Scotland’s Population 2020

Summary

“Since 1855 Scotland’s Registrar Generals have delivered an annual report to Parliament and the Scottish public. These reports detail key information on births, deaths and marriages. In doing so they provide invaluable statistics that help describe how Scotland’s population is changing.

"I am immensely proud of the work my colleagues across National Records of Scotland (NRS) have done during the last 18 months. Working closely with our partners across the country we have innovated and adapted to ensure the maintenance and delivery of a number of vital services.

"An excellent example of this has been the work we have done to deliver a range of important statistics. Foremost, is our weekly COVID-19 publication which continues to provide vital evidence on how the COVID-19 pandemic affects Scotland.

"The Registrar General’s Annual Review (RGAR) has evolved in content and style over time. This year’s RGAR is a major change to previous versions. The report is split into a number of short chapters which identify some of our key findings on topics such as COVID-19 mortality, our changing population, and health inequalities. The publication also provides links to the more detailed reports and statistics held on NRS’s website, which I know is important to those looking to explore these key issues in greater depth.

"I hope that you find this new approach informative and helpful.

"Please feel free to contact us and let us know what you think.”

Paul Lowe, Chief Executive, National Records of Scotland

 

COVID-19 deaths

The year 2020 saw two waves of people dying from COVID-19

The first wave between late March 2020 and August 2020 saw a lot of deaths in a short space of time. There were just over 4,200 deaths during this period. It also had a higher peak of deaths than the second wave. During the first wave, 77% of deaths occurred in people aged 75 or more.

In contrast, the second wave lasted longer and saw more deaths. There were just under 5,900 deaths between September 2020 and May 2021. And 68% of deaths occurred in people aged 75 or more.

In the first wave, care homes saw a bigger proportion of all deaths than in the second wave. Just under a half occurred in care homes and a similar number in hospitals. In the second wave, about 7 in 10 deaths were in hospital with just over 2 in 10 occurring in care homes.

 

COVID-19 deaths in Scotland by location of death, March 2020 to August 2021

Source: Deaths involving COVID-19 in Scotland

 

 

Most people dying from COVID-19 are 75 and over

This is partly because older people often have other risk factors. For example, underlying health issues.

About 72 in 100 COVID-19 deaths have been of people 75+ years old. People under 45 accounted for around 1 in 100 deaths.

The first wave of the pandemic saw about 5,000 more deaths from all causes than the same period in previous years. COVID-19 was a big reason for this increase. In the second wave, there were about 3,000 excess deaths.

 

Excess deaths by age in Scotland, March 2020 to August 2021

Source: Deaths involving COVID-19 in Scotland

 

 

More people have died in deprived areas

Mortality rates are normally higher in more deprived areas (see our chapter on health inequality). COVID-19 appears to be increasing this effect.

The general mortality rate in the most deprived areas is almost twice the rate in the least deprived areas. However, the mortality rate for COVID-19 in the most deprived areas is around 2.4 times as high. This figure was 2.1 in the early stages of the pandemic. This means the gap in mortality rates between the most and least deprived areas has increased as the pandemic has progressed.

Many of the risk factors for COVID-19 are more common in more deprived areas. For example: diabetes, obesity and lung disease.

 

Age standardised death rates per 100,000 people from COVID-19 by SIMD quintile, Scotland, March 2020 to August 2021

Cause of death	Mortality rate in the most deprived areas (SIMD 1)	Mortality rate in the least deprived areas (SIMD 5)	Ratio between mortality rates in the most and least deprived areas
All causes	2395.5	1260.7	1.9
COVID-19	326.3	137.3	2.4

Source: Deaths involving COVID-19 in Scotland

 

There is evidence of a disparity between some ethnic groups

In the first three months of the pandemic, deaths of South Asian people were almost twice as likely to involve COVID-19 than deaths of White Scottish people.

There was no evidence of a significant difference for Chinese or White Irish people, compared to White Scottish people. The number of deaths in other minority ethnic groups was too low for comparable analysis.

