University research highlighted at British Sociological Association conference
People living in the most deprived neighbourhoods are more likely to die alone at home than those in the least deprived areas, new research says.
They were also less likely to die in a hospice or care home, two researchers from Edinburgh Napier found.
Dr Anna Schneider and Dr Iain Atherton analysed data on all 53,517 people who died within a year after the Scottish census 2011, using the census and death record data.
Dr Schneider told the British Sociological Association medical sociology conference in Glasgow that in 2011 those who were close to death in the most deprived areas were less likely to be living with a family member or friend who was a carer in the house than those in the least deprived areas.
In the last 12 weeks of their life, 37% of those in the least deprived areas lived with a family member or friend who was a carer, but only 28% of those in the most deprived areas did, she said.
When the statistics were adjusted to compare people of the same age, sex and cause of death, in order to isolate the effects of deprivation, the difference between areas was even greater.
The researchers also found that people in the most deprived areas were 37% less likely to die in a care home or hospice – 13% died in a care home, 6% in a hospice, 53% in hospital and 28% at home. They died on average at age 72.5.
For those in the least deprived areas, 22% died in a care home, 8% in hospice, 20% at home and 50% in hospital. They died on average at age 78.8.
When the statistics were adjusted to compare people of the same age, sex and cause of death in order to isolate the effects of poverty, the difference was reduced, but still existed.
“Our research shows that neighbourhood deprivation has an influence on how people spend their last months of life in Scotland,” said Dr Schneider.
“People living in deprived areas are more likely to die in hospital or at home and less likely to access services like hospices or care homes. They are also less likely to receive informal help at home, because they more frequently live alone and have a lower chance of living with a carer.
“End of life care has received much attention from policy makers in the last years, but in order to improve end of life care provision we need a better understanding of the social and economic inequalities in the circumstances people experience at the end of their lives. Administrative data such as we have used provide an unparalleled opportunity to do so.”
Statistics summary: In the least deprived areas of Scotland, 22% die in a care home and 8% in hospice, a total of 30%. For those in the most deprived areas, 13% die in a care home and 6% in a hospice, a total of 19%. The difference between 30% and 19% is just over a third, 37% (11 percentage points).
37% of those in the least deprived areas had a caregiver in the house, but only 28% of those in the most deprived areas, a difference of just under a quarter, 24% (9 percentage points).
The study uses the Scottish Index of Multiple Deprivation, which is not just an indicator of poverty but is also a measure of availability of services such as health care, and of opportunities for employment and education. In this survey, 25% of those surveyed were in the most deprived areas and 15% in the least deprived.