Women's health plan 2021 to 2024: data landscape review
Accompanies the women’s health plan 2021-2024 final report and sets out a range of publicly available data on the health of women and girls in Scotland.
3. Summary and gaps
3.1 Summary
While not intended to be comprehensive in coverage, this report has highlighted that a range of publicly available data on the health of women exist, with key sources including the Scottish Health Survey, data published by Public Health Scotland (PHS) and data published by National Records of Scotland (NRS).
The table below summarises the sources covered in this paper and includes a brief description of the data available from each. Throughout this exercise a number of gaps in the publicly available data have been identified which are discussed below, before next steps are outlined.
| Dataset name | Source | Frequency of publication | Topic covered | Description |
|---|---|---|---|---|
| Life expectancy in Scotland, 2021-2023 | National Records Scotland | Annually | Life expectancy (LE) | Provides a comparison of life expectancy and healthy life expectancy between males and females and presents changes over time. LE and HLE trends, disaggregated by sex, provide a useful insight into the overall health of a population and allow comparisons to be made between Scotland and other countries. |
| Healthy life expectancy in Scotland, 2019-2021 | National Records Scotland | Annually | Healthy life expectancy (HLE) | |
| Scottish Health Survey 2022 | Scottish Government | Annually | Self-assessed general health, mental health, coronary heart disease/ ischemic heart disease, chronic pain, physical activity, obesity, smoking, alcohol, unpaid carers | SHeS provides data on the health of adults (16+) and children (0-15) living in Scotland. It is a useful tool for monitoring trends in population health conditions, health behaviours and provision of unpaid care. It allows analysis to be conducted across different characteristics such as sex, age, income, area deprivation and disability status. |
| It covers a range of health topics such as general wellbeing, mental health, heart disease, chronic pain and obesity. Data on health behaviours allow us to understand the prevalence of certain risk factors for diseases, for example levels of physical activity, smoking and alcohol consumption across different cross-sections of the population. It also provides data on the provision of unpaid care disaggregated by sex and the impacts of unpaid caring responsibilities. | ||||
| Scotland's Census 2022 - Health, disability and unpaid care | Scotland's Census | Every 10 years | Mental health, unpaid carers | Scotland’s Census is the official count of every person and household in the country. The Census provides data on health, disability and unpaid care across the population and disaggregates these data by age and sex. |
| The Census is a good data source for monitoring the health of the entire population and has been useful for highlighting key gender gaps in health. For example, 2022 data has highlighted that young women (aged 16-24) are nearly twice as likely to report a mental health condition compared with their male counterparts (20% and 11% respectively). However, as it is only published every ten years, regular trend analysis cannot be conducted. | ||||
| Mental Health Inpatient Census 2022 | Scottish Government | Annually | Mental health inpatients | The Mental Health Inpatient Census is carried out by the Scottish Government and all NHS Boards annually. It covers patients occupying mental health, addiction and learning disability beds who are funded by NHS Scotland at a point in time, together with patients receiving Hospital Based Complex Clinical Care (HBCCC). |
| The Mental Health Inpatient Census enables us to track differences in mental health care provision between men and women, but only across mental health inpatients, not across the general population. | ||||
| Long-Acting Reversible Contraception (LARC) Key Clinical Indicator (KCI) 2024 | Public Health Scotland | Annually | LARC methods contraception | PHS publish data on LARC methods of contraception in primary care and sexual health settings which is useful for monitoring uptake of these methods over time and across different settings. LARC includes the contraceptive implant, the intrauterine decide (IUD) and intrauterine system (IUS) and therefore does not give us information on other reversible methods of contraception such as the contraceptive pill or barriers methods, such as condoms. |
| Dispenser payments and prescription cost analysis 2024 | Public Health Scotland | Annually | Contraception and female sex hormones and their modulators (including HRT) | PHS collect data on prescriptions dispensed in community pharmacies which may add value to our understanding of healthcare provision. However, these data are not published with the intention of monitoring population health and they do not cover prescriptions dispensed elsewhere (for example in hospital pharmacies or sexual health clinics), therefore caution is advised when interpreting results. |
| The report includes the number of contraception and emergency contraception prescriptions dispensed. It should be noted that because these data only cover prescriptions dispensed in community pharmacies and not those prescribed in other settings such as sexual health clinics, the data could be under reporting. | ||||
| Additionally, the report covers the dispensing rate of female sex hormones and their modulators which includes Hormone Replacement Therapy ( HRT) to treat the symptoms of menopause. However, it should be noted that whilst these data may include HRT it cannot be said whether this trend represents the dispensing rate of HRT for treating menopause symptoms alone. | ||||
