Health Inequalities in Scotland: Looking beyond the blame game | Health Equity

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People in Scotland suffer from large and unjust inequalities in health – these are best be explained by considering the stark and growing inequalities in income, wealth and power between groups. Since the late 1970s, a series of neo-liberal economic and social policies have widened inequality in the UK and have, of course, had an impact in Scotland – for example, male life expectancy in certain more disadvantaged areas in Scotland can be as low as 61 years old. Health inequalities arise because of political decisions and processes and because of this it is essential to campaign for a narrowing in the power, income and wealth gaps that cause them. This paper is part of a series of papers which have resulted from the Whose Economy? seminar series, held in Scotland in 2010 – 2011, whose purpose was to provide a space for researchers, representative organisations, policy-makers and people with experience of poverty to come together and explore the causes of poverty and inequality in today’s Scotland.
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    Oxfam Discussion Papers Health inequalities in Scotland: looking beyond the blame game  A Whose Economy   Seminar Paper Gerry McCartney and Chik Collins June 2011   www.oxfam.org.uk  Health inequalities in Scotland: looking beyond the blame game    A Whose Economy   Seminar Paper, June 2011 2 About the authors Gerry McCartney  is   a consultant in public health medicine and Head of the Public Health Observatory, NHS Health Scotland. He was a previously a General Practitioner and public health doctor for NHS Greater Glasgow and Clyde. He trained in medicine at the University of Glasgow (MBChB 2001, MPH 2006, MD 2010) and has an honours degree in economics and development (University of London, 2007). His MD thesis was on the host population impacts of the Glasgow 2014 Commonwealth Games. His main research interests and publications focus on the causes of health inequalities and the health impacts of socio-economic, political and environmental change. He writes here in a personal capacity and his views are not necessarily representative of NHS Health Scotland. Email:  gmccartney@nhs.net   Chik Collins is Senior Lecturer in the School of Social Sciences at the University of the West of Scotland. He holds a BA (Honours) in Social Science from Paisley College of Technology (1987), a postgraduate diploma in housing from the University of Stirling (1991), and a doctorate from the University of Paisley (1997) –  published as Language, Ideology and Social Consciousness (Ashgate, 1999). He has written on urban policy, community development, the role of language in social change, and more recently, in collaboration with Gerry McCartney and others, on health. He has also worked with Oxfam and the Clydebank Independent Resource Centre in producing The Right to Exist: The Story of the Clydebank Independent Resource Centre  (2008) and To Banker from Bankies: Incapacity Benefit –   Myth and Realities  (2009). Email: Chik.Collins@uws.ac.uk   Whose Economy Seminar Papers  are a follow up to the series of seminars held in Scotland between November 2010 and March 2011. They are written to contribute to public debate and to invite feedback on development and policy issues. These papers are ‗ work in progress‘ documents, and do not necessarily constitute final publications or reflect Oxfam policy positions. The views and recommendations expressed are those of the author and not necessarily those of Oxfam. For more information, or to comment on this paper, email ktrebeck@oxfam.org.uk  Health inequalities in Scotland: looking beyond the blame game    A Whose Economy   Seminar Paper, June 2011 3 Contents Executive summary ................................................................................. 4   Introduction: l ooking beyond ‘the blame game’  .................................... 5   Health inequalities: separating myths from reality ............................... 6   Health inequalities aren’t inevitable  ..................................................... 10   Inequalities: why we do care and why we should care ....................... 11   Conclusion .............................................................................................. 12   References .............................................................................................. 13    Health inequalities in Scotland: looking beyond the blame game    A Whose Economy   Seminar Paper, June 2011 4 Executive summary People in Scotland suffer from large and unjust inequalities in health. These inequalities are best explained by considering the stark and growing inequalities in income, wealth and power between groups. The likelihood that a child will suffer premature mortality or debilitating health conditions is very substantially determined by where the child is born, the resources it will have at its disposal and the social class of its parents. If where one is born can be thought of as a ‘lottery’, then life (and death) is indeed ‘a gamble’.  Health-determining inequalities are, like health inequalities themselves, neither fixed nor natural, but arise from particular political choices and the values they reflect. In the decades after WWII, the UK became a significantly less in equitable country. Since the late 1970s, a series of neo-liberal economic and social policies have served once again to widen the inequalities which do so much to shape health outcomes. During this latter period, Scotland has suffered from growing health inequalities, a faltering in its improvement in overall life expectancy compared to other countries, and increasingly worse overall health outcomes than might be expected –  even considering the high levels of poverty and deprivation which prevail here. Moreover, the available evidence suggests that the association between neoliberal policies and the observed trends in overall health outcomes and health inequalities is of a causal  nature. Health inequalities have become, particularly in recent years, a source of great social and political concern. The injustices they crystallise challenge our basic humanity. It is inherently distressing to understand how a newborn child, losing out in the lottery of birth, faces such a challenge to achieve a decent, healthy life span. But such inequalities have much broader negative consequences for the whole of society –  this is also a source of great concern. All of this concern should –  and can   –  be translated into activities likely to redress the still-heightening inequalities in the socio-economic determinants of health.
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