A healthier future: Scotland's diet and healthy weight delivery plan

Outcome 5: Diet-related health inequalities are reduced

Reducing health inequalities is a primary objective of this plan, and runs all the way through it, consistent with the Fairer Scotland Duty, which came into force on 1 April 2018, whereby Scottish Government Ministers must actively consider whether they can narrow inequalities of outcome caused by socio-economic disadvantage when making strategic decisions. As we said in relation to all our public health priorities, reducing health inequalities is not just a matter of social justice. It is also a question of human rights. Our ambition for children reflects our commitment to support the United Nations Convention on the Rights of the Child, ^[57] which acknowledges the right for children to be as healthy as possible.

The causes of health inequality are broad and entrenched. If we want everyone in Scotland to eat well and have a healthy weight, we have to tackle the underlying factors as well, with poverty and deprivation remaining the biggest and most important challenges.

At the same time, we are clear that the efforts of society as a whole must increasingly turn toward supporting 'wellbeing' creation. This is not something that is achieved primarily through the NHS. The Public Health Priorities for Scotland provides the framework for this kind of societal change and the new coalition we need to deliver it.

Recognising this broader context, this plan prioritises the health of people in our most deprived communities. In particular:

• its strong focus on preventative measures and early intervention from pre-birth to adolescence will lessen inequalities;
• it contains action designed to empower people to make better decisions, and a commitment that we and our partners will work differently with communities and co-produce services they will use. The design and delivery of weight management services as part of our Type 2 Diabetes Prevention Framework is a great opportunity to get this right;
• there are population measures that impact everyone in Scotland. Learning from our wider experience such as the ban on smoking in public places, we know that these types of measures are more effective in reducing health inequalities than those aimed at changing people's behaviour. ^[58]

The diagram on next page sets out the specific actions that will help reduce inequalities against each of the delivery plan's outcomes. Taken together, the combined effect of these policies should mean that everyone in Scotland, no matter where they live, can eat more healthily and move towards a healthy weight, reducing the health harms associated with inequalities.

Westerhailes Health Agency

Outcome 1 - Children have the best start in life

• Supporting good nutrition and a healthy weight before and during pregnancy (1.1)
• Supporting women to breastfeed for longer (1.2)
• Prioritising and funding health and wellbeing interventions in closing the attainment gap (1.7 & 1.8)
• Expanding and improving provision of healthier food in early learning and childcare settings (1.11 & 1.12)
• Consulting on proposals to further tighten nutritional standards for school meals (1.13)
• Improving nutritional guidance and food standards for early years childcare providers (1.14)
• Supporting children facing food insecurity during school holidays (1.15)
• Supporting low income families to have access to a healthy diet (1.16)

Outcome 2 - The food environment supports healthier choices

• Restricting targeted promotion and marketing of HFSS foods within premises where foods are sold to the public (2.1)
• Restricting HFSS foods advertising (2.2 – 2.7)
• Urging UK Government to restrict the use of licenced characters etc. for HFSS foods promotion to children (2.8)
• Supporting healthier choices in Out of Home outlets (2.9 – in part)
• Exploring controls over food outlets near schools (2.12)
• Reformulating products to reduce public health harm (2.13 & 2.14)
• Restricting the sale of energy drinks to under 16s (2.15 & 2.16)
• Supporting fiscal measures that encourage healthier choices (2.17 - 2.19)

Outcome 5 – Diet-related health inequalities are reduced

Outcome 3 - People have access to effective weight management services

• Investing £42m to support weight management interventions for people with type 2 diabetes (3.1)
• Continue to fund Health Boards to deliver weight management programmes, with an emphasis on deprived communities (3.6, 3.8 & 3.9)
• Improving the equity of access to high-quality weight management services for children, young people and adults (3.7 & 3.10)
• Improving identification, referral and support for children and young people who are overweight or obese (3.11)
• Reducing weight related stigma as a barrier to accessing support (3.12)

Outcome 4 - Leaders across all sectors promote healthy diet and weight

• Improving the provision of healthier choices in a variety of settings including the public sector (4.1 - 4.3)
• Ensuring those impacted by food insecurity can eat well (4.4 – 4.6)
• Enhancing community-led initiatives on access to healthy affordable food. (4.7)
• Supporting students to eat well and have a healthy weight (4.8)
• Championing a whole-systems approach to diet and weight, working with local partners (4.9 - 4.10)
• Promoting the health and wellbeing of Scotland’s workforce (4.13 – 4.15)

Next Steps – Evidencing impact (6.1 - 6.3) and Ensuring strong accountability (6.4 & 6.5)