The health of the Scottish population is, and has been for many years, worse than that of the English. Life expectancy is the lowest in the UK, at 77.1 for men and 81.1 for women, and one of the lowest in the OECD. The gap between Scotland and England has grown since 1980. Some of this is clearly attributable to economic disadvantage, but the differences in health status are more pronounced that would be expected on that basis. It has often been suggested that the Scottish diet is to blame. This is particularly so in

Glasgow Glasgow ( ; sco, Glesca or ; gd, Glaschu ) is the most populous city in Scotland and the fourth-most populous city in the United Kingdom, as well as being the 27th largest city by population in Europe. In 2020, it had an estimated popul ...

and the

Glasgow effect The Glasgow effect refers to the lower life expectancy of residents of Glasgow compared to the rest of the United Kingdom and Europe. The phenomenon is defined as an " cess mortality in the West of Scotland (Glasgow) after controlling for depriv ...

has been the subject of some academic study.

Legislation

Following

Scottish devolution Devolution is the process in which the central British parliament grants administrative powers (excluding principally reserved matters) to the devolved Scottish Parliament. Prior to the advent of devolution, some had argued for a Scottish ...

1999, responsibility for health and social care policy and funding became devolved to the

Scottish Parliament The Scottish Parliament ( gd, Pàrlamaid na h-Alba ; sco, Scots Pairlament) is the devolved, unicameral legislature of Scotland. Located in the Holyrood area of the capital city, Edinburgh, it is frequently referred to by the metonym Holyro ...

. A few aspects of Scottish health policy, such as

surrogacy Surrogacy is an arrangement, often supported by a legal agreement, whereby a woman agrees to delivery/labour for another person or people, who will become the child's parent(s) after birth. People may seek a surrogacy arrangement when pregnan ...

remain reserved powers of the UK government.

Healthcare

Healthcare in Scotland is mainly provided by Scotland's public health service,

NHS Scotland NHS Scotland, sometimes styled NHSScotland, is the publicly funded healthcare system in Scotland and one of the four systems that make up the National Health Service in the United Kingdom. It operates 14 territorial NHS boards across Scotland, ...

. It provides healthcare to all permanent residents free at the point of need and paid for from general taxation. Health is a matter that is

devolved Devolution is the statutory delegation of powers from the central government of a sovereign state to govern at a subnational level, such as a regional or local level. It is a form of administrative decentralization. Devolved territories h ...

, and considerable differences have developed between the public healthcare systems in the different countries of the United Kingdom. Though the public system dominates healthcare provision, private healthcare and a wide variety of alternative and complementary treatments are available for those willing to pay.

Alcohol

High rates of alcohol related illnesses pose a major public health challenge for Scotland.

estimate that there were 3,705 deaths attributable to alcohol consumption in 2015, this equates to 6.5% or around 1 in 15 of the deaths for the whole of Scotland for that year. Alcohol misuse was estimated to cost the Scottish economy 3.56 billion per year in 2007. Alcohol consumption in Scotland is approximately 20% higher than in England and Wales.

Public Health Measures

Drink Driving Limit

In December 2014, the Scottish Government reduced the legal drink driving limit in an effort to reduce the number of alcohol related deaths and serious injuries on Scottish roads. The reduction in the legal limit from 80 mg to 50 mg of alcohol in every 100ml of blood brought Scotland in to line with other European countries such as France, Germany, Italy and Spain. In 2018, researchers from Glasgow University found that rates of road traffic accidents in Scotland had increased since the reduction in the drink driving limit had been introduced, proposing that the change in the limit may not have been enforced or publicised sufficiently to have the expected effect in reducing accidents.

