Tag: health inequalities

Challenge Poverty Week: Change is possible, says Public Health Scotland

This Challenge Poverty Week, Public Health Scotland’s CEO, Paul Johnston explains how PHS are advocating for a Scotland where everyone has access to an adequate income to enable a healthy standard of living:

Living in poverty is detrimental to health and one of the main causes of poor health and health inequalities, with negative consequences for children and adults. Policy changes which impact on the drivers of poverty (income from employment, income from social security and the cost of living) have the potential to impact on population health and health inequalities.

Since 2010 a series of changes have been implemented to the UK (reserved) social security system. An intention of The Welfare Reform Act 2012 which triggered these changes was to help people into work and reduce poverty for adults and children, which in turn would lead to improvements in health.

Policies included reduced financial support to low-income families with three or more children and increased conditionality for lone parents. These are families who already have an increased risk of living in poverty.

Since 2013, Public Health in Scotland (PHS) has been monitoring the economic and health trends associated with Welfare Reform. Our latest report Improving Lives? highlights that the anticipated improvements to income and health from Welfare Reform have not been realised for people in Scotland.

Aspects of health have worsened or remained unchanged since 2010 and importantly, many of these trends pre-date the COVID-19 pandemic. These trends were also observed for the rest of the UK. A forthcoming PHS systematic review found that for people exposed to the changes, UK Welfare Reform made mental health worse, and had no positive effect on physical health.

While some working-age families and children benefitted from Welfare Reform (through increased employment), these gains were offset by those who were harmed by the changes.

This is concerning, especially as our report shows that population groups most likely to be affected by these changes are the groups who are already more likely to be at risk of or experiencing poverty. We know from 2013 that the relative child poverty rates in Scotland increased after a period of decline.

Evidence also tells us that mental health problems became more prevalent, especially after 2015, while health inequalities have risen. The period also saw stalled improvement or worsening trends in financial insecurity and long-term sickness.

This Challenge Poverty Week, we are advocating for a Scotland where everyone has access to an adequate income to enable a healthy standard of living. This will help to create a Scotland where everybody thrives.

A number of changes are needed to make this happen. These include promoting quality employment which supports good health. Almost 19% of employees in Scotland aged 18-55 are in poor quality work, and most working-age adults and children in poverty live in a household where someone works.

We also need to ensure our social security system protects people’s mental health and wellbeing. This could include an Essentials Guarantee to protect people from hardship, supported by 72% of the population.

It could also include improved support for working-age adults with health problems, especially mental health problems.

We know that change is possible.

During 1997–2010 policy choices by the UK government directed financial support at children and pensioners and as a result poverty fell for both of these groups. This period also saw increased employment rates translate into improved mental health for lone parents. This proves that we can make a difference to people’s lives through social security and employment policies.

In Scotland, child poverty rates are lower than many other UK nations. In Scotland, we are doing things differently to tackle child poverty.

The Scottish Government estimates that around 100,000 children will be kept out of poverty as a result of the Scottish Child Payment this year and low-income families are being further supported with the costs of pregnancy and looking after children through Best Start Grants and Best Start Foods payments.

Scotland is delivering a strengthened employment offer to parents, to provide holistic support and address specific barriers to enable more parents to gain and progress in work. This along with focussed action to create a Fair Work Nation, which includes supporting more employers to pay the living wage, provides a platform to build on, to support more parents to escape poverty.

Learning and evidence from past UK policy approaches and Scotland’s actions to tackle child poverty should be used to inform further policy changes to address poverty and improve health.

It is imperative that providing an effective social security safety net for when families need it and creating high quality, flexible employment opportunities for parents, will be central to the UK’s child poverty strategy going forward.

From austerity to crisis: Covid-19 Inquiry highlights UK’s pre-pandemic weaknesses, says TUC

Just three days short of its second anniversary, the Covid-19 Public Inquiry published the report from the Module One investigation into the resilience and preparedness of the United Kingdom (writes TUC’s NATHAN OSWIN).

The report highlights the devastating consequences of austerity in the decade that preceded the pandemic and the risk of vulnerability in the UK population.