| Teenage Pregnancy Statistics 2023 | Public Health Scotland | Annually | Teenage pregnancy | This annual release by PHS allows us to monitor rates of teenage pregnancies over time and has highlighted the recent increases. These data are disaggregated by age, area deprivation, outcome of pregnancy, health board and local authority allowing us to understand differences in trends across multiple groups. It also provides data for England and Wales which provide useful context. |
| Termination of pregnancies 2023 | Public Health Scotland | Annually | Termination of pregnancies | This annual release by PHS provides an update on termination of pregnancies. Trend analysis allows us to monitor rates across time which has highlighted the recent stark increase in terminations of pregnancies. Data are disaggregated by age, place, known ethnicity, area deprivation as well as previous termination, statutory ground, gestation and method of termination. |
| Births in Scottish Hospitals 2023 | Public Health Scotland | Annually | Pregnancy, childbirth, early care of babies | This annual release by PHS reports on pregnancy, childbirth and the early care of babies born in Scotland. This allows us to monitor live birth rates, gestation at birth, birthweight, neonatal care required as well rates of maternal BMI and diabetes. |
| Maternity Care Survey 2018 | Scottish Government and National Records of Scotland | 2013, 2015, 2018 | Antenatal care, labour and birth, postnatal care in hospital/ midwife-led unit, neonatal care, feeding, postnatal care at home and community | The Maternity Care Survey was run by the Scottish Government, with support from NRS. It gives us insight into NHS maternity care experience from antenatal care through to care at home after birth. The latest published report covers data collected in 2018 which was the third iteration of the survey with the first run in 2013 and the second in 2015. This means that publications only represent pre-pandemic results and follow up analysis cannot be conducted. |
| Endometriosis UK | Endometri-osis UK (Public Health Scotland data) | One-off | Endometrios-is diagnoses, admissions and waiting times for diagnoses/ treatment | This report was published by Endometriosis UK and analysed endometriosis data from PHS. It gives us some insight into age groups most likely to be diagnosed with endometriosis and waiting times for laparoscopy. However, due to the lack of a clear methods approach in the report and lack of transparency into the specific data used, as well as only presenting data from 2015/16 and 2019/20, it could not provide us with a trend analysis and interpretation of data is limited. |
| The Scottish Burden of Disease study 2019 | The Scottish Burden of Disease | Ad hoc | Disease prevalence by sex - Alzheimer's and dementias and ischemic heart disease | This study is useful for understanding the burden of different diseases across Scotland and provides a comparison of disease prevalence between males and females. It has highlighted the burden of diseases such as Alzheimer’s and dementia and ischemic heart disease has on women in Scotland. However, it is updated on an ad hoc basis with the latest update being 2019, therefore it may not be the most reliable source for monitoring population health. |
| Cancer incidence in Scotland 2023 | Public Health Scotland/ Scottish Cancer Registry | Annually | Cancer incidence - breast and cervical cancer | This annual release by PHS provides an update of cancer incidence statistics in Scotland from January 1997 to December 2021. The Scottish Cancer Registry collects information on every cancer in Scotland and uses data to inform cancer control. These data are disaggregated by sex which allows us to monitor which cancers are most prevalent in women. |
| Scottish breast screening programme statistics 2023 | Public Health Scotland | Annually | Breast screening uptake | This annual release by PHS provides an update on breast screening statistics. It includes Scottish Breast Screening Programme (SBSP) performance standards, attendance figures, cancer detection rates, biopsy results and screening outcomes. This report provides us with information on public health surveillance and prevention programmes across different groups of the population. |
| Scottish cervical screening programme statistics 2023 | Public Health Scotland | Annually | Cervical cancer screening uptake | This release by PHS provides annual and quarterly cervical screening statistics. It reports on screening population coverage by age group, NHS board, deprivation and HPV immunisation status. As above, cancer screening data provides us with information on public health surveillance and prevention programmes across different groups of the population. For example, it has highlighted that cervical screening uptake is lowest in young women (age 25-29) and those from deprived areas. |
| Health and Care Experience Survey 2021/22 | Scottish Government/ Public Health Scotland | Annually | Experiences with health and social care | The Health and Care Experience Survey (HACE) is run in partnership by the Scottish Government and Public Health Scotland. |
| It is useful for monitoring experiences of those who engage with health and social care services and disaggregates data by sex (though these breakdowns are not published annually). The survey allows us to gain insight into differences in satisfaction in service provision between men and women and highlights areas where patients feel there is a need for improvement. It should be used for analysing health and social care experiences rather than being used as a tool for monitoring disease prevalence in the population due to its sampling method not being representative of the population. | ||||
