About Nesta

Nesta is an innovation foundation. For us, innovation means turning bold ideas into reality and changing lives for the better. We use our expertise, skills and funding in areas where there are big challenges facing society.

Stakeholder engagement on health inequalities in Scotland

Nesta Scotland was commissioned by the Health Foundation in early 2022 to conduct a series of workshops and interviews with senior stakeholders from key organisations across Scotland working in and around issues relating to health inequalities.

The aim of this work was to understand and collate views in relation to current health inequalities across the country. In particular, key issues such as the current drivers of health inequalities, barriers to action in addressing health inequalities and ideas for how we can do better in the future were all debated and discussed. The insight generated from this will feed into the Health Foundation’s Health inequalities in Scotland: An independent review.

It is important to note that this report does not represent the views or opinions of any one organisation or individual that engaged with this process. Instead, this paper presents summarised interpretations from the Nesta Scotland team based on what we captured throughout this engagement work.

Key findings:

  • Persistent levels of poverty alongside growing income and wealth inequality across Scottish society were seen by stakeholders as the primary drivers of health inequalities.
  • Multiple forms of insecurity and discrimination experienced by people in their day-to-day lives, such as insecurity of work, pay, housing, financial instability and access to food also came up consistently.
  • Many stakeholders noted Scotland’s centralised and risk-averse operating environment as a barrier to taking new or radical approaches to tackle health inequalities.
  • It was also noted that our adversarial political discourse, where opposition and disagreement across party lines are the default position, often made taking new approaches difficult.
  • There was a consistent view that there is a gap in Scotland between our progressive political rhetoric or policy ambitions on health inequalities and what actually happens on the ground.
  • Many stakeholders repeatedly stressed the need for longer-term, more joined-up and more coherent thinking in relation to both our policy development and service resourcing in Scotland. We heard regularly that progress is often hampered by short-term thinking and annualised funding models.
  • We heard strong views in favour of more radical models of wealth redistribution, such as a minimum income guarantee, to help tackle our persistent levels of poverty and growing inequality.

The Nesta Scotland team want to thank all those stakeholder organisations and individuals that engaged with this project and who gave so willingly of their time, wisdom and experience to inform this research.