Community Vulnerability Measure and information resources Introduction The Scottish Public Health Observatory (ScotPHO) has developed a community vulnerability measure to help guide the social mitigation response to the effects of COVID- 19. ScotPHO used routinely available data from the Health and Wellbeing Profiles. The criteria for selecting the indicators (in the table below) for the measure were:  direct relevance to COVID-19 vulnerability (demographic or clinical), or  relevance to other demands on clinical or public health services, or  social factors likely to modify the impact of COVID-19 on communities. A combined vulnerability score for each geographical area (Council Area, Intermediate Zone and Data zone) has been calculated. Each area has then been assigned a quintile based on that score, with quintile 1 indicating the 20% of areas across with the highest vulnerability score and quintile 5 with the lowest vulnerability score.

Table 1: Indicator from Health and Wellbeing Profiles Vulnerability Geography 1. Population income deprived Social DZ, IZ, CA 2. Children in low income families Social DZ, IZ, CA 3. Single adult dwellings Social DZ, IZ, CA 4. Working age employment deprived Social DZ, IZ, CA 5. People aged 65+ with high levels of care needs who are cared for at home Social CA 6. Children registered for free school meals Social CA 7. Children on the child protection register Social CA 8. Household with children living in fuel poverty Social CA 9. Mid-year population estimate - aged 65+ years Demographics DZ, IZ, CA 10. Mid-year population estimate - aged 75+ years Demographics DZ, IZ, CA 11. Mid-year population estimate - aged 85+ years Demographics DZ, IZ, CA 12. Alcohol-related hospital admissions Clinical DZ, IZ, CA 13. Asthma patient hospitalisations Clinical DZ, IZ, CA 14. Coronary heart disease (CHD) hospitalisations Clinical DZ, IZ, CA 15. Deaths all ages Clinical DZ, IZ, CA 16. Deaths, aged 15-44 years Clinical DZ, IZ, CA 17. Early deaths from cancer, aged <75 years Clinical DZ, IZ, CA 18. Early deaths from CHD, aged <75 years Clinical DZ, IZ, CA 19. Emergency patient hospitalisations Clinical DZ, IZ, CA 20. Life expectancy, male Clinical CA 21. Life expectancy, female Clinical CA 22. Multiple emergency hospital admissions, aged >65 years Clinical DZ, IZ, CA 23. Chronic obstructive pulmonary disease (COPD) patient hospitalisations Clinical DZ, IZ, CA 24. Drug-related hospital stays Clinical DZ, IZ, CA 25. Cancer registrations Clinical DZ, IZ, CA 26. Population prescribed drugs for anxiety/depression/psychosis Clinical DZ, IZ, CA 27. Diabetes hospitalisations Clinical DZ, IZ, CA 28. Psychiatric patient hospitalisations Clinical DZ, IZ, CA

What it measures The overall vulnerability score was produced through statistical analysis that combined the indicators from the three categories in Table 1: social (indicators 1–8), demographic (indicators 9-11) and clinical (indicators 12-28).

Purpose The measure, based on demographic, social and clinical indicators, can be used to identify areas of vulnerability and where to target resources in East, North and South . The information could aid decision making by services to reflect the varying levels of need across Ayrshire & Arran. It can be used to aid prioritisation of clinical work including in the Recovery Phase planning process. Local organisations will also be able to use the maps at intermediate and data zone level to target resources in the areas with most need.

Context The Scottish Index of Multiple Deprivation already shows that there are high levels of multiple deprivation across . Those communities living in socio-economic disadvantage experience inequalities in health, including premature mortality, relatively more ill-health, earlier onset of long-term conditions, poorer mental wellbeing, higher levels of in- work poverty, low paid and precarious employment, low financial resilience and fuel and food poverty. COVID-19 and the essential policies associated with it such as lockdown, loss of income, debt, arrears, the threat of job losses, reduced access to health and social care services and social isolation will have a disproportionately negative impact on the 20% most vulnerable areas.

