Comparing Antonovsky's sense of coherence scale across three UK post-industrial cities

Walsh, D., McCartney, G., McCullough, S., Buchanan, D. and Jones, R. (2014) Comparing Antonovsky's sense of coherence scale across three UK post-industrial cities. BMJ Open, 4(11), e005792. (doi: 10.1136/bmjopen-2014-005792) (PMID:25424994) (PMCID:PMC4248084)

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Objectives: High levels of ‘excess’ mortality (ie, that seemingly not explained by deprivation) have been shown for Scotland compared to England and Wales and, especially, for its largest city, Glasgow, compared to the similarly deprived English cities of Liverpool and Manchester. It has been suggested that this excess may be related to differences in ‘Sense of Coherence’ (SoC) between the populations. The aim of this study was to ascertain whether levels of SoC differed between these cities and whether, therefore, this could be a plausible explanation for the ‘excess’. Setting: Three post-industrial UK cities: Glasgow, Liverpool and Manchester. Participants: A representative sample of more than 3700 adults (over 1200 in each city). Primary and secondary outcome measures: SoC was measured using Antonovsky's 13-item scale (SOC-13). Multivariate linear regression was used to compare SoC between the cities while controlling for characteristics (age, gender, SES etc) of the samples. Additional modelling explored whether differences in SoC moderated city differences in levels of self-assessed health (SAH). Results: SoC was higher, not lower, among the Glasgow sample. Fully adjusted mean SoC scores for residents of Liverpool and Manchester were, respectively, 5.1 (−5.1 (95% CI −6.0 to −4.1)) and 8.1 (−8.1 (−9.1 to −7.2)) lower than those in Glasgow. The additional modelling confirmed the relationship between SoC and SAH: a 1 unit increase in SoC predicted approximately 3% lower likelihood of reporting bad/very bad health (OR=0.97 (95% CI 0.96 to 0.98)): given the slightly worse SAH in Glasgow, this resulted in slightly lower odds of reporting bad/very bad health for the Liverpool and Manchester samples compared to Glasgow. Conclusions: The reasons for the high levels of ‘excess’ mortality seen in Scotland and particularly Glasgow remain unclear. However, on the basis of these analyses, it appears unlikely that a low SoC provides any explanation.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Walsh, Dr David
Authors: Walsh, D., McCartney, G., McCullough, S., Buchanan, D., and Jones, R.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
Journal Name:BMJ Open
Publisher:BMJ Publishing Group
ISSN (Online):2044-6055
Published Online:25 November 2014
Copyright Holders:Copyright © 2014 The Authors
First Published:First published in BMJ Open 4(11):e005792
Publisher Policy:Reproduced under a Creative Commons License

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