Scotland's Population Health Framework

Enabling Healthy Living

Develop supportive environments that promote health and wellbeing and reduce health harming activities.

Having good physical and mental health ensures people can live longer, healthier and more fulfilling lives. Activities that enhance health and wellbeing include eating a varied and balanced diet, limiting consumption of health harming products and being physically and mentally active at all ages.

The forecast rise in disease over the next 20 years is largely caused by preventable diseases, including diabetes, cardiovascular disease, cancer and dementia. Many of these conditions are partly or wholly caused by modifiable risk factors such as alcohol, tobacco and drug use; physical inactivity; poor diet and the cumulative impact of poor mental health.

Culture, communities, our surroundings and our online environments have a significant influence on our ability to make healthy choices. We know that the choices we make are based on the choices we have. The evidence suggests effective ways to prevent ill health include actions that reduce the availability and consumption of harmful products and ensure people affected by substance-related harms receive the right support.

We also know we need to go further to ensure the healthy choice is the easy choice. This is why increasing access to environments and appropriate public services that support health are key to improving the health and wellbeing of people in Scotland. Similar to how well-designed places can encourage greater physical activity through play, walking, wheeling and cycling, improvements need to be made to our commercial environments to improve the products and services available.

Building Upon Existing Action

Actions within this driver build upon existing action already being progressed under the following, non-exhaustive, list of policies and strategies:

• Mental Health and Wellbeing Strategy
• National Good Food Nation Plan
• Best Start Foods
• UNICEF Baby Friendly Initiative
• Health and Wellbeing in Schools
• Setting the Table Guidance
• Physical Activity for Health: Framework
• Tobacco and Vaping Framework: Roadmap to 2034
• National Mission on Drugs
• Dementia Strategy for Scotland

Conditions for Change

The choices we make about our health are shaped, and often limited by, the environments and systems around us. Enabling healthier lives centres on improved nutrition and physical activity to promote healthy weight and prevent cardiovascular disease, cancer, type 2 diabetes and other chronic conditions (non-communicable diseases). To support healthier lives, we need to ensure our food environments provide access to nutritious options and that our communities are designed to encourage and enable regular physical activity.

Ambitious outcomes set in the national Good Food Nation Plan will guide action on food policy across Scottish Government. Outcomes set in the Good Food Nation Plans of Health Boards and local authorities will identify local priorities.

We need to reduce the harms associated with health harming products – tobacco, vapes, alcohol and gambling. Whilst progress has been made in recent decades, including the effects of public health policies such as banning smoking in public places and implementation and uprating of minimum unit pricing of alcohol, health harming products continue to have a significant effect on health.

We must also continue to address the devastating effects of substance use on individuals, families and communities. With one of the highest drug death rates in the developed world, and continuing high levels of alcohol-specific deaths, we will seek to improve how people affected by substance use are involved in decisions concerning the design, delivery and monitoring of future services.

We recognise that there is an important window to influence and support the current and future health of mothers and their babies, which is key to delivering primary prevention. As a period where women routinely access services and support, preconception and pregnancy provide opportunities to use existing service provision to maximise health promotion and preventative healthcare. Building on what the evidence tells us works, we will work in a holistic, integrated, focused and person-centred way to support healthy life choices, including but not limited to, tackling alcohol, tobacco and drug use.

In the medium to long-term our aim will be to:

• increase access to a healthy, balanced diet
• reduce consumption of health harming products
• increase levels of physical activity
• enable people to receive the right support at the right time for problem drug and alcohol use
• better consider the clustering of health harming activities in national and local responses
• create the first generation free from tobacco addiction
• better understand and address harms from social media
• reduce gambling harms through action supported by the Gambling Levy

Building for Our Future

Over the next two years we will progress the following actions with our partners:

Food Environment and Nutrition

Publish a two-year implementation plan of preventative action to improve the food environment and support improvements to diet and healthy weight.

This will include:

• developing legislation to improve the food environment
• increasing the availability and affordability of healthy foods
• adopting evidence-based interventions for tackling overweight and obesity
• supporting innovation to improve the health of people affected by obesity-related conditions, including type 2 diabetes
• supporting wider government priorities such as Good Food Nation, Scottish Dietary Goals, food security, malnutrition and the just transition to net zero to support reducing inequalities

Physical Activity

Support the implementation of evidence-based physical activity policy actions as outlined in the National Physical Activity for Health Framework.

This will include:

• strengthening collaborative leadership and accountability to actively champion our vision of a more active Scotland through a whole systems approach
• creating active environments, policies and opportunities across all places of learning
• prioritising active travel infrastructure and support and encouraging active travel behaviour
• strengthening access and ensured sustainability of good quality public and green spaces, green networks, recreational spaces, play and sports amenities
• embedding the provision of appropriate physical activity opportunities and programmes between NHS Scotland, health practitioners and physical activity providers
• integrating communications and public education into both national and local strategies for physical activity
• ensuring that sport and active recreation opportunities target people and communities where the need is greatest, whilst supporting those who are already active to remain so
• working towards ensuring that everyday physical activity is supported in workplaces in Scotland

Tobacco Free Generation

Deliver our initial two-year Tobacco and Vapes Implementation Plan.

This will include:

• implementing legislation to ban single use vapes from 1 June 2025
• taking forward legislation on a four nations basis to phase out the legal sale of cigarettes, creating the first generation free from addiction to tobacco
• setting out the next iteration of actions under the Tobacco and Vapes Framework by 2026

Drugs and Alcohol

Publish an Alcohol and Drugs Plan, building on progress made by the National Mission on Drugs, on how the Scottish Government and partners will reduce alcohol and drug related harms and deaths.

This will include:

• engaging widely with partners, stakeholders and people with lived and living experience
• developing preventative action to reduce the harm caused by drugs and alcohol including reducing the availability, affordability and accessibility of alcohol in line with World Health Organization guidance
• delivering high quality and accessible treatment and care though the embedding of standards and guidance
• promoting a culture change to address stigma and take a person-centred approach
• supporting licensing boards on how the ‘Protecting and Improving public health’ objective in the statutory guidance can better consider the impact of the sale and consumption of alcohol on health

Preconception and in Pregnancy

Reduce health harming risks during preconception and in pregnancy.

This will include:

• improving action to increase smoking cessation in pregnancy
• investing to provide specific support to develop services for mothers who use drugs and for their babies

Healthy Digital Use

Develop a robust approach to reducing health harms associated with the digital environment.

This will include:

• examining and evidencing the impact of social media on mental health and wellbeing
• identifying effective interventions to prevent harm, in particular among young people

Gambling Harm

Progress interventions to reduce gambling harms as the Gambling Levy comes into operation.

This will include:

• delivering a comprehensive approach to prevention and early intervention
• promoting treatment and support services
• strengthening research and evidence into the causes and impacts of gambling harm