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CHAPTER FOUR: EVALUATING CLOSING THE OPPORTUNITY GAP OBJECTIVES

INTRODUCTION

4.01 The purpose of this Chapter is to consider the extent to which progress has been made in achieving each of the CtOG Objectives. For the purposes of this interim evaluation, the baseline against which progress is measured is July 12 ^th 2004, the date on which the six CtOG Objectives were launched.

4.02 Evaluating CtOG Objectives is less straightforward than evaluating CtOG Aims and CtOG Targets for two reasons. First, unlike CtOG Targets, CtOG Objectives are multi-dimensional and evaluation necessitates an appraisal of a range of socio-economic conditions, as opposed to the evaluation of a single and narrowly-focused outcome ²⁰. Second, unlike both CtOG Targets and CtOG Aims, evaluating CtOG Objectives requires considering appropriate definitions and indicators.

4.03 The evaluation of each CtOG Objective is a four stage process (see Annex A for further details):

• Definition: it is necessary to review the Objective and clarify relationships between any multi-faceted goals which comprise it
• Indicator Specification: proxy indicators must be identified to appraise the extent to which each of these goals are being achieved
• Measurement
• Interpretation: for reasons outlined in Chapter Two, conclusions cannot be drawn directly for each Objective from interpretation of the quantitative evidence.

4.04 This Chapter uses a standard format to evaluate each CtOG Objective, comprising:

• Summary Evaluation: overview of the extent to which progress has been made in achieving the Objective
• Policy Context: a brief review of the role of the CtOG Objective in CtOG and in relation to wider Scottish Executive policy
• Towards Measurement: a brief explanation of how the Objective is interpreted ( Interpretation) and measured ( Indicators and Data)
• Evidence: presentation and interpretation of evidence
• Data Considerations: appraisal of the evidence base, with a view to informing subsequent evaluations of the CtOG Objective.

4.05 For each indicator, the evaluation focuses on three dimensions:

• Headline Trend for Target Population: aggregate trend for the 'target population', specified in the CtOG Objective.
• Headline Trend for Scotland: evidence is appraised to ascertain whether this trend for the target population is 'closing the opportunity gap', or is part of a broader trend for the whole of Scotland
• Trend Divergence, Key Subpopulations: where evidence for the target population can be disaggregated, data is presented and interpreted to ascertain whether movement is experienced evenly across key sub-populations
• Trend Divergence, Equalities Groups: evidence for the target population is disaggregated by Equalities Groups, where possible. Where this is not possible, insights are gathered from interviews undertaken with representatives of Equalities Groups (further details are provided in Annex A).

4.06 Supplementary data tables for CtOG Objectives are presented in Annex 4.

4.07 Table 4.1 provides a summary overview of progress for each of the CtOG Objectives. This evaluation comprises:

• Direction of Travel: whether or not progress is being made for each CtOG Objective;
• Cohort Analysis: whether or not key sub-populations and Equalities Groups share the same direction of travel as the target population, as a whole
• Data Quality: the extent to which existing data facilitates the interim evaluation of progress toward achieving CtOG Objectives. The quality of data is assessed in relation to its relevance to the Objective; availability throughout the necessary period ( i.e. continuously from the launch of CtOG in 2004); and its scope and coverage ( i.e. national, available at small area level, may be disaggregated by relevant population sub-groups and equalities groups).

4.08 At the end of the Chapter, a summary conclusion is offered commenting on progress towards CtOG Objectives overall

Table 4.1: Summary Evaluation of CtOG Objectives

Note: Evaluations of direction of travel, content analysis and data quality for each Objective are qualitative, and summarise the authors' assessments as expressed in the main body of the report.

OBJECTIVE 1:
To increase the chances of sustained employment for vulnerable and disadvantaged groups - in order to lift them permanently out of poverty

SUMMARY EVALUATION

4.09 Objective 1 is evaluated by considering whether the chances of vulnerable and disadvantaged groups entering employment have increased since the launch of CtOG; in particular the employment uptake rates of those from minority ethnic communities, disabled people, and women. The limited data available means that employment sustainability cannot be measured, although DWP data available from February 2007 will enabled this analysis to be included in future evaluations.

4.10 In this interim evaluation, vulnerable and disadvantaged groups are defined as those who are both workless and either women, disabled adults or adults from Minority Ethnic groups. Qualitative analysis is provided on the employment circumstances of adults whose sexuality is lesbian, gay bisexual or transsexual (hereafter LGBT). Time series data are not available by faith, and sample sizes are too small for all faith groups other than Christian. For this interim evaluation, time series analysis has not been undertaken by age.

4.11 The available data show that there are inequalities in the rates at which people move into employment by gender, disability and ethnicity, with workless disabled people having the lowest rates of entry to formal jobs. Since Autumn/Winter 2002, the only clear change shown by the data has been slightly negative: the rates at which workless women, workless disabled people and workless people from Minority Ethnic groups move into employment are now slightly less likely than at the start of the data series. The rate at which workless men move into employment has remained constant since the start of the data series.

4.12 Although there is no evidence of an improvement in the rates at which workless people enter employment, there have been significant reductions in the numbers of people claiming workless benefits, as can be seen from the analysis undertaken for Target A ( see Chapter 5). These findings suggest that the current rates of movement into employment by people who were previously workless, which have been relatively constant since Autumn/Winter 02, are enabling significant reductions in the numbers of people claiming workless benefits. Were improved employment entry rates achieved, the reductions in the number of people claiming workless benefits could be expected to be even greater than at present.

4.13 There are currently insufficient income data available to assess whether workless adults who enter employment have a greater chance of permanently leaving poverty than before CtOG.

SUMMARY FINDINGS FROM RELATED TARGETS

4.14 Objective 1 links most closely to CtOG Target A, which aims to "reduce the number of workless people dependent on DWP benefits in Glasgow, North & South Lanarkshire, Renfrewshire & Inverclyde, Dundee and West Dunbartonshire by 2007 and 2010". To date there has been positive progress towards Target A, with significant reductions in the numbers of people claiming workless benefits in the CtOG Target areas. Since 1999 there has been a linear downward trend of approximately 1,855 fewer workless claims per quarter. Since 2003 there has been a more pronounced downward trend, with approximately 2,486 fewer workless cases per quarter.

4.15 Using the Scottish Executive's measure, Target A will be met; but using our amended measure which has a different baseline figure (discussed further in 5.19 and 5.20) the reductions made are not sufficient to meet the target by 2010. In addition, the reductions have been more limited for women and disabled people (data for the other equalities groups are not available).

4.16 Target C is also relevant to Objective 1. Target C requires that "Public sector and large employers tackle aspects of in-work poverty by providing employees with the opportunity to develop skills and progress in their career". Analysis reveals that the NHS pilots schemes, intended to act as an example to both public and private sector employers, have been fairly successful in helping workless people into sustainable jobs, but that evidence of other employers following this example is limited.

POLICY CONTEXT

4.17 In the broadest sense, the UK Government and Scottish Executive are committed to an approach to tackling poverty, which involves enabling those on welfare to enter the formal labour market. The breadth of initiatives that have been implemented to increase the chances of sustained employment for vulnerable and disadvantaged groups is extensive and to provide a comprehensive account is beyond the remit of this interim evaluation. Nevertheless, of particular note, is the work programme that underpins CtOG Target A and the Scottish Executive's recently published employability framework, Workforce Plus, which seeks to address, "... the combination of factors and processes which enable people to progress towards or get into employment, to stay in employment and to move on in the workplace"²¹. Examples of work occurring as part of this programme are: NHS pre-employment training schemes designed to equip workless participants with the skills they need to fill existing vacancies within NHS Scotland; the introduction of a New Deal programme option which allows clients to fill short term contracts for the Scottish Executive; and the development of partnerships such as Glasgow Local Development Company Network which work with the private sector to ensure that workless people benefit from economic development within Scotland. These three examples are discussed in more detailed as part of the analysis of Target C.

OPERATIONALISING CtOG OBJECTIVE 1: TOWARDS MEASUREMENT

4.18 The primary goal of Objective 1 is to increase the chances of sustained employment for vulnerable and disadvantaged groups. This primary goal is to be met in order to achieve the secondary goal of lifting vulnerable and disadvantaged groups permanently out of poverty.

Interpretation

4.19 In this interim evaluation, vulnerable and disadvantaged groups are defined as those claiming workless benefits and either women, disabled adults, from Minority Ethnic groups or those whose sexuality is lesbian, gay bisexual or transsexual ( LGBT).

4.20 The primary goal of Objective 1 is open to interpretation. It could be taken to mean an improvement in 'job readiness', i.e. for vulnerable and disadvantaged groups to undertake training and life coaching which would increase their chances of sustaining employment (which, in turn, it could be assumed would lift them out of poverty). However, the interpretation taken in this interim evaluation is that Objective 1 requires an improvement in sustained employment, rather than job readiness.

4.21 The nature of the association between the primary goal and the secondary goal in Objective 1 is also open to interpretation. It could be understood that the secondary goal (lifting vulnerable and disadvantaged groups out of poverty) would be achieved only if any sustained employment was sufficiently rewarding to ensure that they were lifted out of poverty (which requires income data). However, the interpretation taken in this interim evaluation is that Objective 1 concerns moves into employment which, it is assumed, will lead to these vulnerable and disadvantaged groups being lifted out of poverty.

Indicators and Data

4.22 There are no data available for the period required to allow analysis of whether vulnerable and disadvantaged groups had entered employment and thereafter sustained this employment.

4.23 This analysis uses Labour Force Survey Microdata, specifically two-quarter data sets, beginning with Autumn-Winter 2002 and ending with Winter-Spring 2006 ( i.e. Winter 2005 and Spring 2006). The analysis examines the percentage of the workless population who move into employment in any given two-quarter period between these start and end dates. Cohort analysis has been undertaken by gender, disability and ethnicity. The dataset does not allow for analysis of any other variables that could be used as proxies for vulnerability or disadvantage. These quarterly LFS data are not boosted, so there are insufficient cases to disaggregate by the 15% most deprived areas in Scotland.

EVIDENCE

Moves Into Employment by Gender

4.24 Figure 4.1 illustrates the proportion of workless men and women entering employment, at regular intervals, since Autumn-Winter 2002. The trends for both men and women exhibit clear seasonality, with in general, rises in the proportion moving into work toward Summer, and falls in the proportion moving into work toward Winter.

