Disabled people face additional costs compared to non-disabled people. These costs are many and varied, and depend on individual circumstances, such as type of disability, household composition, and rurality. Additional costs of disability can have knock-on effects when not compensated, creating poorer living standards which can contribute to poorer outcomes for disabled people.
A system of disability benefits which recognises these additional costs has long been part of the UK’s social security system and is now part of the devolved benefit system in Scotland. The Social Security (Scotland) Act 2018 states that Scotland’s social security system will be designed based on evidence. 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.
Methods
Data from the 2021-22 Living Costs and Food Survey (LCFS) was used to look at expenditure differences between disabled households and non-disabled households across four essential categories (food, energy, transport, and health). This is the best expenditure data available for this purpose since it is designed to be representative of the UK population, indicates whether each household member has a disability, and allows users to look at Scotland specifically.
The analysis of the LCFS was supplemented with weekly diaries completed by six disabled people living in Scotland over a 5-week period in January and February 2024. Individuals were asked to record extra costs related to their disability, their financial situation each week, and experiences of accessing support. These diaries are not designed to represent all disabled individuals, but they provide context of the lived experience of additional costs related to disability including the drivers of these costs, other available support, and the impact of the continued higher costs of living in 2024 which the data by itself cannot provide.
Findings
National Survey Data
Spending data from the Living Costs and Food Survey showed that disabled households in Scotland spend slightly more in essential categories such as health and energy but less on transport. There was also historical evidence of additional spending by disabled households in the food category. The transport findings echo evidence from the UK that disabled people travel less than non-disabled people. This finding may also be partly driven by disabled people having access to concessionary travel.
Similar results were found when looking at those with more severe disabilities. The key difference here was that households with more severe disabilities were less likely to spend extra on health items. This could be due to those with more severe health conditions tending to draw more on NHS services rather than relying on over-the-counter options.
When analysing urban versus rural households, results showed additional spending by disabled households was higher in urban areas than rural areas. It’s possible that the extra costs of living in a rural area are overshadowing the additional costs related to having a disability in this data.
Overall, analysis of the LCFS showed that this data is limited when it comes to analysis at the Scotland level. Small sample sizes were a problem, particularly when analysing severity of disability and rurality. Importantly, spending data does not capture unmet need which was highlighted by the findings from the diary participants.
Diary Participants
Diary entries over a five-week period in January and February 2024 provided additional data on the lived experiences of managing additional costs of a disability/health condition for six individuals who had a range of physical and mental health conditions and who were all receiving disability benefits (either Personal Independence Payment or Adult Disability Payment).
The diary entries captured the unmet needs of the six participants, including costs that they were struggling with and support they were not able to access. The diaries were completed during a period of continued high costs of living and high energy costs and cutting back on energy were a common occurrence across the diary entries. Only one participant, who was in employment, recorded that they found their income OK to manage in three of their five diary entries. The five other participants recorded that they found managing on their income either very difficult or quite challenging each week. Participants were asked to record in their diaries whether they had experienced a range of consequences each week including going without basic essentials (e.g., eating less, not having a shower/bath). Four participants said that they were going without basic essentials every week during the project.
The diaries also provided insights on accessing support in the community. One participant was in receipt of self-directed support. Four of the other six participants gave examples of support that they needed and were not able to access due to lack of availability of support in their local area and costs. One of the participants who had a physical disability wrote that he often was not able to access personal assistance for support he needed during the week.
The diary entries also revealed impacts on the physical and mental health of some of the participants as a consequence of not being able to afford essential costs for their health or disability. Examples shared by the diarists included not using their heating or hot water, not leaving their home and borrowing money from family or friends. For all of the participants, financial insecurity caused uncertainty and stress, with several examples shared of routinely having to make adjustments to try to lower spending. One participant wrote: ““I combined all my journeys outside of the home into one combined journey, to save petrol costs, then did all my errands etc in one day, which resulted in experiencing fatigue and a day mostly in bed.” In an interview with a participant, the long-term impacts of financial insecurity on their health were emphasised, which we were not able to capture in this short-term project.
Conclusions
The LCFS data is far from perfect. Small sample sizes are a problem at the Scotland-level, particularly when we start to look at severe disability and urban versus rural households. And importantly, spending data does not capture what households need but cannot afford.
The diary entries showed that the six participants’ incomes were not providing consistent, adequate levels of income for additional costs associated with having a disability or health condition. While these diaries do not represent all disabled households in Scotland, there have been other studies which show similar findings on a wider scale. The diaries also showed that adequate social care provision may reduce additional costs related to disabilities.
Going forward, policymakers will need to think carefully about how to measure additional costs of disability and the adequacy of benefits and other public services to ensure an evidence-driven approach.
There is no single existing source of quantitative data that can provide robust enough evidence on additional costs in Scotland, and even if this was the case, the personal nature of disabilities means that costs are likely to differ markedly between different people. An effective evidence-based policy to meet additional costs of disability will need to recognise that rather than assuming a one size fits all approach will suffice.
The full research report is available at: 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 Officer, The Poverty Alliance.
Chirsty McFadyen, Fraser of Allander Institute, University of Strathclyde