Scottish Government

CHAPTER THREE. DEMOGRAPHIC PROFILE, GENERAL HEALTH AND LONG-STANDING CONDITIONS

Demographic information

3.1 As noted in Chapter 2, data was weighted by sex, age, tenure and social class. This weighting ensured that the sample was representative for these key variables, notably when compared with the 2001 Census. The sample distribution across the six urban/rural categories was also in line with data from the most recent Scottish Household Survey. Subject to estimated sampling error, this sample is representative of the adult population of Scotland. Those interviewed were aged between 16 and 90 and the weighted male/female ratio was 47/53%. Respondents in the main study sample described themselves primarily as white/Scottish (80%) with most of the remainder (16%) seeing themselves as white/other British. With 3% of respondents classifying themselves as white/other, only 1% of those interviewed described themselves as non-white. This profile is very much in line with the 2001 Census data.

3.2 Demographic details were collected for the survey respondent only and it was not therefore possible to obtain information on household structure. The demographic details were collected to ensure that the sample was properly representative and also to assess which factors most influenced people's attitudes across the range of NHS services. More information about the key demographic factors is given in 3.10-16.

3.3 A quarter of people in the sample were living alone and a third were in households with one other person. A further 18% of respondents lived in households consisting of three people, while nearly a quarter (23%) were in homes with four or more members. Just over half (53%) of those aged 65+ were living alone, and 41% of this age group were living with one other person. Thirty percent of all respondents lived in a home with a child aged under 16 and a similar proportion of households contained an adult aged over 60 years. The average number of people per household was 2.5.

3.4 Nearly two-thirds of the weighted sample were owner-occupiers and almost all of the remainder were renting their homes, either from the local authority, Scottish Homes, a housing association or a private landlord.

3.5 Fourteen percent of the weighted sample of respondents were in the professional or managerial social classes (AB). Nearly four in ten (38%) of the sample were living in households in which the chief wage earner was either in unskilled manual work, or in homes entirely reliant on state benefit (DE).

3.6 There were many demographic differences within the sample, notably by social class. The profile of those living in DE households, for example, contrasts with other groups in terms of sex, age, disability and tenure. Table 3.1 shows that DE respondents were much more likely to live in social housing (e.g. renting from Scottish Homes), have a limiting illness/disability, be female or be aged over 65. These profiles should be kept in mind when looking at some of the survey results - for example, if older people hold a particular view and those in DE households have similar but less pronounced attitudes, it is quite possible that there is no real difference by social class because the DE figure is actually a function of the older age profile of these households. The same situation can apply to other factors such as the association between social housing and disability.

Table 3.1: Profile of tenure, age and disability by social class

Base: all = 2600

3.7 Over half of the people in the sample were in paid work (55% including 5% who actually worked for the NHS in Scotland). Of the remainder, just under a quarter were retired (23%), 6% were unemployed (consisting of 3% who said that they were seeking work, and 3% who said that they were not), 5% were in full time education, a further 5% stated that they were permanently disabled, and 4% were not in paid work (including those who work in the home). This profile is broadly representative of Scotland based on the 2001 Census and trends since then.

3.8 Eighteen percent of those interviewed were qualified to degree level. For 13% of the sample, the highest qualifications were Highers and for a further 9%, Standard Grades. A quarter of people interviewed stated that they had no formal qualifications at all.

3.9 The weighted sample profile for 2004 was generally similar to that obtained in 2000, with the exception of social class and the spread of age among the over-55's. The table below shows demographic profile data for both surveys - no direct comparison is drawn with the most recent Census as the latter was used for all 2004 weights, other than social class. The weights for social class were taken from NOP's in-house database. The age difference between the two samples may be a reflection of weighting approaches - it is possible that the 2000 survey was weighted for those aged 65 and over, rather than separately for 65-74 year olds and those aged 75 or over, as was the case in 2004.

Table 3.2: Demographic profiles from the 2000 and 2004 weighted samples.

Base: all = 2600 (in 2004) and 3052 (in 2000)

3.10 It is important to note the relative significance of the factors examined in the demographic analysis. As was the case in 2000, sex and, especially, age were powerful predictors of views and attitudes. Social class was also a significant factor, notably in terms of those living in AB households who had a better self-reported health status and were more aware of the new or modernised NHS services.

3.11 Age, regardless of sex of the respondent, was important in explaining self-reported health, use of home visits, expectations about the future of the health service and, importantly, satisfaction levels with all NHS services.

3.12 Sex of the respondent was only occasionally a powerful factor in explaining attitudes but some examples include awareness of pharmacist services and views about the NHS in recent years.

3.13 Sex interlocked with age was a strong factor in some responses including use of the Out-of-hours service (higher among women aged 16-54), lower expectations of the NHS in the next few years (women aged 35-54) and wishing to give negative feedback on health services (women aged under 65).

3.14 The level of deprivation in the area where the respondent lives was as a strong factor in explaining some views such as self-reported poor health, disability, lower awareness of some NHS services and more optimistic expectations of future performance by the health service.

3.15 People with limiting infirmity, illness or disability were notably likely to use Out-of-hours services, to report poorer health and to have difficulties in physical access to NHS sites. They also were more likely to make negative comments about their experience of using the health service.

3.16 Partly as a function of small sample sizes, other factors examined in the survey, such as tenure and geographical location, only rarely led to significant differences in the data.

Rating of general health

3.17 A few questions were asked in respect of self-reported general health and limiting conditions. The intention of these questions was partly to assess whether the self-reported health status of the sample was similar to that shown in other studies and partly to see if, as elsewhere, people's attitudes to the NHS varied with their health status. Exactly 70% of people interviewed rated their general health over the last twelve months as being either very good or good. Almost one in five (19%) rated it as being fair, while 10% of people said that their health had been bad or very bad. The last reported Scottish Health Survey used the same scale and showed 77% of the sample claiming to be in very good or good health with 6% being in bad health.

3.18 By allocating a point scoring system to each answer (i.e. very good = +2 and bad = -2), it is possible to identify some other significant differences. There were higher than average claimed levels of good health amongst the younger respondents (particularly those aged 16-24), those in AB households and owner-occupiers. People living in the least deprived areas were more likely than other respondents to say that they were in good health.

Figure 3.1: Over the last twelve months, would you say your health has on the whole been …

Base: all = 2600

Long-standing limiting conditions

3.19 The survey used the standard Census questions to assess how many people had a long-standing illness, disability or infirmity and the extent to which this limited their activities. Around one third (35%) of those interviewed reported having a long-standing illness or disability and most of this group (representing 24% of the total sample) said that their activities were limited by their condition.

3.20 There were variations across the sample groups, most markedly by age, deprivation and social class - see Table 3.3. These figures are very similar to those recorded at the 2001 Census which showed 23% of adults with a limiting illness, disability or infirmity. This question was not asked in a comparable format in 2000.

Table 3.3: Do you have any long-standing illness, disability or infirmity? By long-standing, I mean anything that has troubled you over a period of time, or that is likely to affect you over a period of time. IF YES: Does this illness, disability or infirmity limit your activities in any way?

Base: all = 2600

Summary

3.21 The questions on general health and long-standing conditions had two purposes - firstly to check the sample profile and, secondly, to see what impact health status had on people's attitudes to the NHS in Scotland. This data and the demographic profile shows that the sample is representative in respect of key variables such as sex, age, social class, tenure, geographical location and limiting conditions.