This website is now part of Public Health Scotland. Publications released after 16 March 2020 are now published on the Public Health Scotland website.
Improving health
Previously NHS Health Scotland

The Scottish Government has made improving the quality of later life a National Outcome. A variety of legislation, strategies and polices have been implemented to support the health and wellbeing of older adults. You can find information below on

  • the Scottish Government’s initiative Reshaping Care for Older People
  • Optimising Older People’s Quality of Life: an outcomes framework
  • Active and Healthy Ageing: An Action Plan for Scotland 2014 – 2016.
  • Between mid-2005 and mid-2015 there was an 18% population increase in the 60-74 age group, compared with a decrease of 2% in the number of children under 16.
  • By 2031 there will be an additional 25% demand for health and social care services.
  • By 2035 there will be more than 1.7 million people aged 60 and over - a 31% increase on  2015.
  • By 2035 there will be almost 740,000 people aged 75 and over - a 68% increase on 2015.

You can read more data on older people on the Scottish Public Health Observatory (ScotPHO) website (external).

Older people and health inequalities

Life expectancy and healthy life expectancy are increasing for both men and women. However, the length of time spent in ill health is also rising as the incidence of health problems increases with age.

Just as there is a social gradient in health across the adult population, there is also a social gradient in healthy ageing that is rooted in inequality. The lower a person’s social status, the more likely they are to enter older age in poor health and die younger than people from higher social classes. Therefore, the best way to reduce health inequalities in older age is to reduce the inequalities in society across the life course.

Health inequalities in older age are mostly a result of the social patterning of chronic diseases such as heart disease, stroke and cancer. As a result

  • older people living in disadvantaged areas are more likely to die from coronary heart disease than those in more affluent areas
  • type 2 diabetes tends to be diagnosed in older people and is often associated with obesity, which is linked with lower socio-economic status
  • incidence rates increase with age for most cancers and there is a social gradient in incidence, the steepest of which is for smoking-related cancers such as laryngeal, lung and oral cavity cancers.

As well as the influence of lifelong exposure to the harmful effects of inequality, a significant proportion of older people are affected by the damaging impact of living in poverty. The latest Scottish Government figures show that

  • over half of single pensioner households and nearly half of pensioner couples in Scotland live in fuel poverty
  • 15% of pensioners in Scotland were living in relative poverty in 2013-2014 (12% after housing costs are factored in)
  • female pensioners are more likely to live in poverty than male pensioners, largely a result of having fewer years of employment due to caring responsibilities.

National and local action

Various strategies and policies have been developed to support the health and wellbeing of older people including free personal and nursing care and free bus travel for people over the age of 60.

Reshaping Care for Older People 

The Scottish Government’s Reshaping Care for Older People (RCOP) initiative was launched in 2011. This provides a long term and strategic approach to delivering the vision for future care for older people in Scotland.

Outcomes Framework

‘Optimising Older People’s Quality of Life: an outcomes framework’ was produced by in 2014 by NHS Health Scotland, the Joint Improvement Team, the Scottish Government and other agencies in the field.

The framework is made up of a strategic outcomes model and four nested logic models that illustrate a range of preventive measures. It highlights long term and medium term outcomes for older adults and provides summaries of available evidence.

Active and Healthy Ageing action plan

‘Active and Healthy Ageing: An Action Plan for Scotland 2014 – 2016’ presents a vision where all older adults can ‘enjoy full and positive lives – happy and healthy at home or in a homely setting’. The plan highlights principles, outcomes and actions to support older adults to be active and to achieve better outcomes.

At a local level, the integration of health and social care is intended to improve the way local partnerships plan for, organise and deliver the health and social care services needed by all adults, but particularly those in their later years.

You can contact us to learn more about our work improving the outcomes of older people.