Coronavirus (COVID-19) - disabled people: health, social and economic harms - research report

Introduction

This report uses demographic data and data on deaths involving COVID-19 to assess whether COVID-19 mortality rates for disabled people in Scotland are similar to rates in England and Wales. Mortality rates are a way of measuring the number of deaths (in this case involving COVID-19) in a particular population, scaled to the size of that population.^[8] In this analysis we are interested in the number of disabled people whose deaths have involved COVID-19 out of a population of 100,000 disabled people.

The Scottish Government supports the 'social model' of disability, which sees the barriers created by society – such as negative attitudes towards disabled people, and inaccessible buildings, transport and communication – as the cause of disadvantage and exclusion, rather than the impairment itself.^[9] However, it should be noted that as the social model is seldom used in the context of survey-based data collection, statistics using this definition are limited. Instead, the statistics cited here use the 'medical model' of disability, which views an individual as being disabled by their impairment.

Impact of COVID-19 on mortality rate for disabled people

Provisional analysis from the ONS, released in September 2020, demonstrated that after adjusting for region, population density, socio-demographic and household characteristics, the relative difference in mortality rates between those disabled and limited a lot and those non-disabled was 2.4 times higher for women and 2.0 times higher for men in England and Wales.^[10] The analysis compared the risk of death involving COVID-19 according to a person's disability status, as recorded in the 2011 Census, and found that disabled people, including those with conditions relating to aging, made up almost 6 in 10 (59%) of all COVID-related deaths from 2^nd March to 14^th July 2020^[11].

When ONS considered the age-standardised mortality rates (ASMRs)^[12] for deaths involving COVID-19 in England and Wales, they found that relative gaps in ASMRs between disabled and non-disabled men and women were largest amongst those aged 9 to 64 years. The largest relative gap was between women aged 9 to 64 years who were disabled and limited a lot who had a rate of death involving COVID-19 10.8 times greater than non-disabled women in this age group. Men aged 9 to 64 years who were disabled and limited a lot had a rate of death involving COVID-19 6.5 times greater than non-disabled men. Relative gaps in ASMRs between non-disabled and disabled groups were smaller in the 65 years and over age group. Men aged 65 years and over, who were disabled and limited a lot, were 2.4 times more likely and women were 3.1 times more likely to die than their counterparts who were non-disabled.^[13]

It should be noted that new ONS estimates of COVID-related deaths in England by disability status covering the period between 24 January to 20 November 2020 was published in February 2021.^[14] This analysis uses linked data from the 2011 Census, death registrations, and primary care and hospital records. The NRS work due to be published in March 2021 uses a similar model to the ONS analysis published in September 2020; using linked data from the 2011 Census and death registration data.

Our assessment is that the NRS results are likely to be similar to the ONS findings on England and Wales for the following reasons:

• Demographics of the disabled population are broadly similar in Wales/England and Scotland.
• Frequency of long term-conditions are similar in Scotland, England and Wales.
• Demographic profile of COVID related death is similar.
• Frequency of types of pre-existing health conditions involved in COVID deaths are similar for older people.

These reasons will be discussed in more detail in the following sections. Section 1 will begin by comparing the demographic profiles of the disabled populations of England/Wales and Scotland. It will then compare the frequency of long-term health conditions in Scotland, England and Wales.

Section 2 will move on to consider the demographic profile of COVID-19 deaths in England/Wales and Scotland, before moving on to consider the frequency of types of pre-existing health conditions involved in COVID deaths in England/Wales and Scotland. Section 2 then goes on to explain the weaknesses in the data, for example issues around the age of the most recent Census.

Section 3 will provide statistics on COVID-19 mortality rates for people with learning/intellectual disabilities in Scotland. Finally section 4 will consider the wider impacts of COVID-19 on disabled people in Scotland, including: non-COVID health and social care impacts; social impacts, and economic impacts. We will conclude by offering the next steps we are taking to better understand the impact COVID-19 is having on disabled people.