1. The Scottish Governments’ attempts to reduce health inequalities through: - promoting better health - reducing poverty - improving male health

2. New Year's resolutions - Live Well - NHS Choices New Year's resolutions - Live Well - NHS Choices

3. Promoting Better Health (Improving lifestyles choices) Main Scottish policy: ‘Better Health, Better Care’ (2007) This Action Plan sets out the Government's programme to deliver a healthier Scotland by helping people to sustain and improve their health, especially in disadvantaged communities, ensuring better, local and faster access to health care.

4. Help people live healthier lives We want the people of Scotland to live healthier lives. We need to find new ways of getting people to lead healthy lives and Stop smoking Drink less Stop abusing drugs Live healthy lives

5. DAMAGE CAUSED BY SMOKING Smokers in their 30s and 40s are five times more likely to have a heart attack than non-smokers. Smoking contributes to coronary artery disease which increases the risk of a heart attack or stroke. It does huge damage to the lungs and massively increases the risk of lung cancer. Smoking also increases the risk of other cancers such as oral, uterine, liver, kidney, bladder, stomach and cervical cancer. Exposure to second-hand smoke can reduce lung function, exacerbate respiratory problems, trigger asthma attacks, reduce coronary blood flow, irritate eyes, and cause headaches and nausea. Smoking in pregnancy greatly increases the risk of miscarriage and is also associated with lower birth weight.

6. Smoking – Ban on smoking in enclosed public places (2006); raise age to 18 for purchase; display ban; tougher fines for those selling to youngsters; vending machine ban (2009/10); clearer health warnings; targets for smoking reductions; poster campaigns: ‘A Breath of Fresh Air for Scotland’. In Dundee, a trial programme paying pregnant mothers to stop smoking. Plain cigarette packaging is to be introduced in Scotland under a plan to make the nation "tobacco free" by 2034.

7. TOBACCO BAN – SCOTLAND 2013 BBC News - Tobacco display ban in large shops comes into force BBC News - Tobacco display ban in large shops comes into force Scottish Grocers' Federation - JOHN DRUMMOND BBC News - Tobacco display ban in Scotland to begin in April 2013 BBC News - Tobacco display ban in Scotland to begin in April 2013

8. Scotland was the first country in the UK to introduce a smokefree law in March 2006. England's smokefree laws came into force on 1 July 2007, with Northern Ireland on 30 April 2007 and Wales on 2 April 2007. Each year smoking: Kills around 13,500 Scots (one in five of all deaths) Is responsible for around 33,500 hospital admissions Costs the NHS in Scotland around £400 million to treat smoking-related illness

9. BBC News - Smoke ban 'cutting heart attacks' Since Scotland introduced a ban on smoking in public places in 2006 there has been a 10% drop in the country's premature birth rate,

10. Smoking ban has saved 40,000 lives 1 / 1 INDEPENDENT GRAPHICS Independent – December 2013

12. 2008 - More than two billion fewer cigarettes were smoked and 400,000 people quit the habit since the ban was introduced a year ago, which researchers say will prevent 40,000 deaths over the next 10 years. Cigarette sales fell by 6 per cent in the past year, according to the market research company, Neilson. In the 10 months from July 2007 to the end of April 2008, 1.93 billion fewer cigarettes were sold in England and 220,000 fewer in Scotland (where the smoking ban was introduced a year earlier), equivalent to a total decline in sales over the full year of 2.6 billion.

13. Drug abuse – 52,000 drug abusers in Scotland. 420 drug deaths in 2007. Cost £2.6bn. ¾ of all crimes linked to drugs. National Drugs (Road to Recovery’) strategy adopted 2008. The Scottish Government's new national drugs strategy that focuses on recovery but also looks at prevention, treatment and rehabilitation, education, enforcement and protection of children. Greater emphasis on prevention and support. Illegal drugs cost the country (UK) more than £16 billion a year in crime, health and policies to tackle the illicit trade – The Telegraph 2009.

14. Promoting Better Health Alcohol Misuse – Bigger problem in Scotland than in rest of UK and Europe. Cost to Scottish economy around £3b in 2010. Almost 3,000 people died early in 2010 with alcohol- related condition. New SP legislation 2010: crackdown on drinks promotions; tougher penalties for illegal sales; greater requirement to check proof of age. Government also providing more resources for education; targets for reductions.New SP legislation 2010

15. Promoting Better Health Exercise - ‘Let’s Make Scotland more active’ campaign. ‘Healthy Promoting Schools’ (school sports co-ordinator; target of two hours PE per pupil per week); Healthy Living Initiatives. Diet (Obesity seen as major health challenge for future) James Report. ‘Hungry For Success’ Health Initiative in schools; free fruit in schools; ad. campaigns; breakfast clubs; ban on fizzy drinks and sweets in schools; attempts to reduce junk food advertising on early evening TV when children are watching. Increase in provision of free school meals. Extension to parents receiving Child and Working Families tax credits. All P1-P3 nutritious free school meal by August 2010.

