Introduction There is evidence that health behaviours cluster together in certain patterns and that this varies by individual and socio-demographic characteristics. This study took a different perspective by investigating whether the clustering of health behaviours varies geographically in Scotland.
Methods Secondary, cross-sectional data from the Scottish Health Survey (2003) were analysed. The prevalence of meeting national recommendations on four health behaviours—alcohol, smoking, physical activity and fruit and vegetable consumption—was calculated. Two geographical divisions were made—east and west, and urban and rural. The number of healthy behaviours individuals have was analysed geographically, using binary logistic regression to control for confounders. Clustering was investigated using observed to expected ratios for each pattern of health behaviour, a method which indicates which patterns occur more or less frequently than would be expected by chance.
Results Prevalence of healthy behaviour differed significantly across both geographical divisions, except for alcohol behaviour. After controlling for age, sex and deprivation, a significant but small difference in number of healthy behaviours was found between urban and rural areas, but not between east and west. The most prevalent pattern of behaviour was not drinking or smoking, but also not eating enough fruit and vegetables and not exercising enough. Clustering of health behaviours did not differ geographically.
Conclusion Clustering of health behaviour may not contribute to geographical health inequalities in Scotland. However, the occurrence of multiple unhealthy behaviours was common and may be an important consideration for public health programmes in Scotland.
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