The Impact of austerity on public services

Inquiry Chair, Baroness Hallett, states plainly that, “In short, the UK entered the pandemic with its public services depleted, health improvement stalled, health inequalities increased, and health among the poorest people in a state of decline.” This blunt assessment underscores the critical condition of the nation’s public services as they faced the unprecedented challenges of the Covid-19 pandemic.

The role of the TUC and evidence from frontline workers

As Core Participants in the Inquiry, the TUC played an integral role in the process, working with our unions to provide the evidence that ten years of under-investment and real terms funding cuts to public service in the run up to the Inquiry left key services struggling to cope.

“Public services, particularly health and social care, were running close to, if not beyond, capacity in normal times” the report states, a statement that doctors, nurses, porters and social care workers have been telling us all. 

The Inquiry also heard that “there were severe staff shortages and that a significant amount of the hospital infrastructure was not fit for purpose. England’s social care sector faced similar issues. This combination of factors had a directly negative impact on infection control measures and on the ability of the NHS and the care sector to ‘surge up’ during a pandemic.”

A call to avoid past mistakes

The report is both a damning indictment and a call to never repeat the mistakes of that decade – a desperate reminder of the need to invest in our public services.

And while the report is not naive about the costs needed to make the UK more resilient ahead of the next pandemic – a matter of when not if – it reaches  the conclusion that “the massive financial, economic and human cost of the Covid-19 pandemic is proof that, in the area of preparedness and resilience, money spent on systems for our protection will be vastly outweighed by the cost of not doing so”.

Addressing health inequalities

What’s more, the Inquiry is crystal clear as to the price we pay for inequality across our communities. It notes that at the outset of the pandemic, the UK had “substantial systematic health inequalities by socio-economic status, ethnicity, area-level deprivation, region, social excluded minority groups and inclusion health groups”.

And Baroness Hallett’s report correctly states that these inequalities weakened the ability of the UK to cope, stating that “resilience depends on having a resilient population. The existence and persistence of vulnerability in the population is a long-term risk to the UK.’ 

Recommendations for the future

The recommendations themselves speak of the need to engage with wider society for planning on how we handle a crisis and to take into account the “capacity and capabilities of the UK”. 

No one knows the capacity and capabilities of our public services better than the staff that deliver them and the TUC and its affiliated unions stand ready to assist the government in this vital work.

Conclusion: Building a resilient future together

It is by working in partnership – with proper resources going into our public services – that we can truly learn the lessons this report sets out and secure the resilience and preparedness that the UK needs for a future full of challenges.

Major new research to tackle health inequalities in Roma communities

Project to invest in training and support, building capacity and skills through co-creation

A new £1.1M research project led by Heriot-Watt University is set to improve health outcomes and reduce inequalities for Roma communities across the UK.

Roma populations experience some of the poorest health and wellbeing outcomes, including significantly lower life expectancy of 10 or more years below the national average as well as a higher prevalence of long-term chronic conditions and increased social exclusion.

Poorer health can result from barriers and challenges when accessing the physical, social, and cultural supports that are needed to age across the life course.

The new three-year project will work in partnership with community groups of Roma people now living in the UK, civil society organisations and public authorities across three focus areas in Luton, Peterborough and Glasgow.

Funding for the research is led by AHRC in collaboration with BBSRC, ESRC, MRC and NERC, all part of UKRI. Additional funding is from UKRI’s Building a Secure and Resilient World, and Creating Opportunities, Improving Outcomes strategic themes and the programme is run in partnership with the National Centre for Creative Health.

Including co-researchers from Roma communities, the research will use innovative visual and creative methods to help identify barriers faced by Roma people in accessing healthcare and other services in mid to later life.

The project will then co-design new place-based ‘Integrated Hubs’ to better connect Roma people with culturally appropriate health, wellbeing and community resources which build upon existing expertise and assets within the community.

Dr Ryan Woolrych, director of the Urban Institute at Heriot-Watt University, said: “This research is urgently needed as public health bodies and government reports continue to evidence the inequalities faced by Roma people living in the UK today which is severely impacting life expectancies and creating growing social exclusion.

