On this page you will find resources to help you identify effective actions to reduce health inequalities, including a publication for senior NHSScotland staff.
Our publication 'Maximising the role of NHS Scotland in reducing health inequalities' provides senior NHSScotland staff with an overview of their unique and key contributions to reducing health inequalities. It describes practical actions staff can put in place to reduce health inequalities ensuring the best attainable health outcomes for both the people and communities they serve and the staff they employ.
Health inequalities policy review
Our Health Inequalities Policy Review sets out what works, and does not work, to reduce health inequalities. You can download the Health Inequalities Policy Review below.
Four key findings from the Policy Review are
- Tackling health inequalities requires a combination of action to undo the fundamental causes, prevent the harmful wider environmental influences and mitigate (make less harmful) the negative impact on individuals.
- Undoing health inequality,for example backing fairer social policy so that resources are better distributed.
- Mitigating the consequences of health inequality, for example improving access to health and social care through service design and approach.
- Preventing inequalities in health, for example working with Community Planning Partnerships to address local social circumstances and to build the resilience of individuals and local communities.
- To be most effective at both improving health and reducing health inequalities, interventions need to focus at a structural or regulatory level. This means making changes to the context in which services operate. Some examples include
- income support
- reducing price barriers for example free prescriptions and Universal Free School Meals
- improving the accessibility of services, for example, the location and accessibility of primary health care and other core services
- structural changes in the environment, for instance, area wide traffic calming schemes, separation of pedestrians and vehicles and installing affordable heating in damp, cold houses
- legislative and regulatory controls, for example drink-driving legislation, lower speed limits, seat belt legislation
- fiscal policies, such as increasing the price of tobacco and alcohol products.
- Providing universal services with added intensive support for vulnerable groups (proportionate universalism) is effective in improving health and reducing health inequalities. Some examples include
- offering intensive support in a personalised manner through face-to-face groups or home visiting
- starting young through pre and postnatal support and interventions, home visiting in infancy, preschool day care
- prioritising disadvantaged groups such as deprived families and communities, unemployed people and poor people.
- There is evidence that interventions which require individuals to opt-in and those which involve significant price barriers may assist in improving health, but tend not to be effective at reducing health inequalities. Some examples include
- housing or regeneration programmes that raise housing costs
- information-based campaigns and written materials, such as leaflets
- approaches with significant barriers to take-up like price, access, etc.
- campaigns/messages designed for the whole population or reliant on people taking initiative to opt in
- whole school health education approaches, for example, school-based anti-smoking and alcohol programmes.
Identify effective actions
There are several sources of support to identify effective actions.
- You can access effectiveness evidence resources through, for example, NHS Evidence (external site) or Scottish Intercollegiate Guidelines Network (external site).
- You can access our Evidence Briefings which provide accessible summaries of current evidence and thinking on specific subject areas. These briefings are produced to inform policy and strategy development, practice, and to provide access to evidence through a number of partner websites.
- You can build your skills and knowledge around finding and critically appraising research evidence through one of the many courses available in Scotland, such as the ones provided by Scottish Intercollegiate Guidelines Network (external website) or the Critical Appraisal Skills Programme (CASP) (external website) provided elsewhere in the UK.