Background
Objectives
Methods
The study population
Measuring CF and CFS
Measuring common mental disorder
Social adversity
Physical inactivity
Questionnaire and measures
Statistical analysis
CF | CFS | |||
---|---|---|---|---|
Demographics | Percentage (n/N), unweighted | OR (95% CI), weighted | Percentage (n/N), unweighted | OR (95% CI), weighted |
Ethnic group | ||||
White | 22.6 (189/836) | 1 | 0.8 (7/835) | 1 |
Irish | 21.7 (159/732) | 1 (0.7 to 1.3) | 2.0 (15/732) | 2.6 (0.98 to 6.9) |
Black Caribbean | 19.8 (137/691) | 0.8 (0.6 to 1.01) | 2.5 (17/690) | 2.6 (1.04 to 6.7)b
|
Bangladeshi | 19.4 (126/650) | 0.8 (0.6 to 1.03) | 3.4 (22/650) | 3.2 (1.3 to 7.8)b
|
Indian | 19.3 (124/643) | 0.8 (0.6 to 1.1) | 3.1 (20/643) | 3.3 (1.3 to 8.3)c
|
Pakistani | 20.2 (146/724) | 0.8 (0.6 to 1.04) | 3.7 (27/723) | 4.3 (1.7 to 10.5)d
|
Sex | ||||
Male | 19 (368/1,939) | 1 | 2.6 (50/1,937) | 1 |
Female | 22 (513/2,337) | 1.2 (1.01 to 1.4)b
| 2.5 (58/2,336) | 0.9 (0.6 to 1.4) |
Age group, yr | ||||
16 to 34 | 12 (198/1,646) | 1 | 0.7 (12/1,645) | 1 |
35 to 54 | 24.2 (416/1,720) | 2.5 (2 to 3)d
| 3.5 (60/1,718) | 5.4 (2.5 to 11.4)d
|
55 to 74 | 29.3 (267/910) | 3.3 (2.7 to 4.2)d
| 4.0 (36/910) | 5.5 (2.5 to 12.1)d
|
Marital status | ||||
Married | 22.4 (617/2,752) | 1 | 2.9 (80/2,751) | 1 |
Divorced/separated | 31.1 (97/312) | 1.5 (1.5 to 1.9)c
| 3.8 (12/312) | 1.2 (0.6 to 2.5) |
Widowed | 28.5 (45/158) | 1.2 (0.8 to 1.8) | 3.8 (6/158) | 1.4 (0.6 to 3.7) |
Single | 11.6 (122/1,054) | 0.5 (0.4 to 0.6)d
| 1 (10/1,052) | 0.4 (0.2 to 0.9)b
|
Employment status | ||||
Employed | 17.5 (397/2,272) | 1 | 1.5 (35/2,271) | 1 |
Unemployed | 17.9 (30/168) | 0.9 (0.6 to 1.5) | 2.4 (4/168) | 0.9 (0.3 to 3.5) |
Retired | 30.6 (144/470) | 1.6 (1.2 to 2.1)d
| 3.4 (16/470) | 1.7 (0.8 to 3.4) |
Other economically inactive | 23.4 (290/1,238) | 1.2 (1.1 to 1.5)b
| 4.0 (49/1,236) | 2.1 (1.3 to 3.4)c
|
Educational level | ||||
Degree or above | 19.2 (188/977) | 1 | 1.4 (14/976) | 1 |
A level/GCSEe
| 17.9 (275/1,536) | 0.9 (0.7 to 1.1) | 2.0 (30/1,534) | 1.5 (0.7 to 3.2) |
Foreign qualification | 23.3 (38/163) | 1.2 (0.8 to 1.9) | 2.5 (4/163) | 2.3 (0.6 to 8.3) |
No qualification | 25.5 (375/1,468) | 1.4 (1.1 to 1.7)c
| 4.0 (59/1,468) | 2.8 (1.4 to 5.7)c
|
Type of employment (head of household) | ||||
Nonmanual labour | 19.7 (334/1,693) | 1 | 1.7 (29/1,692) | 1 |
Manual labour | 20.8 (484/2,326) | 1 (0.8 to 1.2) | 2.9 (68/2324) | 1.6 (0.99 to 2.6)b