4.25 Average movements for the four different periods of workless adults moving into employment have been calculated for men and women respectively. This demonstrates that one constant over this period is that a higher proportion of workless men than workless women enter work. From Winter-Spring 2004 to Summer-Autumn 2005, the rate of moves into employment fell for women, while they rose for men. Both men and women experienced falls to Summer-Autumn 2005, followed by a rise in recent periods. However, there remains a 2% gap between men and women in terms of moves into employment.

Figure 4.1: Moves into employment for workless women and men

Source: LFS two-quarter longitudinal data sets, beginning with Autumn-Winter 2002 and ending with Winter-Spring 2006

Moves Into Employment by Disability

4.26 Figure 4.2 shows the proportion of workless disabled and non-disabled adults respectively entering employment since Autumn-Winter 2002. Given the small sample size, averages over four periods provide more robust estimates of the proportion of disabled people moving into employment. Figure 4.2 highlights the disparity between non-disabled and disabled workless adults. Very low levels of movement into employment - around 2-3% - are reported for disabled workless people in Scotland, compared to entry rates of between 13% and 19% for non-disabled workless people. There is no evidence of significance progress in recent years in narrowing this disparity.

Figure 4.2: Moves into employment for workless people who are disabled and not disabled

Source: LFS two-quarter longitudinal data sets, beginning with Autumn-Winter 2002 and ending with Winter-Spring 2006

4.27 Interviews with representatives from Equalities groups indicated that they recognised that there had been a drive in recent years towards providing more employment opportunities for people with disabilities or learning difficulties. More than one interviewee perceived that the emergent policy framework set out by the Scottish Executive Working for Change initiative was closely linked to CtOG and that several positive statutory changes have come directly out of CtOG. The main driver of progress was, however, perceived to be the new disability equality duty introduced as a result of the Disability Discrimination Acts (1995 and 2005).

4.28 Despite this, the over-riding concern of these key informants was that disabled people still faced significant social barriers in entering the world of work, including attitudes, as well as physical barriers, such as the inadequacy of reasonable adjustments being made to buildings, public transport use and carer support requirements.

Moves Into Employment by Ethnicity

4.29 Figure 4.3 compares the proportion of Minority Ethnic and white workless adults entering employment since Autumn-Winter 2002. Given the sample size, eight-period moving averages provide more robust estimates of the proportion of Minority Ethnic people moving into employment.

4.30 While the rate of entry to employment is fairly consistent for white workless people at around 10%; the estimated rate for the Minority Ethnic workless people is slightly lower, ranging from 7% to 10%. However, variability in the rate of moves into employment among workless people from Minority Ethnic groups is likely to be due, in part, to sampling error. Furthermore, caution must always be taken when not disaggregating Minority Ethnic group data for specific Minority Ethnic groups, which is not possible in this case due to small sample sizes.

Figure 4.3: Moves into employment by ethnicity

Source:LFS two-quarter longitudinal data sets, beginning with Autumn-Winter 2002 and ending with Winter-Spring 2006

4.31 Representatives of Minority Ethnic and faith organisations did not refer to any noticeable improvement in employment for their communities. In fact, one key informant perceived that employment opportunities had worsened for minority ethnic applicants due to increased competition for jobs at the lower end of the private sector labour market from recent migrants from the new EU accession states.

Moves Into Employment by Sexuality

4.32 It is not possible to disaggregate Labour Force Survey data by sexuality. Consequently, analysis draws upon interviews with her representatives of LGBT groups. These key informants perceived marked improvements in employment practice in recent years. This was attributed to a growing number of employers, particularly in public sector (including the Scottish Executive) who are developing an equality and diversity agenda to create inclusive working environments. The 2003 Sexual Orientation Employment legislation was noted as being especially helpful in this regard as it has made more employers more aware of sexuality discrimination issues and increased transparency in the employment application process. Similarly, the development of non-legislative workplace policies and guidance within the Scottish Executive is seen by stakeholders to be providing leadership on workplace LGBT issues.

4.33 However, there is also awareness that there remains a distinct lack of data and research on relative employment opportunities foe LGBT people. For example, there are no data to ascertain whether LGBT young people are, as LGBT representatives suspect, leaving school earlier and therefore not gaining the same qualifications as their straight peers, which in turn might restrict employment opportunities. Similarly, measuring direct discrimination practice, particularly against those attempting to enter the labour market, is a complex undertaking. Many vulnerable LGBT people are reluctant to relay any information on their personal experiences of prejudice when looking for work and, consequently, it remains problematic to accurately monitor exclusion in access to employment for LGBT individuals, particularly when comparing against similarly qualified straight peers.

DATA ISSUES

4.34 The data series as presented is based on Labour Force Survey microdata made available by ONS. The two quarter LFS data used for this analysis has been used by ONS for articles in Economic and Labour Market Review and its predecessors, but other analyses of the microdata do not automatically carry National Statistics status. We recommend that, if such data is to be used for assessing progress against the CTOG Objectives, that such an analysis should be subject to National Statistics quality assurance to minimise the possibility of criticism of the trends identified. We would recommend the Scottish Executive should liaise with ONS to facilitate this, as the data is essential to enable the monitoring of Objective 1.

4.35 Another useful data source with which to assess progress towards this Objective would be DWP job entry rates across Scotland. These data can be disaggregated by age, ethnicity, disability, faith and the 15% most deprived local areas. Publication of these data have however been delayed until February 2007.

4.36 The only way in which the Scottish Executive could accurately measure sustained employment rates amongst vulnerable and disadvantaged groups would be through use of the Work and Pensions Longitudinal Study. Calculating sustained employment requires analysis of change in the employment status of individuals. Securing access to WPLS would enable large-scale longitudinal analysis of all changes in employment status experienced for individuals over time.

OBJECTIVE 2:
To improve the confidence and skills of the most disadvantaged children and young people - in order to provide them with the greatest chance of avoiding poverty when they leave school

SUMMARY EVALUATION

4.37 Data on children's health shows that children and young people in deprived areas are more likely than their counterparts in richer areas to have poor psychosocial health. The available data suggest that, relative to all young people in Scotland, the skills of the most disadvantaged young people are not showing significant improvement.

4.38 In recent years there has been little overall change in the tariff scores of S4 pupils in the 15% most deprived areas (between 2003 and 2004 they showed a very slight fall of 0.16), although there has been a slight improvement in S4 tariff score in Scotland as a whole. Young people receiving Free School Meals have lower tariff scores than those in the 15% most deprived areas. However, it must be stressed that these data pre-date CtOG.

4.39 Outcomes among equalities groups are varied. Young women do better than young men in relation to the indicators of skills and confidence and, but the impact of gender is not as great as the impact of deprivation level. Pupils with a Record of Need/Individual Education Programme ( RoN/IEP) do far worse than pupils in general, an effect that is stronger than the impact of deprivation. There is considerable variation in the tariff scores of young people from different Minority Ethnic groups. No data are available for other equalities groups.

4.40 There is currently no way to measure improvements in the skills of children below the age of 16, nor to measure improvements in the confidence of the most disadvantaged children or young people.

SUMMARY FINDINGS FROM RELATED TARGETS

4.41 Target F aims to "increase the average tariff score of the lowest attaining 20 per cent of S4 pupils by 5% by 2008". The analysis undertaken for this interim evaluation shows that in 2003 the average tariff score of the lowest attaining 20 per cent of pupils was 53, compared to a national average tariff of 168. Overall, there has been no positive trend in this measure in recent years. However, the available data pre-date CtOG.

POLICY CONTEXT

4.42 Improving the skills and confidence of the most disadvantaged young people is an integral part of the longer-term government strategy to tackling poverty. The breadth of initiatives that have been implemented to improve educational performance in Scotland's schools is extensive and to provide a comprehensive account is beyond the remit of this interim evaluation. Nevertheless, of particular note, is the work programme that underpins CtOG Targets B, E, F and G. More generally, For Scotland's Children, published by the Scottish Executive in 2001, sought to transform the way children's services are delivered in Scotland by encouraging integrated service provision ²². At the heart of this strategy was the concern to improve the prospects for the most disadvantaged children in Scotland.

OPERATIONALISING CtOG OBJECTIVE 2: TOWARDS MEASUREMENT

4.43 The primary goal of Objective 2 is to improve the confidence and skills of the most disadvantaged children and young people in Scotland. This primary goal is to be met to achieve the secondary goal of giving them the greatest chance of avoiding poverty when they leave school.

Interpretation

4.44 In this interim evaluation, children are understood to be people aged under 16, or aged between 16 and 18 years and in full-time education; young people are understood to be people aged between 16 and 19 years old. The most disadvantaged children and young people are understood to be those living in the 15% Most Deprived Areas in Scotland (as defined by the Scottish Index of Multiple Deprivation, 2004), those eligible for Free School Meals, those with a Record of Needs/Individualised Education Programme, those who are looked after by local authorities and those who are refugees or are seeking asylum. It is assumed that skills can be represented by educational outcomes in schools, and confidence can be represented by selected psychosocial measures from the Scottish Health Survey.

4.45 The nature of the association between the primary goal and the secondary goal in Objective 2 differs to that of other Objectives. For the purpose of this interim evaluation, the secondary goal is assumed to be aspirational, as opposed to measurable.

Indicators and Data

4.46 Suitable data for evaluating Objective 2 are limited but the best available data on children and young people's confidence and mental health are from the Scottish Health Survey. Data on the tariff scores of S4 pupils (aged 16-17) is used to assess skills.

4.47 The Scottish Health Survey has been undertaken in 1995, 1998 and 2003. Current proposals are for it to be continuous from 2008. Data are available from the 1998 and 2003 surveys. The 2003 data have been considered here. Although these data pre-date CtOG, they provide a baseline for confidence levels among children from the most deprived areas in Scotland, which has the potential to be revisited towards the end of the CtOG programme (should the Scottish Health Survey be updated). The 1998 data have not been considered as there was no index of deprivation in operation when the data were collected; therefore there is no potential for meaningful analysis of how the confidence levels of children living in the most deprived areas have changed between the two surveys. These data can be broken down by gender and age, but sample sizes are too small to permit meaningful analysis of the relationship between disability, ethnicity, and sexuality by psychosocial health. No data are collected on sexuality.