16. In a £63.5m three-year initiative, Hungry for Success, the devolved government is putting real ingredients back into school food and taking fat and sugar out. It has introduced nutritional guidelines for school meals in primary schools. For instance, the Scottish standards dictate that oily fish should be served at least once a week and processed meat products only once a week; that brown bread should always be on offer; and that there should be two helpings of vegetables and two of fruit on every menu each day. There are product specifications for levels of sodium and fat in processed meat, fish and some other products such as pizza.

17. MARTHA PAYNE Nine-Year-Old Food Blogger Documents Disappointing School Lunches – YouTube Nine-Year-Old Food Blogger Documents Disappointing School Lunches – YouTube BBC News - NeverSeconds blogger Martha Payne school dinner photo ban lifted BBC News - NeverSeconds blogger Martha Payne school dinner photo ban lifted BBC News - Council u-turn on school dinner blog ban BBC News - Council u-turn on school dinner blog ban

18. Promoting Better Health - Health Promoting Schools 1. HPV immunisation programme - cervical cancer and HPV immunisation programme. 2. Schools (Health Promotion and Nutrition) (Scotland) Act 2007 places a duty on local authorities to ensure that all of their schools are health promoting environments. Health promotion in schools is not just about encouraging children and young people to eat well and to exercise; it encompasses a much broader holistic approach. This approach is called the 'whole school approach', which includes promoting the physical, social, spiritual, mental and emotional wellbeing of all pupils and staff.

19. Promoting Better Health - Others Educational / advertising campaigns / laws to: Promote breast-feeding (2004 law passed to make illegal to prevent women breastfeeding in public). Improve access to health services for minority groups. Calls for more information on Scotland’s ethnic minority groups. Improve dental health (£12m ‘Childsmile’ campaign promotes good oral health and provide treatment to reduce tooth decay). Healthy Living Awards – Catering businesses gain recognition for promoting healthier eating. Reduce sexually transmitted diseases. Reduce teenage pregnancies. National and Regional Health Authority targets have been set e.g. Tayside Health Inequalities Strategy (2003) and Dundee: Joint Health Improvement Plan 2005-08.

20. Reallocating Resources / Increasing Uptake of Services Creation of ‘Health Inequalities Task Force’ (‘Equally Well’) to co-ordinate government activities to help reduce health inequalities.Health Inequalities Task ForceHealth Inequalities Task Force Development of community-based services in deprived areas promoting better health. ‘Keep Well’ (formerly known as ‘The Prevention 2010’ initiative) will involve extra resources for check-ups, screening, vaccinations, etc. in the most deprived areas of Scotland.Health checks for 40-64 year olds in Scotland - Keep Well Scotland - NHS ScotlandHealth checks for 40-64 year olds in Scotland - Keep Well Scotland - NHS Scotland

21. Reducing Gender Inequalities Focus on health promotion: -Well Man Clinics check general fitness and welfare of men and provide information and support. -Over 40s (men and women) given legal right to ‘health MOT’ in England and Wales. Note: There are voluntary organisations, such as Male Health Scotland and the Male Health Forum Scotland, which promote men’s health. Men’s Health is UK’s biggest selling male magazine.

22. Reducing Poverty (Reminder: reducing social class / geographic inequalities. See earlier notes) Jobcentre Plus to reduce unemployment (‘work is way out of poverty’). New Deal and National Minimum Wage. Working Tax Credit and Child Tax Credit. Investment in social housing; Scottish Government to end sale of council housing (‘Right to Buy’). Improved benefits/support to families with children (Sure Start/Child Trust Fund) and pensioners (Winter Fuel Payment). Scottish Government abolished prescription in charges 2011.

23. Scottish and UK Government Policies to Reduce Health Inequalities 1. Describe the ways that the UK Government and Scottish Governments are attempting to reduce health inequalities in each of the following areas: -Through health promotion - Gender specific policies - Reducing poverty 2. Do you think the UK and Scottish Governments will be successful in reducing health inequalities? Explain your answer.