Redistribute wealth to boost health, researchers say

‘More action’ needed to fix the root causes of health inequalities, according to NHS Health Scotland

Wednesday 24th April 2019

Transferring income from the wealthiest to the poorest is key to reducing ill-health and health inequalities across society, Scotland’s public health agency has claimed.

In a report out today, NHS Health Scotland says fixing the root causes of health inequalities – disparities in health between different groups of people, often linked to socio-economic status – by transferring income to those on the lowest incomes is the best way to improve people’s health.

Other approaches – such as helping people to deal with poor health or improving social factors like employment and the environment – were less expensive but did not reach as many people.

Government statistics show there is more than ten year life expectancy gap between the richest and poorest Scots, and people living in the most deprived areas can expect to spend more of their lives  in ill health.

Researchers compared three different approaches to tackling these inequalities by forecasting their impact on hospital admissions and premature deaths up to 20 years into the future.

The cheapest option to implement – helping people deal with poor health by offering more weight loss support, smoking cessation services or mental health services – would help individuals but only reach a small section of the population, the study states.

Addressing social factors by improving the quality of the local environment, boosting wages and increasing the amount of benefits claimed was found to reach more people. Researchers estimated increasing benefit uptake by 1% would prevent 3,000 unnecessary hospital admissions and 80 premature deaths over the next five years.

The final option of fixing the underlying wealth and income inequalities that contribute to ill-health would have the ‘greatest potential population impact’, though the authors admit this would be the most expensive.

They found increasing all means-tested benefits by 50% would prevent 170,000 hospital stays and prevent 4,000 people dying early – but would cost £8.7bn.

Increasing the tax-free personal allowance or replacing the welfare system with a basic income where everyone would be paid a cash sum with no strings attached would also be beneficial.

NHS Health Scotland says a ‘combination of actions’ is needed, and resources have to be targeted where they will have the greatest impact.

Andrew Pulford, the report’s lead author, says: 

“Health inequalities persist in Scotland, they are unjust but they are not inevitable. Their causes are complex – but we have a good understanding of the range of actions required to reduce them and improve health. For policy makers, knowing where to focus energy and resources to do this is crucial.

“…By comparing a whole host of interventions, we show the breadth of actions that can effect the change we need, and the potential scale of their impact on the health of Scotland’s people.”