Health inequalities Scottish experience and response

Saturday 27th June 2009  Friends Meeting House Victoria Street Edinburgh EH1 2JL

Notes kindly compiled by Lesley Scott Reid

with Professor Richard Wilkinson – the Equality Trust

Great inequality is the scourge of modern societies. We provide the evidence on each of eleven different health and social problems: physical health, mental health, drug abuse, education, imprisonment, obesity, social mobility, trust and community life, violence, teenage births, and child well-being. For all eleven of these health and social problems, outcomes are very substantially worse in more unequal societies.

We have checked the relationships wherever possible in two independent test beds: internationally among the rich countries, and then again among the 50 states of the USA. In almost every case we find the same tendency for outcomes to be much worse in more unequal societies in both settings.

We also present evidence on four other important issues. One is how achieving greater equality within the rich countries may contribute to tackling the inequalities between rich and poor countries. Another is a discussion of both the compatibility and relative merits of greater equality and economic growth as sources of improvements in the quality of life among rich countries. There is a page discussing how greater equality may contribute to policies designed to tackle global warming, and lastly, a page (The Remedies) pointing out that there are many different ways of increasing equality in our societies.

The data we use comes from the most respected international sources including The World Bank, World Health Organisation, United Nations, UNICEF, and US Census Bureau. Much of this work has already been published in peer reviewed academic journals, and some of the relationships have been tested many times by different research groups using data for different societies.

See also Reith Lectures 2009 – Michael Sandel, Harvard Professor of Government, delivers four lectures about the prospects of a new politics of the common good. Sandel considers the expansion of markets and how we determine their moral limits.

Professor John Frank Scottish Collaboration for Public Health Research and Policy: Where are we with Health Inequalities in Scotland?

The Collaboration seeks to develop and robustly test novel public health policies and programs to equitably improve health status in Scotland, through the convening and ongoing support of researcher/research-user consortia – but they haven’t got a website yet.

Human Early Learning Partnership – evidence of early assessment followed by resources to address identified need – effective as early intervention – an interdisciplinary research network of faculty, researchers and graduate students from British Columbia’s six major universities. Led by Dr. Clyde Hertzman, HELP facilitates the creation of new knowledge, and helps apply this knowledge by working directly with government and communities – evidence of early assessment and additional resources to respond working.

John Frank Key phrases: – Planning Requires Logic – Culturally Framed

Important to cultivate shared values – case manager and key worker outlined in Equally Well – move to team around the person – from signposting to drawing a service in.

Professor Stewart Mercer Department of General Practice & Primary Care Glasgow.

Note – involving a health economist in his work – observer related methoods – activating patients – role of extra time – enabling and encouraging self care – proactive – reactive – patients expectations – patient centeredness

Professor Allyson Pollock Centre for International Public Health Policy University of Edinburgh

Pollock AM, Kirkwood G. Independent sector treatment centres: learning from a Scottish case study. BMJ 2009

Pollock AM. Is private-sector money the right tool to construct tomorrow’s public Britain? No. The Observer 01 Feb 2009

Kay Barton who heads the Health Improvement Strategy Division at the Scottish Government Health Department. She advises Ministers on overall policy on improving health, preventing illness and reducing inequalities in health. Her team also works on specific aspects of health improvement, including healthy eating, physical activity and healthy weight management.

Scottish Government Better Health, Better Care:Action Plan Not a static policy – developments between now and Christmas – practical examples – potential move away from Pilot Projects.Is this a move to a whole system intervention approach – What we are interested in is how we can effect change. Identified the need for clearing house for practice that works – need to transfer knowledge – examples of how this is done in Canada.

Government Website for Poverty Stats

The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation

An overview of child well-being in rich countries UNICEF

This event was organised in conjunction with Lothian Deprivation Interest Group