Item 9 - Collaboration for Health Equity
West Dunbartonshire Council · 20 November 2025
Back to Community Planning West Dunbartonshire Management Board — 20 November 2025 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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Report by the to CPWD Management Board Management Group: 20 November 2025 ___________________________________________________________________ Subject: Collaboration for Health Equity (CHES) 1. Purpose 1.1 The purpose of this report is to provide Community Planning West Dunbartonshire (CPWD) Board members with a briefing on Scotland’s Collaboration for Health Equity (CHES) approach and reports published in October 2025 and available here. 2. Recommendations 2.1 CPWD Management Board members are asked to note the content. 3. Background 3.1 CHES is a two-year (2024-26) collaboration involving Public Health Scotland (PHS) and University College London’s Institute of Health Equity (IHE) which seeks to inform national and local approaches and support the development and implementation of policies to tackle health inequalities. There are two strands to this work: At a national level to provide new insights into the most effective ways to secure progress on health equity in Scotland Work in three places in Scotland to collaborate on developing and implementing interventions and policies to enhance health equity CHES will work with 3 Local Authorities - Aberdeen City, North Ayrshire and North Lanarkshire- to more fully understand inequalities locally and address why existing approaches have not had the intended impacts on health and health inequalities. ITEM 9
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3.2 CHES has published two reports to date: Health Inequalities in Scotland (first-report)- Chapter 1 provides a summary of health inequalities across Scotland with chapter concentrating on the three areas working with CHES The Social Determinants of Health in Scotland (2nd report)- Chapter 2 examines if the General Revenue Funding Grant relates sufficiently to each Council’s levels of deprivation. 4. An Overview of Health Inequalities in Scotland (First Report) 4.1 West Dunbartonshire is the 26th most populace Local Authority in Scotland but is 10th highest in proportion of population living in the most deprived data zones. West Dunbartonshire is amongst the four local authority areas with the greatest imbalance between deprivation and overall population- Glasgow City, Inverclyde and North Ayrshire being the others. The Council’s contribution to Scotland’s population in deprived Data Zones is more than twice its contribution to Scotland’s overall population. 4.2 The report details the clear association between the following health measures and deprivation: Life expectancy - in the most deprived 20% of areas compared with the least deprived areas is 11.6 years less for men and 9 years less for women Healthy life expectancy (how long you can expect to live in good health)- males living in most deprived small areas have healthy life expectancy below 50 years. Mortality under 75 (i.e. deaths which are often considered to be preventable)- West Dunbartonshire is ranked 7th out of 32 authorities for this measure. Major diseases –Cancer, chronic obstructive pulmonary disease (COPD) and coronary heart disease. Asthma- West Dunbartonshire has a lower prevalence of asthma in children under 16 than the Scottish average. Mental health- Psychiatric patient hospitalisations in the most deprived areas are almost 3 times as high as those in the least deprived. Infant Health- In West Dunbartonshire, nearly a quarter of all young children (aged 27-30) months were identified as having developmental concerns. Women who live in the most deprived 20 percent of areas are nearly
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ten times more likely to smoke during pregnancy than those in the least deprived. Alcohol- West Dunbartonshire has the third highest alcohol related hospital admissions per 100,000 population in Scotland. Smoking- rates of smoking in Scotland in both males and females have fallen since 2012. There is a weak association between smoking rates and deprivation across local authorities. Drug Use- Hospital admissions related to drugs are 10 times higher in the most deprived areas than the least deprived. The report confirms that there are wide inequalities in health across Scotland related to the extent of deprivation within Council areas. 5. An overview of The Social Determinants of Health in Scotland (2nd Report) 5.1 It is stated in this report that it is not an overview of policies or programmes which have been implemented but instead orientated around identifying particular trends and issues in the social determinants of health which are identifiable in available data. It states that subsequent reports from CHES will address the suitability of available policies and programmes in Scotland and the effectiveness of their implementation and make recommendations in these areas- based on CHES work in the three places: Aberdeen City, North Ayrshire and South Lanarkshire. This report provides a data overview of inequalities in the social determinants of health in Scotland based on the Marmot 8 principles (Professor Sir Michael Marmot, IHE, University College London) and the how public expenditure relates to inequalities and individual Council’s capacity to tackle inequality in their area. 5.2 The 8 Marmot Principles are: 1. Give every child the best start in life The number of children living in relative poverty in West Dunbartonshire is the 4th highest in Scotland. The percentage of children using any form of childcare-even funded- is lower in most deprived areas than in least. 2. Enable all children, young people and adults to maximise their capabilities and have control over their lives School absences in secondary schools are higher in those children receiving free school meals with greater levels of deprivation. In West Dunbartonshire over 20% of absences are by those eligible for free meals. School exclusion rates are also higher for children eligible for school meals.
