title: Are differential consumption patterns in health-related behaviours an explanation for persistent and widening social inequalities in health in England?
abstract: During the last two decades, differential consumption patterns in health-related behaviours have increasingly been highlighted as playing an important role in explaining persistent and widening health inequalities. This period has also seen government public health policies in England place a greater emphasis on changing 'lifestyle' behaviours, in an attempt to tackle social inequalities in health. The aim of this study was to empirically examine the variation in health-related behaviour in relation to socio-economic position, in the English adult population, to determine the nature of this relationship and whether it has changed over time.
  
  
  
  The study population was derived from the Health Survey for England between 2001 and 2012 (n = 56,468). The relationships between health-related behaviour (smoking, fruit and vegetable intake, alcohol consumption and physical activity) and three socioeconomic indicators (educational level, occupational social class and equivilised household income) were analysed using log bi-nomial regression.
  
  
  
  The study found that each of the three socio-economic indicators were statistically related to smoking, fruit and vegetable consumption and alcohol intake, with the strongest relationship found for smoking. For physical activity, no relationship was found in 2003 by education or income and in 2008 by occupation. Statistical analysis showed that the difference between those at the highest and lowest end of the socio-economic indicators had widened in relation to smoking, as measured by educational level, occupation and household income. A similar trend was also found for physical activity as measured by educational level and household income. However, for fruit and vegetable intake and alcohol consumption, the relationship between health-related behaviour and socio-economic position had narrowed over time as measured by education and income.
  
  
  
  The findings provided only partial support for the thesis that socio-economic variations in health-related behaviours may be significant in explaining widening health inequalities. The significance of socio-economic variations in health-related behaviours might reflect both materialist and cultural explanations for socio-economic inequalities although it was not possible to separate and estimate the relative importance of these effects.
authors.affiliation: School of Social Policy, Sociology and Social Research, University of Kent, Canterbury, CT2 7NF, UK. ejs51@kent.ac.uk.
authors.forename: Emma
authors.identifier: 0000-0003-2593-5489
authors.initials: E
authors.lastname: Stait
authors.affiliation: School of Social Policy, Sociology and Social Research, University of Kent, Canterbury, CT2 7NF, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Calnan
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology*; D004032:Diet / Q000706:statistics & numerical data*; D004739:England; D015444:Exercise; D005260:Female; D015438:Health Behavior; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008019:Life Style; D008297:Male; D012907:Smoking / Q000453:epidemiology*; D012923:Social Class; D012959:Socioeconomic Factors
keywords: England; Health-related behaviour; Social inequalities in health