|
Place of birth | ||||
United Kingdom | 16.1 (238/1,476) | 1 | 1.1 (16/1,475) | 1 |
Other | 23 (459/1,993) | 1.3 (1.1 to 1.6)c
| 4.2 (84/1,992) | 3.5 (1.8 to 6.8)d
|
Age of migration, yr | ||||
<11 | 16.7 (391/2,335) | 1 | 1.2 (28/2,333) | 1 |
≥11 | 21.6 (223/1,031) | 1.3 (1.1 to 1.6)c
| 4.3 (44/1,030) | 4.2 (2.4 to 7.4)d
|
CFS correlate | Percentage (n/N), unweighted | OR (95% CI), weighted |
---|---|---|
Social support | ||
Confiding/emotional support | ||
Low | 3.1 (35/1,132) | 1 |
Average | 2.3 (38/1,675) | 0.7 (0.4 to 1.3) |
High | 2.4 (33/1,398) | 0.8 (0.5 to 1.5) |
Practical support | ||
Low | 1.9 (16/861) | 1 |
Average | 2.1 (28/1,317) | 0.99 (0.5 to 2) |
High | 3.1 (62/2,032) | 1.4 (0.7 to 2.7) |
Negative aspects of support | ||
Low | 0.6 (4/631) | 1 |
Average | 2 (30/1,472) | 2.3 (0.7 to 7.6) |
High | 3.4 (72/2,103) | 4 (1.2 to 12.4)b
|
Chronic strains | ||
Tertiles of total score | ||
Low | 0.9 (9/1,023) | 1 |
Average | 2.2 (46/2,124) | 2.3 (1.04 to 5)b
|
High | 4.8 (53/1,100) | 4.9 (2.2 to 10.6)c
|
Perceived discrimination | ||
Total score (means) | - | 1.5 (1.1 to 2)d
|
Mental health (CIS-R subscales) | ||
Depression score | - | 2.2 (1.9 to 2.6)c
|
Anxiety score | - | 2.2 (1.9 to 2.6)c
|
Physical inactivity | ||
Days of moderate activity of ≥30 minutes/day in past 4 weeksb
| ||
5 or more (high) | 1.4 (16/1,126) | 1 |
1 to 4 (medium) | 1.3 (16/1,256) | 1.02 (0.4 to 2.3) |
1 or <1 (low) | 4 (75/1,883) | 3.3 (1.7 to 6.2) |
Activity intensity | ||
Moderate/vigorous | 1.7 (55/3,217) | 1 |
Inactive/light | 5.7 (53/926) | 4.6 (2.9 to 7.2) |
Sample size, n(%) | ||||||||
---|---|---|---|---|---|---|---|---|
Demographic variable | Total, N(%) | White | Irish | Black Caribbean | Bangladeshi | Indian | Pakistani |
Pvalue |
835 (19.5) | 733 (17.1) | 691 (16.1) | 650 (15.2) | 648 (15.1) | 724 (16.9) | |||
Sex | ||||||||
Male | 1,950 (45.5) | 365 (43.7) | 323 (44.1) | 280 (40.5) | 321 (49.4) | 316 (48.8) | 345 (47.7) | ≤0.04 |
Female | 2,332 (54.5) | 471 (56.1) | 410 (55.9) | 412 (59.5) | 329 (50.6) | 331 (51.2) | 379 (52.3) | |
Age, yr | ||||||||
16 to 34 | 1,774 (41.4) | 260 (31.1) | 209 (28.5) | 269 (38.9) | 376 (57.8) | 248 (38.3) | 412 (56.9) | ≤0.001 |
35 to 54 | 1,647 (38.5) | 355 (42.5) | 345 (47.1) | 251 (36.3) | 187 (28.7) | 280 (43.2) | 229 (21.6) | |
55 to 74 | 862 (20.1) | 221 (26.4) | 179 (24.4) | 171 (24.7) | 88 (13.5) | 120 (18.5) | 83 (11.5) | |
