Abstract Introduction
We developed a tool to model the estimated impact of a range of interventions on population health and health inequalities in Scotland.
Methods
Forty potential interventions were identified in consultation with an advisory group and topic experts. We conducted rapid reviews to obtain evidence of the effect of the interventions on all-cause mortality, or on an exposure associated with all-cause mortality. We extracted data to allow estimation of intervention costs, the prevalence of exposure, the prevalence of the eligible population, and the extent of intervention effect decay. We estimated the impacts of interventions on premature mortality across the Scottish population after five years of follow up, compared to the baseline no-policy scenario, and assessed inequalities between area deprivation quintiles.
Results
Income-based interventions that disproportionately redistribute income to those with the lowest incomes were estimated to have the largest potential impact on both population health and health inequalities. The best policies for achieving both policy objectives were increases to means-tested benefits (-4.1% premature mortality, -21.7% Relative Index of Inequality (RII)), increases to benefits devolved to the Scottish Government (-1.6% and -6.1%), and the introduction of a mandatory Living Wage (-2.2% and -5.2%). The estimated impact of interventions that aim to influence individual behaviour change was much more limited in scale.
Conclusion
Interventions affecting incomes have the potential for substantial effects on health and health inequalities in Scotland. Our modelling tool should be used to inform discussion and debate about the potential scale of different types of interventions across policy areas. External funding details