SPECTRUM highlights opportunities to shape Scottish policy, improving health and reducing inequalities

SPECTRUM responses were submitted in relation to consultations on the draft National Planning Framework 4, and on health inequalities in Scotland.

1 April 2022

Two SPECTRUM consultation responses, submitted yesterday, emphasise the role of effective public health policies to reduce harm from non-communicable diseases (NCDs) in Scotland.

An opportunity to limit availability

Responding to the Scottish Government’s consultation on the draft National Planning Framework 4 (NPF4), SPECTRUM has highlighted a significant opportunity for place-based policies to help address public health challenges in Scotland.

The submission follows evidence provided by Professor Jamie Pearce, SPECTRUM co-investigator and Work Package 5 lead, to the Scottish Parliament Health, Social Care and Sport Committee earlier this year.

Whilst the NPF4 includes a welcome focus on health, there is an opportunity to go further. In particular, by acknowledging the role that unhealthy commodities play in driving NCDs and health inequalities and expanding the framework to include action to limit their availability.

Pointing to recent research from the SPECTRUM team, the response emphasises the detrimental impact of high local availability of tobacco and alcohol products to the health of communities across Scotland, contributing to recent increases in health inequalities.

 We are concerned that there is a lack of focus on the vital preventative role that the planning system can and should play in relation to health and health inequalities, and particularly the lack of acknowledgement in the NPF4 on the role that unhealthy commodities play in driving non-communicable diseases, and the significant burden of poor health these create in Scotland … We are concerned that in its current draft form, the NPF4 could be a missed opportunity to utilise place-based policies effectively to reduce the exposure of communities to health harming products to protect health, and in turn make significant progress towards a number of the National Outcomes in Scotland’s National Performance Framework.

Reducing health inequalities

A SPECTRUM response was also submitted to the recent Health, Social Care and Sport Committee inquiry into health inequalities in Scotland, further highlighting the role of unhealthy commodities in driving health inequalities.

The submission recognises that despite bold policy action taken by Scotland over the past 20 years to address the burden of harm from NCDs, such as smoke-free legislation and minimum unit pricing for alcohol, much more needs to be done in light of the agenda to build back better after the COVID-19 pandemic.

However, it is important to consider that NCD prevalence and health inequalities are strongly related to the social and commercial determinants of health and existed prior to the pandemic. Any action to address them must recognise this.

Health inequalities are underpinned by the unequal distribution of income, power and wealth; therefore, priorities need to include the development of more sustainable, equitable and healthier contexts for people to live their lives.  Addressing the underlying causes of inequalities will require a whole system approach that rapidly reduces social and economic inequalities (including eradicating child poverty, educational disparities) as well as robust action on NCD prevention (including evidence-based public health interventions) and healthcare.

Increasing price, restricting marketing and controlling availability are recognised by the World Health Organisation (WHO) as three of the most effective and cost-effective approaches to reducing health harm. To date, whilst some promising progress has been made in respect of pricing and marketing of unhealthy commodities in Scotland, more can and should be done.

Read the responses