Marital status | ||||||||
Married | 2,674 (62.5) | 518 (62.1) | 461 (62.8) | 279 (40.4) | 446 (68.7) | 464 (71.7) | 506 (69.9) | ≤0.001 |
Divorced/separated | 313 (7.3) | 75 (9) | 78 (10.6) | 84 (12.2) | 18 (2.8) | 32 (4.9) | 26 (3.6) | |
Widowed | 142 (3.3) | 36 (4.3) | 25 (3.4) | 18 (2.6) | 28 (4.3) | 19 (2.9) | 16 (2.2) | |
Single | 1,150 (26.9) | 205 (24.6) | 170 (23.2) | 310 (44.9) | 157 (24.2) | 132 (20.4) | 176 (24.3) | |
Employment status | ||||||||
Employed | 2,273 (55) | 536 (66.4) | 490 (69) | 376 (57.4) | 181 (29.1) | 394 (61.9) | 296 (42.4) | ≤0.001 |
Unemployed | 168 (4.1) | 10 (1.2) | 12 (1.7) | 39 (6) | 40 (6.4) | 33 (5.2) | 34 (4.9) | |
Retired | 446 (10.8) | 130 (16.1) | 96 (13.5) | 97 (14.8) | 33 (5.3) | 49 (7.7) | 41 (5.9) | |
Other economically inactive | 1,242 (30.1) | 131 (16.2) | 112 (15.8) | 143 (21.8) | 369 (59.2) | 160 (25.2) | 327 (46.8) | |
Educational level | ||||||||
Degree or above | 951 (23.2) | 213 (26.5) | 195 (27.6) | 172 (26) | 62 (10.1) | 187 (29.9) | 122 (17.8) | ≤0.001 |
A level/GCSE | 1,549 (37.8) | 356 (44.3) | 294 (41.6) | 272 (41.1) | 172 (27.9) | 221 (35.3) | 234 (34.1) | |
Foreign qualification | 172 (4.2) | 32 (4) | 35 (5) | 30 (4.5) | 17 (2.8) | 29 (4.6) | 29 (4.2) | |
No qualification | 1,428 (34.8) | 202 (25.2) | 183 (25.9) | 188 (28.4) | 365 (59.3) | 189 (30.2) | 301 (43.9) | |
Social class (employment type) | ||||||||
Nonmanual labour | 1,681 (41.9) | 463 (56.3) | 351 (48.5) | 279 (42.7) | 92 (16.4) | 279 (44.6) | 217 (34.5) | ≤0.001 |
Manual labour | 2,335 (58.1) | 360 (43.7) | 372 (51.5) | 375 (57.3) | 469 (83.6) | 347 (55.4) | 412 (65.5) | |
Social support scores (tertiles) | ||||||||
Confiding/emotional support | ≤0.001 | |||||||
Low | 1,137 (27) | 225 (27.1) | 194 (26.8) | 226 (33.5) | 154 (24) | 168 (26.5) | 170 (24.1) | |
Average | 1,667 (39.6) | 301 (36.3) | 244 (33.7) | 239 (35.4) | 313 (48.8) | 262 (41.4) | 308 (43.7) | |
High | 1,404 (33.4) | 303 (36.6) | 287 (39.6) | 210 (31.1) | 174 (27.1) | 203 (32.1) | 227 (32.2) | |
Practical support | ≤0.001 | |||||||
Low | 892 (21.2) | 200 (24.1) | 149 (20.5) | 179 (26.5) | 68 (10.6) | 145 (22.9) | 151 (21.4) | |
Average | 1,308 (31) | 296 (35.7) | 259 (35.7) | 253 (37.4) | 130 (20.3) | 185 (29.2) | 185 (26.2) | |
High | 2,013 (47.8) | 334 (40.2) | 318 (43.8) | 244 (36.1) | 443 (69.1) | 303 (47.9) | 371 (52.5) | |
Negative aspects of support | ≤0.001 | |||||||
