Scotland's most deprived 'more likely to die alone at home'

Study shows impact of health inequalities on end-of-life care across areas of country

People in the most deprived areas of Scotland are more likely to die alone at home, according to research that reveals the significant impact of health inequalities on end-of-life care.

Researchers at Edinburgh Napier University also discovered that elderly people in those areas were 37% less likely to die in a care home or hospice than those living in the least deprived areas.

Dr Anna Schneider and Dr Iain Atherton analysed data on 53,517 individuals who died in the year after the 2011 Scottish census, combining statistics from NHS Scotland and National Records of Scotland.

Schneider, who will present her findings at the British Sociological Association medical sociology conference in Glasgow on Thursday, found that, in the last 12 weeks of their lives, 37% of those in the least deprived areas lived with a family member or friend who was a carer, compared with 28% of those in the most deprived areas.

Higher deprivation was connected to a greater chance of living alone. In the last 12 weeks of their lives, 23.3% of people in the least deprived areas lived alone, as opposed to 38.4% of those in the most deprived areas.

Schneider said she believed this related to a mixture of inequalities in the availability of professional care and a family’s personal social networks and their ability to look after dying relatives.

Schneider said: “Elderly people are most likely to live alone in deprived areas. While people adjust their living arrangements towards the end of life based on their personal need, it may be that those who are more deprived have fewer resources available to them to make the changes they want to.”

The researchers found that, of those who died in the most deprived areas during the research period, 13% did so in a care home, 6% in a hospice, 53% in hospital and 28% at home. They died on average aged 72.5, 6.3 years earlier than someone in the least deprived areas.

For those in the least deprived areas, 22% died in a care home, 8% in a hospice, 20% at home and 50% in hospital. On average, they died aged 78.8.

Scotland continues to have some of the lowest life expectancy rates in western Europe, with the country also trailing behind the UK as a whole. The average male life expectancy north of the border is 77.1, compared with 79.2 for the UK.

The researchers used the Scottish index of multiple deprivation, which is an indicator of poverty but also a measure of availability of services such as healthcare, and of opportunities for employment and education. In this study, 25% of those surveyed were in the most deprived areas and 15% in the least deprived.


Libby Brooks Scotland correspondent

The GuardianTramp

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