During the second wave in England and Wales, most Black and South Asian groups remained at higher risk compared to White British people.

 

Disabled people are at greater risk

Health problems and disabilities are more common in older people. But even after taking age into account, disabled people were more likely to die with COVID-19:

• People whose daily activities were limited a little were almost twice as likely to die with COVID-19
• People whose daily activities were limited a lot were around three times as likely to die with COVID-19

Pre-existing health conditions were present in most deaths

There is a clear link between COVID-19 related deaths and pre-existing health conditions.

Across all COVID-19 related deaths, 93% had at least one pre-existing condition.

Dementia and Alzheimer’s disease was the most common pre-existing condition in COVID-19 related deaths. This disease was apparent in 1 in 4 deaths. For females aged 65 and over this becomes 1 in 3.

April to July 2020 saw more drug deaths compared to the same period over the last 5 years

There were 1,339 drug-related deaths in 2020. This was a 5% increase on 2019 and the largest number ever recorded. Drug-related deaths have been increasing since 1996 but since 2013 the upward trend has been steeper.

Within 2020 we can look at how drugs deaths for individual months compare to what might be expected based on the past. The number of drug deaths during April, May, June and July of 2020 was significantly higher than it was during the same months in the last 5 years. These months also cover the time of the first national lockdown.

There were 1,190 alcohol-specific deaths in 2020. This was a 17% increase on 2019 and the highest number recorded since 2008 (1,316). We saw increases between 2012 and 2018 before a 10% decrease in 2019. The increase of 17% in 2020 reversed the fall in 2019.

 

Excess deaths by cause of death in Scotland, January to December 2020

Source: Deaths from specific causes

 

Within 2020 the number of alcohol-specific deaths was especially high in April and from September to November compared to the last 5 years.

There were 805 suicides in 2020. This was a 3% decrease on 2019. There was a downward trend in suicides from the early 2000s until 2017. This was followed by increases in 2018 and 2019.

Within 2020 the number of suicides between July and September was higher than in any of the last 5 years.

Note: An error was noticed in the monthly deaths in both the probable suicide and alcohol specific death publications. Deaths for these measures were based on month of occurrence within the 2020 registration year, rather than month of registration. This has been corrected.

April 2020 saw a spike in dementia and Alzheimer’s deaths

Cancer deaths in 2020 were broadly similar to the average over the previous 5 years. During March and April 2020, deaths due to cancers were 5% and 9% above average. In October and November 2020, cancer deaths were slightly below average.

Circulatory disease deaths (such as heart disease and strokes) show a similar pattern. There were 15% more circulatory deaths than average in April 2020. But over the year the number of deaths was broadly similar to the average over the previous 5 years.

Respiratory diseases include conditions such as asthma and chronic obstructive pulmonary disease (COPD). Deaths from these diseases were 23% below average in 2020. Although COVID-19 affects the respiratory system, COVID-19 deaths are counted separately and not included in deaths due to respiratory diseases.

In 2020 the number of dementia and Alzheimer’s deaths was 3% higher than average. There was a very large spike in April, 67% above the five year average. The timing of this spike is very similar to the spikes in circulatory and cancer deaths. However, the magnitude was far greater. In November and December the number of people dying from dementia and Alzheimer’s disease dropped below the five year average.

 

Excess deaths by cause of death in Scotland, January to December 2020

Source: Deaths from specific causes

More work is required to understand the link between the COVID-19 pandemic and deaths from other causes. However, it is likely that some people who died from COVID-19 in 2020 would have died from other causes such as cancer, respiratory disease, or dementia in a more normal year. And this is likely to have affected the number of deaths from these causes.

 

Health inequality

Improvements in life expectancy have stalled since the early 2010s

Our figures on life expectancy go back to the early 1980s. For most of that time life expectancy at birth increased. But it has always been lower than the UK and many other countries in western Europe.