“There is a significant evidence gap in terms of exploring what it means to age within Roma communities and the interventions needed to ensure healthy and active ageing.

“We will address this by taking an inclusive, community-centred approach to understanding barriers faced by Roma people in accessing healthcare and other services before supporting the development of services that build on their cultural assets and lived experiences. By doing so, we can positively influence a shift in health, wellbeing and place policies and practices for Roma groups.

“We will employ innovative and creative methods like storytelling, dance and photography, working alongside communities to gain deeper insight into Roma experiences to co-design interventions that will deliver impact where they are needed the most.”

The multidisciplinary team includes the Roma Support Group, Luton Roma Trust, Compas and Community Renewal Trust’s Rom Romeha (meaning for Roma by Roma) in Govanhill as well as expertise from Coventry University, Anglia Ruskin University and the University of Dundee.

Crina Morteanu from the Luton Roma Trust said: “As a grassroots organisation, having worked with the Roma for more than ten years, we are delighted to be part of this project which is aimed at tackling one of the most critical issues that Roma face – access to health.

“Many Roma in Luton and the UK generally, face multiple barriers in their access to health.  This project will tackle those barriers which, in return, will result in appropriate solutions and ultimately improving their quality of life.”

Mihai Bica from the Roma Support Group said: “The Roma Support Group is thrilled to be part of this exciting and much needed research addressing some of the existing Roma health inequalities.

“We are particularly pleased that this project will draw on the knowledge and expertise of Roma from across the UK to co-develop healthcare solutions, while equipping them with the skills and capacity to play a central role in future research projects and drive policy change.”

The research builds on already established relationships with Roma communities, public authorities and health providers across the case study areas to give Roma people a voice in developing services that respect their dignity.

Leon Puska of Rom Romeha, Glasgow said: “As a Roma-led organisation, we bring first-hand understanding and passion to address the unique challenges our community face for maintaining good health throughout their lives.

“We are delighted to be part of this UK-wide partnership which will give us the opportunity to work with community researchers to better understand community situations and to co-design appropriate responses.”

Supporting children and young people’s mental health

Funding for new project announced

The Scottish Government has announced additional funding for a new project to support LGBTQI+ children and young people’s mental health.

LGBT Youth Scotland will receive £50,000 to establish a new Mental Health LGBT Youth Commission.

LGBTQI+ young people continue to experience significant health inequalities and face real barriers to accessing healthcare.

The Commission will explore barriers and challenges LGBTQI+ young people face when accessing mental health support and services. This work, will be taken forward with young people, and their lived experience will help inform future work, designing targeted and tangible solutions, formulated by the LGBT Scotland Youth Scotland Mental Health Ambassadors.

This project has been developed based on the feedback and recommendations of children, young people and families and will provide important additional mental health support to the LGBTQI+ young people in Scotland.

Mental Wellbeing Minister Maree Todd said: “I am happy to announce this additional support for LGBT Youth Scotland on top of the substantial investment we are already making in improving the mental health and wellbeing support provided to children, young people and their families.

“We have listened to children, young people and families, and are taking direct action in the areas where they have told us more support is needed.

“Making sure all children and young people can get the mental health and wellbeing support they need, at the right time, is important to this government as our continued record investment in this area goes to show.”

LGBT Youth Scotland, Chief Executive, Dr Mhairi Crawford said: “There is a tremendous amount of work still needed to ensure that the voices of LGBTQ+ young people in Scotland are heard. However, this funding represents a step in the right direction.

“We recognise the current pressures on the NHS, but even during times of crisis, we cannot deprioritise the needs of marginalised groups.

“LGBT Youth Scotland’s Mental Health Youth Commission will see young people share their lived experience to drive change and inform solutions.

“We thank the Scottish Government for supporting this project which will amplify the voices of LGBTQ+ young people, have a significant impact on services and help LGBTQ+ young people across Scotland thrive.”

