The existence of health inequalities in Scotland means that the potential for everyone to experience the highest possible levels of physical and mental health is unequal across the population. Health inequalities are unfair, avoidable and systematic differences in people’s health across social groups and between different populations (NHS Health Scotland, 2016; The King’s Fund, 2022) – What are health inequalities? | The King’s Fund (kingsfund.org.uk). They are about differences in individual health status but the term is also used to describe differences in the care people receive and the opportunities to make healthy choices.
Heath inequalities are driven by the complex interaction of numerous individual, political and social factors, which can lead to an unequal distribution of:
- Income e.g. salary, received over a period of time
- Power e.g. ability or capacity to do or control something, knowledge, beneficial connections, social resources
- Wealth e.g. material and capital assets which provide a financial reserve
- Transport e.g. the ability for a parent to bring their child to a dental appointment
- Access to care e.g. access to dental services
- The wider Determinants of Health themselves
This can in turn influence wider environmental factors such as the availability of good quality housing, employment and learning opportunities, as well as access to social and cultural support within an area or society more broadly. This influence impacts the sort of choices available to an individual and shapes their individual experiences and outcomes. These factors have the potential to reinforce one another. Unemployment can directly impact health itself and limit earning potential, which consequently affects income and poverty, which can dictate health behaviours and restrict choices that favour health.
In particular, a child’s early life circumstances and experiences shape their physical, social, mental, cognitive and emotional development and negative early experiences can have a lifelong impact on health, learning and behaviour. This includes a child’s oral health.