Life expectancy at birth in Scotland by sex compared to other countries, 1980 to 2019

Source: Life Expectancy in Scotland

 

More recently life expectancy improvements have stalled. The main causes of this stall are:

• Past decreases in heart disease deaths have slowed down
• The number of drug-related deaths has increased
• The number of deaths from dementia and Alzheimer’s has increased

 

People in more deprived areas can expect far fewer years in good health

Life expectancy is an important measure of how healthy we are. But it’s not the whole picture. A long life does not guarantee a life spent in good health.

There is a huge gap in healthy life expectancy for people in the most and least deprived areas.

Areas	Females	Males
10% least deprived areas	71.6 years in good health (84%)	72.1 years in good health (87%)
10% most deprived areas	50.1 years in good health (66%)	47.0 years in good health (68%)

Source: Healthy Life Expectancy in Scotland

 

Males born in the most deprived areas can expect about 25 fewer years in good health than males born in the least deprived areas. The gap is over 21 years for females.

 

Most drug-related deaths are of people aged 35 and over

Drug-related deaths have been rising at a dramatic rate. And the year 2020 saw the largest number ever recorded. Our drug-death rate is over 3 times that for the UK as a whole, and higher than that of any European country.

Drug-related deaths are highly concentrated in certain areas. People in the most deprived areas are 18 times as likely to have a drug-related death as those in the least deprived areas (after adjusting for age). That ratio has almost doubled in 20 years. Another change over the last 20 years is people dying at older ages. Over the last 20 years the average age of a drug-related death has increased from 32 to 43.

About 2 in 3 drug-related deaths are of men.

Recent years have seen a rapid increase in deaths where ‘street’ benzodiazepines were implicated (e.g. etizolam). In 2015 these drugs were implicated in 58 deaths. But in 2020 that increased to 879 deaths. Opiates/opioids such as heroin and methadone were implicated in almost 9 in 10 deaths in 2020. More than one drug was found to be present in the body in over 9 out of every 10 deaths.

Drug-related death rate per 100,000 population by age group in Scotland, 2000 to 2020

Source: Drug Related Deaths in Scotland

 

The Scottish Government has stated Scotland has a troubled relationship with both alcohol and drug use.

The 1990s and early 2000s saw a significant increase in alcohol-specific deaths. This peaked in 2006 with over 1,400 deaths. The number of these deaths has generally decreased since then. But that reduction started to stall and then reverse around 2013.

In May 2018 the Scottish Government introduced minimum unit pricing. This was followed by a decrease in alcohol-specific deaths in 2019. Which suggests that this may be linked to the policy. But in 2020 deaths increased. Returning to the previous upward trend which has been increasing since 2012.

The alcohol-specific death rate in the most deprived areas is 4.3 times the rate in the least deprived areas in 2020.

People in more deprived areas are more likely to die from suicide

Suicides decreased between 2011 and 2014, but have generally risen again since then. The suicide rate in Scotland’s most deprived areas is three times the rate in the least deprived areas.

In every year since 1985, men have accounted for more than 7 in 10 suicides. Men have generally been around 3 times as likely to die from suicide as women.

In 2020 about one in every five suicide deaths was to someone under the age of 30.

 

Migration

Immigration drives population growth in Scotland

For most of the 20th Century, Scotland had:

• more births than deaths
• more people leaving than arriving

But in the 1960s and 1970s births began to fall dramatically. This happened for many reasons (see our chapter on historical demographic changes).

Since then, the number of births and deaths have generally been similar each year. However deaths have now outnumbered births for the last six years.

 

Natural change and net migration in Scotland, 1952 to 2020

Source: Mid-year population estimates

 

Since the early 2000s more people started to move here than leave. Especially after the EU expanded in 2004.

This means that migration now drives population growth in Scotland.

People move here from both overseas and the rest of the UK. Most are between 16 and 34 years old and many come here to work or study.

 

About 1 in 13 people are of non-British nationality

Scotland is home to over 400,000 non-British nationals:

• 231,000 people with EU nationality
• 178,000 people with non-EU nationality

 

 

Polish is the most common non-British nationality, with around 88,000 people. That is about 4 times the number of people with the second most common nationality: Indian.

