Inquiry on health inequalities

The Royal Society of Edinburgh responds to the Scottish Government’s Health, Social Care and Sport Committee Inquiry on Health Inequalities.

The Royal Society of Edinburgh (RSE), Scotland’s National Academy, welcomes the opportunity to respond to the Health, Social Care and Sport Committee Inquiry on Health Inequalities.

Key Findings

The recommendations in many reports and policies introduced before 2015 have not yet been implemented or fully considered in Scotland, which has inhibited progress towards improving health inequality over the intervening years.

Findings across research have found that health inequalities result from unequal access to wealth and power. Increasing income and reducing inequalities in income are likely to have the greatest effect on inequalities in health over the long term.

Governmental priorities for sometimes conflicting objectives such as economic growth, environmental sustainability and wellbeing of the population may need to be more carefully balanced. Health inequalities are driven by sectors outside of the health and social care remit. Therefore, successful approaches will require collaboration across governmental sectors, addressing policy issues in housing, education, environment, and economic strategy, all of which contribute to people experiencing disadvantage.

A clear strategy should be generated and applied across governmental sectors that have the remit to address the varied factors that result in health inequalities. With a clear line of accountability established and the Cabinet being responsible for its efforts in reducing health inequalities.

It is essential that there is a bottom-up approach as well as a top-down approach across government agencies. Local initiatives that will effectively address health inequality may vary across different communities and geographies, and attention needs to be paid to promoting the potential for local communities and local service agencies to work collaboratively.

More work should be done to understand how the general public experience, understand and value health equality since this is ultimately crucial for the success of the governmental policy. Studies that qualitatively and statistically record the experiences of the most disadvantaged groups and those caring for them may be especially important in informing the debate on health inequality.

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