Independent review will strengthen evidence to tackle health inequalities in Scotland

An independent review announced today aims to provide a detailed and thorough analysis of the trends and wider factors that have influenced people’s health in Scotland over the last two decades. 

The study, led by the independent charity the Health Foundation, comes amid ongoing concern around widespread and persistent health inequalities in Scotland, which are likely to have further widened during the pandemic.  

From the 1980s to the late 2000s, life expectancy in Scotland increased significantly. However, over the last decade there has been a slowdown in life expectancy growth. While improvements have also stalled across the whole of the UK, Scotland currently has the lowest average life expectancy at birth of all UK countries, and one of the lowest in western Europe. And the gap in life expectancy between the richest and poorest areas has widened over the last five years. Men and women born in the most deprived areas of Scotland can expect to live about 24 fewer years in good health than people born in the least deprived areas. 

The review, which is due to report its findings later this year, will provide a detailed and thorough analysis of how socioeconomic factors and public health interventions have influenced people’s health in Scotland over the last two decades. But it also aims to go beyond the numbers, capturing a wide range of perspectives and experiences across the country, including those of people of different ages, backgrounds and circumstances, and living in rural as well as urban areas. In building a comprehensive picture of health in Scotland, the Health Foundation intends for the review to provide a robust evidence base for future policy development and delivery – action that will improve people’s long-term health and close the health gap between the richest and poorest. 

An expert advisory group is advising on the approach, findings from the research and their implications. Chris Creegan (Associate Director at the Coalition of Care and Support Providers in Scotland and Chair of the Scottish Association for Mental Health) is the strategic advisor to the review and will chair the review’s expert advisory group.  

The Scotland review follows the publication of the Health Foundation-commissioned Marmot Review: Ten years on report in February 2020, which examined progress in addressing health inequalities in England. The Foundation’s subsequent COVID-19 impact inquiry revealed that the pandemic had further exposed growing differences in health between people living in different areas and circumstances across the UK.  

These studies both highlighted how people’s health is influenced by the conditions in which they are born, grow, live, work and age, and experiences in their day-to-day lives. They also showed how differences in these conditions lead to health inequalities. The Scotland review will explore similar themes, but will examine issues specific to Scotland, informed by research conducted by experts at the Social and Public Health Sciences Unit at the University of Glasgow, and the Fraser of Allander Institute.  

David Finch, Assistant Director of Healthy Lives at the Health Foundation, said: 

‘COVID-19 has shone a spotlight on the tragic consequences of widespread ill health in Scotland. However, health had already been in decline prior to the pandemic with improvements in life expectancy stalled, and even reversed in some parts of the country.  

‘Our independent review brings together academic research with stakeholder and public engagement in Scotland. This means that our conclusions for future action will be co-designed by experts and citizens. Policymakers in Scotland have demonstrated the will to act on health inequalities. This inquiry aims to inform ongoing policy, providing insight for future action to tackle the root causes of ill health and inequalities.’ 

Chris Creegan, Chair of the review’s expert advisory group, said: 

‘In Scotland, for many years dubbed the ‘sick man of Europe’, there has been no shortage of research attention and policy focus on the issue of health. Indeed, it might be argued that Scotland has world-leading policy. Yet health inequalities remain widespread and persistent. That this is unacceptable is surely not contentious. However, the pressing issue, never more so than in the wake of the COVID-19 pandemic, is how can we close the gap and improve people’s health over the long term.  

‘To achieve this, we need a better understanding of the factors that led to the pre-pandemic stalling of life expectancy and the wider influences on health, such as rising poverty, education gaps that opened through the pandemic and the extent of the post-pandemic employment recovery. This review is therefore timely and crucial if we are to stem the tide of avoidable ill health in Scotland and reverse it.’ 

Media contact

Simon Perry
Simon.Perry@health.org.uk
20 7257 2093