4.48 Tariff score data provides an aggregate measure of qualifications achieved by pupils in S4 across Scotland, which is the best available proxy for measuring skill levels among secondary school pupils in Scotland. The data can be broken down by gender, by whether young people have a Record of Needs/Individual Education Programme and by ethnicity - although small sample sizes mean that trend data are not available for analysis by the last category. Once again, these data pre-date CtOG. No data are available by faith or sexuality. Since the end of key stage testing in Scotland, no qualifications data are available for younger children. Primary school achievement is currently assessed by the Scottish Survey of Achievement - a sample survey of half of Scottish local authorities. These data cannot be matched with individual pupil records, or with postcode. This means that, at present, analysis of the relationship between primary school achievement and deprivation levels cannot be undertaken.

4.49 The available data do not allow for an analysis of whether the most disadvantaged children have a greater chance of avoiding poverty. They do however provide potential for assessment of longer-term change in the levels of confidence of children and young people living in the most deprived areas, and analysis of change in educational outcome for young people facing the greatest disadvantage.

EVIDENCE

Skills as Evidenced by Educational Outcomes

Aggregate Data for Most Deprived Areas

4.50 In recent years, there has been little overall change in the tariff scores of S4 pupils in the 15% most deprived areas (between 2003 and 2004 they showed a very slight fall of 0.16), although there has been a slight improvement in S4 tariff score in Scotland as a whole. This gap exists for both young women and for young men, with deprivation clearly having a greater impact than gender upon young people's qualification outcomes.

Figure 4.4: Average tariff scores of S4 pupils in Scotland for all data zones and for the 15% most deprived data zones and by gender

Notes: School years refer to the beginning of the session, i.e. 2004 refers to school year 2004/05.

Source: Tariff score data for S4 pupils in Scotland and SIMD 2004.

4.51 Similar trends emerge when only pupils without a Record of Needs (RoN) or an Individual Education Programme ( IEP) are considered. There is a 47-point difference in average tariff scores between those in the Most Deprived areas and the general population. This is one point more than the difference when those with a RoN/IEP are included in the analysis.

Figure 4.5: Average tariff scores for S4 pupils in Scotland with no IEP/RoN and for all data zones and for the 15% most deprived data zones by gender

Notes: School years refer to the beginning of the session, i.e. 2004 refers to school year 2004/05. Some sub-groups are relatively small.

Source: Tariff score data for S4 pupils in Scotland and SIMD 2004.

4.52 Compared to the Scottish average, the tariff scores of pupils in the 15% most deprived areas were worse in 2004 than they were in 2002. For these pupils there has therefore been no closing of the opportunity gap. However, some improvement is evident among the most deprived areas within the Most Deprived 15%: for the 10% and 5% most deprived areas, pupil achievements were slightly closer to the Scottish average in 2004 than they were in 2002 (Figure 4.6). Nevertheless, attainment of pupils in these most deprived 5% and 10% areas remained low in 2004 - at 70.36% and 67.20% of the Scottish average respectively.

Figure 4.6: Average tariff scores for S4 pupils in deprived areas as a percentage of the Scottish average

Note: School years refer to the beginning of the session, i.e. 2004 refers to school year 2004/05.

Source: Tariff score data for S4 pupils in Scotland and SIMD 2004.

By Gender in Most Deprived Areas

4.53 Young women outperform young men in S4 educational attainment in deprived areas across Scotland. This difference is evident in the 5%, 10% and 15% Most Deprived areas (Figure 4.7). However, as noted above, the impact of gender on education is not as great as the impact of deprivation level. For example, young women in the 15% Most Deprived areas have an average tariff score of 131, which is 18 points higher than young men in the same areas, but 42 points lower than the national average for young women and 26 points lower than the national average for young men.

Figure 4.7: Average 2004 tariff scores for young women and young men in Scotland

Note: School years refer to the beginning of the session, i.e. 2004 refers to school year 2004/05.

Source: Tariff score data for S4 pupils in Scotland and SIMD 2004.

4.54 As well as achieving lower tariff scores than young women, young men in deprived areas fare worse compared to their male peers in more affluent areas than young women in deprived areas do relative to young women in more affluent areas (Figure 4.8). Again the difference by gender is not as great as the difference that is made by deprivation. For example, young men in the 15% most deprived areas achieve 67% of the national average scores for young men, whereas young women in the 15% most deprived areas achieve 70% of the national average scores for young women. However, the 30% proportional achievement gap between young women in the Most Deprived areas and young women in general is much higher than this 3% proportional achievement gap between young men and young women in the Most Deprived areas.

Figure 4.8: 2004 average tariff scores for S4 pupils in deprived areas by gender, as a percentage of the Scottish average for each gender

Note: School years refer to the beginning of the session, i.e. 2004 refers to school year 2004/05.

Source: Tariff score data for S4 pupils in Scotland and SIMD 2004.

Aggregate Data for pupils receiving Free School Meals

4.55 It is also possible to undertake analysis of achievement by whether young people qualify for Free School Meals ( FSMs), a proxy for living in a low-income household. Figure 4.9 shows that young people receiving Free School Meals have lower tariff scores than both those in the 15% most deprived areas, and the general population of S4 pupils. In 2004, the average tariff score for young people receiving Free School Meals was 110, 12 points less than the average of 112 in the 15% Most Deprived areas. The gender effect remains, with young women receiving FSMs achieving better results than young men. In 2004, young women from the Most Deprived areas receiving FSMs achieved an average 12 points more than young men receiving FSMs from the same areas. Again, this gender effect is far less than the impact of deprivation overall, with young women receiving FSMs achieved an average of 73 points less than young women in the general population.

Figure 4.9: Average tariff scores of all S4 pupils in Scotland by Free School Meals ( FSM) eligibility and by gender

Note: School years refer to the beginning of the session, i.e. 2004 refers to school year 2004/05.

Source: Tariff score data for S4 pupils in Scotland.

By Record of Need/Individual Education Programme in Scotland and by Deprivation and Geography

4.56 Pupils with a Record of Need/Individual Education Programme ( RoN/IEP) do far worse than pupils in general. In 2004 the average tariff score for young people without a RoN/ IE was 116, while for those with a RoN/IEP it was 82. Among young people with a RoN/IEP, young men do slightly better than young women, but the gender effect is weaker than for young people without a RoN/IEP (Figure 4.10).

Figure 4.10: Average tariff scores of all S4 pupils in Scotland by RoN/IEP and by gender

Note: School years refer to the beginning of the session, i.e. 2004 refers to school year 2004/05.

Source: Tariff score data for S4 pupils in Scotland.

4.57 Pupils with a Record of Need/Individual Education Programme ( RoN/IEP) who live in the Most Deprived areas fare worse than the general population of young people with a RoN/IEP: in 2004 the average score for young people with a RoN/IEP in the Most Deprived areas was 30 points lower than for young people with a RoN/IEP in the general population.

4.58 Among those in the Most Deprived areas, the gender effect for young people with a RoN/IEP is stronger. In 2004, young women achieved an average of 8 points less than young men. This could, however, be a consequence of small sample sizes.

4.59 While young people with a RoN/IEP in the Most Deprived areas have lower educational attainment than their peers, it is also interesting to note that the gap between the general population of young people and those with a RoN/IEP is much less in the Most Deprived areas. This is because educational achievement among all young people is generally lower in these locations than in less deprived areas (Figure 4.11).

Figure 4.11: Average tariff scores of all S4 pupils in Scotland in the 15% most deprived data zones by RoN/IEP and by gender

Notes: School years refer to the beginning of the session, i.e. 2004 refers to school year 2004/05. Some sub groups are relatively small.

Source: Tariff score data for S4 pupils in Scotland

4.60 There are similar trend among young people with a RoN/IEP who receive Free School Meals. Pupils in receipt of FSMs have lower average S4 tariff scores than their peers who do not. The impact of receiving FSMs on education is greater than living in the Most Deprived areas (Figure 4.12).

Figure 4.12: Average tariff scores of all S4 pupils in Scotland in the 15% most deprived data zones by Free School Meals eligibility and by gender

Notes: School years refer to the beginning of the session, i.e. 2004 refers to school year 2004/05. Some sub groups are relatively small.

Source: Tariff score data for S4 pupils in Scotland

4.61 Average tariff scores also show variation by geography. Young people without a RoN/IEP in remote rural areas and small towns have higher educational attainment than those in urban areas (this is however likely to be strongly influenced by the strong association between deprivation levels and urban areas) Although they show more variation, likely due to small sample sizes, outcomes for young people with a RoN/IEP follow similar trends, with those in rural areas doing better (Figure 4.13).

Figure 4.13: Average tariff scores of all S4 pupils in Scotland by geography and by IEP/RoN status

Notes: School years refer to the beginning of the session, i.e. 2004 refers to school year 2004/05. Some sub groups are relatively small.

Source: Tariff score data for S4 pupils in Scotland

By Other Equalities Groups

4.62 There is considerable variation in the tariff scores of young people from different Minority Ethnic groups. (Figure 4.14). Young people of Chinese and Mixed ethnicity have the highest S4 average tariff scores, while young people from Black Caribbean and Black Other groups have the lowest averages. There are also gender variations within and between groups, with, for example, young Pakistani women having considerably higher average tariff scores than young Pakistani men (Figure 4.14).

Figure: 4.14: Average tariff scores of young people by ethnicity and gender, 2002 - 2005 three year average

Notes: School years refer to the beginning of the session, i.e. 2004 refers to school year 2004/05. A three year average is used due to the small and fluctuating numbers

Source: Tariff score data for S4 pupils in Scotland

4.63 No educational outcome data are available by either faith or sexuality. No educational outcome data are available for younger children.

4.64 In the absence of appropriate quantitative data, qualitative research provides some insight into variations in educational attainment among equalities groups. Key stakeholders perceive that attitudinal barriers inhibit achievement within the education sector for LGBT people and also for disabled people. However, they also perceive that improvements are evident, both in terms of a growing recognition of the challenges faced by disabled people in learning environments and greater awareness of homophobic bullying in schools. Noted initiatives include Scottish Executive policy over past two years supporting training opportunities for people with disabilities and the ongoing partnership with LGBT groups to review solutions in schools. Some LGBT groups have been allowed into schools to deliver awareness training with teachers, although it is perceived that barriers remain in place with regard to faith schools.

