Population Health Framework: evidence paper

5. Conclusion

This report has highlighted recent shifts in the health of Scotland’s population, including stalled mortality improvements and widening inequalities. While these trends are concerning, historical data offers a glimmer of hope, demonstrating that positive change is possible. For example, the period leading up to around 2012 saw notable improvements in population health and a reduction in health inequalities. As the evidence covered in this report has shown, reversing the current trajectory will require a coordinated, collaborative effort to shift to a system that is centred on primary prevention and addresses the social, economic, and commercial determinants of health.

Section 4 outlined a range of measures and frameworks, such as Health in All Policies, life course, and place-based approaches, which can form the basis of an effective prevention focused system. Successful implementation of these has the potential to stabilise current population health trends, as well as create the conditions necessary for long-term improvement. While the challenges discussed in section 3 present additional complexities, they also represent critical areas where focused action can drive meaningful change.

5.1. Monitoring progress

As part of the PHF, a high-level aim has been set:

By 2035 we will improve Scottish life expectancy whilst reducing the life expectancy gap between the most deprived 20% of local areas and the national average.

Further details on the analytical work which informed the development of this aim can be found in the Annex – Technical note on the aim of the Population Health Framework.

We will provide updates on a regular basis offering an assessment of progress towards meeting our aim. This will include discussion of the headline life expectancy measure, along with other measures such as healthy life expectancy.

These metrics are also included in the Population Health Dashboard, which will be a crucial part of ongoing monitoring of the PHF at both national and local levels.

The Population Health Dashboard has been designed to support long-term monitoring of population health outcomes and health inequalities in Scotland, with a set of indicators structured around the social determinants of health as defined by the Marmot Eight principles (IHE, 2025). As well as life expectancy and HLE, the dashboard covers the earliest years of life (including during pregnancy), good education, fair work and income, healthy places, ill-health prevention, discrimination and racism, and environmental sustainability. The aim of the dashboard is to provide consistent national and local monitoring around a shared set of outcomes, enabling understanding of how Scotland’s population health and the social determinants of health are changing. This will help assess whether progress is being made and identify areas where efforts may need to be intensified.

However, the dashboard is only one tool and further investment in research and evaluation to understand the impact and contribution of actions being delivered under the PHF should be prioritised by all partners across the whole system. A collaborative approach will enhance capacity to effectively monitor progress and evaluate interventions aimed at improving Scotland’s population health outcomes.