Scottish Census Research Articles

Privacy Preserving Evaluation of Sensitive Population Record Linkage in the Absence of Ground Truth Data

ObjectivesLinkage of data containing personal information allows extensive studies in the health and social sciences for population level studies. However, real-world linkage applications often lack ground truth (GT) data, generally due to privacy concerns, which hinders linkage quality assessment. We propose a method to assess the linkage of sensitive population data in the absence of GT data. ApproachOur method takes as input a set of sensitive and public population clusters. The sensitive clusters are generated with some record linkage algorithm, whereas the public population dataset, which is considered an approximation for the GT, is assumed to have a group identifier allowing generation of known clusters, such as households or families. We encode clusters as bit vectors and conduct cluster matching across the sensitive and public datasets using vector comparisons. Based on matched clusters, the population linkage quality of sensitive data is estimated. ResultsWe conducted experiments on a sensitive Scottish birth data set containing 17,613 records from 1861 to 1901, and four successive publicly available Scottish census datasets from 1871 to 1901. Using the quality measures precision, recall and the F-measure, we show that our estimations are close to GT quality, with a high correlation in F-measure values ranging from 88% to 99%. ConclusionWe proposed a method to estimate the linkage quality of sensitive population data for situations where public data with similar characteristics are available for approximating the GT. Our experimental evaluation showed that our method was effective in estimating true linkage quality with high accuracy.

Quality of ethnicity data within Scottish health records and implications of misclassification for ethnic inequalities in severe COVID-19: a national linked data study.

We compared the quality of ethnicity coding within the Public Health Scotland Ethnicity Look-up (PHS-EL) dataset, and other National Health Service datasets, with the 2011 Scottish Census. Measures of quality included the level of missingness and misclassification. We examined the impact of misclassification using Cox proportional hazards to compare the risk of severe coronavirus disease (COVID-19) (hospitalization & death) by ethnic group. Misclassification within PHS-EL was higher for all minority ethnic groups [12.5 to 69.1%] compared with the White Scottish majority [5.1%] and highest in the White Gypsy/Traveller group [69.1%]. Missingness in PHS-EL was highest among the White Other British group [39%] and lowest among the Pakistani group [17%]. PHS-EL data often underestimated severe COVID-19 risk compared with Census data. e.g. in the White Gypsy/Traveller group the Hazard Ratio (HR) was 1.68 [95% Confidence Intervals (CI): 1.03, 2.74] compared with the White Scottish majority using Census ethnicity data and 0.73 [95% CI: 0.10, 5.15] using PHS-EL data; and HR was 2.03 [95% CI: 1.20, 3.44] in the Census for the Bangladeshi group versus 1.45 [95% CI: 0.75, 2.78] in PHS-EL. Poor quality ethnicity coding in health records can bias estimates, thereby threatening monitoring and understanding ethnic inequalities in health.

A neighbourhood Output Area Classification from the 2021 and 2022 UK censuses

AbstractUK‐wide multivariate neighbourhood classifications have been built using small area population data following every census since 1971, and have been built using Output Area geographies since 2001. Policy makers in both the public and private sectors find such taxonomies, typically arranged into hierarchies of Supergroups, Groups and Subgroups, useful across a wide range of applications in business and service planning. Recent and forthcoming releases of small area census statistics pose new methodological challenges. For example, the 2022 Scottish Census was carried out a year after those in other UK nations, and some of the variables now collected across different jurisdictions do not bear direct comparison with one another. Here we develop a methodology to accommodate these issues alongside the more established procedures of variable selection, standardisation, transformation, class definition and labelling.

Ethnic inequalities in positive SARS-CoV-2 tests, infection prognosis, COVID-19 hospitalisations and deaths: analysis of 2 years of a record linked national cohort study in Scotland

BackgroundThis study aims to estimate ethnic inequalities in risk for positive SARS-CoV-2 tests, COVID-19 hospitalisations and deaths over time in Scotland.MethodsWe conducted a population-based cohort study where the 2011 Scottish...

