Health inequalities in Scotland: An independent review An independent review of health and health inequalities in Scotland

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The Health Foundation will be carrying out an independent review of health and health inequalities in Scotland to provide a detailed and thorough analysis of the health trends and wider factors that have influenced people’s health in Scotland over the last two decades. 

The study 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. 

What will our review do?

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, we hope the review will provide a robust evidence base for future policy development and delivery to improve people’s long-term health and close the health gap between the richest and poorest. 

An expert advisory group will advise 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) will act as strategic advisor to the review and will chair the review’s expert advisory group.  

Both the Marmot Review: Ten years on report and the Health Foundation’s COVID-19 impact inquiry 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 variations in these conditions between people and places are a major determinant of health inequalities.  

The Scotland review will explore similar themes, but will examine issues specific to Scotland, supported by research conducted by experts at the MRC/CSO Social and Public Health Sciences Unit at the University of Glasgow, and the Fraser of Allander Institute. 

 

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Expert advisory group 

The review is being led by secretariat within the Healthy Lives team at the Health Foundation, with guidance from an expert advisory group.  

Our independent review of health inequalities in Scotland will look at the data and beyond, also gathering insights from a range of stakeholders, including the public, capturing a wide range of perspectives. The research will be carried out by external partners.  

An expert advisory group will advise on the approach, findings from the research and implications. 

Chris Creegan has spent his career in the public and third sectors. He has worked in policy, research, and communications, and held a number of senior leadership roles. He was Director of Corporate Affairs and Deputy Director of Qualitative Research at the National Centre for Social Research between 2006 and 2012, and Chief Executive of the Scottish Commission for Learning Disability between 2013 and 2019.

Chris has extensive experience in public life including as a trade union official, a local councillor, and as a charity and not for profit non-executive. He was Chair of Tower Hamlets Homes between 2007 and 2011, and Scottish Adoption between 2008 and 2015.

Chris is a regular blogger, occasional columnist, and commentator across social media, newspapers and radio. He is a Fellow of the Royal Society of Arts, Manufacturing and Commerce, and of the Chartered Institute of Personnel and Development.

Chris is a lifelong runner and competes regularly for Edinburgh AC. He spends much of his spare time reading and writing, and in the East Neuk village of Pittenweem with his husband, Allan, and their Border Terrier, Craigie

Chris Creegan

David is currently Emeritus Professor of Economics, University of Stirling, Visiting Professor of Economics, Adam Smith Business School, University of Glasgow and Honorary Professor,  Moray House School of Education and Sport, University of Edinburgh.

He currently chairs the Scottish Government’s Regional Economic Policy Advisory Group (REPAG), is Co-I on a research project on the health and economic effects of Covid-Fear in Scotland, is Co-PI on the HAGIS – Healthy AGeing in Scotland - study, is Co-I on project the response of the devolved nations fiscal frameworks to COVID and also Co-I on review of UK-Scottish Fiscal Framework for the UK and Scottish Governments 

He has held posts in economics or statistics at the Universities of St Andrews, Strathclyde, Warwick and Glasgow. His most recent full-time post was a professorship in Economics in the Stirling Management School at the University of Stirling. He was awarded emeritus status in 2020 and has since been awarded a visiting professorship-p an the University of Glasgow and an honorary post at the University of Edinburgh. He was made a fellow of the Royal Society of Edinburgh in 2003, of the Academy of Social Sciences in 2018 and was awarded a CBE for services to Economics and public policy in 2018. 

He received a PhD from the University of Strathclyde in 1981, having previously received an MSc in Econometrics and Mathematical Economics from the London School of Economics and an MA in Economics and Statistics from the University of Aberdeen, 

David Bell

Jo Bibby is Director of Health at the Health Foundation. Jo is responsible for leading the Foundation’s Healthy Lives strategy to create the opportunities for everyone to lead a healthy life.

Joining the Foundation in November 2007, Jo initially led the Foundation’s influential portfolio of work in patient safety and person-centred care.  