Low | 646 (15.4) | 159 (19.2) | 113 (15.6) | 135 (20) | 31 (4.9) | 100 (15.8) | 108 (15.3) | |
Average | 1,484 (35.3) | 365 (44) | 331 (45.6) | 225 (33.3) | 126 (19.7) | 200 (31.6) | 237 (33.6) | |
High | 2,078 (49.4) | 306 (36.9) | 282 (38.8) | 316 (46.7) | 481 (75.4) | 332 (52.5) | 361 (51.1) | |
Chronic strain mean scoresb
| 1.62 | 1.34 | 1.44 | 1.71 | 2.31 | 1.38 | 1.53 | ≤0.0001 |
Perceived discrimination mean scoresb
| 0.30 | 0.13 | 0.15 | 0.65 | 0.19 | 0.39 | 0.35 | ≤0.0001 |
Days of moderate activity ≥30 minutes/day in past 4 weeks | ≤0.001 | |||||||
5 or more (high) | 1,131 (26.5) | 268 (32.1) | 231 (31.6) | 228 (33.1) | 93 (14.3) | 170 (26.2) | 141 (19.5) | |
1 to 4 (medium) | 1,274 (29.8) | 278 (33.3) | 247 (33.7) | 201 (29.2) | 139 (21.4) | 192 (29.6) | 217 (30.1) | |
1 or <1 (low) | 1,870 (43.7) | 288 (34.5) | 254 (34.7) | 260 (37.7) | 418 (64.3) | 286 (44.1) | 364 (50.4) | |
Activity intensity | ≤0.001 | |||||||
Inactive/light | 903 (22) | 6 (0.7) | 102 (14.4) | 116 (17.4) | 308 (49.9) | 156 (24.9) | 215 (31.3) | |
Moderate/vigorous | 3,201 (78) | 795 (99.3) | 606 (85.6) | 549 (82.6) | 309 (50.1) | 470 (75.1) | 472 (68.7) | |
Anxiety mean scoresb
| 0.30 | 0.31 | 0.38 | 0.29 | 0.20 | 0.29 | 0.32 | 0.005 |
Depressive mean scoresb
| 0.43 | 0.41 | 0.41 | 0.42 | 0.36 | 0.46 | 0.51 | 0.003 |
Variable | Sex | Age | Education | Employment | Social strain | Discrimination | Negative social support | Physical inactivity | Depression | Anxiety |
---|---|---|---|---|---|---|---|---|---|---|
Sex | 1.000 | |||||||||
Age | -0.0400a
| |||||||||
Education | -0.0381a
| -0.2628d
| 1.0000 | |||||||
Employment | 0.2070 d
| 0.1481d
| -0.3573d
| 1.0000 | ||||||
Social strain | 0.0674d
| -0.1135d
| -0.0777d
| 0.1089d
| 1.0000 | |||||
Discrimination | -0.1176d
| -0.0397b
| 0.1288d
| -0.1038d
| 0.1293d
| 1.0000 | ||||
Negative social support | 0.0445b
| -0.1189d
| -0.0443b
| 0.0753d
| 0.2077d
| 0.0467b
| 1.0000 | |||
Physical inactivity | -0.0135 | 0.1103d
| -0.2693d
| 0.2538d
| 0.0947d
| -0.0487b
| 0.1186d
| 1.0000 | ||
Depression | 0.0529c
| -0.0060 | -0.0096 | 0.0564c
| 0.1768d
| 0.0943d
| 0.0913d
| 0.0727d
| 1.0000 | |
Anxiety | 0.0537d
| -0.0038 | 0.0462b
| 0.0154 | 0.1884d
| 0.0730d
| 0.0879d
| -0.0187 | 0.3617d
| 1.0000 |
Basic model (N= 3,794; R
2= 0.05) | Basic model and social variables (N= 3,741; R
2= 0.14) | Basic model and physical inactivity (N= 3,792; R
2
| Basic model and psychological variables (N= 3,794; R