Understanding multimorbidity trajectories in Scotland using sequence analysis

Understanding how multiple conditions develop over time is of growing interest, but there is currently limited methodological development on the topic, especially in understanding how multimorbidity (the co-existence of at least two chronic conditions) develops longitudinally and in which order diseases occur. We aim to describe how a longitudinal method, sequence analysis, can be used to understand the sequencing of common chronic diseases that lead to multimorbidity and the socio-demographic factors and health outcomes associated with typical disease trajectories. We use the Scottish Longitudinal Study (SLS) linking the Scottish census 2001 to disease registries, hospitalisation and mortality records. SLS participants aged 40–74 years at baseline were followed over a 10-year period (2001–2011) for the onset of three commonly occurring diseases: diabetes, cardiovascular disease (CVD), and cancer. We focused on participants who transitioned to at least two of these conditions over the follow-up period (N = 6300). We use sequence analysis with optimal matching and hierarchical cluster analysis to understand the process of disease sequencing and to distinguish typical multimorbidity trajectories. Socio-demographic differences between specific disease trajectories were evaluated using multinomial logistic regression. Poisson and Cox regressions were used to assess differences in hospitalisation and mortality outcomes between typical trajectories. Individuals who transitioned to multimorbidity over 10 years were more likely to be older and living in more deprived areas than the rest of the population. We found seven typical trajectories: later fast transition to multimorbidity, CVD start with slow transition to multimorbidity, cancer start with slow transition to multimorbidity, diabetes start with slow transition to multimorbidity, fast transition to both diabetes and CVD, fast transition to multimorbidity and death, fast transition to both cancer and CVD. Those who quickly transitioned to multimorbidity and death were the most vulnerable, typically older, less educated, and more likely to live in more deprived areas. They also experienced higher number of hospitalisations and overnight stays while still alive. Sequence analysis can strengthen our understanding of typical disease trajectories when considering a few key diseases. This may have implications for more active clinical review of patients beginning quick transition trajectories.

Exploring Social and Locality Variations of Dog Bites in Scotland Using Administrative Data Sources.

ObjectivesPrevious research has shown that hospital admissions for dog-bites are highest in the most deprived areas across England and Wales. In Scotland, thus far there has been no rigorous empirical investigation into social inequalities in dog-related injuries. This study aims to address this gap through analysis of linked administrative data.
 ApproachThe study uses administrative health data from NHS24 calls, A&E and SMR01 records involving dog-related injuries linked to Scotland Census micro-data. Area-based measures of social circumstance are considered through the SIMD, along with an exploration of novel, area-level characteristics including measures of local greenspace, average garden size and dog populations. Individual/household level measures of social circumstance taken from the Scottish Census are used to compare the characteristics of individuals with health records involving dog-related injuries to a random sample of individuals not appearing in the health data sets.
 ResultsWhen looking at individual level records and during modelling at aggregate area level, SIMD was an important factor in all models. Whilst some variation was observed across the different types of health data, the number of records, incident risk ratios and odds ratios were all consistently at least 2-3 higher when comparing the most to least deprived areas. Accounting for dog populations and introducing interaction terms for SIMD decile by dog population increased the main effect of SIMD.
 When comparing individual/household level measures of social circumstance taken from the Scottish Census, occupation-based measures such as NS-SEC appeared to be relatively important predictors of risk, alongside ethnicity, household composition and age, with children disproportionately represented.
 ConclusionIncident rates of dog-related injuries were higher in more deprived areas and circumstances where individuals may be seen as more socially disadvantaged at the individual or household level. Social/legal policies related to dog-bites typically don’t consider social disadvantage in any meaningful way. These results show the importance of doing so.

Quantifying the health and economic benefits of active commuting in scotland

BackgroundDespite the substantial evidence base for the health and economic benefits of walking and cycling, there remains a lack of published findings on the levels and benefits of active commuting at a national level. This study aimed to quantify the proportion of active commuters who met a daily equivalent of weekly physical activity recommendations through their commuting journeys, and the economic value of health benefits associated with active commuting in Scotland. MethodsA repeat cross-sectional analysis of the 2001 and 2011 waves of the Scottish Census was conducted. We analysed data from approximately 250,000 respondents aged 16–74 at each time-point who selected walking or cycling for their usual journey to work. A count was taken of walkers and cyclists whose daily commuting time was at least 30 min. The Health Economic Assessment Tool was used to estimate the number of deaths averted by active commuting, and the associated economic value of walking and cycling annually and over a 10-year period. ResultsActive modes of commuting accounted for a modal share of 13.5% (n = 244,009) in 2001, and 14.5% (n = 286,145) in 2011. In 2001, 46.5% of all active commuters met a daily target of 30 min of moderate intensity activity rising to 50.2% in 2011. In Scotland, the annual health economic benefit of commuting to work by walking was estimated to be approximately EUR 700.2 million, and EUR 79.8 million for cycling to work. ConclusionThis study provides clear evidence of the substantial health and economic benefits that active commuting makes at a population level. These findings support the case for further investment to increase levels of walking and cycling.