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3. Create fair employment and good work for all In 2023 to 24, West Dunbartonshire had more economically inactive and more unemployed people ages 16-64 than the Scottish average. 4. Ensure a healthy standard of living for all Weekly median earnings of full-time workers in West Dunbartonshire are slightly below that of Scotland. 5. Create and develop healthy and sustainable places and communities 6. Tackle racism, discrimination and their outcomes 7. Strengthen the role and impact of ill-health prevention 8. Pursue environmental sustainability and health equity together 5.3 Public Expenditure and Inequalities. The report seeks to assess whether, despite the many complex funding needs of councils, the allocations relate sufficiently to each council’s level of deprivation. Scotland’s budget allocation from the UK is solely based on population-this is the only consideration of ‘need’ in the Barnett formula. Recommendations have been made to replace the Barnett formula with a needs-based formula (Calman Commission) In 2023-4 Scotland received £37 billion as a block grant from the UK Government and its total budget was £58 billion. The additional £21 billion is raised in Scotland mainly through service income, non-domestic rates and Council Tax. The calculation of assumed non-domestic rates (business rates) per head of population in West Dunbartonshire is amongst the highest in Scotland. The Scottish Government seeks to distribute this general funding equitably between councils by agreeing the method of distribution with the Convention of Scottish Local Authorities (COSLA) with methods such as “The Floor” and additional funding made available to support service delivery to rural communities. 5.4 Council areas with a higher levels of deprivation – like West Dunbartonshire- receive slightly more funding per head of population than less deprived councils. However, island councils with relatively low levels of deprivation receive a much greater grant per head of population. Increasing the role of deprivation in the amount available to councils would require changes to the formulae and the Floor mechanism in determining how funding is distributed.
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The report states that the amount available to councils from General Funding related to deprivation and homelessness represents less than two percent of all public expenditure in Scotland. Given the burden that deprivation places on services on a day-to-day basis, it alone is inadequate for tackling inequalities and reducing deprivation. 6. Conclusions 6.1 The report states that there are stark inequalities in key social determinants of health between and within areas. People who live in deprived areas have worse outcomes in all the eight social determinants principles looked at in the report and there remains a strong relationship between deprivation and poorer social determinants of health. General Revenue Funding Grants to councils is insufficient to mitigate the impacts of structural inequalities and reduce inequitable health outcomes. Funding mechanisms play a critical role in supporting Councils to address inequalities and some aspects may not be sensitive enough to need or can even constrain responsiveness to need. Small-area variation is significant. Broad averages can hide pockets of high need. Interventions need to be targeted and responsive to local neighbourhood level data. 7. People Implications 7.1 None. 8. Financial Implications 8.1 None. 9. Risk Analysis 9.1 None. 10. Equalities Impact Assessment (EIA) 10.1 None. 11. Consultation 11.1 None required. 10. Strategic Assessment 10.1 None.
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Date: 10 November 2025 Person to Contact: Colin Smith, Communities Team Leader. colin.smith@west-dunbarton.gov.uk Appendices: none Background Papers: none Wards Affected: All