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People with disabilities incur additional costs compared to non-disabled people. These costs vary widely and depend on individual circumstances, including the type of disability, household composition and region. If not compensated for, the additional costs of disability can have knock-on effects, leading to lower standards of living and worse outcomes for people with disabilities.
Disability benefit schemes that take into account these additional costs have long been part of the UK social security system and are now part of Scotland’s devolved benefits system. The Social Security (Scotland) Act 2018 provides that Scotland’s social security system will be evidence-based in its design. The Fraser of Allander Institute and the Poverty Alliance were commissioned to provide evidence on the additional costs of disability. This blog summarises their findings.
Method
We used data from the 2021-22 Cost of Living and Food Survey (LCFS) to look at differences in spending in four basic categories (food, energy, transport and health) between disabled and non-disabled households. This is the best expenditure data available for this purpose as it is designed to be representative of the UK population, indicates whether each household member has a disability or not, and allows users to look specifically at Scotland.
The LCFS analysis was supplemented with weekly diaries completed by six disabled people living in Scotland over a five-week period in January and February 2024. Participants were asked to record their experience of receiving support, their additional costs related to their disability, their weekly financial situation, and these diaries are not designed to be representative of all disabled people, but they provide a picture that data alone cannot provide, such as the lived experience of additional costs related to disability, the drivers of these costs, other available support, and the impact of the continuing high cost of living in 2024.
Investigation result
National survey data
Expenditure data from the Cost of Living and Food Survey found that disabled households in Scotland spend slightly more on essential areas such as health and energy, but less on transport. There was also historical evidence that disabled households spend additional money on food. The findings on transport costs are consistent with UK evidence that disabled people travel less than able-bodied people. This finding may be due in part to the availability of discounted travel for disabled people.
Similar results were found for people with more severe disabilities. The main difference here is that households with more severe disabilities are less likely to spend extra on health-related products. This is likely because people with more severe health conditions tend to rely more on NHS services rather than relying on over-the-counter options.
Analysing urban and rural households, we find that the additional expenditures of households with disabilities are higher in urban than rural areas. This data may mask the additional costs of living in rural areas.
Overall, analysis of the LCFS showed that this data is limited in terms of analysis at a Scottish level, with small sample sizes being an issue, particularly when analysing severity of disability and rural context. Importantly, expenditure data does not capture the unmet needs highlighted in the findings of diary participants.
Diary Participants
Five weeks of diary completion in January–February 2024 provided additional data on the lived experiences of managing the additional costs of their disability/health condition for six individuals with a range of physical and mental health conditions and receiving disability benefits (either Personal Independence Payment or Adult Disability Payment).
The diaries recorded the unmet needs of the six participants, including expenses they were struggling with and supports they could not access. The diaries were completed during a time when the cost of living and utilities remained high, and energy reductions were common across the diaries. Only one employed participant recorded that their income was just enough to make ends meet in three of the five diaries. The other five participants recorded that they found it very difficult or quite difficult to make ends meet on their income each week. Participants were asked to record in their diaries whether they experienced various outcomes each week, such as not having basic necessities (e.g., eating less, not being able to shower or bathe). Four participants stated that they went without basic necessities every week during the project.
The diaries also provide insight into access to support within the community: one participant received voluntary support; four of the other six participants gave examples of needed support that they were unable to access due to the lack of availability and cost of support locally; one participant with a physical disability wrote that they often did not receive the support they needed from individuals during the week.
Diary entries also revealed that the inability to pay for health and disability expenses affected the physical and mental health of some participants. Examples given by diary writers included not using heat or hot water, not leaving the house, and borrowing money from family and friends. For all participants, financial insecurity was a source of uncertainty and stress, and several examples were given of them having to make adjustments to their daily lives to curb spending. One participant wrote, “I consolidated all my trips out of the house into one trip to save on gas, then did all my errands in one day, which left me feeling exhausted and spending most of the day in bed.” Participant interviews highlighted the longer-term impacts of financial insecurity on health, which were not captured in this short-term project.
Conclusion
The LCFS data is far from perfect – at Scottish level, small sample sizes suffer, particularly when comparing severe disability and urban and rural households – and, crucially, expenditure data does not capture what households need but cannot afford.
The diary entries revealed that six participants’ incomes were not stable enough to cover the extra costs associated with their disability or health condition. The diaries are not representative of all disabled households in Scotland, but other studies have found similar results more broadly. The diaries also revealed that appropriate social care provision could reduce the extra costs associated with disability.
Going forward, policymakers will need to think carefully about how to measure the additional costs of disability and the adequacy of benefits and other public services to ensure an evidence-based approach.
There is no single source of quantitative data that can provide sufficient evidence about the additional costs in Scotland, and even if there were, costs are likely to vary significantly from person to person due to the personal nature of disability. Effective evidence-based policy to address the additional costs of disability must recognise this, rather than assuming that a one-size-fits-all approach will be sufficient.
The full inquiry report can be found here: https://www.parliament.scot/chamber-and-committees/committees/current-and-previous-committees/session-6-social-justice-and-social-security-committee/business-items/the-extra-costs-of-living-with-a-disability
Dr Laura Robertson, Senior Research Fellow, Poverty Alliance;
Christy McFadyen, Fraser of Allander Institute, University of Strathclyde
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