Healthy Halifax Lifestyle Survey

Background
For the period 2009 to 2011, NHS Calderdale, in partnership with Calderdale Metropolitan Borough Council, was awarded
£2 million for ‘Healthy Halifax’ as part of the UK government’s Healthy Towns Programme. The overall aim of 'Healthy
Halifax' was to target initiatives on facilitating healthier lifestyles in local populations living in four Calderdale wards with
the greatest health inequalities and poorest health outcomes. As part of understanding 'what works' and how best to meet
the health needs of these target populations, a lifestyle survey was undertaken across the four wards.
Method
The Healthy Halifax lifestyle survey was designed and distributed based on the most up-to-date evidence-based
recommendations, and sought to elicit population data on health-related attitudes and behaviours, physical activity, diet,
alcohol consumption, smoking, and perceptions of community. Demographic and anthropometric information was also
collected.
Surveys were distributed in two phases, March to May 2011 and October to November 2011. A random sample of
postcodes from the target wards was generated using a Royal Mail address database, and survey booklets were distributed
to all domestic addresses within each randomly selected postcode. The main method of survey distribution was
door-to-door, either conducted by a bilingual member of the community to overcome language and/or literacy barriers,
or by a trained interviewer familiar with the local area.
The target response rate was 250 completed surveys per ward, and following completion of Phase 1, under-represented
groups based on gender, ethnicity and age (working age or retired) were identified by comparison of respondents with ward
profile proportions, and a target quota sample was calculated. In Phase 2, target respondents were identified on-street or
door-to-door by a market research team, and the surveys were completed using face-to-face
Interview methods.
Results
The Healthy Halifax lifestyle survey sample (n=1339) was found to be representative of the target wards when compared
with ward profile demographics. This resulted in an accurate and rich source of health data collected from traditionally
under-represented, hard to reach groups. Findings suggest that poor health behaviours constitute predominant social
norms within these wards, but differences in health behaviours were observed both within and between the target wards,
indicating that generalised area interventions informed by local and national policy may not be accurate (and therefore not
effective) as they do not reflect the complexities of individual populations. However, findings also suggest that there is clear
potential to invest and build on existing community assets in order to increase social capital and create more sustainable
changes in order to reduce health inequalities.
Conclusions
Findings from the Healthy Halifax lifestyle survey appear to recommend a bottom-up community development approach
alongside a top-down commissioner approach to target resources where they are most needed. More detailed,
longitudinal research and evaluation within target populations is needed in order to increase knowledge of health
behaviours and attitudes in such communities and measure changes over time.