New Scotland-wide data resource sheds light on disability, living arrangements and COVID-19 inequalities
A new Scotland-wide linked data resource is helping researchers understand how COVID-19 outcomes differed by disability and where people lived. The cohort brings together information for almost 3.72 million adults, allowing disability, household living arrangements and COVID-19 health outcomes to be studied together at a scale rarely possible in previous research.
Described in a new cohort profile published in the International Journal of Population Data Science (IJPDS), the resource links Scotland’s health register with the 2011 Scottish Census, residential address information, COVID-19 testing records, hospital admissions and death registrations.
This made it possible to identify people with intellectual and physical disabilities and examine their health outcomes alongside household size and whether they lived in private homes or communal settings.
The final cohort included 3,719,651 adults aged 16 years and over who were living in Scotland at the start of the pandemic and could be linked to Census records. Among them, 17,354 had an intellectual disability and 377,706 had a physical disability.
Between March 2020 and April 2022, 306,343 people in the cohort had a laboratory-confirmed COVID-19 infection, 22,945 were hospitalised with COVID-19 and 12,893 died from COVID-19-related causes.
Important differences were visible across both disability status and living arrangements. After accounting for age and sex, rates of infection, hospitalisation and mortality were higher among adults with intellectual and physical disabilities than among people without reported intellectual or physical disability.
Rates were also markedly higher among people living in communal establishments than among those in private homes, with the largest differences seen for COVID-19 mortality.
These comparisons are descriptive and do not by themselves show that disability or residential setting caused the differences.
The cohort profile is part of a wider programme of work by Yusuff Adebayo Adebisi, Angela Henderson, Nick Bailey, Chris Dibben and Serena Pattaro. A study protocol, previously published in BMJ Open, set out how the linked cohort would be constructed and analysed, while a subsequent national analysis used the cohort to examine inequalities in COVID-19 outcomes among adults with intellectual and physical disabilities.
The new cohort profile documents the data resource itself: how it was built, who it includes and what kinds of questions it can answer.
Its value also extends beyond COVID-19. By combining disability information with detailed residential and household data, the resource can support research into healthcare use, other infectious diseases, long-term conditions, mortality and wider health inequalities among disabled people.
Lead author Yusuff Adebayo Adebisi said: “COVID-19 showed that health risks are shaped not only by individual characteristics, but also by the environments in which people live.
“Bringing disability and residential context together in one national linked dataset gives us a stronger basis for understanding where inequalities are concentrated and for developing more inclusive public health responses, both during future health emergencies and beyond.”
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Yusuff Adebayo Adebisi, PhD Researcher, Administrative Data Research (ADR) Scotland, University of Glasgow, United Kingdom