4.65 A primary concern and focus for LGBT campaigning groups is to highlight the difficulties faced by young people in educational settings. They contend that young LGBT people can feel excluded in schools, and that a lack of respect, understanding and advice or support leads to many young LGBT people to opt out of school earlier. While there is recognition that the issue of the experience of LGBT young people in schools is on the agenda in Scotland, interviewees believed that, overall, a stronger engagement with issues of school homophobia exists in England and Wales.

4.66 Minority Ethnic and faith organisations perceived a general improvement in school resources, but an increase in the racial harassment of children in schools (particularly following the July 7 ^th 2005 London bombings). An increased and, as yet unmet, demand for services for children with English as an additional language was noted in certain regions.

By Looked After status

4.67 The formal educational attainments of young people who are looked after by local authorities are much worse than the general population of young people. The educational outcomes for young people who are looked after are similar to those of young people with a RoN/IEP resident in the Most Deprived areas. In 2004, young people who were not looked after achieved an average 116 above those who were. The gender effects for looked after children are limited, and in 2004 there was only a 1 point difference between the average scores of looked after young men and young women. This may however be a consequence of small sample sizes.

Figure: 4.15: Average tariff scores of S4 pupils in Scotland by gender and by looked after status

Notes: School years refer to the beginning of the session, i.e. 2004 refers to school year 2004/05. Some sub groups are relatively small.

Source: Tariff score data for S4 pupils in Scotland

By Asylum Seeking status

4.68 Young people from asylum-seeking households have lower average tariff scores than young people from other households, but the difference is not as great as for some other groups. Young women from asylum-seeking households have higher education attainments than young men - although the extent of these differences and the recent trends are likely to be a result of small sample sizes.

Figure: 4.16: Average tariff scores of S4 pupils in Scotland by whether or not young people are seeking asylum and by gender

Notes: School years refer to the beginning of the session, i.e. 2004 refers to school year 2004/05. Some sub groups are relatively small.

Source: Tariff score data for S4 pupils in Scotland

Levels of Confidence

4.69 The Scottish Health Survey contains some measures of psychosocial health that can be used to provide an indication of how children and young people's confidence levels vary among different groups. These data are available for 2003, but the survey will not be repeated until 2008. These findings therefore provide a baseline analysis for Objective 2, but cannot be used to assess progress towards its achievement.

4.70 The Strengths and Difficulties Questionnaire ( SDQ) is used to assess psychosocial health amongst children aged 4-12. The SDQ comprises 25 questions covering aspects such as consideration, hyperactivity, malaise, mood, sociability, obedience, anxiety and unhappiness. There are condensed into 5 component scores corresponding to emotional symptoms, conduct problems, hyperactivity, peer problems and prosocial behaviour. A total SDQ score is calculated by summing scores (excluding prosocial scores) from each domain, with values classified as normal (0-13), borderline (14-16) and abnormal and psychosocial disorder within the clinical range of difficulty (above 17). More information on the scale is provided in the technical report of the Scottish Health Survey 2003 ²³.

4.71 The Scottish Health Survey also uses a General Health Questionnaire ( GHQ) to assess the psychosocial health of young people aged 13-15. However analysis of the GHQ has not been included, as sample sizes are too small to enable reliable analysis of the impact of deprivation on psychosocial health.

Aggregate Data for Most Deprived Areas

4.72 4-12 year olds in the 10% most deprived data zones are over 25% more likely than those in the 10% least deprived data zones to have very poor psychosocial health (Figure 4.17).

Figure 4.17: Combined SDQ scores for children aged 4-12 by deprivation deciles

Note: The total number of respondents was 1789.

Source: Scottish Health Survey, 2003.

4.73 A similar trend - an inverse relationship between deprivation and psychosocial health - is evident when results are considered by income quintile. Children from the lowest income families are more than 10 times more likely to have poor psychosocial health than children from the wealthiest families (Figure 4.18).

Figure 4.18: Combined SDQ scores for children aged 4-12 by household income quintile

Notes: The total number of respondents was 1607. The income data are presented by quintile as this is how they are coded in the Scottish Health Survey.

Source: Scottish Health Survey, 2003.

By Gender in Most Deprived Areas

4.74 There are significant gender variations in levels of psychological wellbeing among children. Male respondents aged 4-12 who live in areas of high deprivation were more likely than girls of the same age, and in the same area, to have poor psychosocial health. This gender difference also exists in more wealthy areas but is much less pronounced (Figures 4.19 and 4.20) ²⁴.

Figure 4.19: Combined SDQ scores for girls aged 4-12 by deprivation deciles

Note: The total number of respondents was 893.

Source: Scottish Health Survey, 2003.

Figure 4.20: Combined SDQ scores for boys aged 4-12 by deprivation decile

Note: The total number of respondents was 896.

Source: Scottish Health Survey, 2003.

By Other Equalities Groups in Most Deprived Areas

4.75 No reliable proxy data for confidence levels are available by disability, ethnicity, faith or sexuality.

DATA ISSUES

4.76 Future analysis of the Scottish Survey of Achievement will allow analysis of the impact of deprivation on achievement. Realisation of current proposals for the continuous funding of the Scottish Heath Survey from 2008 could enable greater analysis of changes in the confidence levels of children and young people in the most deprived areas. Undertaking analysis of the relation between educational achievements and confidence levels and the chances of young people entering poverty would require increased longitudinal tracking of individuals probably involving boosts to existing social surveys.

OBJECTIVE 3:
To reduce the vulnerability of low income families to financial exclusion and multiple debts - in order to prevent them becoming over-indebted and/or to lift them out of poverty

SUMMARY EVALUATION

4.77 The primary goal of Objective 3 is to reduce the vulnerability of low income families to financial exclusion and multiple debts. Lack of financial products is more intense a problem in Scotland than in the UK as a whole. SHS data for 2005 shows that low income households are less likely to have savings than higher income households, although two fifths do possess some savings. There is little difference in the propensity to save between low income groups. The profile of sums saved is similar across different 'bands' of low income households and low income households are only marginally more likely than higher income households to have savings of less than £5000. The key issue seems to be in enabling people to save, rather than encouraging low income savers to accumulate more savings. SHS data shows that low income households are less likely than higher income households to borrow money, marginally more likely to turn to friends and family, and less likely to use a bank overdraft facility. There is no evidence widespread of use of high credit sources such as money lenders or cheque cashing facilities.

4.78 Disabled people, LGBT people and minority ethnic communities continue to face difficulties in accessing financial services, although progress is being made to address discrimination against LGBT people and in practices affecting disabled people. Key informants suggest there is limited, if any progress in relation to minority ethnic communities.

4.79 The SHS will remain a key data source to track progress over time, although it has limitations as the low income measure is not equivalised. The longitudinal Wealth and Assets Survey should be explored as a complementary additional source of data to relate changes in financial well-being to household circumstance.

SUMMARY FINDINGS FROM RELATED TARGETS

4.80 The work that underpins CtOG Target K contributes most directly to this Objective. Target K aims to "increase the availability of appropriate financial services and money advice to disadvantaged communities to reduce their vulnerability to financial exclusion and multiple debts" by 2008. Data from the Family Resources Survey and SHS show that access to a range of financial services have improved among the lowest income groups over the last 5 - 10 years. Provision of Money Advice services has also increased, but there is little information on the level of uptake of this improved access among the most deprived and financially vulnerable households.

POLICY CONTEXT

4.81 Tackling financial inclusion fulfils an important role in the Scottish Executive's efforts to tackle poverty and to 'close the opportunity gap'. For example, alongside CtOG and tackling child poverty, facilitating financial inclusion is presented as one of the three approaches to tackling social inclusion that the Scottish Executive are undertaking ²⁵, promoting financial inclusion is described as an integral part of CtOG²⁶.

4.82 The Financial Inclusion Action Plan, launched in 2005, is the overarching strategy pursued by the Scottish Executive to facilitate financial inclusion ²⁷. The Action Plan involves a partnership approach to promoting financial inclusion (involving, for example, the financial services sector and local government) and associated action for financial services, advice and support and financial education.

OPERATIONALISING CtOG OBJECTIVE 3: TOWARDS MEASUREMENT

4.83 The primary goal of Objective 3 is to reduce the vulnerability of low income families to financial exclusion and multiple debts. This primary goal is to be met in order to achieve the secondary goals of preventing them becoming over-indebted and/or to lifting them out of poverty.

4.84 In this interim evaluation, it is assumed that the primary goal of reducing vulnerability will lead to the achievement of the secondary goal of leading low income families lifting themselves out of poverty and/or reducing multiple debts. It could be argued that the secondary goal would have be achieved only if the reduction in vulnerability to financial exclusion and multiple debts was sufficient to ensure that low income households were lifted out of poverty (in which case income data would be required for analysis) and/or that their debts were restructured to avoid multiple debts. However, the interpretation taken in this interim evaluation is that it is assumed that reducing their vulnerability will lead to these low income families lifting themselves out of poverty and/or reducing multiple debts.

4.85 It should be acknowledged that the secondary goals lack clarity, through the use of 'and/or'. However, given that the impact of the primary goals on the secondary goals is assumed in this interim evaluation, this is not an immediate concern.

Interpretation

4.86 In the UK, low income families tend to be defined as those experiencing income poverty (living in households with an income 60% below equivalised median household income after housing costs). However, in this interim evaluation, low income families are defined more crudely as those at the lower end of the income scale, i.e. those earning less than £15,000 per annum. This reflects the best available measure of low income in the Scottish Household Survey, the data source which is best placed to measure financial exclusion among low income households in Scotland at the current time.

4.87 Financial exclusion involves not having access to financial products, such as bank accounts and Credit Union services, which are measured in Target K. In this interim evaluation, the analysis for Objective 3 is taken to complement and extend that of Target K by focusing on savings and use of high cost credit services. Thus, the evaluation for Objective 3 is both more broadly based than the focused approach for Target K and more probing in that it seeks to estimate the wider impact of changes effected through Target K (access to mainstream and basic financial products should enable low income families to save and should reduce their dependence on more costly forms of credit).