This inequality is made clear from the National Records for Scotland’s analysis of all deaths and Covid-19 deaths in Scotland by deprivation quintile provided the chart below.

COVID-19 death rate by SIMD quintile, March and April 2020 500

450 death rate from all causes is 1.9 400 times higher in the most 350 deprived areas death rate than the least from COVID- 300 19 is 2.3 times higher in the 250 (most most deprived depriv areas than the 200 ed) least deprived areas 150 (least depri Death rate per 100,000 rate per 100,000 population Death 100 ved) quintile 5 quintile 1 50 quintile 2 quintile 3 quintile 4 quintile 1 quintile 2 quintile 3 quintile 4 quintile 5 0 All causes COVID-19

Note on methodology Two versions of the Community Vulnerability Measure dataset are available; Unweighted quintiles  Quintile 1 indicates an area with the highest vulnerability score - it represents the 20% most vulnerable areas according to the ScotPHO vulnerability measure.  Quintile 5 indicates an area with the lowest vulnerability score - it represents the 20% least vulnerable areas according to the ScotPHO vulnerability measure. Population weighted quintiles: (weighted using 2018 mid-year population estimates)  Quintile 1 indicates an area with the highest vulnerability score - it represents an area in which the 20% most vulnerable people live (vulnerability according to the ScotPHO vulnerability measure).  Quintile 5 indicates an area with the lowest vulnerability score - it represents an areas in which the 20% least vulnerable people live (vulnerability according to the ScotPHO vulnerability measure). This weighting increased the vulnerability in terms of the size of the population affected so the population weighted quintiles data have been used where available and this is noted.

Summary of findings from the Community Vulnerability Measure Figures 1 and 2 show all three local authorities in Ayrshire and Arran are identified as being at high risk to Covid-19 with having the highest demographic vulnerability score in Scotland.

Figure 1: Top 10 areas in Scotland with highest demographic vulnerability

Demographic vulnerability Score 3.50 3.00 2.50 2.00 1.50 1.00 0.50 0.00 South Na h- North & Angus Scottish East Argyll & Ayrshire Eileanan Ayrshire Galloway Islands Borders Ayrshire Bute Siar

Figure 2: Top 10 areas in Scotland with highest social/clinical vulnerability

Social/clinical vulnerability Score 12.00 10.00 8.00 6.00 4.00 2.00 0.00

Ayrshire and Arran has a higher proportion of older people and higher levels of multiple deprivation relative to many other areas in Scotland and the community vulnerability measure is therefore higher. The measure is an aid to decision making, other knowledge such as socio-economic data, ethnic minority and disabled communities will strengthen its use. Links to some selected resources that support the purpose of this measure are included at the back of this report.

Table 2: Number of datazones in each of the ScotPHO Vulnerability Quintiles Overall Vulnerability Number Data zones Measure Quintiles South Ayrshire 1 Most Vulnerable 51 69 58 2 38 55 41 3 32 33 27 4 26 14 20 5 Least Vulnerable 16 15 7

Table 2 shows the high number of datazones in Quintile 1 in Ayrshire and Arran, this report highlights the top ten most vulnerable intermediate zones. More detail can be found at ScotPHO.

Most Vulnerable Intermediate Zones (IZs) Tables with the overall, social/clinical and demographic vulnerability scores for the ten most vulnerable intermediate zones along with 2018 mid-year populations are presented below for North, East and South Ayrshire respectively. Not every data zone within an intermediate zone is equally impacted therefore the population totals may be an overestimate. Small areas, such as South, will have a higher number of older people living in them and will therefore have a higher demographic vulnerability score. Those areas with a high social/clinical vulnerability score are likely to have higher levels of multiple deprivation and experience health inequalities across the range of indicators.

