Long Term Monitoring of Health Inequalities: Headline Indicators – October 2014

Background

A Ministerial Task Force on Health Inequalities led by the Minister for Public Health was established in 2007 to identify and prioritise practical actions to reduce the most significant and widening health inequalities in Scotland. The Task Force recognised the need to monitor progress in tackling health inequalities in the longer term as well as managing short and medium term progress.

A short life technical advisory group was set up in early 2008 to advise the Task Force on long-term monitoring of health inequalities. The group recommended a range of indicators on health inequalities to be monitored over time, and most recently met in 2012 to review the list of indicators and methods^[1]. This publication updates those headline indicators^[2].

In 2012, the Ministerial Task Force on Health Inequalities was reconvened to review progress. Through the review, the Task Force received an update on the latest evidence. The Task Force noted that, despite a lot of commitment and resource, the scale of health inequalities - as measured by the indicators - had not reduced.

The Task Force heard evidence from a Policy Review^[3] conducted by NHS Health Scotland that, whilst the publication of Equally Well^[4] in 2008 marked the desire to shift focus to the social determinants of health, link beyond the NHS and engage local authorities, in practice there had been a tendency towards focussing on 'downstream' activities (dealing with people after they have acquired problems) rather than dealing with issues 'upstream' in order to prevent these problems arising in the first place.

The Task Force was asked to reflect on changes in the way that people and communities were being engaged in decisions that affect them, and the impact of the Christie Commission on how health inequalities are being tackled. In addition, the Task Force looked at how "place" had an impact on health inequalities.

The Task Force published its findings in March 2014^[5]. In doing so, it re-iterated the commitment to tackling health inequalities, identifying priorities including a focus on developing social capital and supporting Community Planning Partnerships. The Task Force agreed that a regular 2 year review may not be the best way to monitor progress nor influence the current way of working, and agreed alternative arrangements should be considered. Since publication, a new Inequalities Action Group has been established to progress delivery of actions that contribute to reducing health inequalities.