In 2004 the EU expanded. This allowed more people from Poland and other countries to move here.

59% of non-British nationals live in larger cities compared to 25% of British nationals. Larger cities are:

• Glasgow City
• City of Edinburgh
• Aberdeen City
• Dundee City

 

Reduced EU migration could mean fewer children and people of working age

We project that Scotland’s population will grow. But this growth will slow down over the next 20 years.

All of this growth is projected to come from migration. This is because deaths are projected to outnumber births.

 

Population projection variants in Scotland, 2019 to 2043

Note: Vertical axis does not start at 0.

Source: Projected Population of Scotland (2018-based): Additional variants using alternative European Union migration assumptions

 

We project that migration could be roughly split between people from overseas and the rest of the UK. Most people moving to Scotland are young adults between 16 and 34 years old.

We project that over the 25 years following mid-2018 we could have:

• a 10% decrease in children (from 920,000 to 823,000)
• roughly the same number of people of working age (from 3,484,000 to 3,477,000)
• a 23% increase in people of pensionable age (from 1,035,000 to 1,275,000)

However, if migration from the EU fell by half, then over the same period we could have:

• a 13% decrease in children (from 920,000 to 802,000)
• a 2% decrease in people of working age (from 3,484,000 to 3,416,000)
• a 23% increase in people of pensionable age (from 1,035,000 to 1,275,000)

If EU migration fell by a half, we project our population would peak in the early 2030s and then start to decline. This would continue the ageing of Scotland's population (see our chapter on ageing population).

 

Some parts of Scotland already face a decline in population

Most of the central belt and other urban areas are projected to grow in population. But we project that the population in almost half of our 32 local authorities will decline. These are mainly in the west and south west of Scotland.

 

Projected population change, 2018 to 2028

Source: Population Projections for Scottish Areas (2018-based)

In the areas we project an increase, most of this growth is likely to be from migration. This would include people moving from both overseas and the rest of the UK.

Areas with a projected decline are mainly seeing increased deaths and fewer births without enough migration to compensate.

Part of the explanation is that the late 1940s baby boom generation are reaching the end of their lives.

 

Ageing population

Scotland’s older population continues to increase

Scotland is now home to about 400,000 more people than in the 1990s. But this change has not been the same across age groups. Over that time, the number of children has reduced by about a tenth. In contrast, the number of people aged 65+ has grown by over a third.

Some of the main factors that explain this are:

• people are having fewer children
• people are living longer
• people born in the post-war baby booms are getting older

All 32 Scottish council areas have seen an increase in their population aged 65+ in the last decade.

This includes areas where the total population fell.

For example, in the 10 years up to mid-2020, Argyll and Bute saw a 17% increase in 65+ year olds and a 13% decrease in children. Over the same period, Na h-Eileanan Siar saw a 19% increase in 65+ year olds and a 12% reduction in children.

We project that our population is likely to continue ageing for some decades. These changes will probably impact local services like: care homes, public transport, and schools.

 

Population profiles by age group in Scotland, 1931, 2019, and 2043

Source: Population Estimates Time Series Data, Projected Population of Scotland (2018-based)

 

 

As the population ages our most common causes of death are changing

In the last 20 years mortality rates have decreased and the most common causes of death have changed.

Heart disease continued to be the most common cause of death. But these have nearly halved since 2000 (reducing from over 12,000 to under 7,000).

Deaths from cerebrovascular disease (e.g. strokes) have also fallen dramatically (reducing from almost 7,000 to almost 4,000). In 2020, COVID-19 overtook cerebrovascular disease as the third most common cause of death with 6,048 deaths.

However, the number of deaths caused by Dementia and Alzheimer's disease has roughly tripled since 2000. It is now the second most common cause of death (increasing from about 2,000 to over 6,000).

One of the main factors explaining this is advances in treatment of common causes of death. Another factor is improvements in our lifestyle choices. For example, the Scottish Health Survey has found reductions in smoking and hazardous or harmful drinking. Food Standards Scotland has also found evidence for a downward trend in our salt intake.

