National Care Service - health and demographic profile: evidence

Provides an overview of Scotland’s health and demographic profile and population projections. It is part of a collection of contextual evidence papers, setting out key sources of information about social care and related areas in Scotland.

This document is part of a collection


1. Worral, P. & Chaussalet, T.J. (2015). A structured review of long-term care demand modelling. Health Care Management Science, 18: 173-194.

2. Macdonald A, Cooper B (2007) Long-term care and dementia services: an impending crisis. Age and Ageing 36(1):16–22.

3. Comas-Herrera A, Whittenberg R, Pickard L, Knapp M (2007) Cognitive impairment in older people: future demand for long-term care services and the associated costs. Int J Geriatr Psychiatr 22(10):1037–1045

4. Kim E-Y, Kim C-Y (2004) Who wants to enter a long-term care facility in a rapidly ageing Non-western society? attitudes of older Koreans toward long-term care facilities. J Am Geriatr Soc 52(12):2114–2119

5. Karlsson M, Mayhew L, Plumb R, Rickayzen B (2006) Future costs for long-term care - cost projections for long-term care for older people in the united kingdom. Health Policy 75(2):187–213

6. Martikainen P, Moustgaard H, Murphy M, Einio EK, Koskinin S. et al (2009) Gender, living arrangements and social circumstances as determinants of entry into/exit from long-term institutional care at older ages: a 6-year follow-up study of older Finns. The Gerontologist 49(1):35–45.

7. Henderson, D.A.G.; Atherton, I.; McCowan, C.; Mercer, S.W. & Bailey, N. (2021). Linkage of national health and social care data: a cross-sectional study of multimorbidity and social care use in people aged over 65 years in Scotland. Age & Ageing, 50: 176-182.

8. Eurostat Data browser. Life expectancy at birth by sex

9. National Records of Scotland (2021) Life Expectancy in Scotland 2018-2020

10. The life expectancy estimates presented in this report relate to 'period' life expectancy. They are calculated assuming that mortality rates for each age group in the time period (here 2018-2020) are constant throughout a person's life. Given that future changes in factors such as medicine and legislation are not taken into consideration, period life expectancy is not an accurate prediction of how long a person born today will actually live, but is a useful measure of population health at a point in time and is most useful for comparing trends over time, between areas of a country and with other countries.

11. National Records of Scotland (2021) Life Expectancy in Scotland 2018-2020

12. Richardson E, Taulbut M, Robinson M, et al (2021) The contribution of changes to tax and social security to stalled life expectancy trends in Scotland: a modelling study. J Epidemiol Community Health 2021;75:365-370.

13. Popham F. and Boyle, P. (2011) Assessing Socio-Economic Inequalities in Mortality and Other Health Outcomes at the Scottish National Level: Final Report. Scottish Collaboration for Public Health Research and Policy

14. The Scottish Index of Multiple Deprivation (SIMD) is a measure of how deprived an area is. A score is given to all of Scotland's datazones (small area geographies) based on several indicators of deprivation. The datazones are then ranked 1 to 6,976 based on their score. The rankings are split into 10 equally sized groups for SIMD deciles and five groups for SIMD quintiles. More information can be found on the Scottish Government website: Scottish Index of Multiple Deprivation 2020 - (

15. Walsh D, McCartney G, Minton J, et al. Changing mortality trends in countries and cities of the UK: a population based trend analysis. BMJ Open 2020;10:e038135

16. Further information on the Scottish Government's Urban Rural Classification can be found on the Scottish Government website

17. Asthana, S. and Halliday, J. (2004), What can rural agencies do to address the additional costs of rural services? A typology of rural service innovation. Health & Social Care in the Community, 12: 457-465.

18. For further information, see NRS Methodology:

19. National Records of Scotland (2022). Healthy Life Expectancy in Scotland, 2018-2020

20. See footnote 14 for further information.

21. Some of the island council areas are amongst those with the highest recorded HLE estimates, however they also have the widest confidence intervals because they have small populations and this makes their HLE estimates less reliable. Further information is available in NRS Healthy Life Expectancy 2018-2020

22. Burden of disease studies use a single measure which combines fatal burden [i.e. years lost because of early death – years of life lost (YLL)] and non-fatal burden [i.e. years lost because they are lived in less than ideal health – years lived with disability (YLD)]. The measure used to describe the overall burden of disease is called the disability-adjusted life year (DALY).

23. ScotPHO Archive - Scottish Burden of Disease (SBoD)

24. It is important to note that a vast body of epidemiological and sociological research highlights that health-related behaviours are shaped to a large degree by structural determinants, and that socio-economic inequalities in health persist even when these behaviours are controlled for statistically. See: Katikireddi, S.V.; Higgins, M.; Smith, K.E. & Williams, G. (2013). Health inequalities: The need to move beyond bad behaviours. Journal of Epidemiology & Community Health, 67(9): 715-716.

25. Person-years is a measure of incidence of a particular condition. It refers to the number of years times the number of members of a population who have been affected by a certain condition.

26. ScotPHO (2016) The Scottish Burden of Disease Study, 2016: Overview Report

27. ScotPHO (2016) The Scottish Burden of Disease Study, 2016: Deprivation Report

28. Payne RA, Abel GA, Guthrie B, Mercer SW. (2013). The effect of physical multimorbidity, mental health conditions and socio-economic deprivation on unplanned admissions to hospital: a retrospective cohort study. Canadian Medical Association journal; 185(5): E221 -8

29. Palmer, K.; Marengoni, A.; Forjaz, M.J.; Jureviciene E.; Laatikainen, T.; Mammarella, F. et al (2018). Multimorbidity care model: Recommendations from the consensus meeting of the Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS). Health Policy, 122(1): 4-11.

30. Academy of Medical Sciences (2018) Multimorbidity: A Priority for Global Health Research.

31. Whitty C J M, MacEwen C, Goddard A, Alderson D, Marshall M, Calderwood C et al. Rising to the challenge of multimorbidity

32. Henderson, D.A.G.; Atherton, I.; McCowan, C.; Mercer, S.W. & Bailey, N. (2021). Linkage of national health and social care data: a cross-sectional study of multimorbidity and social care use in people aged over 65 years in Scotland. Age & Ageing, 50: 176-182.

33. Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. (2012). Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet; 380(9836): 37-43.

34. McLean G, Gunn J, Wyke S, et al. (2014). The influence of socio-economic deprivation on multimorbidity at different ages: a crosssectional study. The British journal of general practice. The journal of the Royal College of General Practitioners, 64(624): e440-7.

35. Mercer, S.W.; Zhou, Y.; Humphris, G.M.; McConnachie, A.; Bakshi, A.; et al. (2018). Multimorbidity and Socio-economic Deprivation in Primary Care Consultations. Ann. Fam. Med., 16(2): 127-131.

36. ScotPHO (2021) Recent Mortality Trends

37. National Records of Scotland (2022) Projected Population of Scotland (2020-based)

38. National Records of Scotland (2021) Estimates of Households and Dwellings in Scotland, 2020

39. National Records of Scotland (2020) Household Projections for Scotland (2018-based)



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