4.88 It is worthwhile to clarify the relationship between Target K and Objective 3. For the purpose of this interim evaluation, the goal of Target K concerns financial empowerment, i.e. for low income families to be provided through financial education, support and service provision with the means to enable them to reduce their vulnerability to financial exclusion and multiple debts. In contrast, the goal of Objective 3 concerns the financial well-being (which should follow from financial empowerment), i.e. for low income families to have reduced their vulnerability to financial exclusion and multiple debts (as evidenced through savings accrued and withdrawal from high cost credit).

Indicators and Data

4.89 Data are drawn from the most recent annual report of the Scottish Household Survey. This facilitates analysis of savings, extent of savings and use of high cost credit by household income.

EVIDENCE

Savings

4.90 Table 4.2 sets out the proportion of low income households with access to savings against households with £15,001 to £20,000 and the average for Scotland as a whole.

Table 4.2: Having savings, by level of household income

Source: Scottish Executive (2006) Scotland's People 2005. Edinburgh: Scottish Executive, Table 6.45

4.91 Low income households are more likely not to have savings than higher income households, although a substantial minority (two-fifths) of low income households do possess savings. Interestingly, there is little difference among low income households, with those on the lowest incomes (less than £6000 per annum) being as likely as those with marginally higher income (£6001 to £10000 per annum) to possess savings.

4.92 Among low income households, those on the very lowest incomes appear most sensitive to this subject, with almost one in ten of those with an annual income of up to £6000 per annum refusing to answer this question in the Scottish Household Survey.

Level of Savings

4.93 Table 4.3 expands upon Table 4.2 by reviewing the level of savings among those households with savings, and comparing their level of savings to savings within households with £15,001 to £20,000, and the average for Scotland as a whole.

Table 4.3: Level of savings among households with savings, by level of household income

Source: Scottish Executive (2006) Scotland's People 2005. Edinburgh: Scottish Executive, Table 6.50

4.94 Among households with savings, differences between low income households and other households are much less marked in terms of the level of savings accrued. Low income households are only marginally more likely than higher income households to have savings of less than £5000. The key issue thus seems to be enabling people to save in the first place, rather than encouraging low income savers to accumulate more savings.

Use of Informal Credit Sources and High Cost Credit to Borrow Money

4.95 Table 4.4 reports on the extent to which low income households have borrowed money over the last twelve months and the sources on which they have drawn. These data are, once again, compared to households earning between £15001 and £20000 per annum, and against the average for Scotland as a whole.

Table 4.4: Means used to borrow money, by level of household income

Source: Scottish Executive (2006) Scotland's People 2005. Edinburgh: Scottish Executive, Table 6.63
Note: Ng refers to a negligible return (less than 1%)

4.96 Table 4.4 shows that low income households, on the whole, are less likely than higher income households to borrow money, marginally more likely to turn to friends and family when they do need to borrow, less likely to use a bank overdraft facility, and that there is no evidence of extensive use of high credit sources such as money lenders or cheque cashing facilities.

Equality Groups

4.97 While disabled people continue to face difficulties in accessing banks, opening accounts and managing their accounts, there was consensus from interviews with key informants that policy initiatives and private sector practices were addressing some of these concerns.

4.98 However, representatives of LGBT organisations reported discrimination towards LGBT people in access to financial services, although once again, statutory changes were reported as having a positive impact. There was also recognition that civil partnership legislation has strengthened the financial position of people within the LGBT community.

4.99 Representatives of minority ethnic and faith groups referred to a long-standing lack of access to financial services and investment for small businesses and enterprises - one interviewee referred to the Scottish Executive's own report on this: Minority Ethnic Enterprise in Scotland²⁸. None of the key informants from these organisations identified any progress made in accessing personal financial services, and one interviewee perceived that there was a large volume of unmet need and financial exclusion among minority ethnic communities which remained undocumented.

DATA ISSUES

4.100 The Scottish Household Survey has provided benchmark data against which future changes may be compared, as CtOG begins to impact of the landscape of financial inclusion in Scotland. Given the sample size and the stability of this source, continued monitoring of these key financial inclusion data is to be encouraged in the years ahead. However, it must be acknowledged that there are limitations in the use of the SHS as a resource to monitor financial inclusion. Most notably, the measures of low income are not equivalised and are presented in broad income bands.

4.101 The potential of the longitudinal Wealth and Assets Survey must be explored and exploited in subsequent evaluations of this CtOG Objective. This UK-wide survey will provide Scottish data which will examine possession of financial and non-financial household assets. Its longitudinal design will afford the maximum opportunity to relate changes in financial well-being to household circumstance. However, the availability of Scottish data from the Wealth and Assets Survey should be used to complement data from the SHS, rather than substitute it. The substantial sample size of the SHS renders it a resource that should not be overlooked when seeking to understand the scale of financial exclusion in Scotland. There is a need to distinguish between savings and assets in bank accounts, i.e. assets do not necessarily accrue from thrift or the ability to save income.

OBJECTIVE 4:
To regenerate the most disadvantaged neighborhoods - in order that people living there can take advantage of job opportunities and improve their quality of life

SUMMARY EVALUATION

4.102 The broad focus adopted for CtOG Target J means that there is little scope in Objective 4 to undertake an additional evaluation that enhances understanding of community regeneration. The manner in which the wide-ranging remit of Target J ("To promote community regeneration of the most deprived neighborhoods, through improvements by 2008 in employability, education, health, access to local services, and quality of the local environment") is reflected in the corresponding Target monitoring and evaluation procedures: " This target will be achieved if, by 31st March 2008 we have made progress on our wider targets for employment, health and education (targets A, D and F) and measurable improvements to the quality of the local environment in the most deprived neighborhoods. It will also be defined in terms of delivering the outputs and achieving the outcomes set out in each Regeneration Outcome Agreement ( ROA)". This means that there is little left for an additional evaluation of Objective 4 in this interim evaluation.

SUMMARY FINDINGS FROM RELATED TARGETS

4.103 Evidence from the evaluation of Target J remains incomplete for some of the relevant policy areas, but comparison of the situation of the most deprived communities between the 2004 and 2006 Scottish indices of deprivation show some improvements in employment, education, health and access to services conditions ( see Chapter 5 for details).

POLICY CONTEXT

4.104 Scotland has a long tradition of area-based approaches to local area regeneration that stretches back several decades, and includes schemes such the Community Development Programme (1960s), the Glasgow Eastern Area Renewal Scheme (1970s) as Local Enterprise Zones (1980s), and Strathclyde Regional Council's Areas for Priority Treatment ²⁹.

4.105 The Scottish Executive has continued to pursue area-based approaches to regenerate Scotland's most deprived neighbourhoods. Three approaches are of particular note. First, Social Inclusion Partnerships ( SIPs) were the principal area regeneration initiative in Scotland between 1998-2004 ³⁰. These have since been replaced by Community Planning Partnerships, which have the intention of ensuring "that all partners address regeneration and local deprivation as core activities rather than see these as secondary concerns or the responsibility of specialist agencies [such as SIPs]. Regeneration policy was to be pursued through agencies' mainstream budgets with less reliance on discrete funding of specific projects" ³¹.

4.106 Second, in February 2006, the Scottish Executive published People and Place, a regeneration policy statement, which outlines its vision and priorities for area regeneration in Scotland ³².

4.107 Finally, the work programme that underpins CtOG Target J contributes most directly to achieving this Objective. Communities Scotland is charged with managing the Community Regeneration Fund ( CRF) to improve the effectiveness of regeneration in Scotland. This is to be achieved through CPPs presenting a Regeneration Outcome Agreement, a three year plan, to use CRF funds to attend to CtOG goals.

OPERATIONALISING CtOG OBJECTIVE 4: TOWARDS MEASUREMENT

4.108 The primary goal of Objective 4 is to regenerate the most disadvantaged neighborhoods. This primary goal is to be met in order to achieve the secondary goal of ensuring that people living in such neighborhoods can take advantage of job opportunities and improve their quality of life.

Interpretation

4.109 In this interim evaluation, most disadvantaged neighbourhoods are defined the 15% Most Deprived Areas as defined in the 2004 Scottish Index of Multiple Deprivation.

4.110 The nature of the association between the primary goal and the secondary goal in Objective 4 is open to interpretation. It could be understood that the secondary goal (to ensure that people living in the Most Deprived Neighborhoods can take advantage of job opportunities and improve their quality of life) would only be achieved if regeneration was undertaken in a manner for which it could be demonstrated that people living in these neighborhoods were then able to take advantage of job opportunities and improve their quality of life. However, the interpretation taken in this interim evaluation is that Objective 4 concerns regeneration which, it is assumed, will lead to people living there being able to take advantage of job opportunities and improve their quality of life.

EVIDENCE

4.111 Quantitative evidence for community regeneration is considered in Target J. Information gathered from interviews with key informants and equality group representatives are reported in this section of the report.

4.112 No key informants referred to significant changes in conditions within deprived neighbourhoods. For those with disabilities, significant mobility challenges and problems causes by reductions in services persist. It was also perceived that disabled individuals remain more vulnerable in terms of community safety. In addition, community-policing budgets were understood to have remained low in some deprived areas.

4.113 LGBT representatives, referred to LGBT individuals still feeling unsafe in their neighbourhoods, (especially transgendered people). Noted improvements include improved policing practice building trust between the police forces and increasing the confidence of LGBT people to report crime. Positive collaboration between police forces and LGBT groups has also led to the establishment of remote reporting facilities where LGBT people can report crime, and homophobic hate crime is beginning to be recognised by the police force.

4.114 Minority ethnic and faith organisations identified both improvement and deterioration, depending on both the area in question and aspect of neighbourhood quality considered. On the positive side, it was perceived that certain neighbourhoods had benefited from physical refurbishment, and that overcrowding and the number of social housing voids had fallen in particular areas. On the negative side, it was felt that littering had increased due to infrequent council collections and that racist vandalism was more common.

DATA ISSUES

4.115 The Scottish Executive should reconfigure indicators and monitoring of Objective 4 in conjunction with Target J, to ensure that each has a specific and complementary remit.

