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It is well known that the experience of poor health depends on adverse social and material circumstances and on unhealthy behaviour. In 1990 a British study asserted that privileged people gain more health benefit from a healthy lifestyle than do deprived people. In the present study this assertion was taken as a hypothesis, assuming statistical interaction between circumstances and health behaviour. The combined effect of these variables was studied in Denmark. Data was obtained from a 1987 national Health and Morbidity Survey; variables were selected to correspond closely with those in the earlier British study. The analysis included a multivariate analysis of variance. The results show that health-related behaviour has a positive effect on health both for those who are deprived and those who are not deprived, which is at variance with the findings of the British study. It confirms earlier analyses of Danish and Dutch data. [ABSTRACT FROM AUTHOR]

This paper derives its main hypothesis from results of the Health and Lifestyle Survey as reported in Blaxter's monograph Health and Lifestyles. In this book it is argued that in a favourable social environment a healthy lifestyle matters but in a unfavourable social environment a healthy lifestyle does not make much difference. This hypothesis is tested with data from health surveys from the Netherlands and Denmark. The Dutch data showed a highly significant relationship of unfavourable material and social circumstances with both poor health and an unhealthy lifestyle. In turn, an unhealthy lifestyle was also related to poor health. The Danish study showed similar, although generally weaker, associations. When the British findings would apply to Denmark and the Netherlands, we should find an interaction between material and social circumstances and health related behaviour in their association with health and illness. Neither the Dutch nor the Danish data showed an interaction of the type that the British study assumes. The paper concludes with a discussion of the reasons why the findings from the UK could not be replicated. [ABSTRACT FROM AUTHOR]

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This paper examines problems in measuring the occurrence of acute symptoms of ill health. Health interview surveys and health diaries often lead to different results. Two key hypotheses assume that: 1, interviews using checklists are more sensitive to the respondent's psychological distress than are the open-ended questions of health diaries; and 2, health diaries demand high levels of compliance leading to underreporting of symptoms. An additional 3rd hypothesis assumes that the effect of psychological distress on response patterns is strong for reporting psychological symptoms but insignificant for musculoskeletal symptoms. The hypotheses were tested and explored with data from the Dutch Survey of General Practice, a nationwide study among 161 GPs. A random sample of 100 patients per GP was approached for a health interview and asked to keep a structured health diary during three weeks. Symptoms were recorded during the interview with a checklist and queried in the health diary with open-ended questions. The occurrence of symptoms was modelled with logistic regression. High levels of psychological distress increase the likelihood of recording symptoms for both instruments, but the increase is greater for the interviews. Respondents who have only received limited education, heavy smokers and those who suffer from chronic conditions have a significantly lower likelihood of recording symptoms in the diary as compared to the questionnaire. There was no significant effect of taking an interest in health matters, gender, and work and domestic role obligations. Taking the nature of symptoms into account, it was found that psychological distress had indeed a great effect on the response pattern for psychological symptoms, but not for musculoskeletal symptoms. The criticism that symptom checklists are sensitive to psychological distress rather than to physical illness alone, is confirmed in this study. Open-ended questions prevent biased responses, but result in fewer symptoms being recorded. Health diaries with open-ended questions 'produce' more symptoms but take more effort to complete, requiring sufficiently motivated respondents. It is recommended that a less biased specific list for the assessment of acute symptoms be developed.