Entrepreneurship in Scotland, 1851–1911

This article uses the British Business Census of Entrepreneurs (BBCE) to examine the history of entrepreneurship in nineteenth- and early twentieth-century Scotland. The BBCE identifies every business proprietor listed in the 1851–1901 Scottish censuses, correcting for non-response issues. The BBCE, therefore, allows the whole population of Scottish entrepreneurs to be examined for the first time. These data are combined with a reweighted version of the 1911 Scottish Census report to allow the trends in entrepreneurial numbers and rates to be examined as a whole and broken down by sector and gender. The article also shows how entrepreneurship varied by location. This article offers support for previous work on Scottish entrepreneurship, notably stressing the continued importance of small-scale businesses. It also reveals that female entrepreneurship rates were far higher than previously thought. This article lays the groundwork for future studies of Scottish entrepreneurship using the BBCE data.

A Hidden Community: Justifying the Inclusion of Roma As an Ethnic Identity in the 2021 Scottish Census

This article investigates the invisibility of Roma communities within Scottish census ethnic monitoring categories and broader empirical data. Consistent negative stereotyping as well as systematic oppression within social policy, dominant discourses, and data collection processes excludes Roma from participatorycitizenship. This article identifies precise forms of marginality and invisibility within official government data – permeated through social and education policy – that thereby limit the effective targeting of resources to marginalized communities. Specifically, the article argues that omitting Roma as an ethnic category from past data gathering processes limits understanding of the commonalities and differences within and amongScottish communities, rendering entire populations invisible within broader empirical data and therefore restricting both identification of needs and effective resource allocation. Thus, the article presents a timely argument for the inclusion of Roma as an ethnic category in the 2021 Scottish census, while addressingissues within the census approach to data collection – including the impending digitization of the process. Through discussing and advancing the case for the inclusion of Romani communities in the 2021 Scottish Census, the paper also seeks to establish the current social context by chronicling the history of Romanimigration and marginalization within Europe.

Evidencing the gap between health expectancy and life expectancy for ethnic groups in Scotland.

Background
 Recent evidence has shown that ethnic minorities live longer than the majority population in Scotland. This mortality advantage in ethnic minorities is not unique to Scotland. However, whether morbidity patterns by ethnicity align with mortality patterns by ethnicity is unknown. Thus, this study explores ethnic differences in health expectancies (HE) in Scotland and contrasts HE with life expectancy (LE) findings.
 Methods
 The Scottish Health and Ethnicity Linkage study anonymously links the Scottish Census 2001 for 4.6 million people to mortality records. The Scottish Census 2001 collected two measures of self-assessed health, self-declared ethnicity, age, and sex. Utilising the life tables used to calculate life expectancy by ethnicity and sex in Scotland, the Sullivan method was employed to calculate two measures of health expectancy (healthy life expectancy and disability-free life expectancy) by ethnicity and sex. 95% confidence intervals were calculated to detect significant differences compared to the majority White Scottish population, taken as reference.
 Results
 Longer health expectancies were found in males and females of Other White British, Other White, and Chinese origins as well as in Indian males compared to White Scottish populations. Any Mixed Background and Pakistani populations had the shortest healthy life expectancies. Patterns of health expectancy by ethnicity mostly aligned with patterns of life expectancy by ethnicity with the clear exception of the Pakistani population who showed among the longest life expectancies with the shortest health expectancies. Contrasting HE with LE findings, the number of years in an unhealthy state was greater in females than in males for each ethnic group. In relation to ethnicity, Pakistani and Indian populations had the highest number of years in an unhealthy state in Scotland. Pakistani females showed the strong-est disadvantage in this respect.
 Conclusion
 Pakistani populations had the shortest health expectancies contrasting with the longest life expectancies in Scotland. Future research should aim to understand why such a discrepancy occurs while policy makers ensure that fair and adapt-ed care is provided to offer better quality of life for the most vulnerable.