 

Changes in causes of death in Scotland, 2000 to 2020

Source: Causes of Death

 

 

Average household size is decreasing as more people live alone

People in Scotland are increasingly living alone. In the 1960s, most households had 3 or more people. Now it is more common to find households of 1 person. These now account for more than 1 in 3 households.

This is partly because Scotland's population is ageing. Older people are more likely to live alone or in smaller households. In particular, older women are most likely to live alone.

 

Marriage

Most same-sex couples choose marriage over civil partnerships

Scotland legalised same-sex marriage in December 2014. Just over 30 years since homosexuality among men was illegal. Now more than 1 in 30 marriages are of same-sex couples.

 

Civil partnerships and same-sex marriages in Scotland, 2005 to 2020

Source: Marriages and Civil Partnership Time Series Data

 

 

Humanist marriages quickly become common after they were authorised

In 2005 Scotland authorised humanist ceremonies. Since then, growing numbers of people have chosen a humanist marriage.

There are several humanist organisations in Scotland. And they now conduct around 1 in 4 marriages in Scotland.

Marriages conducted by the Church of Scotland and the Roman Catholic Church have both been in decline for around the last 60 years.

 

Marriages by type of ceremony in Scotland, 1961 to 2020

Source: Marriages and Civil Partnerships

 

 

Historical demographic changes

Babies and children are now much less likely to die

2020 saw the lowest ever recorded rate of infant deaths in Scotland.

Stillbirths and infant death rates have fallen greatly since the Second World War. Infant death rates improved markedly in the last 30 years.

There are many reasons for this improvement. For example, most women today can expect better housing and sanitation.

Stillbirths, child mortality, and infant mortality in Scotland, 1901 to 2020

Source: Deaths time series data

 

Healthcare has improved a lot too. We now have:

• the NHS and the Royal College of Midwives
• vaccines for infectious diseases like measles and rubella
• antibiotics like penicillin
• better evidence on staying healthy during and after pregnancy

 

There are now fewer births each year

Until the mid-20th century, births had always outnumbered deaths by a sizable margin.

But in the 1960s and 1970s this started to change. Births began to fall dramatically. And for the first time in recorded history, some years saw more deaths than births.

Births and deaths in Scotland, 1855 to 2020

Source: Births time series data, Deaths time series data

 

These changes were partly because babies and children had better chances of survival. But there were other reasons too:

• more women in education and work
• new equality laws like the Equal Pay Act and the Sex Discrimination Act
• better access to contraception
• changing attitudes in society
• people having children later in life
• fewer people having very large families

More recently in 2020, births fell to the lowest ever recorded level.

 

We have had 3 baby booms

A baby boom is a period of time when the birth rate increases a lot.

Scotland's first baby boom on record happened around 1920. This was after the First World War and a flu epidemic known as the 'Spanish Flu'. Many people at the time delayed having children until these two big events had passed.

The second baby boom happened after the Second World War and peaked in 1947. Many of these babies were children of the first baby boom. These babies were some of the first to benefit from things like the NHS and national insurance.

The third baby boom started in the mid-1950s and lasted until the end of the 1960s. People married younger during this time than in any other period on record. This meant women were generally married for longer during their childbearing years.

Mean age at marriage in Scotland, 1855 to 2020

Source: Marriages and civil partnerships

 

There are now fewer deaths each year

Since our records began in 1855, the number of deaths each year has fluctuated. But overall the trend, especially since the First World War, has been fewer deaths each year.

This downward trend is despite our population growing for most of that time. That means the mortality rate has also been going down.

This follows improvements in things like:

• living conditions and sanitation
• healthcare
• lifestyle choices like smoking
• health and safety laws

But that reduction in deaths has not happened every year. Some events have caused a rapid increase in deaths.

For example, starting in 1918 many people died from a severe influenza epidemic. This became known as the ‘Spanish Flu’.

 

In coming years, the full impact of COVID-19 on our population will become clearer. Although we have already seen a jump in deaths for 2020.