North Ayrshire Table 4(a): Ten most vulnerable IZs for Covid-19 for demographic vulnerability Intermediate zone Demographic Weighted Quintile: 2018 mid-year vulnerability Demographic population Score vulnerability Largs South 6.28 1 3,675 Central 3.88 1 3,725 Irvine 3.81 1 2,991 North West 3.58 1 2,783 Largs North 3.54 1 3,981 Arran 2.97 1 4,576 Central 2.79 1 3,143 Largs Central & Cumbrae 2.70 1 4,781 West & Blacklands 1.95 1 4,146 Irvine Central 1.92 1 3,243 Total population 37,044

Table 4(b): Ten most vulnerable IZs for Covid-19 for social/clinical vulnerability Intermediate zone Social/clinical Weighted Quintile: 2018 mid-year vulnerability Social/clinical population Score vulnerability Irvine Fullarton 10.57 1 2,991 Saltcoats Central 8.81 1 3,725 Irvine Castlepark South 8.20 1 3,307 Ardrossan Central 7.90 1 3,143 Irvine 6.49 1 2,275 Kilwinning West & Blacklands 6.38 1 4,146 Kilwinning Pennyburn 6.14 1 3,003 Stevenston Hayocks 5.62 1 4,061 Irvine Castlepark North 5.60 1 3,500 Ardrossan North East 5.19 1 4,304 Total population 34,455

Table 4(c): Ten most vulnerable IZs for Covid-19 for overall vulnerability. Intermediate zone Overall Weighted Quintile: 2018 mid-year vulnerability Combined population Score vulnerability Irvine Fullarton 1.72 1 2,991 Saltcoats Central 1.63 1 3,725 Ardrossan Central 1.48 1 3,143 Stevenston North West 1.35 1 2,783 Kilwinning West & Blacklands 1.32 1 4,146 Irvine Castlepark South 1.22 1 3,307 Irvine Castlepark North 1.22 1 3,500 Irvine Central 1.19 1 3,243 Largs South 1.15 1 3,675 Irvine East 1.13 1 3,083 Total population 33,596

East Ayrshire Table 3(a): Ten most vulnerable IZs for Covid-19 for demographic vulnerability Intermediate zone Demographic Weighted Quintile: 2018 mid-year vulnerability Demographic population Score vulnerability Bonnyton & Town Centre 2.77 1 3,880 New Farm Loch South 1.96 1 2,803 South Central & Caprington 1.85 1 2,824 New 1.70 1 2,660 Cumnock North 1.55 1 3,859 Doon Valley South 1.45 1 3,172 1.43 1 3,661 1.42 1 2,779 Bellfield & Kirkstyle 0.88 2 4,168 Piersland 0.84 2 3,211 Total population 33,017

Table 3(b): Ten most vulnerable IZs for Covid-19 for social/clinical vulnerability Intermediate zone Social/clinical Weighted Quintile: 2018 mid-year vulnerability Social/clinical population Score vulnerability Shortlees 8.66 1 4,438 Altonhill South, Longpark & Hillhead 7.51 1 4,726 Doon Valley South 7.48 1 3,172 Altonhill North & Onthank 5.67 1 4,558 5.15 1 2,660 Auchinleck 3.76 1 3,661 Cumnock South & Craigens 3.07 1 4,798 Bellfield & Kirkstyle 2.97 2 4,168 Newmilns 2.85 2 2,779 Kilmarnock South Central & Caprington 2.77 2 2,824 Total population 37,784

Table 3(c): Ten most vulnerable IZs for Covid-19 for overall vulnerability. Intermediate zone Overall Weighted Quintile: 2018 mid-year vulnerability Combined population Score vulnerability Doon Valley South 1.33 1 3,172 New Cumnock 1.22 1 2,660 Shortlees 1.19 1 4,438 Bonnyton & Town Centre 1.18 1 3,880 Altonhill North & Onthank 1.15 1 4,558 Auchinleck 1.12 1 3,661 Altonhill South, Longpark & Hillhead 1.12 1 4,726 Kilmarnock South Central & Caprington 1.11 1 2,824 Newmilns 1.07 1 2,779 Bellfield & Kirkstyle 1.03 1 4,168 Total population 36,866

