There is "limited evidence" that policies designed to tackle inequalities and improve population health are working, according to researchers.

In its first report, the newly-created Scottish Health Equity Research Unit (SHERU) warned that "key outcomes related to health and inequalities are not significantly improving and are, in some cases, worsening".

The think tank - a joint initiative funded by the Health Foundation charity and bringing together experts from the Fraser of of Allander Institute and Strathclyde’s Centre for Health Policy - said a lack of data was also hindering evaluation.

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It said: "Despite the Scottish Government's awareness of the issues and its implementation of various strategies, there is limited evidence that these policies have effectively reduced inequalities.

"Often, the data available is either incomplete or insufficiently detailed to demonstrate the true impact of the policies, leaving uncertainty about whether investments are being allocated appropriately or at an adequate scale."

However, the think tank said it has "not found evidence that policy is driving improvements in socioeconomic or health inequalities" and that the "overall lack of progress in tackling socioeconomic and health inequalities indicates that policies are not working in the right way or at the scale required to improve outcomes".

The report, entitled the '2024 Inequality Landscape', noted that there are "concerning trends" in health and living standards such as life expectancy, which began to stall in the early 2010s and is now in decline.

Real-terms household incomes have not yet returned to pre-2010 levelsReal-terms household incomes have not yet returned to pre-2010 levels (Image: SHERU)

Middle-income households have experienced the biggest falls, before housing costsMiddle-income households have experienced the biggest falls, before housing costs (Image: SHERU)

It adds that average living standards measured by household incomes "have never returned to pre-2010 levels of growth and have fallen since 2019", with middle income households worst hit with declines of around 5-6% excluding housing costs.

More people in Scotland are in relative poverty now than were pre-pandemic, including 24% of children, and the number of working age adults who are economically inactive due to long-term illnesses has gone from around 22% in 2019 to 28% in 2023.

The report said this was "largely connected to mental health".

The Scottish Health Equity Research Unit (SHERU) was set up in 2024 to provide insights and analysis on the socio-economic factors that shape health. The unit brings together expertise on public health and socioeconomic analysis in a joint collaboration between the University of Strathclyde’s Centre for Health Policy and Fraser of Allander Institute, supported by the Health Foundation

The Scottish Government has set a target to reduce the gap in employment levels between disabled and non-disabled people from 37% in 2016 to just under 19% by 2038.

The SHERU report found that the gap had already narrowed to 29.9% by 2023 - apparently ahead of target - but this was "not, as far as we can tell, due to the impact of government policy".

Rather than more disabled people moving from unemployment into paid work, the researchers said the shift was due to an increase in the number of people already in work identifying a disability - defined as a long-term limiting health condition.

This trend "follows a similar one seen across the UK, and a general trend in increased disability prevalence and reporting worldwide".

The impact of the Scottish Child Payment 'should be significant', said SHERU, but it did not find evidence of a widening divergence with rest of the UK - where families do not get the extra supportThe impact of the Scottish Child Payment 'should be significant', said SHERU, but it did not find evidence of a widening divergence with rest of the UK - where families do not get the extra support (Image: SHERU)

On the Scottish Child Payment - which provides an additional £26.70 each week per eligible child to low income families - the report said the impact of the policy "should be significant".

However, SHERU found that there is currently "no evidence of it making an impact on the official child poverty statistics", adding: "We would have expected the Scottish relative poverty line to diverge further from the [rest of UK] trend from the point of SCP rollout in 2021.

"This hasn’t happened and we need to understand why. Issues with data collection are thought to be part of the problem."

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Social Justice Secretary Shirley-Anne Somerville said the government would continue to take "wide-ranging action" to address the root of inequality.

She said the government had spent £3bn on policies tackling poverty and mitigating the cost of living since 2022-23, and had spent about £1.2bn mitigating "14 years of harmful UK government policies".

She said: “Modelling in February estimated that Scottish government policies will keep 100,000 children out of poverty this year.

"These policies include the ‘game-changing’ Scottish Child Payment, which is not available elsewhere in the UK and which has been widely hailed for its impact by anti-poverty campaigners.

“We will continue to work with our partners to drive improvements in health, tackle poverty, and embed health considerations within wider policy making.”