To support healthy aging we must tackle health inequalities

Reflecting on key messages from the ACRC Symposium.

Health inequalities – the gap in health outcomes between the most and least advantaged groups in society – have been widening across the UK for more than a decade. That means that those least well off have not benefitted in the same way from advancements in healthcare as more affluent members of society. In fact, the difference in average healthy life expectancy – the number of years someone spends living in good health – is now more than 25 years between people living in the most and least deprived areas of Scotland.

If every cloud has a silver lining, I suppose ours is this: many of the most common conditions that people develop later in life are preventable. Disparities in life expectancy and healthy life expectancy are driven by inequalities like poverty, discrimination and other adverse experiences throughout life. This means that if we make the right policy choices – focus on prevention and health creation through tackling the social determinants of health – we can move closer toward achieving equity of health and wellbeing for us all, at every stage of life.

This was the message from Professor Graham Ellis, former deputy chief medical officer (CMO) for Scotland, to a recent symposium hosted by the Advanced Care Research Centre (ACRC). The ACRC is a multidisciplinary research programme based at the University of Edinburgh that aims to enable data-driven, personalised and affordable care that enables independence, dignity and high quality of life for people later in life.

Unsurprisingly, nearly every presentation at the event focused on health inequalities in some way. Those working across every part of health and social care – researchers, practitioners, managers and policy wonks like myself – are well aware of these disparities and the unfortunate reality that many people across Scotland are not able to access their right to good health and wellbeing. Yet, by reminding us about how political choices shape health and wellbeing, Professor Ellis’s message was one of hope. Inequalities are neither inevitable nor immutable.

There were many insightful and informative presentations covering a wide range of topics like the importance of lived experience in research and co-design, the challenges and opportunities of artificial intelligence, and place-based approaches to understanding health and wellbeing.

There is so much learning already out there from people with lived experience of accessing and providing care and support, as well as researchers, that we can use to shape evidence-informed policies, services and supports.

For example, as Professor Ellis highlighted, we know that relational continuity with GPs improves outcomes and trust in doctors. The question therefore is: how can we make this the norm for those who need it most urgently?

It may also mean finding ways to harness data so that we can more readily identify households in need of support and use that knowledge to enhance and tailor primary care services, as called for by Dr Clare MacRae, a GP and Senior Clinical Research Fellow at the Usher Institute.

We also heard about important research that will give us even better insights into some of these challenges so we can make more informed decisions in the future, such as a deeper understanding of the links between social cohesion, loneliness, deprivation and the likelihood of developing more than one condition in later life.

Advancements in data linkages and tools to analyse them will give us a more nuanced picture not only across the whole population but at the local and even hyper-local levels so that we can design more personalised supports and target interventions effectively, while making the best use of the resources available.

The commitment to creating a better, more sustainable and equitable health and social care system demonstrated at the ACRC symposium reflected what I see through our work at the ALLIANCE and gives me hope that despite the challenges we face right now, we will keep moving toward making Scotland a place where everyone enjoys their right to live well with dignity and respect.

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