People living in the most deprived neighbourhoods are 24 percent 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 University 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 today [Thursday, 13 September 2018] 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.
In the last 12 weeks of their life, 37 percent of those in the least deprived areas lived with a family member or friend who was a carer, but only 28 percent 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 percent less likely to die in a care home or hospice – 13 percent died in a care home, 6 percent in a hospice, 53 percent in hospital and 28 percent at home. They died on average at age 72.5.
For those in the least deprived areas, 22 percent died in a care home, 8 percent in hospice, 20 percent at home and 50 percent 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."
Note re 'least deprived' and 'most deprived'. This study uses the Scottish Index of Multiple Deprivation (SIMD, in quintiles), 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 percent of those surveyed were in the most deprived areas and 15 percent in the least deprived.
Statistics summary: In the least deprived areas of Scotland, 22 percent die in a care home and 8 percent in hospice, a total of 30 percent. For those in the most deprived areas, 13 percent die in a care home and 6 percent in a hospice, a total of 19 percent. The difference between 30 percent and 19 percent is just over a third, 37 percent (11 percentage points).
37 percent of those in the least deprived areas had a caregiver in the house, but only 28 percent of those in the most deprived areas, a difference of just under a quarter, 24 percent (9 percentage points).
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