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Improving Health in Scotland - THE CHALLENGE
THE CONTEXT
SCOTLAND'S HEALTH CHALLENGE
Our health as individuals, and as a nation, is a complex interaction of many different factors. Personal choices and behaviour (smoking, diet, alcohol consumption, physical activity), the environment in which we live (housing, air quality, workplace, etc.), the social environment and access to resources (poverty/wealth), education, employment, all inter-relate and impact on our health and well-being. The relative impact of these factors varies at different times in our lives. There is also increasing evidence that (not just in Scotland, but across the world) mental ill health is increasing and disproportionately affects the more disadvantaged groups in our communities. Raising our awareness and understanding of mental health coupled with action to promote good mental health and prevent mental health problems will be essential components of our approach to improving health in Scotland. If Scotland aspires to be a
'healthy living' nation, good physical health and good mental health both matter.
The 'Challenge' we confront can be summarised as follows:
Scotland has poor health by UK and European standards
Scotland has high levels of inequality in health outcomes for different socio economic groups (for example - in terms of life expectancy, rates of Coronary Heart Disease)
Poverty in the broader sense is a central feature of the problem
There are strong cultural influences on health that have to be confronted
Health improvement requires change; by both society and individuals
History demonstrates that societies and people can adapt to meet new threats and challenges.
Scotland's health (e.g. life expectancy) has improved in recent decades, however, so have other nations in Western Europe many to a greater extent. Differences in life expectancy at birth demonstrate the extent of the challenge that remains. Scotland lags behind comparable countries such as Sweden and Denmark and also suffers in comparison to other parts of the UK including industrial regions like the North East of England.
THE NEED FOR A CHANGE
Projected trends suggest that the situation is unlikely to improve unless we act now to achieve a more rapid rate of health improvement in Scotland.
To achieve a more rapid rate of health improvement in Scotland we need to:
Inspire, enable, encourage and challenge the nation to achieve that vision
Implement policies that will transform elements of Scottish life to make a real difference to individuals' expectations of good health
Select a few key objectives (e.g. reduce fat, particularly saturated fat consumption, increase physical activity) and deliver these effectively
Encourage the national best practice of professionals especially in multi-agency settings to achieve their full potential
Release the inner resources of individuals and communities by building social capital, and improve the infrastructure of communities to make rapid progress.
The Vision for Scotland in 2020
A thriving Scotland with appropriate working, housing and living conditions, less smoking, healthier eating, more activity in daily life and less binge drinking, producing an improvement in quality of peoples' lives, enhanced well-being and increased life expectancy for all men and women, fewer early deaths from heart disease, diabetes and cancer.
Individuals and organisations taking more individual and corporate responsibility, with more people living their lives in good health both physically and mentally.
All Scotland's children have a positive expectation of appropriate housing, education, community and family life with the aim of maturing into positive, confident and productive citizenship.
THE HEALTH IMPROVEMENT CHALLENGE
Our approach to health improvement must be relevant to people's daily lives, wide-ranging and all embracing. Individuals, families, groups, communities and organisations across the public, private and voluntary sectors all have distinct and critical roles to play. Actions in relation to both life circumstances and lifestyles will be required.
The responsibility for achieving improved health cannot lie solely in the hands of any one agent - Government, professional groups, organisations or individuals. For example, we will have to improve the physical environment of our most deprived areas. We will have to recognise problems of social isolation, stress and fear of crime. We will have to tackle key choices like smoking and the rising problem of obesity. Scotland will have to examine its approach to alcohol as never before. The people of Scotland will need to make healthy choices in all aspects of their lives and to feel that they are supported in making these choices.
Much of this document concentrates upon the role played by the Scottish Executive and its key partners. The Scottish Executive with its partners has a vital role to lead strategic changes in Scotland that will help to bring about a healthier society. Four examples will illustrate this.
1. Actions that impact on child health and well-being will result in better health that will last into adult life.
2. If children's lives, including the experience of transition from primary school through the first few years of secondary school and onto higher education or employment, could be transformed in such a way that all pupils are engaged in a spectrum of positive, life-enhancing activities, it would have a profound effect on teenage smoking, mental health, drug use, pregnancy and alcohol consumption.
3. The prosperity and the health/well-being of future generations depend to a very great extent on the health of our working-age population. By helping working-age people to live healthy and fulfilled lives, we can improve the well-being of the whole nation.
4. Statutory and voluntary processes will be used to develop a sense of community responsibility, engaging people in taking responsibility and a sense of pride in their communities.
This plan outlines the ways through which we can provide real leadership as we work together to meet the health improvement challenge. However, it is only by showing individuals that realistic, achievable changes in their own actions can bring both immediate and long-term benefit to them, their families and Scotland that we will succeed in improving health.
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