OBJECTIVE 5:
To increase the rate of improvement of the health status of people living in the most deprived communities - in order to improve their quality of life, including their employability prospects

SUMMARY EVALUATION

4.116 Analysing Objective 5 requires monitoring changes in health indicators in the most deprived communities in Scotland. In choosing how best to present this change, this evaluation follows the lead of the Scottish Executive, which has been monitoring changes in Cancer and Coronary Heart Disease ( CHD) rates in the most deprived communities since 2003 for Target D of the CtOG Programme. It was felt that the Objective 5 analysis and the Target D analysis, both of which include an analysis of Cancer and CHD rates, should not present Cancer and CHD data in a different way to existing Scottish Executive analysis.

4.117 As measured by the seven indicators analysed below, health in the most deprived areas in Scotland improved between 2003 and 2005. Moreover, the rate of improvement over the last two years was higher than for the previous period. On the whole, improvements impacted upon the most severely deprived areas as well as those which are relatively less deprived.

SUMMARY FINDINGS FROM RELATED TARGETS

4.118 Target D aims to " reduce health inequalities by increasing the rate of improvement for under 75 Coronary Heart Disease Mortality and under 75 Cancer Mortality (1995-2010) for the most deprived communities by 15% by 2008". Cancer and CHD rates are wholly relevant to Objective 5, and so are considered within the analysis of this Objective.

4.119 The Target D monitoring data presented on the Scottish Executive website is presented in terms of average annual percentage improvement in cancer rates and CHD rates. The Scottish Executive calculates average annual percentage improvement as a geometric average; i.e. the percentage improvement which, when applied 'n' times, produces the total percentage improvement observed over 'n' years. Reflecting this practice, much of the data in this section is also presented in terms of average annual percentage improvements, and averages are calculated using the Scottish Executive's method ³³.

POLICY CONTEXT

4.120 Evidence has existed for some time that the health status of individuals in Scotland varies significantly with socio-economic status. For example, a report by the Measuring Inequalities in Health Working Group showed that for the period 1991 to 1993, the rate of early deaths among males in Scotland was almost four times greater for those in Social Class V than for those in Social Class I ³⁴.

4.121 Recognising these differences, NHS Scotland acknowledged in Our National Health: A plan for action, (December 2000) that "in Scotland, terrible inequalities still exist between the health of the worst off and the health of the better off", and identified reducing health inequalities in Scotland as a core aim. The Scottish Executive's health policy in recent years has been driven by this aim: in Improving Health in Scotland - The Challenge, the Challenge is summarised as: to improve the health of all the people in Scotland and to narrow the opportunity gap; and to improve the health of our most disadvantaged communities at a faster rate, thereby narrowing the health gap.

4.122 Accordingly, reducing health inequalities was highlighted as a major goal in the Scottish Executive's 2003 White Paper on health - "our objective is to improve Scotland's health and reduce the health inequalities within our society… NHS Boards will also step up their efforts to reduce health inequalities" - and in NHS Scotland's 2005 delivery plan Delivering for Health, which identifies 'reducing the health gap' as a Key Action for NHS Scotland delivery.

4.123 Since the publication of Our National Health, a range of measures have been introduced across Scotland to tackle health problems and promote healthy living among vulnerable and hard-to-reach individuals, in order to address the difference in health status between the better off and the worst off in Scotland. In many cases - for example the Prevention 2010/ Keep well pilots which have been introduced to deliver progress towards Target D of the CtOG programme - such initiatives have targeted deprived areas in an attempt to reduce socio-economic inequalities in health, and indeed, Objective 5 is defined in terms of deprived areas ³⁵.

4.124 Objective 5 reflects the Scottish Executive's desire to improve health in Scotland. By requiring an increase in the rate of improvement, rather than merely an improvement, it also identifies the need for health to improve quickly in the most deprived areas, so that the current differences in health status between deprived areas and the rest of the country can be addressed.

4.125 As implied in the wording of Objective 5, the health agenda is closely linked to the employment agenda. It is increasingly recognised that employment has positive effects on health, and that poor health is keeping a large percentage of individuals from entering paid employment. In particular, those areas that are employment deprived tend to also be health deprived, as demonstrated in the high correlation between the Employment and Health Domain in the SIMD 2004. Thus it is hoped that improving the health status of people in deprived areas can also improve their employability and employment opportunities, thus increasing employment rates and reducing levels of deprivation.

OPERATIONALISING CtOG OBJECTIVE 5: TOWARDS MEASUREMENT

Choice of indicators

4.126 The 'most deprived communities' have been identified by the Scottish Executive for Target D using the Carstairs Index. The Carstairs Index has thus been used in this analysis wherever possible. However, benefits data was only available for the 15% most deprived areas as defined by the Scottish Index of Multiple Deprivation ( SIMD) 2004. The discussion on 'Measuring deprivation' in the 'Data Issues' section below provides more details on the differences between the Carstairs Index and the SIMD.

4.127 Following the publication of Our National Health, the Scottish Executive established the Measuring Inequalities in Health Working Group. The Working Group was set up to determine the most appropriate indicators to use in monitoring progress towards tackling health inequalities in Scotland and to advise on possible targets. It identified 23 possible indicators:

1) Smoking during pregnancy
2) Breastfeeding
3) Dental health of children
4) Low birth-weight babies
5) Accidents in children aged 0-9 (hospital admissions)
6) Infant mortality
7) Accidents in children aged 10-14 (hospital admissions)
8) Teenage pregnancies (females aged 13-15)
9) Teenage pregnancies (females aged 13-19)
10) Suicides among young people aged 10-24
11) Diet

• consumption of fresh fruit
• consumption of green vegetables

12) Adult smoking
13) Self-reported general health in

• people aged 16-44
• people aged 45-64

14) Self-reported limiting long-standing illness
15) Obesity
16) Mental health ( GHQ12 scores)
17) All cause mortality rate among people under 75
18) Mortality rates from coronary heart disease among people under 75
19) Mortality rates from cancer among people under 75
20) Life expectancy
21) All cause mortality rate among people over 75.
22) Mortality rates from coronary heart disease among people 75 and over
23) Mortality rates from cancer among people 75 and over.

4.128 This evaluation uses those six of these 23 indicators which are monitored by the Scottish Executive and disaggregated by level of deprivation, plus benefit data from the Department of Work and Pensions. In some indicators, the most recent data is from 2005, which is barely one year after the launch of CtOG Objectives and Targets. Such data may best serve as a baseline for future evaluation rather than an assessment of CtOG impact.

4.129 The seven measures of health status used to evaluate progress towards Objective 5 here are:

1) Suicide among young people (per 100,000) in the 20% most deprived areas
2) Adults smoking (per 100) in the 20% most deprived areas
3) Under 75 cancer mortality (per 100,000) in the 20% most deprived areas
4) Under 75 coronary heart disease mortality (per 100,000) in the 20% most deprived areas
5) Expectant mothers smoking during pregnancy (per 100) in the 20% most deprived areas
6) Teenage pregnancy (per 1,000) in the 20% most deprived area
7) Working age individuals receiving Incapacity Benefit ( IB) and/or Severe Disablement Allowance ( SDA) (per 100) in the 15% most deprived areas ³⁶

4.130 Note that for all the indicators considered here, a positive improvement represents a reduction in the indicator.

4.131 Incapacity Benefit ( IB) and Severe Disablement Allowance ( SDA) are paid to people judged to be incapable of work due to illness or disability. Although not all individuals with a severe illness or disability will be in receipt of IB or SDA, these rates of receipt provide a general picture of the overall level of ill-health in the most deprived areas relative to the rest of Scotland.

4.132 In its Inequalities in Health, report the Working Group calculated all of these 23 indicators for the most deprived and least deprived quintiles in Scotland (according to the Carstairs Index). However, that analysis was not suitable for this interim evaluation of CtOG, as the data it was based on predated the implementation of CtOG (for some indicators the most recent available data was from 1998). Neither was it replicable within the scope of this interim evaluation, because of the difficulties of accessing data at postcode level and matching sensitive health data with geographical identifiers, in order to calculate the indicators for the most deprived areas. In addition, it is likely that the CtOG programme will take several years to impact upon factors such as life expectancy and birth-weight, and so extensive analysis of the kind carried out by the Working Group would be more appropriate later in the evaluation process. Given sufficient resources, a repeat of the Working Group's analysis at the end of the CtOG programme, compared against their earlier analysis, would provide a comprehensive assessment of improvement in health status in the most deprived areas.

EVIDENCE

4.133 Figure 4.21 shows the annual percentage improvement for each of these indicators, for the two periods 1995 to 2003, and 2003-2005. For all seven measures, the annual improvement is greater for the 2003-2005 period. Therefore, to the extent that these indicators are representative of the health status of individuals living in deprived areas, they show that Objective 5 was met for the period up to 2005.

4.134 Two of the changes illustrated are particularly notable. First, there has been improvement in the annual reduction of youth suicides: rising to 8.6% per year in 2004-05 from 0.2% in 1995-2003. It should be borne in mind that suicides per 100,000 young people each year are relatively few, and these figures can be subject to fluctuation. Second, the proportion of people in receipt of IB/ SDA in the most deprived areas decreased by 2.7% each year between 2003 to 2005, having increased in the previous period. This change may reflect a wider trend in UKIB/ SDA claimant rates, which increased throughout the 1990s and early 2000s and have recently begun to fall marginally.

Figure 4.21: Annual percentage improvement in health indicators in 20% most deprived areas: 1995-2003 and 2003-2005

Notes: Because numbers of teenage pregnancies and suicides among young people are subject to fluctuation, the figures provided by the Scottish executive are 3-year averages. Each 3-year average has been taken to represent the most recent of those years. For example, the figure we have used to represent 1995 is the 1993-1995 3-year average. Due to lack of data availability, the teenage pregnancy figure labelled 2003-2005 in fact represents only the period 2003-2004. Teenage pregnancy figures for 2005 are due to be released in autumn 2007.

Due to lack of data availability, the IB/ SDA figure labelled 1995-2003 in fact represents only the period 1999-2003. Sources: General Register Office for Scotland ( GROS), Analytical Services Division of the Scottish Executive Health Department ( ASD Health), Information Services Division of the NHS Scotland ( ISD), Scottish Household Survey.