South Ayrshire Table 5(a): Ten most vulnerable IZs for Covid-19 for demographic vulnerability Intermediate zone Demographic Weighted Quintile: 2018 mid-year vulnerability Demographic population Score vulnerability South Harbour & Town Centre 6.31 1 5,445 3.81 1 5,403 & 3.78 1 5,936 Ailsa 3.08 1 3,239 2.86 1 3,948 Belmont 2.52 1 5,405 West 2.09 1 4,039 Ayr North Harbour, Wallacetown & 1.73 4,517 Newton South 1 Carrick South 1.57 1 5,321 Craigie 1.55 1 2,599 Total population 45,852

Table 5(b): Ten most vulnerable IZs for Covid-19 for social/clinical vulnerability Intermediate zone Social/clinical Weighted Quintile: 2018 mid-year vulnerability Social/clinical population Score vulnerability Ayr North Harbour, Wallacetown & 9.61 1 4,517 Newton South Dalmilling 7.09 1 2,960 Lochside, Braehead & Whitletts 6.91 1 4,126 Craigie 3.56 1 2,599 Girvan Glendoune 3.09 1 3,216 2.75 2 4,637 Barassie 2.45 2 3,948 Castlehill & 2.07 2 4,212 Girvan Ailsa 1.61 2 3,239 Ayr South Harbour & Town Centre 1.14 2 5,445 Total population 38,899

Table 5(c): Ten most vulnerable IZs for Covid-19 for overall vulnerability. Intermediate zone Overall Weighted Quintile: 2018 mid-year vulnerability Combined population Score vulnerability Ayr North Harbour, Wallacetown & 1.48 4,517 Newton South 1 Ayr South Harbour & Town Centre 1.42 1 5,445 Dalmilling 1.30 1 2,960 Lochside, Braehead & Whitletts 1.21 1 4,126 Barassie 1.18 1 3,948 Girvan Ailsa 1.15 1 3,239 Craigie 1.12 1 2,599 Girvan Glendoune 1.08 1 3,216 Troon 1.04 1 5,403 Maybole 1.01 1 4,637 Total population 40,090

The impacts of Covid-19 on the economy and health Policies of lockdown and social distancing were essential to protect the health of the whole population. The economic impact of the Covid-19 pandemic is significant and is likely to have a disproportionate impact on people living in areas of multiple deprivation, those who were not in a good position prior to the pandemic. The Institute for Public Policy Research have mapped the potential impacts of the pandemic on Scotland’s labour market and caution that at this stage it is illustrative. Based on the Office for Budget Responsibility (OBR) UK-wide forecast, it is anticipated that 150,000 jobs will be lost as employers may not manage to the end of the crisis. The impacts are shown for the different sectors in Figure 3.

Figure 3: Estimated number of jobs lost and employees furloughed by industry

The local economic impact of Covid-19 The Improvement Service have developed a dashboard summarising local economic impact and uptake of government support in each local authority. Figure 4 shows the number of people aged 16-64 claiming Job Seekers Allowance plus Universal Credit. The increase from lockdown in March to July is marked and adds up to 7,610 people. The percentage increase was 68.5% in East, 64.2% in North and 78.6% in South respectively although the largest number of new claims was in North Ayrshire. The total number of employments furloughed at 31st July 2020 were 17,000 in East Ayrshire, 17,600 in North Ayrshire and 15,400 in South Ayrshire. The total furloughed per 100 of the 16-64 population are similar in Ayrshire to the Scottish rate per 100 of 22.2.