Jo has worked in health care at local and national level for 25 years, including 10 years at the Department of Health. As Head of NHS Performance, she oversaw the implementation of the policy agenda set out in the NHS Plan. At the NHS Modernisation Agency, Jo led an international quality improvement initiative – Pursuing Perfection.

Before joining the Foundation, Jo was the Director for the Calderdale and Kirklees Integrated Service Strategy where she led a major service reconfiguration programme to deliver improvements in quality, safety and patient experience.

She is a trustee at the Centre for Homelessness Impact and from June 2021 a non-executive director at Rotherham NHS Foundation Trust.

Jo has a PhD in Medical Biophysics.

Jo Bibby

Sarah Davidson is CEO at Carnegie UK, which works to improve the collective wellbeing of people throughout the UK & Ireland. 

In 2021, Carnegie UK published its new strategy “Learning how to live well together”, which sets out a vision of everyone having what they need to live well now and in the future. 

Prior to joining Carnegie UK in August 2019, Sarah had a 25-year career in civil service, latterly as Director General in the Scottish Government. She is Trustee and Chair of WEvolution UK, Trustee of the Scottish Chamber Orchestra; Director of St Mary’s Music School in Edinburgh, a Fellow of the RSA, and was appointed CB in the 2019 New Year’s Honours List.  

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Cam Donaldson FRSE is Yunus Chair and Distinguished Professor of Health Economics at Glasgow Caledonian University (GCU). He was Pro Vice Chancellor Research (2016-21) when GCU became the first university to base its research strategy on the Sustainable Development Goals. Cam was previously Health Foundation Chair at Newcastle University, Svare Chair at University of Calgary and Professor at Aberdeen University. Renowned for developing methods for economic appraisal of health interventions and founding GCU’s Yunus Centre for Social Business & Health, Cam has published around 300 refereed journal articles and authored/edited 7 books, his research having attracted £30m in competitive funding over his career. Cam’s work has been recognised through a Public Services Fellowship funded by the Economic & Social Research Council and senior investigatorships from the Canadian Institutes of Health Research and the National Institute for Health Research. In 2022, Cam was listed by Research.com in the top 500 Economics and Finance Scientists (top 50 in the UK) all-time, by citation and publications and was elected to the Fellowship of the Royal Society of Edinburgh.

Cam Donaldson

Anna is Chief Executive of the Scottish Council for Voluntary Organisations (SCVO).  She took up post in April 2018. 

She leads Scotland’s national membership body for the voluntary sector, influencing on behalf of the sector, delivering services and participating in national strategic cross-sectoral work, eg the Deputy First Minister’s group on COVID recovery and the Social Renewal Advisory Board. 

Before that, she was Chief Executive of the Scottish Social Services Council – the professional regulator for social work and social care. Before that, she worked on children and young people’s policy in Scottish Government and in COSLA, having spent the first 18 years of her career in HR in local government. 

She is currently a member of The Promise Oversight Board. 

She has a degree in History of Art from Edinburgh University and is a Chartered Member of the Chartered Institute of Personnel and Development. 

Anna Fowlie

Mubin joined abrdn Financial Fairness Trust in May 2018 as Chief Executive.

Mubin leads the work of Financial Fairness, an independent funder that has a focus on improving living standards and tackling financial problems faced by those living on low-to-middle incomes in the UK. 

It supports a wide range of research, campaigns and policy work. The Trust rebranded at the end of 2021 and was previously called Standard Life Foundation. 

Mubin has worked for a number of independent funders, including Trust for London where he was Director of Policy and Grants. He is currently a trustee of GambleAware and is a member of the Scottish Government’s Minimum Income Guarantee expert group.  Mubin has been on the boards of a range of organisations including as Chair of London Funders and on the boards of Community Foundation Network, the London Strategic Migration Partnership and the Homelessness Transition Fund. 