4.135 Figure 4.22 shows actual rates of incidence for each of the indicators for 2003, 2004 and 2005. These figures reveals that more than a fifth of people of working age in the 15% most deprived areas were in receipt of Incapacity Benefit and/or Severe Disablement Allowance in 2005, and more than one in three adults (people aged 16 years and over) smoked. Just under a third of expectant mothers smoked, although the figure had fallen by four percentage points from 35.8% in 2003.

Figure 4.22: Health Indicators in 20% most deprived areas: 2003-2005 I

Notes: Because numbers of teenage pregnancies and suicides among young people are subject to fluctuation, the figures provided by the Scottish executive are 3-year averages. Each 3-year average has been taken to represent the most recent of those years. Due to lack of data availability, the teenage pregnancy figures labelled 2003, 2004 and 2005 in fact represent the years 2002, 2003 and 2004 respectively. Teenage pregnancy figures for 2005 are due to be released in autumn 2007.

Sources: GROS, ASD Health, ISD and Scottish Household Survey.

4.136 Figure 4.23 shows rates of Incapacity Benefit and/or Severe Disablement Allowance ( IB/ SDA) receipt in the 15% most deprived areas and for the rest of Scotland. Rates of IB/ SDA receipt are around four times higher in the most deprived areas of Scotland than in the rest of the country. Both in the most deprived areas and in the rest of Scotland, rates of IB/ SDA receipt increased between 1999 and 2001, and then began to fall. In both cases rates fell by 5.9% between 2001 and 2005. This provides some evidence that the overall level of severe illness or disability in deprived areas is decreasing, and at a similar rate to that in the rest of the country.

Figure 4.23: Percentage of working age population in receipt of Incapacity Benefit and/or Severe Disablement Allowance: 1999-2005

Notes: Deprivation measured using the SIMD 2004. Includes Incapacity Benefits (Stat group 2) only. Working age population is Men aged 16-64 (inclusive) and Women aged 16-59 (inclusive). 1999 and 2000 population data is based on census 2001 populations, 2001 - 2005 populations from small area population estimates from GROS.

Sources: DWP 100% Client Group Data Scan, Scottish Index of Multiple Deprivation ( SIMD) 2004 and GROS.

4.137 Figure 4.24 presents under 75 cancer and coronary heart disease ( CHD) mortalities per 100,000 population, in the 20% most deprived areas. It shows that the rate of deaths from both illnesses fell between 2003 and 2005. Cancer and CHD mortalities in the 20% most deprived areas are discussed further in the Target D analysis.

Figure 4.24: Health Indicators in 20% most deprived areas: 2003-2005 II

Sources: GROS, ASD Health.

Impact on Equalities Groups

4.138 It has been shown that annual improvements for all seven of the Objective 5 indicators were higher between 2003-2005 than between 1995-2003. These annual improvement rates are broken down below by gender and, where data are available, age, to reveal the changes experienced by different sub-groups of the deprived population. The analysis also compares the different percentage improvements experienced by the 5% and 10% most deprived areas in Scotland (which, of course, fall within the 20% most deprived areas being considered).

4.139 Table 4.5 shows the annual percentage improvement in IB/ SDA receipt rates for the 2003-2005 period, disaggregated by gender. This shows that the percentage reduction in the proportion of men in receipt of IB/ SDA was more than double the reduction for women. As illustrated by Figure 4.25, the proportion of IB/ SDA recipients was higher among men than women in 2003; therefore the gender gap is closing.

Table 4.5: Proportion of working age population in receipt of IB/ SDA in 15% most deprived areas: annual percentage improvement 2003 - 2005

Notes: Deprivation measured using the SIMD 2004. Includes Incapacity Benefits (Stat group 2) only. Working age population is Men aged 16-64 (inclusive) and Women aged 16-59 (inclusive). 1999 and 2000 population data is based on census 2001 populations, 2001 - 2005 populations from small area population estimates from GROS.

Sources: DWP 100% Client Group Data Scan, SIMD 2004 and GROS.

Figure 4.25: Percentage of working age population in receipt of Incapacity Benefit and/or Severe Disablement Allowance in the 15% most deprived areas by gender: 1999-2005

Notes: Deprivation measured using the SIMD 2004. Includes Incapacity Benefits (Stat group 2) only. Working age population is Men aged 16-64 (inclusive) and Women aged 16-59 (inclusive). 1999 and 2000 population data is based on census 2001 populations, 2001 - 2005 populations from small area population estimates from GROS.

Sources: DWP 100% Client Group Data Scan, SIMD 2004 and GROS.

4.140 Figure 4.26 shows annual percentage improvement for suicide rates among young people in the most deprived areas. This reveals, first, that females in the 10% most deprived areas saw the largest percentage reduction in suicide rates. Second, it shows that it is not only in the 'less deprived' areas that suicide rates are falling; in fact, percentage reductions were greater in the 5% and 10% most deprived areas than in the 20% most deprived.

4.141 Differences between the most severely deprived areas and other deprived areas are also revealed in Figure 4.27. In the 20% and 10% most deprived areas, the overall smoking rate improved between 2003 and 2005 (that is, a smaller proportion of people were smoking), while in the 5% most deprived areas in Scotland, the proportion of people smoking actually increased. However, as discussed further below, the smoking data used here is taken from the Scottish Household Survey and suffers from large sampling errors when broken down by sub-group.

Figure 4.26: Suicide amongst young people in the 20% most deprived areas: annual improvement 01/03-03/05

Notes: Figures based on rate per 100,000 population. Deprivation measured using the Carstairs index. The number of suicides is relatively small and rates per 100,000 are therefore subject to fluctuation from year to year.

Sources: GROS, ASD Health.

Figure 4.27: Percentage of adults smoking in the 20% most deprived areas: annual improvement 2003-2005

Notes: Deprivation measured using the Carstairs index. Sample sizes in each age group are relatively small. Percentages are therefore subject to fluctuation.

Sources: Scottish Household Survey; ASD Health.

4.142 Figures 4.28 and 4.29 show yearly improvements in under 75 cancer and CHD rates. Both graphs show that the most severely deprived areas are performing well, with percentage reductions in mortalities generally higher than in the slightly less deprived areas. Annual improvements in CHD mortalities for women and for the 45-64 age group averaged nearly 20% for the 2003-2005 period.

Figure 4.28: Under 75 cancer mortality rate in the 20% most deprived areas: annual improvement 2003-2005

Notes: Figures based on rates per 100,000 population; age-standardised to the European population. Deprivation measured using the Carstairs index.

Sources: GROS; ASD Health.

Figure 4.29: Under 75 CHD mortality rate in the 20% most deprived areas: annual improvement 2003-2005

Notes: Figures based on rates per 100,000 population; age-standardised to the European population. Deprivation measured using the Carstairs index.

Sources: GROS; ASD Health.

4.143 Figure 4.30 shows that percentage reductions in teenage pregnancies were fairly small (around 2% a year) in the 20% most deprived areas. Smoking during pregnancy by expectant mothers fell more dramatically.

Figure 4.30: Teenage pregnancy and expectant mothers smoking during pregnancy in the 20% most deprived areas: recent annual improvement

Notes: Deprivation measured using the Carstairs index. Teenage Pregnancy figures are based upon the rate per 1000 population. Because numbers of teenage pregnancies are subject to fluctuation, the rates provided by the Scottish Executive are 3-year averages. The teenage pregnancy improvement figures presented here represent differences between the 2000/2 figures and the 2002/4 figures. Teenage pregnancy figures for 2003/5 are due to be released in autumn 2007. Denominator populations for 13-15 year olds for teenage pregnancy figures are estimated from 5-year age group populations.

Sources: ISD; ASD Health, Scottish Household Survey.

4.144 While it is possible to disaggregate most of the health indicators by age and gender, data are not available to analyse variations by faith, ethnicity, sexuality nor disability status. In recognition of this gap in the available data, the views of representatives of the different equalities groups were sought to gain an independent impression of the progress of individuals of different faith, ethnicity, sexuality and disability status towards Objective 5. The major issues that arose from this research are discussed below.

4.145 There is a belief that health outcomes for people with disabilities have improved in the last few years, but there are still some concerns over whether the health service is sufficiently staffed to cope with people with specific needs, particularly those of people with learning difficulties and mental health problems.

4.146 It is believed that LGBT people still face discrimination within the health services, with many feeling unable to access certain services because of their sexuality. The LGBT Health Scotland ³⁷ has helped raise awareness of the needs of LGBT people and is expected to impact positively on future provision of health services to LGBT people. LGBT organisations argued that traditionally, LGBT people have not seen the health service as meeting their needs, although they recognised that sexual health services and school nurses were making a difference to the lives of some young LGBT people. The Scottish Executive Health Department's involvement with Stonewall and other LGBT groups on the LGBT Health Inclusion ³⁸ project, and the Diversity Task Force set up to look at inclusive workplace practice within the NHS were considered valuable and helpful ³⁹.

4.147 Minority ethnic and faith groups identified a variable picture of some improvements alongside continued problems. Prominent among the latter were access problems due to a lack of information about services and language barriers. However, improvements were noted in some forms of provision, outreach efforts, and a more proactive approach to increase service take-up and access among minority groups in certain areas.

DATA ISSUES

4.148 In contrast to some of other the factors which CtOG is intended to impact upon, a large amount of data are currently collected which enable measurement of the health of people in Scotland. This is evidenced by the long list of measurements from a variety of sources which the Measuring Inequalities in Health Working Group were able to recommend as possible health indicators. However, the majority of these possible indicators cannot be broken down by ethnicity, faith, disability, sexuality nor socio-economic status, because these features are not reliably collected nor recorded at present. As the usefulness of such data has become more apparent, efforts have been made to ensure they are recorded; for example, the DWP are moving towards releasing IB figures broken down by ethnicity. We can therefore expect the availability of such information to improve, although there are likely to be continued difficulties in collecting sensitive data, such as the faith and sexuality of a client or survey respondent.

