The annual Scottish Health Survey has just been published by the Scottish Government, providing a snapshot of Scotland's population in 2023. 

The exercise has been running for nearly 30 years and is considered one of the most important sources of information when it comes to monitoring how the nation's health, lifestyles, and exposure to risks is changing.

What is the Scottish Health Survey? 

The Scottish Health Survey has been carried out annually since 2008. Prior to that it was carried out in 1995, 1998, and 2003.

The survey is commissioned by the Scottish Government's health directorates and has been undertaken since 2018 by the Scottish Centre for Social Research.

The findings provide an insight into population health trends over time, enabling the Government to monitor progress towards specific targets. 

It also provides an estimate for the prevalence of certain health conditions and associated risk-factors, such as smoking, and highlights differences in health behaviours between regions, sexes, age groups, and other subgroups of the population, as well as comparisons with statistics for England. 


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How is it done? 

The survey is designed to yield a representative sample of the general population, including both adults and children. 

Households receive a letter, inviting them to take part. 

Participants are mainly interviewed face-to-face in their homes, although telephone interviews can be used as a contingency measure. 

In 2023, more than 4000 households in total took part covering 4,949 adults and 2,184 children. 

What did it reveal this year? 

  • Obesity is getting worse 

Obesity among adults in Scotland is at its highest level since monitoring began in 2003. 

Adult obesity has never been higher (Image: SHS)

According to the survey, 32% of adults in Scotland had a BMI in excess of 30 in 2023, compared to 24% in 2003. 

Two thirds (66%) of adults are either overweight or obese. This figure has been relatively stable (64-67%) since 2008. 

The average BMI for an adult in Scotland is 28, which falls within the "overweight" bracket. This compares to 27.1 in 2003.

In 2023, 68% of children had a healthy weight, but one in five (17%) were at risk of obesity. This has remained roughly unchanged since 1998, fluctuating between 13% and 18%.

The Scottish Government previously set a target to halve childhood obesity, which would mean reducing prevalence to 7% by 2030.

The Government's childhood obesity target is off track (Image: SHS)

  • Access to dental care is a big problem 

The proportion of adults reporting difficulties when visiting the dentist (34%) has increased since 2019 (20%) and 2021 (23%) and has returned to a similar level as that recorded in 2009 (35%).

The most common difficulties reported when visiting a dentist were: getting a suitable appointment (12%), dental treatment being too expensive (10%), and not being able to get dental treatment under the NHS (7%).

Access to dental care has reverted to 2009 levels (Image: SHS) However, in 2023, the majority of adults (90%) reported having no issues with their mouth, teeth or dentures.

Just under three quarters of adults who had visited a dentist in the last five years had received dental treatment only on the NHS (72%).

Use of the private sector for some form of dental care was highest - at 28% - among adults aged 25-34. 

  • More and more young people are vaping  

In 2023, 15% of all adults were current smokers. This is unchanged from 2022.

The Scottish Government wants Scotland to be "tobacco-free" by 2034 - meaning that smoking prevalence should be 5% or less.

Adults aged 75 and over had the lowest smoking rate (6%), while for all other age groups, the current smoking rate sat at 15%-16%.

Smoking continues to vary massively by deprivation. People living in the most deprived areas have the highest smoking rate (26%) compared to 6% for those in the least deprived postcodes.

Vaping rates have shot up among young people (Image: SHS) In 2023, 12% of adults reported currently using e-cigarettes or vaping devices. This was up from 10% in 2022. 

Usage was highest, by far, among young people. In 2023, more than a fifth (22%) of 16 to 25-year-olds were vaping, up from 15% in 2022. 

  • Alcohol consumption falling - but so are fruit and vegetable intakes

Prevalence of hazardous or harmful alcohol consumption among adults continued to decrease in 2023, with levels falling from 34% in 2003 to 20% in 2023.

Hazardous drinking is defined as a weekly intake of more than 14, but less than 35, units for women, and more than 14 but less than 50 for men. 

Harmful drinking is more than 35 units a week for women (roughly three and a half bottles of wine), and more than 50 per week for men. 

On average, men in Scotland reported consuming 15.2 units per week and women eight units. 

Self-reported alcohol intakes are declining (Image: SHS) Most children are still not getting five portions of fruit and vegetables each day.

After peaking at 21% in 2022, fruit and veg consumption among two to 15-year-olds fell again with only 18% achieving the five-a-day target, although this is still higher than pre-pandemic levels and up from 13% in 2008.  

Meanwhile, 14% of adults reported experiencing "food insecurity" - fearing they would run out of food. This is up from 9% in 2021 and is now at the highest level since monitoring began in 2017. 

After peaking in 2022, fruit and veg consumption in children fell last year (Image: SHS)

  • Physical activity has fallen since the pandemic

Guidelines recommend that adults should aim to be physically active in some way every day for good physical and mental health.

While any activity is better than none, it is recommended that adults accumulate at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity exercise each week. 

In 2023, this was being achieved by 63% of adults - down from a peak of 69% in 2021. 

As in previous years, a higher proportion of men reported having met the guidelines (68%) compared with women (59%).

Roughly two thirds of adults say they are meeting physical activity targets (Image: SHS) Adults aged 75 and over were least likely to have met the physical activity guidelines (37%), while children aged two to 15 were spending roughly four hours a day on weekdays and five per day at the weekend engaged in sedentary activities.