The world is changing and with it, too, is the nature of health and social care.

The NHS was formed in 1948, in a post-war era of austerity and resilience; a time when people came together for the greater good and access to basic healthcare seen as a human right.

But today, people are experiencing very different and inconsistent conditions. Local and global environmental, social and economic changes have resulted in major transitions in the health of populations.

We now find very different outcomes and experiences of health between different groups of people; the gap in health outcomes between the most and least advantaged groups in society is widening.

This is what we mean by the term health inequalities; a phenomenon that has significantly grown over the decades. These inequalities begin in the earliest stage in life and their impact builds throughout a person's life. In Scotland, we have a range of policies and strategies in place to address these inequalities starting, quite rightly, at an early age.

However, it is increasingly apparent that later life is the forgotten dimension in health inequalities. Research from the University of Glasgow shows that, after 60, the health inequalities gap narrows, and by 75 the gap no longer exists.

This isn't because older people represent a more equal and just part of society. It is down to something called selected mortality; in short, disadvantaged people die younger. In Glasgow, a man living at Jordanhill can live to 76 but a man living in Bridgeton is only expected to live 62 years. This is due, in part, to factors such as poverty and fuel poverty, poor housing, social isolation and services that may not be properly equipped to meet the needs of ageing people.

Over the next 20 years, the most elderly sections of the Scottish population are set to increase dramatically, with those aged 75 and over increasing by 82 per cent by 2035. A population that has a larger percentage of older people will have more people with multiple health conditions and multi-morbidity and a greater need for health services.

What happens when we add inequality and socio-economic deprivation to this picture? People living in very deprived areas reach the same level of ill health at age 66 that people living in affluent areas reach at the age of 83. This means that, as the older population increases, more people in deprived areas will die younger. We need to stop this pattern and we need to prevent, reduce and undo these health inequalities.

Tackling health inequalities needs to focus on the multiple challenges older people face in terms of mental, physical, social dimensions to health. We need to ensure services are inclusive and appropriate; tackle poverty and low income; help people to stay healthy and active; and tackle social isolation, promoting social connectedness and encouraging community participation.

The preventative agenda is fundamental for older people. Essential services need to be in place to prevent hospitalisation and help people to live longer, healthier lives at home. Yet it can be hard to invest in preventative services that have an impact in the future when critical services are under pressure at present. Integrated working between NHS and local authorities will go a long way to ensure there is greater investment in prevention.

But bringing agencies together isn't enough. There needs to be a committed focus on working with older people and communities to make a real difference. There are still a lot of vulnerable older people with high support needs, with limited evidence about what they want and value, and a large proportion who aren't empowered to participate in society or decisions that affect their lives. We need to make sure that our older people's voices are heard.

We need to make sure that the rapidly growing population of older people are not forgotten and we need to keep significant focus on improving people's lives now, before it is too late.