4.149 While gender, sexuality, faith, ethnicity and disability status can all impact upon a person's likelihood to require certain primary care services and/or the accessibility of those services, interviews with members of Scottish Executive staff responsible for CtOG Objective 5 highlighted a primary focus on the role of socio-economic status in determining health outcomes - which they believe are the major determinants of inequalities. Currently, the Scottish Executive are focusing on reducing differences between areas of differing levels of deprivation; it may be analysis of health status by an individual-level factor, such as Social Class, would also be useful. If so, these data should be collected along with gender, sex, ethnicity etc. Alternatively, it may be that deprivation of area lived in is considered a suitable proxy for individual socio-economic status.

Measuring deprivation

4.150 The IB/ SDA indicator used to evaluate Objective 5 uses the Scottish Index of Multiple Deprivation ( SIMD) 2004 to identify the most deprived areas, while the other 6 use the Carstairs Index. The Scottish Executive currently uses both these measures of deprivation in their analysis. The Carstairs Index is the measure used in the Inequalities in Health report, and was the only index available when these targets were formulated. The targets will continue to be monitored using the Carstairs index until the target year of 2008 to allow a fair assessment of whether the targets have been met. In the meantime, the SIMD has been developed, and this is used to identify the most deprived 15% of areas for the production of benefit claimant statistics. The Scottish Executive is investigating the possibility of using SIMD in the measurement of its health targets in future, so that only one measurement of deprivation is employed.

4.151 The most important difference to note is that while the 15% most deprived areas as calculated by the SIMD 2004 are the same areas for every year considered in this analysis, the 20% most deprived area according to the Carstairs Index are revised annually. The Carstairs score for each postcode sector in Scotland was originally calculated using 1991 census health data and the '20% most deprived areas' were identified as the collection of postcode sectors, counting the most deprived areas first, which contained 20% of the population. To estimate which postcode sectors comprised the '20% most deprived areas' in all subsequent years, weights which reflect the changes in NHS Board population from year to year are applied to the 1991 census-derived postcode sector populations. The group of postcode sectors defined as the 20% most deprived areas might therefore change between 2003 and 2005, although the single most deprived postcode sector will be the same in every year ⁴⁰.

4.152 It may have been possible to calculate all 7 indicators using the SIMD as the measure of deprivation. However, in order to do this the research team would have required some of the relevant data at postcode-sector or data-zone level. Accessing this data and performing the analysis would have been beyond the scope of this interim report. Moreover, as the Scottish Executive is currently investigating the possibility of moving from Carstairs to the SIMD in the measurement of its health targets, it was considered inappropriate to change methodology before the results of that investigation were available.

Assessing the significance of change

4.153 The smoking amongst adults indicator analysed in this chapter is calculated using data from the Scottish HouseholdSurvey. However, SHS sample sizes in each age group are small, increasing the size of the sampling error. This should be borne in mind when assessing change for a given age group, and for other groups when they are disaggregated by level of deprivation.

Data Sources

4.154 The seven health indicators are listed below along with along with their sources and other relevant information.

Suicide amongst young people (aged 10-24 years) in the 20% most deprived areas
Rate per 100,000 population
Source: General Register Office for Scotland ( GROS); Analytical Services Division of the Scottish Executive Health Dept ( ASD Health)
(1) Deprivation measured using the Carstairs index.
(2) The number of suicides is relatively small. Rates per 100,000 are therefore subject to fluctuation from year to year.

Teenage pregnancy (aged 13-15y) in the 20% most deprived areas
Rate per 1,000 population
Source: Information Services Division of the NHS Scotland ( ISD); ASD Health
(1) Deprivation measured using the Carstairs index.
(2) Denominator populations for 13-15 year olds estimated from 1991 census figures and 5-year age group populations for subsequent years.

Adult (aged 16 years+) smoking in the 20% most deprived areas
Percentage smoking
Source: Scottish Household Survey; ASD Health
(1) Deprivation measured using the Carstairs index.
(2) Sample sizes in each age group are relatively small. Percentages are therefore subject to fluctuation.

Smoking during pregnancy in the 20% most deprived areas
Percentage smoking
Source: ISD; ASD Health
(1) Deprivation measured using the Carstairs index.
(2) Age information not available on the dataset held by ASD Health.

Under 75 cancer mortality in the 20% most deprived areas
Source: GROS; ASD Health
Rate per 100,000 population; age-standardised to the European population
(1) Deprivation measured using the Carstairs index.
(2) <75 mortality rates are used for the Closing the Opportunity Gap Target D rather than all age mortality rates.

Under 75 CHD mortality in the 20% most deprived areas
Source: GROS; ASD Health
Rate per 100,000 population; age-standardised to the European population
(1) Deprivation measured using the Carstairs index.
(2) <75 mortality rates are used for the Closing the Opportunity Gap Target D rather than all age mortality rates.

Percentage of Working Age Population Claiming Incapacity Benefit or Severe Disablement Allowance in the 15% most deprived data-zones
Source: DWP 100% Client Group Data Scan, Scottish Index of Multiple Deprivation ( SIMD) 2004 and General Register Office Scotland
(1) Deprivation measured using the SIMD 2004.
(2) Includes Incapacity Benefits (Stat group 2) only.
(3) Working age population is Men aged 16-64 (inclusive) and Women aged 16-59 (inclusive).
(4) 1999 and 2000 population data is based on census 2001 populations, 2001 - 2005 populations from small area population estimates from GROS.

OBJECTIVE 6:
To improve access to high quality services for the most disadvantaged groups and individuals in rural communities - in order to improve their quality of life and enhance their access to opportunity

SUMMARY EVALUATION

4.155 As the CtOG work programme to improve services in rural Scotland did not start until 2005 and given that there are no plans to evaluate the outcomes of this work until the end of 2007, it is premature at this stage to evaluate progress for Objective 6. Consequently, the Scottish Household Survey 2006 and the 2006 Scottish Index of Multiple Deprivation have been appraised to provide a baseline against which subsequent changes in service provision can be appraised

SUMMARY FINDINGS FROM RELATED TARGETS

4.156 CtOG Target H seeks to tackle the problem of rural service delivery: "… [b]y 2008, improve service delivery in rural areas so that agreed improvements in accessibility and quality are achieved for key services in remote and disadvantaged communities". More generally, each of the other nine CtOG targets is required to consider the rural dimension.

POLICY CONTEXT

4.157 Since its inception, the Scottish Executive has give a high priority to rural issues. A Minister for Rural Affairs was appointed in 1999 and Scottish Executive rural policy was co-ordinated first by a Ministerial Committee on Rural Development, and then by a Cabinet Sub-Committee on Rural Development. The 2003 Partnership Agreement committed the Executive to "… ensure that rural and remote communities have their distinct needs reflected across the range of government policy and initiatives". The Scottish Executive strategy for rural policy was set out in 2000 with the publication of Rural Scotland: A New Approach⁴¹ and progress reports were published in 2003 and 2004. In April 2006 the Executive consulted on its Rural Development Programme for Scotland 2007-2013⁴².

4.158 In December 2005, 22 Rural Service Priority Areas were allocated £100,000 to develop new projects. These RSPAs were identified as the most disadvantaged rural areas. Research was commissioned by the Scottish Executive to ascertain service priorities in RSPAs ⁴³.

4.159 Finally, Scottish Executive approaches to understanding and measuring poverty and social exclusion have shown sensitivity to the rural dimension. In 2001 it published Poverty and Social Exclusion in Rural Scotland, a report by the Scottish Executive convened Rural Poverty and Inclusion Working Group ⁴⁴. Furthermore, one of the seven dimensions of the Scottish Index of Multiple Deprivation is a measure of geographical access to services, which acknowledges the importance of poverty of access in rural Scotland.

OPERATIONALISING CtOG OBJECTIVE 6: TOWARDS MEASUREMENT

4.160 The primary goal of Objective 6 is to improve access to high quality services for the most disadvantaged groups and individuals in rural communities. This primary goal is to be met in order to achieve the secondary goal of improving their quality of life and enhancing their access to opportunity.

Interpretation

4.161 In this interim evaluation, the most disadvantaged groups and individuals in rural communities are defined as those living in areas of Scotland which are classified as "remote rural" in the Scottish Executive urban/rural classification ⁴⁵.

4.162 The primary goal of Objective 6 is open to interpretation in that neither "improving access" nor "high quality services" are defined. Furthermore, the range of services which should be appraised is open to question. The approach taken in this interim evaluation is to focus on a wide range of everyday services and to use the perceptions of service users to ascertain the extent to which services are of "high quality".

4.163 The nature of the association between the primary goal and the secondary goal in Objective 1 is also open to interpretation. It could be understood that the secondary goal (improving quality of life and enhancing access to opportunity) would be achieved only if any high quality services provided were sufficiently rewarding to ensure that these secondary goals were also achieved. However, the interpretation taken in this interim evaluation of Objective 6 is that the provision of key services (which are assumed to be high quality) will itself lead to improvements to the quality of life and enhancements in access to opportunities for most disadvantaged groups and individuals in rural communities.

Indicators and Data

4.164 Two sources of readily available and robust national data are used to appraise Objective 6. First, the Scottish Household Survey ( SHS) provides a wealth of data on the opinions of people living in Scotland on different aspects of service provision. The SHS can be disaggregated by urban/rural area type. In this interim evaluation, 2005 data are used to provide a baseline of opinion on the quality of service provision in Scotland. These data pre-date the implementation of CtOG.

4.165 Complementing these perceptions, are data from the Scottish Index of Multiple Deprivation 2006. These data provide a measure of on-the-ground improvements in accessing services through the geographical access to services domain in the Index. SIMD data can also be disaggregated by urban/rural area type.

4.166 In the following analysis, the approach taken is to compare the experiences of service provision in "remote rural" Scotland against other peripheral areas ('accessible rural' and 'remote small towns') and against Scotland as a whole.

EVIDENCE

Overview of Service Provision

4.167 Table 4.6 considers geographic access to services in Scotland using data from the Scottish Index of Multiple Deprivation 2006. Contemporary experiences (2006) are compared to recent experiences (2004) to provide a measure of change. Four definitions of Most Deprived Areas are presented, with more intense measures of deprived area in the right hand columns in the table.

4.168 Remote rural areas in Scotland have a disproportionate share of neighbourhoods with the worst access to services (Table 4.6). The level of service deprivation correlates with the level of rurality - more rural areas have worse service access. There has been little change in this situation since 2004, although the relative share of the areas in remote rural Scotland with the worst access to services has increased.