Figure 4: Total Monthly Unemployment Benefit Claimant Count January to June 2020

Total Monthly Unemployment Benefit Claimant Count January to June 2020 8000 7000 6000 5000 4000 3000 2000 1000 0 January February March April May June July East Ayrshire North Ayrshire South Ayrshire

Figure 5: Current uptake of government support at 31st July 2020 Covid Business Grants Self-Employment Income Small and Micro Businesses Support Scheme claims East Ayrshire 1,866 3,800 North Ayrshire 2,223 3,600 South Ayrshire 2,056 3,200

The emerging evidence of the long-term impacts of Covid-19 signals challenging times for many, those with less financial resilience will experience hardship and health inequalities will be wider and deeper. Public Health will work in partnership to mitigate the social impacts at the local level however, policies at the macro level will have the most impact in reducing inequalities.

Those areas with a high social/clinical vulnerability score are likely to have higher levels of multiple deprivation and experience inequalities across the range of indicators. Tables 6(a) to 6(c) lists the top 45 most vulnerable data zones for North, East and South Ayrshire. With this measure, the most deprived social/clinical data zone rank in Scotland is 6976 the least deprived is 1. A list of web links relating to more information on the socio-economic impact is provided on the last page.

6(a) Top 45 data zones in North Ayrshire by Social/clinical Vulnerability Score and Rank

Data zone Name and number Social/clinical Social/clinical 2018 Mid-Year vulnerability Score vulnerability Rank Population Saltcoats Central - 04 11.08 6967 631 Irvine Fullarton - 02 9.60 6954 929 Ardrossan Central - 02 9.06 6940 957 Saltcoats Central - 03 7.33 6853 718 Irvine Fullarton - 03 7.32 6852 580 Irvine Castlepark South - 01 7.10 6829 776 Kilwinning Central and North - 01 6.83 6800 839 Stevenston Ardeer - 03 6.80 6797 374 Saltcoats Central - 02 6.79 6796 585 Kilwinning West and Blacklands - 02 6.50 6768 1,054 Irvine Castlepark North - 04 6.49 6767 608 Ardrossan Central - 03 6.40 6755 657 Irvine Bourtreehill - 01 6.32 6746 816 Irvine Fullarton - 04 6.26 6735 959 Kilwinning West and Blacklands - 04 6.08 6710 699 Ardrossan North East - 04 5.95 6690 804 Irvine Castlepark South - 04 5.93 6687 841 Springside and Rural - 03 5.89 6680 651 Irvine Fullarton - 01 5.87 6675 523 Dalry East and Rural - 04 5.87 6674 791 Ardrossan Central - 04 5.80 6664 759 Stevenston North West - 03 5.70 6638 458 Irvine Castlepark South - 02 5.62 6619 971 Ardrossan North East - 03 5.56 6612 751 Kilwinning Pennyburn - 02 5.42 6591 735 Irvine Castlepark North - 05 5.40 6587 408 Irvine Central - 01 5.23 6559 773 Irvine Castlepark South - 03 5.15 6549 719 Irvine East - 04 5.04 6531 658 Stevenston Ardeer - 02 5.03 6525 1,000 Kilwinning Pennyburn - 03 4.98 6512 851 South and - 01 4.90 6492 806 Kilwinning West and Blacklands - 05 4.90 6490 701 Stevenston Ardeer - 04 4.64 6422 475 Irvine Central - 03 4.56 6399 693 and - 06 4.40 6356 741 Irvine Castlepark North - 02 4.36 6343 1,049 Kilwinning Pennyburn - 01 4.34 6339 734 Stevenston North West - 04 4.34 6336 679 Kilbirnie South and Longbar - 02 4.32 6325 839 Kilwinning Central and North - 05 4.21 6286 648 Saltcoats North East - 01 4.13 6270 768 Irvine East - 02 4.10 6260 751 Saltcoats North East - 05 4.08 6249 1,007 Stevenston Hayocks - 01 4.04 6239 746 Total 33,512

6(b) Top 45 data zones in East Ayrshire by Social/clinical Vulnerability Score and Rank

