Introduction

Scotland has an unenviable record as the ‘sick man of (Western) Europe’, with high mortality rates for most major diseases. The Scottish way of life, poor nutrition, smoking, alcohol consumption and lack of exercise are seen to contribute to this image. Other factors in terms of life circumstances, such as income, education, and employment status, are seen as contributing to poor health, particularly for lower socioeconomic groups. The Scottish Executive is committed to tackling the causes of ill health and reducing health inequalities (Scottish Executive, 2000).

To date, most of the research concerning health status and its determinants has been carried out in terms of mortality. This limits the analysis to negative outcomes and to outcomes that affect a minority of the population. On average, mortality rates for 15- to 39-year-olds in Scotland are 50% higher than in England. However, the cumulative mortality risk over 25 years of age is only 2.4% (Scotland), implying that the survival rate is 97.6%. Comparing this with the cumulative survival rate for England of 98.4% does not provide such a dramatic contrast. Among the problems in trying to refocus the analysis on health rather than death is the fact that in surveys most people declare themselves as having good health and suitable sources of health measures or morbidity data are scarce. This chapter explores the contribution that can be made by using data from the British Household Panel Survey (BHPS) and the extended Scottish sample.

The BHPS has not been widely used to explore health-related issues. This limited use of the BPHS may be explained in part by the nature of the health measures that have been included. The General Health Questionnaire (GHQ-12), which is included in all waves of the BHPS and therefore both waves of the extended Scottish panel, was devised as a screening instrument for diagnosable psychiatric disorders. As such, it is restricted in its definition of health. Another recognised scale that is used, the Activities of Daily Living (ADL), is only asked of respondents aged 65+. All waves of the panel have included questions on specific health problems relating to a variety of clinical and functional issues, but these do not appear to be scaled in any way.