Holyrood Committee to drill down on Scotland’s NHS dentistry recovery

The Scottish Parliament’s COVID-19 Recovery Committee has launched a new survey of Scotland’s dentists as part of a snapshot inquiry examining the recovery of NHS dentistry services.

The inquiry will track progress by the Scottish Government on the aims set out in the NHS Recovery Plan 2021-2026, which includes a commitment to return Scotland’s NHS dentistry services to pre-pandemic levels.

Dentists who provide NHS services are being invited to share their views and experiences on the recovery of services through an on-line survey which runs from Friday 5th May to Wednesday 31st May.

The inquiry will also consider the impact of additional funding for equipment and ventilation in NHS dentistry practices and the availability of access to services in communities experiencing health inequalities.

Commenting, Committee Convener, Jim Fairlie MSP said: “The COVID-19 Recovery Committee want to get the root of the issues facing Scotland’s NHS dental recovery in the wake of the pandemic.

“This inquiry will scrutinise the Scottish Government’s commitment to improve the provision of dental services as set out in the Recovery Plan.

“Scotland’s NHS dentists, who work daily on the front-line, are best placed to tell us how services are recovering, and we are encouraging them to share their experiences and views directly with Committee to inform our scrutiny and assist us in tracking progress towards recovery.”

Humzah Yousaf announces another £1 million to tackle health inequalities

First Minister Humzah Yousaf has announced additional support for general practices in most deprived areas. People living in some of Scotland’s most deprived communities will benefit from an additional £1 million of funding to help tackle health inequalities.

The Inclusion Health Action in General Practice programme provides targeted funding for support to patients whose social circumstances have a negative impact on their health.

The funding is allocated directly to practices which are in the NHS Greater Glasgow and Clyde Health Board area and feature on the list of 100 most deprived practices in Scotland.

First Minister Humza Yousaf made the announcement as he visited the New Gorbals Health Centre in Glasgow.

The First Minister said: “General practice is at the heart of our communities and is uniquely placed to deliver the care and support needed by patients who experience health inequalities.

“Of the one hundred poorest practices in the whole of Scotland, shockingly 81 currently sit within the Greater Glasgow and Clyde Health Board area – a statistic I am determined to change.

“This additional funding of £1 million will build on the foundations of previous funding. At a time when the cost of living crisis is widening health inequalities, this is an important step that supports our commitments to prevention and early intervention with patients at highest risk of poor health.”

Lorna Kelly, Chair of the Primary Care Health Inequalities Development Group said: “The NHS needs to be at its best where it is needed the most, or health inequalities will continue to worsen.

“This additional resource to general practices serving the most deprived communities in Scotland is therefore very welcome.”

‘Leave no one behind’: New reseach shows significant health divide across Edinburgh and the Lothians

The Health Foundation’s review shows over 15% of children in West Lothian are living in relative poverty compared to 11.3% in Edinburgh

The state of health and health inequalities in Scotland

A comprehensive independent review of health and health inequalities in Scotland led by the Health Foundation shows that the health of Scots living in the most deprived 20% of local areas are being left behind the rest of society. 

Data shows that in West Lothian 15.5% of children are living in relative poverty compared to 11.3% in Edinburgh and 12.6% and 13.5% in East Lothian and Midlothian respectively.  The national average is 15.1%.

Furthermore, in East and Midlothian the least deprived 20% of men can expect to live between six and seven years longer than the 20% living in the most deprived areas. In Edinburgh the difference in life expectancy between the richest and the poorest is almost 12 years and in West Lothian the poorest 20% will live nine years less than those in the least deprived areas. 

The review found that trends in the socioeconomic factors that influence health provide little indication that health inequalities will improve in future, underlined by increasing rates of extreme poverty.*

The review consolidates research undertaken for the independent charity the Health Foundation by the MRC/CSO Social and Public Health Sciences Unit at University of Glasgow, the Fraser of Allander Institute at University of Strathclyde, Nesta in Scotland, and the Diffley Partnership.

The findings bring together evidence of trends in health inequalities and wider determinants of health over the past two decades since devolution and outline the consequences of worsening health in the most deprived areas. 