Ethnic variations in falls and road traffic injuries resulting in hospitalisation or death in Scotland: the Scottish Health and Ethnicity Linkage Study

ObjectivesTo investigate ethnic differences in falls and road traffic injuries (RTIs) in Scotland. Study designA retrospective cohort of 4.62 million people, linking the Scottish Census 2001, with self-reported ethnicity, to hospitalisation and death records for 2001–2013. MethodsWe selected cases with International Classification of Diseases–10 diagnostic codes for falls and RTIs. Using Poisson regression, age-adjusted risk ratios (RRs, multiplied by 100 as percentages) and 95% confidence intervals (CIs) were calculated by sex for 10 ethnic groups with the White Scottish as reference. We further adjusted for country of birth and socio-economic status (SES). ResultsDuring about 49 million person-years, there were 275,995 hospitalisations or deaths from fall-related injuries and 43,875 from RTIs. Compared with the White Scottish, RRs for falls were higher in most White and Mixed groups, e.g., White Irish males (RR: 131; 95% CI: 122–140) and Mixed females (126; 112–143), but lower in Pakistani males (72; 64–81) and females (72; 63–82) and African females (79; 63–99). For RTIs, RRs were higher in other White British males (161; 147–176) and females (156; 138–176) and other White males (119; 104–137) and females (143; 121–169) and lower in Pakistani females (74; 57–98). The ethnic variations differed by road user type, with few cases among non-White motorcyclists and non-White female cyclists. The RRs were minimally altered by adjustment for country of birth or SES. ConclusionWe found important ethnic variations in injuries owing to falls and RTIs, with generally lower risks in non-White groups. Culturally related differences in behaviour offer the most plausible explanation, including variations in alcohol use. The findings do not point to the need for new interventions in Scotland at present. However, as the ethnic mix of each country is unique, other countries could benefit from similar data linkage-based research.

Variations in the use and availability of formal and informal care at the end of life over time and space

Background In light of increasing death rates and a high need for palliative care at the end of life, it is important to plan formal care resources and understand in what ways informal care may alleviate the pressure on healthcare services. A piece to this information puzzle is understanding spatial variations in the use and availability of formal and informal care and how these develop over time.
 Aim This paper explores spatial variations in place of death and living arrangements (as proxy for informal care availability) in the last year of life in Scotland, comparing two time points.
 Data Analysis is based on population data from the Scottish Census 2001 and 2011 that was linked with NHS data and death records data for everyone who passed away within a year of census enumeration. Geographic data includes the Scottish urban-rural classification and healthboards.
 Methods Data was linked via probability linkage. Descriptive analysis and regression models will be presented.
 Results and Conclusions The study population comprises 49,356 cases from 2001/02 and 46,473 from 2011/12. Understanding how care use has changed over time and varies spatially is key to health and social care resource planning and social policy making.

Childhood adversity and psychosis in detained inpatients from medium to high secured units: Results from the Scottish census survey

BackgroundThere is limited data available regarding the most common forms of psychiatric illness, the occurrence of childhood adversity, and the link between childhood adversity and criminal and psychiatric outcomes amongst forensic inpatients. AimsUsing census data for all Scottish forensic inpatients, we investigated the most common primary psychiatric diagnoses in forensic settings, the occurrence of childhood adversity amongst forensic inpatients, and whether childhood adversity experiences significantly predict a range of criminal and psychiatric outcomes. MethodData for the current study were drawn from ‘The Scottish Forensic Network Inpatient Census’ (N = 422). The Responsible Medical Officers and other members of the clinical team collected all data from official patient records. All forensic inpatients across high, medium, and low security sites were surveyed. ResultsThe majority of patients had a psychotic disorder as their primary diagnosis (86.4%), with schizophrenia being the most common (70.0%). Childhood adversity was highly prevalent (79.2%), with physical abuse being the most common adverse experience (40.1%). Increased levels of childhood adversity were significantly associated with an increased risk of criminal convictions, self-reported abuse of animals, suicidal and self-injurious behaviour, and problematic use of drugs or alcohol. ConclusionsConsidering the association between adversity and psychosis, trauma informed care is essential for the mental health and forensic needs of this population.

