Intellectual and physical disability, household living arrangements and COVID-19 outcomes in Scotland: protocol for a retrospective cohort study

Introduction While evidence consistently demonstrates elevated COVID-19 risks among people with intellectual and physical disabilities, less is known about how household living arrangements shape these inequalities. Residential setting and household size influence exposure, capacity to isolate and reliance on care yet have rarely been examined jointly with disability status at a population scale.

This study aims to estimate disability-related inequalities in COVID-19 infection, hospitalisation and mortality in Scotland and to assess whether residential setting and household size modify these inequalities using linked, population-wide administrative data. Methods and analysis This population-wide retrospective cohort study will use linked administrative data in Scotland.

The study will focus on individuals present in the 2011 Scottish Census with records linkable to the Scottish population spine, which encompasses all individuals registered with a general practice who received a Community Health Index number. The cohort will comprise those who were alive, resident in Scotland and aged 16 years or older on 1 March 2020.

Disability status will be classified from Census records as intellectual disability, physical disability (without intellectual disability) or a comparison group without reported disability.