2
| Full model (N= 3,739; R
22
| |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
OR | 95% CI |
Pvalue | OR | 95% CI |
Pvalue | OR | 95% CI |
Pvalue | OR | 95% CI |
Pvalue | OR | 95% CI |
Pvalue | |
Ethnicity | |||||||||||||||
Irish | 2.12 | 0.8 to 5.71 | 0.13 | 1.96 | 0.70 to 5.44 | 0.2 | 1.76 | 0.64 to 4.80 | 0.27 | 2.25 | 0.83 to 6.09 | 0.108 | 1.72 | 0.58 to 5.1 | 0.32 |
Black Caribbean | 2.33 | 0.90 to 5.98 | 0.078 | 1.48 | 0.55 to 4.02 | 0.44 | 1.80 | 0.70 to 4.60 | 0.22 | 2.62 | 1.02 to 6.74 | 0.045 | 1.65 | 0.58 to 4.68 | 0.34 |
Bangladeshi | 3.24 | 1.17 to 9.01 | 0.02 | 1.54 | 0.55 to 4.34 | 0.41 | 1.89 | 0.62 to 5.68 | 0.26 | 4.5 | 1.61 to 12.4 | 0.004 | 1.87 | 0.61 to 5.75 | 0.27 |
Indian | 2.51 | 0.97 to 6.53 | 0.057 | 2.01 | 0.73 to 5.50 | 0.17 | 1.77 | 0.65 to 4.84 | 0.26 | 2.33 | 0.86 to 6.3 | 0.093 | 1.51 | 0.5 to 4.6 | 0.45 |
Pakistani | 4.09 | 1.6 to 10.44 | 0.003 | 3.34 | 1.27 to 8.75 | 0.01 | 2.71 | 1.01 to 7.30 | 0.048 | 3.74 | 1.39 to 10.05 | 0.009 | 2.49 | 0.83 to 7.45 | 0.10 |
Sex | 0.98 | 0.59 to 1.65 | 0.96 | 1.01 | 0.59 to 1.73 | 0.95 | 1.02 | 0.61 to 1.70 | 0.92 | 0.88 | 0.51 to 1.51 | 0.645 | 0.91 | 0.53 to 1.56 | 0.74 |
Age | 1.02 | 1.01 to 1.03 | 0.002 | 1.03 | 1.02 to 1.05 | <0.001 | 1.01 | 1.01 to 1.03 | 0.015 | 1.03 | 1.01 to 1.04 | 0.001 | 1.02 | 1.01 to 1.04 | 0.001 |
Education | 0.95 | 0.52 to 1.74 | 0.87 | 0.85 | 0.45 to 1.59 | 0.61 | 0.98 | 0.53 to 1.82 | 0.96 | 0.91 | 0.48 to 1.75 | 0.795 | 0.85 | 0.44 to 1.66 | 0.65 |
Employment | 1.18 | 0.66 to 2.12 | 0.56 | 1.20 | 0.66 to 2.18 | 0.55 | 1.07 | 0.59 to 1.93 | 0.82 | 0.90 | 0.49 to 1.68 | 0.760 | 0.86 | 0.44 to 1.68 | 0.67 |
Type of employment | 1.27 | 0.74 to 2.17 | 0.38 | 1.24 | 0.71 to 2.17 | 0.44 | 1.22 | 0.71 to 2.09 | 0.46 | 1.26 | 0.71 to 2.24 | 0.41 | 1.18 | 0.65 to 2.14 | 0.57 |
Strain (score) | 1.44 | 1.08 to 1.94 | <0.0001 | 1.22 | 1.02 to 1.47 | 0.03 | |||||||||
Discrimination (score) | 1.45 | 1.08 to 1.95 | 0.01 | 1.28 | 0.92 to 1.78 | 0.15 | |||||||||
Negative aspects of social support | 2.12 | 1.37 to 3.28 | 0.001 | 2.0 | 1.25 to 3.2 | 0.004 | |||||||||
Physical in activity (moderate/vigorous vs. inactive/light) | 2.33 | 1.37 to 4.00 | 0.001 | 2.17 | 1.13 to 4.16 | 0.02 | |||||||||
Depression score | 1.59 | 1.27 to 1.99 | 0.001 | 1.49 | 1.17 to 1.89 | 0.001 | |||||||||
Anxiety score | 1.91 | 1.54 to 2.39 | 0.001 | 1.80 | 1.43 to 2.27 | <0.001 |