Acting now to add life to years, and years to life for Scotland’s future - Our blog

Dr Fatim Lakha, Consultant in Public Health Medicine at Public Health Scotland (PHS), considers the future health landscape in Scotland by reflecting on recent findings from the Scottish Burden of Disease study and the detail new disease prevalence reports add to the long-term view. Reversing the trend is essential for a healthier, thriving population.

In late 2022, we published findings from the Scottish Burden of Disease study – a forecast of the impact population-level ageing is set to have on the health of Scotland’s population over the next 20 years.

That study estimated that despite a slight projected decline in our population by 2043, Scotland could be looking at a 21% increase in annual disease burden - a shift with significant consequences for quality of life and healthcare provision.

To deepen our understanding of this challenge, we looked in detail at the number of people living with health conditions. By examining historic trends alongside projected changes in our population’s size and shape, we can estimate how many people we would expect to be living with health conditions in the future.

Disease prevalence by 2044

Our condition-specific reports show that Scotland could see a considerable surge* in the number of people living with the following conditions by 2044:

Diabetes - 36% increase (from 308,000 to 419,000 people)
Atrial fibrillation – 56% increase (from 114,000 to 178,000 people)
Stroke – 36% increase (from 105,000 to 143,000 people)
Heart disease – 15% decrease (from 253,000 to 215,000 people)
Chronic obstructive pulmonary disease (COPD) – 63% increase (from 134,000 to 219,000 people)
Chronic liver disease – 54% increase (from 43,000 to 66,000 people)

A focus on prevention

Projected estimates are not inevitable. They provide a window to the future and offer the opportunity for action in the present. Focusing on prevention and early intervention to reduce the rate of new cases occurring and severity for those already living with health conditions, is essential to changing Scotland’s path.

Scotland has implemented world leading public health legislation, such as the ban on smoking in enclosed public places and minimum unit pricing for alcohol, policies with prevention at their very heart which have improved our health. Yet, tackling health harming products alone is not enough. We need to address the fundamental causes of inequality and poor health. Historical improvements in survival rates from the success of public health interventions and medical advances means that more people are now living with long-term health conditions. These findings are telling us that we need to ensure that people are living in better health, not just living longer.

Building blocks of health

The circumstances in which we are born, live, and work directly impact our health and wellbeing. Improving access to good building blocks of health, including adequate income, good housing and a healthy environment, make the biggest difference to our population’s health. This requires all parts of society to work together.

Initiatives like the new Collaboration for Health Equity in Scotland, which joins partners from across the system to address the root causes of health inequality and prevent illness before it starts, play an important role. By bridging the gap between national policies and local implementation, the collaboration aims to create conditions where communities can thrive and people are enabled to live longer, healthier lives.

Next steps

Continuing to build the future picture though monitoring and analysis of changes to population health is important. We are developing the Scottish Burden of Disease study to update our evidence regarding the impact health outcomes and risks have in preventing us from living longer lives in better health. We are also working to understand how the 20-year projections are likely to impact health and social care systems.

Read our recent disease prevalence papers

Find out more about the Scottish Burden of Disease study

Read our recent news story about the Collaboration for Health Equity in Scotland

*figures have been rounded. See individual papers for exact figures.