Differences in ill health and in socioeconomic inequalities in health by ethnic groups: a cross-sectional study using 2011 Scottish census

ABSTRACT Objectives: We compare rates of ill health and socioeconomic inequalities in health by ethnic groups in Scotland by age. We focus on ethnic differences in socioeconomic inequalities in health. There is little evidence of how socioeconomic inequalities in health vary by ethnicity, especially in Scotland, where health inequalities are high compared to other European countries. Design: A cross-sectional study using the 2011 Scottish Census (population 5.3 million) was conducted. Directly standardized rates were calculated for two self-rated health outcomes (poor general health and limiting long-term illness) separately by ethnicity, age and small-area deprivation. Slope and relative indices of inequality were calculated to measure socioeconomic inequalities in health. Results: The results show that the White Scottish population tend to have worse health and higher socioeconomic inequalities in health than many other ethnic groups, while White Polish and Chinese people tend to have better health and low socioeconomic inequalities in health. These results are more salient for ages 30–44. The Pakistani population has high rates of poor health similar to the White Scottish for ages 15–44, but at ages 45 and above Pakistani people have the highest rates of poor self-rated health. Compared to other ethnicities, Pakistani people are also more likely to experience poor health in the least deprived areas, particularly at ages 45 and above. Conclusions: There are statistically significant and substantial differences in poor self-rated health and in socioeconomic inequalities in health between ethnicities. Rates of ill health vary between ethnic groups at any age. The better health of the younger minority population should not be taken as evidence of better health outcomes in later life. Since socioeconomic gradients in health vary by ethnicity, policy interventions for health improvement in Scotland that focus only on deprived areas may inadvertently exclude minority populations.

Applying a process-based livestock model to predict spatial variation in agricultural nutrient flows in Scotland

Achieving an optimal nutrient balance is one of the main targets of sustainable agriculture. The aim of this study was to identify “hotspots” of agricultural nutrient imbalance. This was done by developing a modelling framework and using it to analyse the spatial distribution of agricultural nitrogen and phosphorus flows. The nutrient flows for the main livestock species in Scotland (namely cattle, sheep, pigs and chickens), were quantified using the Scottish Agricultural Emission Model (SAEM). The model was used in connection with agricultural census data for Scotland, which provided spatial distribution of the livestock production, including numbers of animals in certain livestock categories. The average fertiliser application rates for the main crops in Scotland were obtained from the British Survey of Fertiliser Practice and were used as an indicator of the nutrient demand for these crops. The Scottish agricultural census data were used to determine the spatial distribution of different arable crops and grassland in Scotland. This spatial information was combined with the nutrient excretion results to determine the nutrient balance. The results show that the areas with highest nitrogen fertiliser application rate are mainly located in central and eastern Scotland, including the areas where cereal production mainly occurs, while areas where the availability of excreted nutrients is highest are located in southern and north eastern Scotland, i.e. in the main cattle production areas. The higher stability of excreted phosphorus compared to nitrogen allowed a more detailed analysis of a regional phosphorus balance. In major parts of the agricultural production areas in eastern Scotland, the fertiliser application rate (crop nutrient demand) exceeds the amount of phosphorus excreted by the livestock. There are also areas where high phosphorus fertiliser application rate (crop production) and organic phosphorus output (from animal production) overlap, indicating that in these areas there is a high potential to re-use the phosphorus excreted by livestock. Compared to other spatial models for nutrient flows, the modelling framework utilizing a process-based livestock model provides scope to analyse the effects of livestock management and potential changes in livestock systems on regional nutrient balances in more detail.

Named into being? Language questions and the politics of Scots in the 2011 census in Scotland