Overall, stalled improvements in health mean that nationally, since 2013, expectations of how long people are expected to live have reduced by 4.4 years, from 90.4  to 86 years.

The findings show that across a range of measures, there is a wide gap between the health of people living in the most and least deprived areas with people living in the most deprived areas increasingly left behind the rest. The report raises a number of areas of concern which need immediate action, in particular, improving the health of children in their early years and the health of young to middle aged men.

Young to middle aged men are the most likely to suffer from deaths related to drugs**, alcohol or suicide, with the exponential rise in drug deaths concentrated among men in their mid-30s to early-60s. This group engages less with health services and is the most likely not to attend hospital appointments.  Being younger, single, white and male is most strongly associated with experiencing severe multiple disadvantages, which are linked to greater risk of poor health.

Commenting on the findings, David Finch, Assistant Director of the Health Foundation, said: “Life expectancy varies greatly across Scotland. In the most deprived areas, men are dying over 13 years earlier than their peers in the least deprived areas– and women almost a decade earlier.

“A healthy community derives from a range of factors: stable jobs, good pay, quality housing and education. Poor health is almost inevitable when some or all of these factors are absent. Scotland’s wide and sustained health inequalities are being driven by the accumulation of severe multiple disadvantages, a lack of improvement in living standards and public service fragility due to the ongoing impact of austerity.

“Understanding the causes are not enough; a radical shift in approach is needed. The Scottish government, local authorities, businesses and the third sector must come together and collaborate closely with communities. Without action, Scotland’s most deprived communities are likely to continue suffering from poor quality of life and die younger.”

Chair of the Health Foundation’s  Expert Advisory Group, Chris Creegan added: “This review is the most comprehensive study of health inequalities in Scotland since devolution, and while the findings are complex, what they clearly illustrate is that inequality in health is stubbornly high in Scotland.

“The public is receptive to longer term preventative interventions aimed at tackling the fundamental causes of health inequalities, rather than short term measures. They will support a bold, collective response.

“We need actors across economic, financial, social and health systems in Scotland to take note of these findings and use them to build on the strong policy intent we already have to reverse these trends and improve health outcomes for the future. But there is no need for a new strategy; over the last decade, several policy plans and strategies have focused on tackling health inequalities, most recently, 2018’s Public Health Priorities for Scotland. We have the policies, we now need action.”

The full report can be read here. 

Inflation continues to loom large as 2023 gets properly underway

This week always feels like a bit of a transition every year – it starts to feel a bit late to say “Happy New Year”, and the start of the week is dubbed “Blue Monday” as people realise that those well-meaning new year resolutions have already been broken (writes Fraser of Allander Director MAIRI SPOWAGE).

One of mine was to think hard to find the optimistic news in what can sometimes feel like the unrelentingly negative economic situation we are in, which is likely to remain tricky throughout the year. I was tested hard this week as new inflation data was released on Wednesday.

Inflation falls to 10.5% – but let’s not get too excited

The ONS released the official inflation data for December, which showed CPI inflation had fallen from 10.7% in November to 10.5% in December.

The main items driving the fall in inflation are petrol and diesel prices, and prices for clothing in footwear. Prices at the pump have been falling since their peak in July, and in December they were back to roughly the levels they were at before the Russian invasion of Ukraine. Clothing and footwear has fallen really due to a lack of discounting in December 2021, so when compared to December 2022 it appears that prices have fallen.

Obviously, energy prices are still contributing hugely to this very high inflation rate (which, let’s not forget represents a 40 year high of inflation apart from the preceding three months in 2022). That increase is currently stable in the figures due to the UK Government’s Energy Price Guarantee – but this cap on unit prices is only in place until end March, when it increases to £3,000 for a household with typical use. The ONS estimate that this will add 1 percentage point to inflation when it comes into effect.

Worryingly for those on the lowest incomes, food prices continue to increase faster than the headline rate. The inflation rate for food and non-alcoholic beverages increased to 16.9% in December from 16.5% in November.

We were asked two main questions when the data came out on Wednesday.

