Evidence Lacking To Show Scottish Government Poverty Policies Are Working

11th September 2024

There is no evidence Scottish government policies to tackle poverty and health inequalities are making any difference says The Scottish Health Equity Research Unit (Sheru).

There is a gap in data on the effectiveness of programmes such as the Scottish Child Payment.

Sheru - run by the Fraser of Allander Institute and Strathclyde University's Centre for Health Policy - said key information was "either missing or not detailed enough to show the real impact" on inequality.

Professor Kat Smith, co-director of the Centre for Health Policy and co-lead of SHERU, further emphasised the importance of understanding how government actions shape the socio-economic determinants of health. She said: "Without a better grasp of how existing socioeconomic policies are performing, the government will continue to struggle with achieving meaningful improvements to help tackle the poor health affecting large segments of our society.

"In recent years, the Scottish Government has made strides in recognising the importance of gathering insights from service users and their experiences. However, evidence-based decision-making requires ensuring outcomes can be to tracked in the data, as well as engaging with community members."

The authors stress that Scottish Government needs to do more, along with its partners in local government and public bodies, to improve governance. Many of the report findings echo the reflections of the Auditor General in a recent blog reflecting on his period of office so far, where he made a case for enhanced governance and a better understanding of the impact of spend on people's lives.

This report is the first major output by the Scottish Health Equity Research Unit (SHERU) since its creation earlier this year. It examines how Scotland is faring regarding key health-related
policies since the last suite of reports published as part of the Health Foundation's independent review in 2023. Our focus is on the main socioeconomic factors that affect health and inequalities.

Key Findings
Core outcomes related to inequalities and health are not improving significantly and some are getting worse. We have not found evidence that policy is driving improvements in socioeconomic or health inequalities.

Despite the Scottish Government putting in place a range of strategies and policies to tackle inequalities, public sector leaders are not doing enough to understand impact to drive improvement.
A lack of publicly available data of sufficient quality makes it very difficult for us to assess whether policies are working or not.

However, 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.

Key population-level indicators of health and living standards are showing concerning trends:
Life expectancy is no longer rising. While deaths relating to COVID-19 play a part in explaining recent falls, the deviation from the long-run trend dates back to the early 2010s.

Average living standards, measured by household incomes, have never returned to pre2010 levels of growth and have fallen since 2019.

Underneath the headline population averages, inequalities between different parts of the population remain wide. We see some marginal changes, both good and bad, but no systematic
closing of gaps.

Our analysis shows:
More people in Scotland are in relative poverty now than they were in the pre-pandemic period. 24% of children and 39% of households headed by an adult under 25 are in relative
poverty compared to a population average of 21%.

The proportion of young adults not participating in work, education or training, is now higher than pre-pandemic. People in Scotland are now more likely to be inactive due to long-term illnesses.

Food insecurity, homelessness, and fuel poverty are all higher than they were prepandemic. People experiencing homelessness are more likely to cite unsafe situations and mental health conditions in their applications, and the number of deaths among people
experiencing homelessness has increased.

Gaps in education between students in deprived and non-deprived areas remain high. The pandemic led to changes in some measures of attainment inequality (both positive and negative), but the gap has now broadly returned to pre-pandemic levels.

A higher number of children are born in deprived areas compared to non-deprived ones.

Gaps in early health outcomes, such as low birthweight and developmental concerns, are wider than they were pre-pandemic.
Men are also of particular concern, with higher mortality rates from alcohol, drug misuse, and suicide compared to the general population. Drug-related mortality has fallen from its pandemic peak, but increased in 2023, while alcohol mortality also increased in 2023.

This report looks at several areas of Scottish Government policy focus but finds that the data is either unavailable or unreliable enough to measure impacts. One example is the Scottish Child
Payment.

While models suggest it should significantly reduce child poverty, we currently have no evidence of this impact reflected in the official data. We have also examined private sector rents and the disability employment gap. There have been improvements in both, but these are not attributable to the policy intervention.

We have identified two areas related to these findings where improvements could be made to enhance governance and accountability:
Measuring direct impacts: We need to understand how well policies are achieving their primary aims. For example, we should know how housing policies affect housing conditions or how child poverty policies impact child poverty rates.
1.
Evaluating broader impacts: Many socioeconomic factors are interconnected, so it is crucial to assess how key policies influence broader goals like reducing poverty or improving health inequalities.
2.
At present, the Scottish Government is not investing the necessary skills and resources to fully assess the effectiveness and value for money of public spending—a concern that becomes even
more pressing in times of budgetary pressure. If the government wishes to reduce inequalities during a period when savings are being made to public service spending, a strong understanding of programme impacts is essential.

In response to these challenges, organisations like SHERU have a role to play in policy monitoring, evaluation, and data improvement. However, the ultimate responsibility for delivering change, including the robust use of data to deliver policy, lies with public sector
leaders.

Read he full report HERE
Pdf 36 Pages.