Multidimensional poverty in Scotland and health across adulthood-the paradoxical associations with food, fuel, and financial insecurity in later life.

Abstract

Little is known about the impact that older age and the cost-of-living crisis have on health and wellbeing in Scotland, a country with the lowest life expectancy in Western Europe. Using Scotland as a case study, we aim to capture multidimensional poverty across adulthood and study the associations with health. Relying on the Joseph Rowntree Foundation's 2023 Poverty in Scotland Survey, we measured the odds of self-reported food, fuel, and financial insecurities across adulthood. We then assessed the association between these insecurities and self-reported physical, mental, and social domains of health. Overall, older adults (aged 65+) report less food, fuel, and financial insecurity. However, lower-income adults aged 35-74 reported significantly higher odds of fuel insecurity compared to younger, upper-income adults. All dimensions of insecurity are significantly associated with higher odds of poor health outcomes, especially among younger adults. Older adults paradoxically report largely fewer negative health impacts despite existing evidence of the group's health vulnerability to these insecurities. This study shows the importance of analysing poverty multi-dimensionally. It evidences that while pensions are associated with lower reported levels of food and financial insecurity, these associations do not maintain for fuel insecurity, especially among lower-income groups. The results support the reintroduction of non-means-tested winter heating benefits for older adults in Scotland. All three insecurities impact self-reported health, yet reports from older adults do not mirror health across the life course. This may be influenced by survey administration, question framing, understandings of health, problematization of insecurities and stigma.