Open Access Highly Accessed Research article

Is the Scottish population living dangerously? Prevalence of multiple risk factors: the Scottish Health Survey 2003

Richard Lawder1, Oliver Harding2, Diane Stockton1, Colin Fischbacher13, David H Brewster13, Jim Chalmers13, Alan Finlayson1 and David I Conway14*

Author Affiliations

1 Information Services Division, NHS National Services Scotland, Gyle Square, Edinburgh, UK

2 Department of Public Health, NHS Forth Valley Health Board, Stirling, UK

3 Department of Public Health Sciences, University of Edinburgh, Edinburgh, UK

4 Dental School, Faculty of Medicine, University of Glasgow, Glasgow, UK

For all author emails, please log on.

BMC Public Health 2010, 10:330  doi:10.1186/1471-2458-10-330

Published: 11 June 2010



Risk factors are often considered individually, we aimed to investigate the prevalence of combinations of multiple behavioural risk factors and their association with socioeconomic determinants.


Multinomial logistic regression was used to model the associations between socioeconomic factors and multiple risk factors from data in the Scottish Health Survey 2003. Prevalence of five key risk - smoking, alcohol, diet, overweight/obesity, and physical inactivity, and their risk in relation to demographic, individual and area socioeconomic factors were assessed.


Full data were available on 6,574 subjects (80.7% of the survey sample). Nearly the whole adult population (97.5%) reported to have at least one behavioural risk factor; while 55% have three or more risk factors; and nearly 20% have four or all five risk factors. The most important determinants for having four or five multiple risk factors were low educational attainment which conferred over a 3-fold increased risk compared to high education; and residence in the most deprived communities (relative to least deprived) which had greater than 3-fold increased risk.


The prevalence of multiple behavioural risk factors was high and the prevalence of absence of all risk factors very low. These behavioural patterns were strongly associated with poorer socioeconomic circumstances. Policy to address factors needs to be joined up and better consider underlying socioeconomic circumstances.