Where censuses are concerned, politics and ideology are pervasive. The 2011 census in Scotland (a semi-autonomous part of the United Kingdom) was the first to ask a question about Scots, a close relative of English, which is historically the vernacular in many parts of Scotland. While at one time Scots had high status as the national language of Scotland, it is now widely regarded as a ‘dialect’ of English, and for many people it has associations of inferiority. At the same time, it has political relevance because of its potential to be an important cultural marker for an autonomous Scotland. The policy position of the current Scottish government, which advocates independence, is to protect and celebrate Scots. Adding a question about Scots to the census was an attempt to advance this by finding out who and where the users of Scots are. Research carried out before the census had shown that the public had differing ideas about what could be called Scots and whether it was, in fact, a different language from English: according to one previous survey, 64% did not think of it as a language at all. Given this background it is unsurprising that interpretations of the census results were controversial, reflecting to some degree existing language ideologies. According to some, the census provided no useful information, while according to others it demonstrated that there was a robust Scots-speaking population and a clear public understanding of what it meant to be a speaker of Scots. This paper discusses the history and political background to the problematic language questions in the Scottish census, and how the choice of questions, their wording and even their order on the questionnaire may have affected the results. Despite the flawed questions and many difficulties of interpretation, it seems that the 2011 census, whether or not it succeeded in enumerating accurately the speakers of Scots, may nevertheless have helped to raise public awareness of the language and to legitimise it. There are lessons to be learnt from the Scottish census, too, in other situations around the world where there are unclear boundaries between ‘language’ and ‘dialect,’ or where low-status and high-status varieties of ‘the same’ language coexist.

End of Life Care in Scotland: Trends in the Population in Need of Palliative Care

BackgroundEstimation of population-wide palliative care needs is crucial for end-of-life care planning, and literature around it has grown in the last years. However, no estimates have yet been published for Scotland.
 ObjectivesThis paper provides estimates of how many people require palliative care in Scotland and describes changes in the composition of this subpopulation. What are their living arrangements? How have their medical conditions, health service use, and health trajectories changed?
 Methods (including data)The analysis is based on linked hospital records, death records, and Scottish Census data from 2001/02 and 2011/12. The palliative care estimation method by Murtagh et al. is utilised, as well as the illness trajectories distinguished by Murray et al. Comparative cross-sectional descriptive statistics are provided.
 FindingsWhile a recent paper suggests that palliative care need in England/Wales has increased from 72.5% in 2006 to 74.9% in 2014, the share of people with a palliative care need among all deaths in Scotland has decreased from 80.6% to 78.3% in the period of this study. The share of people aged 85+ rose from 26.6% to 31.4%, and we observe a doubling of cases with prolonged dwindling at the end of their life. Despite their high need for care, 4 in 5 people lived in a private household in their last year of life, and 1 in 3 people lived alone.
 ConclusionsOur findings suggest a change in the volume of care need and in the types of care required. They have strong implications for care providers.

Inequalities in the dental health needs and access to dental services among looked after children in Scotland: a population data linkage study

BackgroundThere is limited evidence on the health needs and service access among children and young people who are looked after by the state. The aim of this study was to...

Americans and Return Migrants in the 1881 Scottish Census

This article reveals basic demographic information on Americans and Scottish return migrant parents of the 1321 American children listed in the 1881 Scottish census and investigates reasons for return migration from America to Scotland. Census information was downloaded into an Excel spreadsheet and data including occupation, age, relation to head of household, place of residence and length of time back in Scotland, were counted and listed. General causes of return migration are explored and specific reasons for migrants, especially coal miners, to return to Scotland are briefly touched upon; covering the economic downturn in America during the mid-1870s and tensions towards immigrants in the United States during this period. The results of a deeper genealogical study of four families are reported. More than two-thirds of the parents of American children listed were Scottish with others primarily Irish and English. There was a wide range of occupations with construction and coal mining having the greatest numbers. Most families were living in Lanarkshire and Midlothian but 28 other Scottish counties were found as places of residence. Further research is needed to identify whether American children and their Scottish families are represented in other census years.

Sectarianism in the Scottish Labour Market; what the 2011 Census Shows

As disadvantage can have causes other than discrimination, its presence cannot prove discrimination. However, the absence of patterns of disadvantage in large data sets would be very strong evidence against the presence of sectarian discrimination. In this paper we analyse data on religion, social class, education, gender and region from the 2011 Scottish census. Against those who argue that sectarianism is endemic in the west of Scotland, we find no sectarian association between religion and social class among people at the peak age of their labour market involvement. The class profiles of people in the Other Religion categories are unusual but the profile for Catholics is pretty much the same as for Other Christians. That this analysis involves 487,694 people gives us confidence that the results are robust. Hence we conclude there is no evidence that the Scottish labour market is characterised by sectarian discrimination. We would like to acknowledge the assistance of the staff of the office of the Registrar General for Scotland who kindly provided us with the census data.