Data zone Name and number Social/clinical Social/clinical 2018 Mid-Year vulnerability vulnerability Rank Population Score Altonhill South, Longpark and Hillhead - 07 8.60 6929 589 Altonhill South, Longpark and Hillhead - 02 8.55 6924 577 Doon Valley South - 03 8.55 6923 636 Shortlees - 02 8.10 6899 1,018 Altonhill North and Onthank - 03 8.02 6891 891 Doon Valley North - 03 7.53 6866 693 Doon Valley South - 02 7.25 6844 648 Altonhill South, Longpark and Hillhead - 04 7.18 6839 707 Altonhill North and Onthank - 04 6.88 6807 762 Rural - 05 6.65 6784 720 Altonhill South, Longpark and Hillhead - 03 6.47 6764 466 New Cumnock - 02 6.45 6763 652 Altonhill South, Longpark and Hillhead - 05 6.28 6740 836 Shortlees - 05 6.13 6720 970 Mauchline - 05 5.73 6651 780 Galston - 04 5.69 6633 629 Shortlees - 04 5.54 6609 510 Galston - 06 5.04 6530 685 Cumnock North - 03 4.82 6474 798 Cumnock South and Craigens - 05 4.69 6442 608 Earlston and Rural - 04 4.68 6432 772 Shortlees - 06 4.61 6417 575 Kilmarnock South Central and Caprington - 04 4.55 6394 644 Doon Valley South - 05 4.53 6382 708 Shortlees - 03 4.43 6362 807 Cumnock Rural - 05 4.33 6334 665 Newmilns - 04 4.17 6279 625 Kilmarnock South Central and Caprington - 02 3.79 6158 810 Mauchline Rural - 04 3.74 6132 616 Bonnyton and Town Centre - 01 3.72 6125 848 Cumnock Rural - 06 3.69 6111 786 Altonhill North and Onthank - 02 3.63 6080 908 Bellfield and Kirkstyle - 04 3.61 6072 879 Doon Valley North - 04 3.56 6050 698 Mauchline Rural - 06 3.51 6028 777 Cumnock Rural - 04 3.43 6005 535 Auchinleck - 01 3.40 5995 885 Auchinleck - 04 3.36 5976 1,033 Cumnock South and Craigens - 04 3.25 5927 676 New Cumnock - 03 3.22 5913 534 New Cumnock - 01 3.15 5873 600 Auchinleck - 02 3.14 5863 805 Doon Valley South - 04 3.06 5832 633 Doon Valley North - 05 3.03 5819 724 Altonhill North and Onthank - 01 2.92 5772 664 Total 32,382

6(c) Top 45 data zones in South Ayrshire by Social/clinical Vulnerability Score and Rank