= Minimum Unit Pricing

= In 2012 the Scottish Government passed legislation to introduce a

statutory A statute is a formal written enactment of a legislative authority that governs the legal entities of a city, state, or country by way of consent. Typically, statutes command or prohibit something, or declare policy. Statutes are rules made by le ...

minimum price A price floor is a government- or group-imposed price control or limit on how low a price can be charged for a product, good, commodity, or service. A price floor must be higher than the equilibrium price in order to be effective. The equilibrium ...

per

unit Unit may refer to: Arts and entertainment * UNIT, a fictional military organization in the science fiction television series ''Doctor Who'' * Unit of action, a discrete piece of action (or beat) in a theatrical presentation Music * ''Unit'' (alb ...

of alcohol to try to reduce alcohol consumption by harmful drinkers. The legislation was subject to legal challenges by alcohol trade bodies including the

Scotch Whisky Association The Scotch Whisky Association (SWA) is a trade organisation that represents the Scotch whisky industry. The Scotch whisky industry is an important part of the Scottish economy, and particularly the Scottish export market. Structure The main o ...

but was ultimately upheld by the

Supreme Court of the United Kingdom The Supreme Court of the United Kingdom (initialism: UKSC or the acronym: SCOTUK) is the final court of appeal in the United Kingdom for all civil cases, and for criminal cases originating in England, Wales and Northern Ireland. As the Unite ...

. The act came into effect on 1 May 2018 with an initial minimum price of 50p per unit.

Drugs

The ratio of drug-related fatalities in Scotland has overtaken every other country in the UK, as well as the EU. Recent research has shown Scotland has had a larger number of drug deaths than the United States, which was thought to be the highest in the world. In the US in 2017 the rate of drug deaths of 217 per million of the population is now slightly lower than Scotland's rate (218 deaths per million of population). According to the Guardian newspaper, the increase in drug deaths in recent years are due to

Benzodiazepine Benzodiazepines (BZD, BDZ, BZs), sometimes called "benzos", are a class of depressant drugs whose core chemical structure is the fusion of a benzene ring and a diazepine ring. They are prescribed to treat conditions such as anxiety disorders, ...

Heroin Heroin, also known as diacetylmorphine and diamorphine among other names, is a potent opioid mainly used as a recreational drug for its euphoric effects. Medical grade diamorphine is used as a pure hydrochloride salt. Various white and brow ...

and Ecstasy. In 2020 1,339 deaths related to drug misuse were registered in Scotland, a 5% increase on 2019, and the highest ever recorded. 63% were of people aged between 35 and 54, and men were 2.7 times as likely to have a drug-related death as women. People living in the most deprived areas were 18 times more likely to die from a drug-related condition than those in the least deprived areas. The Scottish Drug Deaths Taskforce reported that use of

naloxone Naloxone, sold under the brand names Narcan (4 mg) and Kloxxado (8 mg) among others, is a medication used to reverse or reduce the effects of opioids. It is commonly used to counter decreased breathing in opioid overdose. Effects begin within ...

kits may have saved almost 1,400 lives in 2020. In 2021, 1,187 people died in Scotland as a direct result of a drug overdose. Nearly half of the drug deaths in Scotland were attributed to methadone.

Obesity

The Health and Sport Committee has called for more action to tackle Scotland's "obesogenic environment".

Smoking

Scotland was the first country in the UK to enact a

smoking ban Smoking bans, or smoke-free laws, are public policies, including criminal laws and occupational safety and health regulations, that prohibit tobacco smoking in certain spaces. The spaces most commonly affected by smoking bans are indoor work ...

in public places. The

legislation Legislation is the process or result of enrolled bill, enrolling, enactment of a bill, enacting, or promulgation, promulgating laws by a legislature, parliament, or analogous Government, governing body. Before an item of legislation becomes law i ...

was passed in the Scottish parliament in 2005 and came into force on 26 March 2006. The effect of the smoking ban has been found to be positive with an 18% drop in the rate of child asthma admissions per year and a 17% reduction in heart attack admissions to nine Scottish hospitals. In 2015, 87% of Scottish adults were found to be in favour of the ban, with only 8% opposed. The tobacco control strategy has had a "positive impact". Scottish smoking rates fell from 31% in 2003 to 21% in 2015. There is a socio-economic gradient with 35% of people living in the most deprived areas smoking compared to 10% in the most affluent areas.

Mental health

There is some evidence that Scottish patients more often seek medical help with stress, anxiety and depression than English patients. To help support this, Scotland has put in place a Mental Health Strategy. The strategy began in 2016 and will last for ten years. It aims to increase accessibility of mental healthcare towards children and adolescents, improve attitudes towards mental illness, and educate the community. The overall goal is to improve how people in Scotland live, grow, work, and age. Scotland is also looking to trial a dedicated mental health ambulance service, following success of a similar scheme in Sweden.

References

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