The most compelling findings of the report are the following:
Life expectancy projections in Scotland have been falling – a person born in 2023 is expected to die 4.4 years earlier than someone born in 2012.
The gap in healthy life expectancy has also been widening. In 2019 there was a 24-year gap in healthy life expectancy between people living in the areas with the highest and those with the lowest socioeconomic status in Scotland.
Growing inequalities regarding drug deaths – the overall rate of drug deaths increased from 6.2 per 100,000 in 2001 to 25.1 per 100,000 in 2019. Deaths in the most deprived areas are 68.2 per 100,000, 18 times higher than those in the least-deprived areas. In 2020, deaths from drug-related causes were 3.6 times higher in Scotland than the UK wide average.
The link between income and health – people living in the poorest two-fifths of households are 8 times more likely to report poor health as the richest fifth.
Rising poverty – since the mid-2010s, the proportion of the population in both relative poverty and extreme poverty has shown a slow but persistent upward trend, which is particularly marked for child poverty.
Median wealth inequality
£1.65mn: the 10% of households with the most wealth in Scotland.
£7,600: the 10% with the least wealth. A 200-fold difference overall.
These are not entirely new issues. Since the 1950s, Scotland has had the lowest life expectancy of all the UK nations. The problems are deep and have been with us for a long time.
What can we do about this?
These are the challenges facing politicians, policy advisors, citizens and communities. The big issue now is to consider what we can do about this.
The Health Foundation ran a webinar –available for all to listen to on their website – and discussed what we could do about the findings of this report.
The inadequacies of the current social security system was also part of the problem identified by more than one participant in the discussion. The need to invest in high-quality social housing on a nationwide scale would offer immediate health gains to many of our poorest families. Learning from good practice and scaling it up to bring meaningful change to our poorest communities is essential. Also learn the lessons from the Covid emergency, when the national government took the lead in supporting individuals and families, preventing economic mayhem and allowing people time to get over a major crisis.
In Scotland we have seen individuals and communities activated through participation in Community Action Plans. We should put poverty reduction and health as the number one priority on all our plans going forward. We must have joined-up government, led by local people who know best where our national resources should be directed. In this way we will have a chance of improving some of the truly shocking findings highlighted in the Health Foundation’s report.
We must identify good practice and innovation and have the tools available to scale this up quickly across the country. We must look seriously at a minimum income guarantee for all citizens. A Universal Basic Income has to be a better system than the failing Universal Credit system we have at the moment.
We need radical solutions linked to a government that is prepared to put in major investment to change the current situation for the better.
“Leave no one left behind” must become a rallying cry for us all. That way, it may turn this piece of research into a lasting legacy.

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