.45 2.56 0.000
Self-assessed health
Hazard ratio
Lower CI
Upper CI
P value
Very good 1.00
Good 1.44 1.11 1.87 0.006
Fair 3.10 2.41 3.98 0.000
Poor 4.98 3.75 6.62 0.000
Very poor 5.80 3.62 9.28 0.000
SHS-SMR Linked Datasets
• Strengths– Large, nationally representative samples– Numbers of events continually increasing– Easily accessible
• Weaknesses– Non response and missing data– Exposure data not updated– Outcomes restricted to ‘major events’
SHS-SMR linked datasets
• Examples of current uses– Modelling impact of public health interventions on
health inequalities– Self-reported alcohol consumption and alcohol-related
hospital admission– Social, biological and behavioural risk factors for
hospital admission and death– Psychological distress as a predictor of
cardiovascular disease and mortality– Developing models of cardiovascular risk and benefit
to improving prescribing decisions
Further information
To find out about the Scottish Health Surveywww.scotland.gov.uk/Topics/Statistics/Browse/Health/scottish-health-survey
To access the survey datawww.data_archive.ac.uk
To access the linked datasets, [email protected]@isd.csa.scot.nhs.uk