National Performance Framework - disability perspective: analysis

Executive Summary

This report compares the outcomes and experiences of disabled people to those of non-disabled people using indicators drawn from Scotland's National Performance Framework (NPF). This is an update to work published in 2019, and provides new indicator data primarily drawn from 2019 onwards, but prior to the COVID-19 pandemic. This report also reflects on the impacts COVID-19 has had on disabled people.

Disability is defined in the Equality Act 2010 as a long-lasting health condition that limits daily activity. This two stage definition is used in most large scale surveys in Scotland. In 2019, the Scottish Health Survey (SHeS) estimated that 35% of adults and 11% of children were disabled.^[1]

In total the NPF contains 11 outcomes which are measured by 81 indicators; 13 of which are in development and 20 of which relate to national level data or structures rather than individuals. From the remaining 48 NPF indicators, eight cannot provide a breakdown by the disability protected characteristic.

Two new indicators have been added since the 2019 report, both of which are included in 'communities':

• Loneliness – a measure of which is drawn from the Scottish Household Survey (SHS)
• Places to Interact – also drawn from the SHS

Across the outcomes for which we have data, a considerable number of indicators suggest that disabled people face some barriers to fully participating in Scottish society. For example:

• The rates of combined material deprivation and low income have been consistently higher in families with a disabled member
• Relative poverty rates were consistently higher where a household had a disabled member than where they did not
• Disabled people are more likely to have experienced food insecurity than non- disabled people
• There is lower mental wellbeing among disabled adults, along with higher levels of loneliness, higher engagement in health risk behaviours, and higher rates of difficulties among disabled children^[2]
• There are lower rates of cultural participation and attendance among disabled people along with lower rates of access to green (parks, woods and countryside) and blue (rivers, lochs, coasts) space and visits to the outdoors

There have also been some significant changes since the last report was published in 2019^[3], a number of which are positive:

• Between 2017 and 2019 the percentage of adults with a limiting long-term condition meeting physical activity guidelines rose significantly from 49% to 55%
• In 2017 there was little difference in the percentage of people with a healthy weight when considering adults with limiting long-term conditions, and adults without a limiting long-term condition. However, by 2019 there was a statistically significant difference. In 2019, 28% of adults with a limiting long-term condition were a healthy weight, compared to 35% of adults without a limiting long-term condition
• The proportion of disabled adults who were confident that everyone has access to the justice system when they need it increased significantly from 68% in 2017/18 to 73% in 2018/19
• In 2017, 21% of disabled people agreed with the statement "I can influence decisions affecting my local area", but by 2019 this had reduced significantly to 17%^[4]

In addition, this report also considers some of the ways COVID-19 is affecting disabled people. Indicator data which covers the COVID-19 pandemic is not yet available, but additional indicator data from a range of small-scale UK and Scottish surveys can provide some insights:

• Disabled adults have a range of limiting long-term physical health conditions, such as those affecting the heart and respiratory system, which are linked to increased vulnerability to COVID-19
• Disabled people are likely to have experienced increased mental health issues as a result of the COVID-19 pandemic
• Disabled people have faced disruption to health and social care arrangements as a result of the COVID-19 pandemic
• The COVID-19 pandemic is likely to have exacerbated food insecurity for disabled people
• There is also evidence indicating that disabled people are likely to come out of the COVID-19 pandemic in more debt