| NHS waiting times - stage of treatment statistics 2024 | Public Health Scotland | Quarterly | Outpatient and inpatient waiting times for different specialties including gynaecology | This report gives us an annual update on NHS waiting times across different specialties. It allows us to monitor the time patients are waiting to be seen for inpatient and outpatient gynaecology appointments. Further analysis broken down by sex would provide useful insight into waiting times experienced by women across all specialties. |
| General practice workforce 2023 | NHS Education Scotland | Annually | Headcount and WTE for GPs, nurses and other GP staff by age, sex and staff group | This annual release by NHS Education Scotland (NES) provides information on the GP workforce contracted to work in Scottish practices. It includes information about the number of GP practices and profile of patients registered. It allows us to monitor the proportion of women in the general practice workforce. |
| Primary care Out of Hours Workforce Survey 2023 | NHS Education Scotland | Annually | GPs and nurses working in primary care OoH, challenges and experiences in filling shifts, use of multi-disciplinary teams | Published annually by NES, the Primary Care Out of Hours (OoH) Workforce Survey has been designed to capture information from the Primary Care OoH services in each NHS Board area. As these data are disaggregated by sex it provides insight into the proportion of women in the primary care out of hours workforce. |
3.2 Data gaps
A number of gaps in the published data were identified in completing this exercise, particularly around reproductive health and female-specific health conditions. These gaps are outlined below.
Firstly, there is a lack of published data on menstrual health. This includes information on menarche, painful and heavy periods, premenstrual syndrome (PMS), period poverty, menstrual migraines, polycystic ovary syndrome (PCOS) and endometriosis. Future research could focus on examining the prevalence of these conditions, for example through analysing clinical datasets, as well as developing our understanding of women’s experiences of these conditions.
The lack of publicly available data on endometriosis in Scotland may be in part due to the challenges associated with diagnosing the condition, which make it difficult to collect data on its prevalence and the experiences of affected women. The only identified published Scottish data on endometriosis was included in a report conducted by Endometriosis UK which analysed PHS data. However, as this was a one-off report which covered the period 2015/16 to 2019/20, more recent trend data on the prevalence of endometriosis and waiting times for care cannot be explored using publicly available information.
There is also a lack of published data on the menopause in Scotland. PHS publish data on the levels of female sex hormones and their modulators dispensed in community pharmacies, including HRT used to treat menopause symptoms. Whilst these data may indicate how many women are receiving treatment for menopause symptoms, it may also include patients receiving female sex hormones to treat other conditions. Therefore, it is not a reliable indicator of the number and rate of prescriptions of HRT being prescribed to treat menopausal symptoms specifically.
Additionally, there is a gap in the publicly available data on the average age of menopause in Scotland and the prevalence of associated symptoms. However, questions on menopause and perimenopause have been introduced for the first time in the Scottish Health Survey 2024 which will be published in 2025.
Another gap is the lack of published data on contraception. Whilst PHS publish routine data on the prescription of LARC methods, this does not include other reversible methods such as the combined and progesterone-only contraceptive pill and barrier methods such as condoms. As mentioned, PHS publish dispensing data on forms of contraception dispensed by community pharmacies, but these do not include sexual health clinics. It would be valuable to understand more about the provision of all contraception in Scotland given the recent increases in terminations of pregnancies and teenage pregnancies.
There is also a lack of data on miscarriages and infertility across Scotland. No published data was identified during this exercise that covers miscarriages. This may be partly due to the difficulty in quantifying miscarriages as many happen before women know they are pregnant. Similarly, it is difficult to monitor infertility as many women may not engage with their health practitioner for a number of years before seeking treatment.
Overall, although there are sources which allow us to analyse women’s health by various characteristics, there is limited data published on under-represented and marginalised groups and more vulnerable populations due to small sample sizes in national surveys. This reflects a gap in the data landscape which would allow for a more detailed understanding of health inequalities across Scotland.
3.3 Next steps
Going forward, the sources identified in this scoping exercise will inform the development of the next phase of the WHP. Further work will be undertaken to explore the sources and their implications in more detail as well as to address the gaps in the published data identified, ensuring that we continue to strengthen the evidence-base on the health of women in Scotland.
Contact
Email: socialresearch@gov.scot
There is a problem
Thanks for your feedback