The first was, of course – what is the outlook for inflation for the rest of 2023? The expectation by the OBR is that inflation is likely to fall to under 4% by the end of the year. But remember, this does not mean that prices will start to fall at this point – just that they will grow less quickly.

This is somewhat simply due to the definition of inflation – it compares prices now to prices a year earlier, so as we move into October, we will be comparing to the much higher energy costs from October 2022. It was therefore inevitable that growth was likely to slow down – a point to bear in mind when some try to take credit for the fall in inflation.

The second is whether we are likely to see further increases in the Bank of England’s base rate at their next meeting on 2nd February – especially given that inflation has come down a bit. Unfortunately for mortgage payers, it is still very likely that we will see further increases in the base rate.

Why? Because inflation is not just been driven by food and energy costs. CPI excluding energy, food, alcohol and tobacco (often referred to as core CPI) is at 6.3%, and has been around this level since July 2022. This is being generated by domestic factors, including the tight labour market, which means the Bank is likely to take the view that they need to continue to cool demand in the economy.

Scottish unemployment remains at 3.3%

We also got updated figures on the labour market on Tuesday, covering the three months to November. Scottish unemployment remained at 3.3%, slightly below the UK rate of 3.7%. Employment remains high, at 76.1%, with inactivity at 21.3%.

Changes in inactivity over the period of the pandemic have been a focus of much analysis – because although the level is now similar to before the pandemic, the underlying reasons why people are inactive seem to have changed – with an increasing number saying that they are not in work or seeking work because of ill health or disability.

See a great Twitter thread on this by our colleague Professor Stuart Mcintyre – as part of his monthly analysis of the labour market.

Alongside the headline labour market numbers, there is also information ONS publishes monthly on earnings and vacancies.

The vacancy level alongside the labour market data helps us understand how tight the labour market continues to be. The total number of vacancies has been falling in recent months, since the record highs in Q2 2022. However, the number of vacancies remains historically very high, with 1.0 unemployed people for each vacancy – a rate which remains indicative of a tight labour market.

Earnings (ex bonuses) grew by 6.4% in the year to the three-month period Sept-Nov. Given the inflation rate over this period, this means that earnings are continuing to fall in real terms. In the face of continuing public sector pay disputes across the UK, the split between the public and private sectors is particularly interesting. Private sector pay grew by 7.2% compared to 3.3% for the public sector.

Health Foundation publishes important research into health and health inequalities in Scotland

This week the Health Foundation published a report to provide a picture of health and health inequalities in Scotland, in order to inform future efforts to improve both.

An independent review underpins their report, and we were delighted to work with the Health Foundation on this programme of work, as one of four independent organisations to carry out supporting research. See our research here.

And finally, I don’t care if it’s too late – Happy New Year everyone! But that is the last time I’ll say it this year.

Work completes on giant mural at Glasgow Royal Infirmary

Latest addition to Glasgow’s Mural Trail shines a light on health inequalities 

A new mural has been officially unveiled at the Princess Royal Maternity Hospital at Glasgow Royal Infirmary, adding to Glasgow’s growing mural trail and raising awareness of health inequalities which exist in Scotland.

The Black mother and baby mural was developed in partnership between NHS Greater Glasgow and Clyde  (NHSGGC) and local campaigner, Rachel Dallas. The mural marks NHSGGC’s own commitment to tackling health inequalities in maternal health and baby outcomes in the UK.

The 20 x 30ft design can be seen above the main entrance to the maternity unit on Wishart Street and features the image of a real mother and baby from the local community.

It comes following research which reveals significant racial disparity in maternal care and baby outcomes within Black and ethnic minority groups across the country. A number of partnership groups within NHSGGC are helping to drive forward and further reduce inequalities by promoting diversity in all areas of healthcare, including public health and staff messaging.

Jackie Sands, senior arts and health lead at NHSGGC, said: “Art plays a powerful role in helping raise awareness of major issues in captivating and thought provoking ways.

“The Black mother and baby mural unveiled today will feature in the landscape of Glasgow for years to come, shining a light on, and reminding people of the continued drive to reduce health inequalities – particularly for Black women and babies.