Mubin Haq

Katie Kelly is the Depute Chief Executive with East Ayrshire Council and her portfolio spans a wide range of services and cross cutting transformational topics including economic growth, community wealth building, community power, community led regeneration, Housing, net zero, workforce planning and wellbeing.

She has recently taken on the role of Senior Responsible officer for the Ayrshire Growth Deal. She has been employed in the public sector in Ayrshire for over 30 years working in various roles including Head of Housing, Communities and Transformation and in other sectors including community sport, health improvement, events, community planning, strategy and policy development and transformational change.  Katie also spent 2 years seconded to NHS Ayrshire and Arran to set up the Community Health Partnership arrangements in East Ayrshire with a strong focus on co creating health and ensuring full engagement of patients, their families and wider communities in local healthcare. 

Over the years Katie has developed and led a range of innovative and community focused services.  Responding directly to the findings of the Christie Commission, greatly influenced ABCD and coproduction based approaches and embracing the views of local people and stakeholders Katie led and implemented the innovative Vibrant Communities approach as part of East Ayrshire’s Transformation Strategy.  Vibrant Communities represents a new and unique approach to the challenge of Public Sector Reform.  Working with, rather than for, communities the aim is to change culture and unlock the knowledge, skills and experience of local people and employees, to harness their enthusiasm, talent and ‘can do’ spirit which exists across East Ayrshire. 

Katie is passionate about working alongside people and communities, reducing inequalities, servant and collaborative leadership, coaching and mentoring approaches, community and workforce empowerment, community wealth building and helping to make a positive and lasting difference to people lives. 

Katie is the SOLACE national spokesperson for Equalities and Justice, a member of the CORRA Foundation’s People in Place Observers Group and is involved in a wide range of national networks and collaborations around Public Service Reform, Leadership Development and Community Power. 

Katie Kelly

Sir Michael Marmot has been Professor of Epidemiology at University College London since 1985, and is Director of the UCL Institute of Health Equity. 

He is the author of The Health Gap: the challenge of an unequal world (Bloomsbury: 2015), and Status Syndrome (Bloomsbury: 2004). Professor Marmot is the Advisor to the WHO Director-General, on social determinants of health, in the new WHO Division of Healthier Populations; Distinguished Visiting Professor at Chinese University of Hong Kong (2019-), and co-Director of the of the CUHK Institute of Health Equity. He is the recipient of the WHO Global Hero Award; the Harvard Lown Professorship (2014-2017); the Prince Mahidol Award for Public Health (2015), and 19 honorary doctorates. Marmot has led research groups on health inequalities for nearly 50 years.

He chaired the WHO Commission on Social Determinants of Health, several WHO Regional Commissions, and reviews on tackling health inequality for governments in the UK. He served as President of the British Medical Association (BMA) in 2010-2011, and as President of the World Medical Association in 2015. 

Sir Michael Marmot is President of the British Lung Foundation.  He is a Fellow of the Academy of Medical Sciences and Honorary Fellow of the American College of Epidemiology and of the Faculty of Public Health; an Honorary Fellow of the British Academy; and of the Royal Colleges of Obstetrics and Gynaecology, Psychiatry, Paediatrics and Child Health, and General Practitioners. He is an elected member of the US National Academy of Medicine and of the Brazilian Academy of Medicine.  He was a member of the Royal Commission on Environmental Pollution for six years and in 2000 he was knighted by Her Majesty The Queen, for services to epidemiology and the understanding of health inequalities.  

Marmot image

Dr Jim McCormick is Chief Executive of The Robertson Trust. 

Previously he was Associate Director Scotland with the Joseph Rowntree Foundation (2017-20), ran an independent research consultancy and was Director of the Scottish Council Foundation think-tank (2002-07).  

He is Chair of the independent Disability and Carers Benefits Advisory Group which reports to the Minister for Social Security. He was a member of the Scottish Government’s Social Renewal Advisory Board (2020-21), Chair of the Edinburgh Poverty Commission (2018-20) and a member of the Social Security Advisory Committee (SSAC) which scrutinises the Department for Work and Pensions’ GB regulations.  

