NHS Lothian Health Inequalities Strategy

Health inequalities are ‘systematic, unfair differences in the health of the population that occur across social classes or population groups’.
In Lothian, people living in our most affluent communities live on average twenty one years longer than people living in the most deprived communities. There is a clear gradient showing progressively poorer health with decreasing affluence and influence. People who are disadvantaged by race, disability, gender and other factors also have poorer health.
The NHS Lothian Health Inequalities Strategy recognises that health inequalities reflect much broader societal forces that the NHS cannot address on its own. However, NHS services play an important role in mitigating the health effects of social inequalities, and NHS organisations can also work with partners to try to address the underlying influences.
Three types of action are needed to address health inequalities:
  • Actions to mitigate the health and social consequences of social inequalities by ensuring high quality healthcare for people with the highest health needs.
  • Actions that help individuals and communities prevent the effects of inequality on health and wellbeing by supporting targeted health improvement activities.
  • Actions to undo the underlying inequalities in power and resources that lead to poor health. This involves partnership work with other organisations.   
Within the NHS, the overall approach to mitigate and tackle health inequalities includes:
  • Using the potential of the NHS as a large employer and through procurement to provide employment, education and training opportunities with fair terms of employment for all staff.
  • Ensuring services are available and accessible to all, and are delivered proportionate to need, to reverse the ‘inverse care law’. This means increasing provision of geographically based primary and community services in the areas with highest needs.
  • Increasing the priority given to primary and community services relative to secondary and tertiary services, as the most disadvantaged groups benefit most from these.
  • Increasing the priority given to early years, early years and preventative interventions relative to interventions in later life, as the most disadvantaged groups benefit most from these.
  • Ensuring the social issues that impact on patients’ health and ability to use healthcare are viewed as legitimate issues for health professionals to consider, are systematically recognised, patient management reflects these needs and patients are referred or signposted to appropriate support.
  • Investing in partnerships with voluntary sector and other organisations that are better placed to address social issues that affect patients’ health.
  • Working with partners to raise awareness of underlying causes and to advocate for policies and interventions that reduce inequalities in income, wealth and power.
The Board approved the NHS Lothian Health Inequalities Strategy in December 2014.
The draft strategy was consulted on over summer 2014. You can read a summary of the consultation responses and how they were addressed here.
The draft strategy also had an impact assessment.  You can read the impact assessment report here 

Last Reviewed: 11/06/2015