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Inequalities in Health
There is now wide recognition in Scotland that inequalities in health are prevalent and there is a commitment to
tackling them at all levels.* The roots of health inequalities run deep and both the Black
Report of 1980 and the Acheson Report of 1998 demonstrate the heightened problem created by dramatically widening living
standards since the late 1970s. Inequalities in health are characterised by variations in health experience between
different groups, that is, some groups of people experience poorer health than the majority of the population. This is due
to a combination of factors including poverty, lack of social infrastructure, or discrimination arising from gender,
ethnicity, age, sexual orientation or disability. In sum, illness is more prevalent among people living in situations of
social deprivation and social exclusion and mortality rates are higher.
Tackling inequalities in health requires a dual strategy of action both within and outside the health care
system, and an emphasis on health as well as treating ill-health. Voluntary and community sector projects, such as Community
Health Initiatives, working on the social determinants of health are therefore in a key position to impact on health
inequalities in a range of ways including:
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Promoting an understanding of positive health as a state of physical, mental and emotional health.
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Developing a collective approach to health and promoting self-confidence |
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Enabling greater access to health resources, affordable food, support groups and appropriate local services
and care. |
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Influencing policy and service provision to become appropriate to local communities. |
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Identifying and influencing factors affecting health. |
Reductions in health inequalities are most likely to be achieved if policies and activities are formulated from
the start with the reduction of inequalities in mind and are developed to address local circumstances and needs.
* Towards a Healthier Scotland, 1999; Partnership for
Care - Scotland's White Paper; Improving Health in Scotland : The Challenge, 2003.
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