Data zone Name and number Social/clinical Social/clinical 2018 Mid- vulnerability vulnerability Year Score Rank Population Lochside, Braehead and Whitletts - 02 11.65 6969 537 Ayr North Harbour, Wallacetown and Newton South - 06 10.08 6961 721 Ayr North Harbour, Wallacetown and Newton South - 03 10.05 6960 977 Ayr North Harbour, Wallacetown and Newton South - 05 9.81 6957 480 Lochside, Braehead and Whitletts - 03 8.09 6898 800 Dalmilling - 02 7.77 6881 481 Ayr North Harbour, Wallacetown and Newton South - 04 6.60 6779 926 Dalmilling - 03 5.97 6695 861 Maybole - 02 5.97 6693 622 Ayr South Harbour and Town Centre - 04 5.96 6691 846 Barassie - 03 5.73 6653 738 Girvan Glendoune - 02 5.56 6613 591 Girvan Glendoune - 03 5.23 6563 466 - 01 5.06 6535 483 Castlehill and Kincaidston - 05 4.92 6498 544 Lochside, Braehead and Whitletts - 01 4.58 6405 540 Lochside, Braehead and Whitletts - 04 4.15 6276 562 Dalmilling - 01 4.08 6248 792 Dalmilling - 04 3.89 6192 826 Maybole - 03 3.85 6175 666 Craigie - 01 3.40 5994 621 Heathfield - 04 3.36 5979 623 Craigie - 03 3.22 5914 976 Heathfield - 06 3.21 5900 1,048 Castlehill and Kincaidston - 06 3.17 5878 575 Muirhead - 01 3.15 5874 558 Barassie - 06 3.10 5850 747 Maybole - 01 3.08 5839 659 Ayr South Harbour and Town Centre - 02 3.02 5811 826 Castlehill and Kincaidston - 04 2.97 5791 676 Lochside, Braehead and Whitletts - 05 2.94 5776 657 Barassie - 02 2.84 5737 529 Girvan Glendoune - 04 2.80 5725 587 , and - the Coalfields - 06 2.80 5720 695 Lochside, Braehead and Whitletts - 06 2.77 5708 1,030 Maybole - 06 2.41 5524 746 Belmont - 05 2.28 5452 943 Newton North - 02 2.21 5419 911 Girvan Ailsa - 05 2.19 5414 502 Newton North - 03 2.18 5408 772 Troon - 05 2.01 5309 1,016 Prestwick East - 05 1.94 5272 794 Belmont - 02 1.94 5269 642 Girvan Ailsa - 01 1.86 5216 574 Dundonald, Loans and Symington - 04 1.73 5144 476 Total 31,642

Selected information resources with links Understanding the Scottish local economic impact of Covid-19 The Improvement Service has published a dashboard summarising local economic impact and uptake of government support including;  Unemployment benefit claims  The Coronavirus Job Retention Scheme  Employments Furloughed, Self-Employment Income Support Scheme  The COVID Business Support Grant Fund

Towards a Robust, Resilient Wellbeing Economy for Scotland: Report of the Advisory Group on Economic Recovery This report details the findings of the independent Advisory Group on Economic Recovery which was established by the in April 2020 to provide expert advice on supporting the different regions and sectors of Scotland’s economy to recover from the impacts of Covid-19. (Local authority tables on pages 73 and 74). Published on 22 June the report contains a series of recommendations directed at both the Scottish Government and other actors in Scotland’s economy identifying interventions to support Scotland’s economic recovery and facilitate the transition towards a greener, fairer and more inclusive economy with wellbeing at its heart. Income-based policies in Scotland – how would they affect health and health inequalities? Public Health Scotland disseminates evidence to relevant decision-makers on the policies and practices that reduce inequalities (avoiding those that are likely to increase them). The NHS Health Scotland Triple I tool identifies how a number of different interventions impact on inequalities.

Coronavirus: Considering the Implications for Child Poverty Supporting local authorities and health boards to consider what steps they can take to respond effectively. The Improvement Service Report seeks to support local authorities and health boards by collating relevant information and by identifying potential drivers/ levers that could be used to ensure that the impact of COVID 19 is addressed in a manner that reduces the risk of causing long term damage to children.

Poverty, Inequality and COVID-19 A Summary by the Improvement Service of some of the issues and potential impact on those living in socio-economic disadvantage. Includes information and useful links on communities of interest.

Types of Advice people are looking for Citizens Advice Scotland (CAS) have published a weekly report tracking the type of advice that people are seeking from the network (59 Citizen Advice Bureaux). Advice about social security, employment and debt are most frequent. Online advice site shows that redundancy queries are increasing. CAS has also run surveys during the pandemic on debt and estimate that 1 in 4 people are worried about personal debt.

The economy of wellbeing: what is it and what are the implications for health? Jonathan Cylus and Peter Smith consider how measurement of wellbeing might be used to set public sector priorities. BMJ 2020;369:m1874

Super-policies? A wellbeing approach to building back better A short paper from Jennifer Wallace at the Policy Network, July 2020

Fraser of Allander Institute asked a diverse mix of experts on the current economic implications of the coronavirus pandemic and how our economy and society may be impacted in the future. Public Health Department – September 2020