There is persistent, and in places deepening, structural inequalities that continue to drive poor health that is concealed by averages.
Although overall, this report suggests there have been modest gains in some living-standards, including some hopeful signs of reductions in child poverty.
Headline message: modest improvements in incomes and some child-poverty measures are not yet translating into material reductions in health inequality. Structural drivers - housing insecurity and quality, working conditions, and the long shadow of austerity - continue to shape outcomes.
Young adult men at heightened risk are a policy ‘blind spot’: a subset experience compounding exclusion across work, housing, justice and mental health. Contact points - homelessness presentations, police/justice interactions, or A&E - typically occur after crises emerge, missing the preventative ambition of Scottish policy.
Overall conclusion: Scotland has begun to stabilise some indicators of living standards but average trends obscure the fact that progress is not evenly distributed. As we show in Part 2, some young adult men facing disadvantage are at high risk of 4 preventable deaths and yet seem to constitute a policy ‘blind spot’. A more joined-up, preventative approach to housing, income security, work quality and early intervention is urgently needed to tackle health inequalities. The path forward requires both targeted upstream investment and governance mechanisms to ensure that joined-up policy approaches are effectively implemented. Without these changes, the Scottish Government cannot credibly drive the action needed for long-term progress.