In 2018 he was a travelling Churchill Fellow looking at the impact of mentoring programmes for children and young people facing disadvantage in the USA, Canada and New Zealand.  

His interests include music, languages and Greenock Morton FC. 

Dona joined NHS Lothian as Director of Public Health and Health Policy on 1st June 2021. Prior to this, Dona was Director of Public Health in Fife, following a six year period as Deputy Director in Lothian. As Director of Public Health she has responsibility for local public health teams that focus on reducing inequalities through a focus on the deteminants of health. 

She has worked in children and young people’s health and education within local authorities, the voluntary sector, Scottish Government and the NHS.  

Dona is a Fellow of the Faculty of Public Health and Honorary Fellow of the Faculty of Sexual and Reproductive Health.  

Her career has taken her to YWCA Scotland as Depute Director (Scotland) and for 7 years she led the ‘Healthy Respect’ National Demonstration Project. In 2008, Dona was seconded to Scottish Government and led the H1N1 vaccination campaign following a period in sexual health and HIV policy. She has worked as a Consultant in Public Health since 2010. 

Her main interests are reducing inequalities, particularly through work on social determinants, reducing poverty and increasing life chances. She is independent chair of the Scottish Youth Work Research Group. In a voluntary capacity, she is a Trustee with Youth Scotland, Inspiring Scotland and the Edinburgh Family Planning Trust.

Dona Milne

Shantini is currently a Clinical Chair in Public Health at the University of Aberdeen and Honorary Consultant in Public Health Medicine at NHS Grampian. She is also the Clinical Lead for the Grampian Data Safe Haven and has a research portfolio that examines inequalities in women and children’s health using record-linked routinely available health and care datasets. 

Shantini was previously the Mansel Talbot Professor of Preventative Medicine at Cardiff University and Co-Director of the Cardiff School of Medicine’s  Division of Population Medicine and a Non-Executive Director at Public Health Wales NHS Trust. 

Shantini graduated from the University of Wales College of Medicine with a MBBCh degree and worked as a junior doctor in obstetrics and gynaecology. She went on obtain a MSc in Medical Statistics with Distinction and a PhD in Epidemiology at the London School of Hygiene and Tropical Medicine. She is a Fellow of the Faculty of Public Health. 

Shantini Paranjothy

Carol was Director of the Glasgow Centre for Population Health from 2005 to 2020.  As well as leading the organisation and its overall development, she had a particular interest in neighbourhood-based approaches to improving health and was a Principal Investigator on the GoWell programme (studying the impacts of urban regeneration on health), and the Children’s Neighbourhoods Scotland programme. 

From 2014 until her retiral in September 2021, she was also the Chief Social Policy Adviser in the Scottish Government where she had a wide-ranging brief working with various teams and Directorates on approaches to supporting communities and tackling deep-rooted inequalities.  Latterly she led the Covid-19 Advisory Groups on Education and Children’s Issues, and on Higher and Further Education.   

Carol has contributed to many international, national and local public health policy and strategy developments.  She graduated with a BA in Human Sciences at the University of Oxford, and MPH and PhD in Public Health at the University of Glasgow.  Thereafter she held posts at the University of Glasgow and in the NHS in Greater Glasgow, including as Director of Health Promotion and Executive Member of the Health Board. 

She is a Fellow of the Faculty of Public Health, the Royal Society of Edinburgh and the Academy of Social Sciences, a Trustee of the Joseph Rowntree Foundation, and Honorary Professor with the University of Glasgow.  Carol was appointed OBE for services to public health in the 2018 Queen’s Birthday Honours list.   

 

Carol Tannahill

Further reading

Research report

Unequal pandemic, fairer recovery

July 2021
Research report

A comprehensive review of the factors that affected the UK’s devastating COVID-19 death toll.

Report

Health Equity in England: The Marmot Review 10 Years On

February 2020
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A new report by the Institute of Health Equity and commissioned by the Health Foundation that...

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