Non-communicable diseases (NCDs) are a leading cause of ill health and death in Scotland.

Whilst our collective memory of 2020 will be of the year COVID-19 struck, the latest causes of death figures (external website) from National Records of Scotland show that 62% of deaths last year were attributed to NCDs such as heart disease, stroke, cancer, diabetes, liver or lung disease.

We know rates of non-communicable disease are fuelled by consumption of health harming products like alcohol, tobacco and food and drinks which are high in fat, sugar and salt. But we also know that the burden of ill health and mortality associated with these products rests disproportionately on people living in our poorest communities. In 2020, alcohol-specific mortality rates for those living the most deprived areas of Scotland were 4.3 times the rate for those living in the least deprived.

So as we look to emerge from the worst of the COVID pandemic, NCDs and the stark inequalities they lay bare remain amongst the most critical public health challenges we face. 

Infographic explaining the burden of obesity, robacco use and alcohol consumption is higher in the most deprived areas and this contributes to a 20-year gap in healthy life expectancy

This week marks Global Week for Action on NCDs (external website). We need bold action in Scotland, and there is evidence to support steps to tackle the availability, price and promotion of health harming products; ensure the provision of high quality and accessible treatment and support services; and address the underlying social and economic drivers of ill health like poverty. The excellent Non-communicable Disease prevention report (external website) published this week by a group of ten third sector organisations in Scotland identifies where progressive and effective action could be taken.

For our part Public Health Scotland will work with our partners across the public and third sectors to act where we can make the biggest difference to people’s health and wellbeing.

We continue to monitor and evaluate Scotland’s alcohol strategy, including the impact of Minimum Unit Pricing, and we are collaborating on a four nations basis to develop the first UK-wide clinical guidelines for alcohol treatment. We will support the implementation of the Out of Home Action Plan the Scottish Government will publish this month, to help people make informed, healthier food choices when eating out or ordering in, and we will enable local and national stakeholders to implement evidence-based actions to reduce the harms associated with tobacco.

As we plan Scotland’s recovery from the COVID pandemic, we can’t return to the status quo, and we should not forget the power of winning hearts and minds along the way.

The ban on smoking in public places, which came into force in Scotland 15 years ago this year, is not only an example of a public health intervention having a demonstrably positive impact on NCDs. It also shows us that culture change around the consumption of a health harming product is possible. Furthermore, it reminds us of the strength of public support that is built up over time, when people feel the difference an intervention is making to their health and to their lives (even when that intervention might be interpreted as a restriction of their choice).

Back to 2021 and the years to come, there is a shared appetite for bold measures to address Scotland’s enduring public health challenges post-COVID-19. To help reduce consumption of health harming products, to prevent ill health and deaths from NCDs where they are experienced most severely, and to achieve our vision of a Scotland where everybody thrives, we must take this opportunity to turn appetite for change into action.

Dr Andrew Fraser will be speaking on ‘NCD Prevention: A Public Health Challenge’ at a public and third sector event on 16 September 2021.

Last updated: 06 October 2022