Deprivation: policy context

Tackling deprivation has been a government priority in Scotland over a long period. In 1988 the Scottish Office launched its New Life for Urban Scotland Initiative which created regeneration partnerships in four peripheral housing estates: Castlemilk in Glasgow, Ferguslie Park in Paisley, Wester Hailes in Edinburgh and Whitfield in Dundee.

After devolution in 1999, the then Scottish Executive committed itself to tackling poverty and disadvantage through its Social Justice Strategy. The Social Justice Strategy was supported nationally by the Social Justice milestones and locally by the establishment of 'Social Inclusion Partnerships (SIPs)' throughout Scotland (replacing what were formerly Priority Partnership Areas (PPAs) and Regeneration Partnerships (RPs). A key feature of these initiatives was their focus on regeneration and social inclusion in areas of high deprivation.

In November 2008, the Scottish Government launched Achieving Our Potential: A Framework to Tackle Poverty and Income Inequality in Scotland, 2008, which outlined a long-term approach to reducing levels of poverty and income inequality in Scotland. Among its key aims are:

to increase overall income and the proportion of income earned by the three lowest income deciles by 2017;
to decrease the proportion of individuals living in poverty; and
to increase healthy life expectancy at birth in the most deprived areas.

Related to this, many of the health-related indicators set out in Scotland Performs (for example, on smoking, problem drug misuse and alcohol-related admissions to hospital) will particularly benefit people living in the most deprived communities in Scotland if their targets are achieved.

A report from the Independent Advisor on Poverty and Inequality to the First Minister, Shifting the Curve, was published in January 2016. The latest report on Long Term Monitoring of Health Inequalities was published in December 2017.

The international context is set by the World Health Organization Commission on Social Determinants of Health (2008), which notes that:

the development of a society, rich or poor, can be judged by the quality of its population's health, how fairly health is distributed across the social spectrum, and the degree of protection provided from disadvantage as a result of ill-health.

In 2010, the Chair of the Commission, Sir Michael Marmot, concluded a strategic review of health inequalities in England (Strategic Review of Health Inequalities in England Post 2010). Its analysis and recommendations remain relevant to Scotland.

In 2017 the Scottish parliament passed the Child Poverty (Scotland) Act 2017. This is an Act of the Scottish Parliament to set targets relating to the eradication of child poverty; to make provision about plans and reports relating to the targets; and to establish the Poverty and Inequality Commission and provide for its functions.

All of the above illustrate the importance of deprivation within past and current government policy.

In 2018, the Joseph Rowntree Foundation published Poverty in Scotland, looking at poverty trends for families with children in Scotland. And in 2017, UK Poverty 2017 a report assessing the progress made in reducing poverty and tackling the underlying drivers of poverty.

Use of SIMD in resource allocation

The NHS Scotland Resource Allocation Committee (NRAC) was established to ensure the Arbuthnott Formula (2000-2005) was still allocating resources to NHS Boards in a way that reflects local need for healthcare. The Arbuthnott formula included a Morbidity and Life Circumstances adjustment for deprivation. NRAC's 2007 report recommended (and it was accepted by Government) that in future there should be separate "additional needs" adjustments for different care groups. It did not recommend using SIMD as part of the revised Formula, since the SIMD indicators did not appear to be the best predictors of healthcare need. However, 30% of NHS Scotland funding (e.g. for dental practices in deprived areas) is allocated using the SIMD.