Guest blog: What can the census can tell us about deprivation and poor health?

Scotland in 2001 was remarkably different from Scotland in 2011.

Between 2001 and 2011, the population grew by more than 200,000 people. Household incomes – adjusted for inflation – grew by nearly 20%. These years also marked a massive cultural shift. Take internet access, for instance: around one third of households in the UK had the internet in 2001. In 2011, this had grown to over 75% of all households.

At the same time, life expectancies grew significantly, by an average of two years for women and more than three years for men. This is a huge leap, although Scotland nevertheless had the lowest life expectancy in Western Europe in both years. Scotland was furthermore plagued by inequalities in health, with wide differences between people living in deprived and non-deprived areas across the decade.

With this in mind, how did Scotland change between 2011 and 2022, the date of the most recent census? Given the changes that occurred between the two preceding censuses, we would expect a to see a very different Scotland in 2022. After all, the UK changed massively between 2011 and 2022: in 2011, Scotland was only a few months into the UK government’s decade-long austerity period; 2016 saw the UK exiting the EU; and 2020 was marked by the Covid-19 pandemic.

In fact, Scotland of 2022 continued to be characterised by inequities in health outcomes. After several decades of steady growth in life expectancies and average incomes alike, Scotland has stagnated in both areas. Life expectancies in the wealthiest parts of the country exceeded those in the poorest by more than ten years. Importantly, people in Scotland in 2022 were more likely to report that they are in poor health than they were in 2011. People were more likely to cite ill health as a reason for being out of work in 2022, as well. The number of people with disabilities or long-term limiting health conditions, particularly mental health conditions, skyrocketed over the decade, especially among young women.

This trend impacted people living in the most deprived neighbourhoods the hardest. While people in wealthier parts of the country also reported worse health over the decade, they did so at a much slower rate. This means that gaps in outcomes between the most and least deprived parts of Scotland have widened.

Worsening health has system-wide impacts. In 2022, people in Scotland were also more likely to be economically inactive to care for their home and family. The burden of unpaid care grew between 2011 and 2022. Again, people in deprived areas had higher rates of unpaid care provision and were more likely to spend 35 hours per week or more providing unpaid care.

The fact that the differences between deprived and non-deprived areas are growing is concerning. Over the next few months, the census will publish data which examines multiple variables at once. This should allow us to understand how health varies for people across other social and economic circumstances, in addition to deprivation. Currently, we know that people living in deprived areas are less likely to own their own homes, less likely to be employed, and less likely to have a degree-level education than people in non-deprived areas. We know that gaps in all of these areas have not improved since 2011. We understand that these factors are connected to health outcomes, though their impact is complex and multifaceted. We are working to gain a deeper understanding of the full extent of these relationships.

At the Scottish Health Equity Research Unit, our goal is to continue to shed light on these gaps, providing insight into the socio-economic factors which shape health. To read our report on these changes, and see our other insight, visit us here.