We undertook this population-based study as part of the Scottish Centre for Administrative Data Research (SCADR), a consortium of Universities across Scotland. It was originally commissioned by the Scottish Government’s Chief Statistical Office to inform the policy response to the pandemic.

The study analysed COVID-19 hospitalisation and death risks for different occupational groups by sex in Scotland between March 2020 and January 2021. It drew on a large administrative data collection that combines individual-level 2011 Census records with household information from property identifiers and electronic health records.

It forms part of a broader SCADR project investigating socioeconomic, household and environmental risk factors for COVID-19 in Scotland, led by Dr Pattaro.

Earlier findings from this research were cited as evidence during the UK Covid-19 Inquiry.

Key messages

Women generally had lower hospitalisation and death risks rates than men. However, there were clear differences across occupational groups, with higher death rates for women in process and machine operative roles and men in transportation and elementary services.

Adjusting for socioeconomic status, pre-pandemic health and occupational exposure reduced the observed risks across most occupational groups.

While similar patterns emerged between the sexes for hospitalisation risks, there were differences for death risks, with women in professional roles (e.g., health professionals) showing lower risks and men in more disadvantaged roles (e.g., large vehicle and taxi drivers) facing higher risks.

Recommendations for policy

Based on these findings, we would recommend that reducing sex-based disparities in future respiratory pandemics requires coordinated interventions to (1) address gaps in the provision of protective equipment and training for health and care workers, and (2) prioritise support for high-risk occupational groups working in sectors such as transport and personal services.

What next?

We’ll continue this collaborative research by focussing on household transmission and its impact on COVID-19 infection, and severe outcomes among vulnerable population groups. As part of the SCADR project, PhD student Yusuff Adebayo Adebisi is exploring the relationship between household living arrangements and COVID-19 outcomes among disabled people in Scotland.

I delivered a keynote presentation at the ADR Scotland Work, Welfare and Economy Workshop, held at the Edinburgh Climate Change Institute on 7 May 2025. This was organised by ADR Scotland, a programme of work run by Scottish Government, in collaboration with SCADR, which supports the linkage and use of data held by government and public bodies across Scotland for public good research.

The event brought together representatives from the Scottish Government, including Social Security Scotland, the Department for Work and Pensions, as well as academia and third sector organisations. It focussed on identifying policy and analytical priorities, and exploring how linked administrative data can be used to address key evidence gaps in the area of work, welfare, and economy.

Read the full paper on the BMJ Journals website.

Dr Serena Pattaro is Research Fellow in the School of Social and Political Sciences at the University of Glasgow, and Co-Investigator and Leadership Group member at the Scottish Centre for Administrative Data Research (SCADR).

The COVID-19 study was conducted with SCADR colleagues Nick Bailey (University of Glasgow) and Chris Dibben (University of Edinburgh).

First published: 26 June 2025

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