Resource for Community Health Partnerships to address health inequalities

This resource details the support, products and services available from NHS Health Scotland, NHS Education for Scotland (external link), the Glasgow Centre for Population Health (external link), the Scottish Public Health Observatory (external link), and key voluntary organisations.

It has primarily been developed to support Community Health Partnerships (CHPs), however it will have value for other partnership organisations engaged in planning and delivering services for improving health and reducing health inequalities.

The resource has been divided into the following six areas:

Each section includes tools, case studies and examples of practice from across Scotland. This resource reflects the support currently available however work is ongoing to develop additional ways of supporting CHPs

Information is also available on this page to find out further details on:



What do we mean by health inequalities?

Health inequalities mean that some people are more likely to be ill or have low levels of wellbeing and die younger than others.

Health inequalities are most often described in terms of socioeconomic status and linked to poverty and deprivation. Health outcomes and health risks may also vary according to people´s age, disability, gender, race, religion or belief, sexual orientation and other individual factors. Health outcomes such as life expectancy generally improve with socioeconomic status.

Tackling health inequalities requires a cross-government approach and cannot be achieved through health policies and health care systems alone. This involves working across all of national and local government´s key responsibilities - for example: enterprise and skills, children, justice and the physical environment, as well as health and wellbeing.

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What are the causes of health inequalities?

There are inequalities in the health of people in Scotland which are unfair and unjust, because they are based on social structures and factors such as how much money people have.

The widely accepted definition of health is: 'a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity' (World Health Organization).

Health may also include people´s ability to lead a socially and economically productive life. Future health inequalities are, to a large extent, determined from a child´s earliest years. This is down to biological factors as well as life circumstances more generally.

Dahlgren and Whitehead’s diagram ‘Policies and strategies to promote social equity in health’ illustrates a social model of health and describes the combination of factors that influence people´s health and wellbeing, and that determine inequalities. The diagram can be found in Equally Well (external link).

More detail specific to Scotland, is available in the
MRC Occasional Paper 17, 2007 – Inequalities in Health in Scotland: what are they and what can we do about them
(external link).

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What are we doing to tackle health inequalities in Scotland?

The Scottish Government has made an ongoing commitment to reduce health inequalities. This is being delivered through a number of policies and plans which address both causes and consequences of health inequalities. National strategies are set out in the following documents:

As previously mentioned, tackling health inequalities requires a cross-government approach. One example of effective partnership working are the Equally Well test sites (external link).

The creation of a small number of test sites was an important aspect of the model of change set out in Equally Well. They are the beginning of a mainstream change process, where local community planning partners can improve both the reach and impact of their local services.

The test site approach recognises the complexity of the challenge posed by health inequalities. While each test site is focussed on a particular aspect of health inequalities, there are many opportunities for shared learning

Further information on the test sites is avaiable on the Shared Learning pages.

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Community Health Partnerships and addressing health inequalities

Community Health Partnerships (CHPs) have a key role in designing and delivering services in a way that meets the needs of their local population to reduce health inequalities. This includes influencing services which impact on health and are provided by local authorities and the third sector through Community Planning Partnerships (CPPs).

The CHP Study published in May 2010 reported that while CHPs were taking some action that improved health, reducing health inequalities was more difficult to quantify as there are mulitple factors that impact on inequalities, many which are out with the control of the NHS. There was a strong sense that CHPs should have a more explicit role with CPPs and that where this had happened, partners reported better health outcomes.

The CHP Association two day annual conference (external link) (September 2010) focused on identifying what support CHPs would find useful to address health inequalities. Several of the special health boards and partner organisations, as well as the territorial boards, presented examples and case studies of inequalities-focused work.

The conference attendees concluded that it would be helpful to have more accessible information on what type and level of support was available–particularly from the special health boards.

NHS Health Scotland, NHS Education for Scotland (external link), the Glasgow Centre for Population Health (external link) and the Scottish Public health Observatory (external link) have collectively identified the support they can offer CHPs and have presented it as this ‘one stop’ web resource

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Topics

This resource has provided guidance and support to address health inequalities, however if you would like support on a specific topic please visit NHS Health Scotland’s topic page.

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Reviewed 29 July 2014

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