“NHSGGC is delighted to play host to such a mural and to play a part in helping reduce some of those inequalities which do exist.

“A huge thanks to Artisan Artworks for painting the mural and to Rachel Dallas for joint fundraising to make the mural possible.” 

Campaigner, Rachel Dallas, said: “This mural is a tribute to the women behind the statistics on racial disparities in maternal health.

“As a mixed Black woman living in Glasgow, I hope it reminds all who enter the hospital (staff, patients, and visitors) of the right to equality of both health care and health outcomes, as well as providing a beautiful representation of the strength and resilience of motherhood.”
                                               
Frank Carty of Artisan Artworks, added: “I am honoured have been involved in painting this mural which it is hoped will highlight inequality in maternal care for Black mothers.

“The image should also be very welcoming and maternal to all visitors to the maternity Hospital, and I’m hoping it will provide a really positive focus for that part of the hospital.”

Tackling Scotland’s health inequalities requires immediate joined-up action, warns Holyrood Committee

A Scottish Parliament inquiry has concluded by calling for urgent, coordinated action across all levels of Government in the UK to tackle health inequalities in Scotland.

A wide-ranging report by the Health, Social Care and Sport Committee calls for urgent action to address health inequalities, and for tackling poverty to be considered a major public health priority at all levels of Government in order to address this.

Read the report

The Committee heard evidence that the Covid-19 pandemic and the rapidly rising cost of living have further exacerbated Scotland’s health inequalities.

The Committee is calling for action across the UK and the Scottish governments, and by local authorities, which it says is essential if these inequalities are to be tackled effectively. This includes further public service reform and strategic action across multiple policy areas.

Among its recommendations, the Committee is calling for action on education, employment and housing to improve health outcomes and better tackle health inequalities. It says safe, secure and affordable housing must be available for all and highlights the significant impact planning policy can have on health outcomes and, if implemented poorly, in widening inequalities.

In compiling its report, the majority of the Committee agreed with the recommendation by the Glasgow Centre of Population Health that, within budget constraints, the UK Government should take action to align benefits and tax credits with inflation and to reinstate the uplift in Universal Credit introduced during the Covid-19 pandemic.

The report also highlights extensive evidence submitted to the inquiry that informal and unpaid caring has a disproportionate impact on health outcomes and that informal carers face significant health inequalities as a result.

To address this issue, the Committee calls on the Scottish Government and Public Health Scotland to provide more targeted support for carers.

Gillian Martin MSP, Convener of the Health, Social Care and Sport Committee, said: “The evidence is clear that health inequalities in Scotland continue to grow, while the pandemic and ongoing cost of living crisis will only exacerbate these inequalities further.

“A number of witnesses contributing to the inquiry argued that, over the past decade, UK Government policies on austerity have also had a negative impact on health inequalities in Scotland.

“We are particularly concerned that the rising cost of living will have a greater negative impact on those groups already experiencing health inequalities, including those living in poverty and those with a disability.

“Government action to date to tackle health inequalities has not been enough in the face of decades-long, major impacts on household incomes. We are calling for urgent action across all levels of government to reduce these stark inequalities which have real life and death consequences.

“There is currently no overarching national strategy for tackling health inequalities in Scotland. Meanwhile, evidence submitted to our inquiry has revealed multiple instances where the design and delivery of public services may be exacerbating inequalities rather than reducing them. We need to deliver further public service reform to ensure this doesn’t continue to happen.

“The reasons why we have failed to make progress in tackling health inequalities are many and varied. Reducing these will require bold and strategic action across all levels of government and by a range of government departments. Tackling health inequalities must be a major public health priority because lives literally depend on it.”

Other key findings in the report include:

  • The Committee express concern that certain vulnerable families report being excluded from free childcare provision, including those who care for disabled children and those who do not have a standard Monday-Friday work pattern.
  • A majority of the Committee is supportive of the concept of a universal basic income and calls on the Scottish Government to work with the relevant UK agencies to consider whether a pilot of the policy could take place in Scotland in order to begin to address health inequalities. A Committee majority would also like to see the implementation of a minimum income guarantee in Scotland.
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