A Widening Gap? Changes in Multiple Lifestyle Risk Behaviours by Socioeconomic Status in New South Wales, Australia, 2002-2012.
BACKGROUND
Socioeconomic inequalities in health outcomes have increased over the past few decades in some countries. However, the trends in inequalities related to multiple health risk behaviours have been infrequently reported. In this study, we examined the trends in individual health risk behaviours and a summary lifestyle risk index in New South Wales, Australia, and whether the absolute and relative inequalities in risk behaviours by socioeconomic positions have changed over time.


METHODS
Using data from the annual New South Wales Adult Population Health Survey during the period of 2002-2012, we examined four individual risk behaviours (smoking, higher than recommended alcohol consumption, insufficient fruit and vegetable intake, and insufficient physical activity) and a combined lifestyle risk indicator. Socioeconomic inequalities were assessed based on educational attainment and postal area-level index of relative socio-economic disadvantage (IRSD), and were presented as prevalence difference for absolute inequalities and prevalence ratio for relative inequalities. Trend tests and survey logistic regression models examined whether the degree of absolute and relative inequalities between the most and least disadvantaged subgroups have changed over time.


RESULTS
The prevalence of all individual risk behaviours and the summary lifestyle risk indicator declined from 2002 to 2012. Particularly, the prevalence of physical inactivity and smoking decreased from 52.6% and 22% in 2002 to 43.8% and 17.1% in 2012 (p for trend<0.001). However, a significant trend was observed for increasing absolute and relative inequalities in smoking, insufficient fruit and vegetable consumption, and the summary lifestyle risk indicator.


CONCLUSIONS
The overall improvement in health behaviours in New South Wales, Australia, co-occurred with a widening socioeconomic gap.


CONCLUSIONS
Governments should address health inequalities through risk factor surveillance and combined strategies of population-wide and targeted interventions.
Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia.
Ding
D
Ding
Centre for Epidemiology and Evidence, New South Wales Ministry of Health, North Sydney, New South Wales, Australia.
Anna
A
Do
Centre for Population Health, New South Wales Ministry of Health, North Sydney, New South Wales, Australia.
Heather-Marie
HM
Schmidt
Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia.
Adrian E
AE
Bauman
D000428:Alcohol Drinking / Q000009:adverse effects; D005260:Female; D015438:Health Behavior; D006306:Health Surveys / Q000379:methods; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D012907:Smoking / Q000009:adverse effects; D012923:Social Class; D012959:Socioeconomic Factors; D014675:Vegetables