A landmark survey shows that nine in ten people across Scotland want the government to close the gap between the richest and poorest communities. Health inequality in Scotland is seen as urgent, and the public strongly favours poverty reduction over punishment when tackling deaths from drugs and alcohol. The findings come from the Scottish Social Attitudes Survey (SSAS) 2025, published by the Scottish Health Equity Research Unit (SHERU) in March 2026.

“It Matters”: Near-Universal Support for Reducing Health Inequalities in Scotland

The survey asked whether the Scottish Government should work to reduce the health gap between better-off and worse-off people. A full 94% said it was either “quite important” or “very important.” That figure barely shifted across demographic groups. People from minority ethnic backgrounds and those in the most deprived areas were slightly more likely to say it mattered, at 96%.

The breadth of agreement is hard to ignore. SHERU researchers describe it as evidence of “a strong public mandate” for action. That mandate crosses age groups, geographies and household types. With Scottish Parliamentary elections due in May 2026, the timing makes these results particularly relevant for policymakers.

What People Think Is Making Scots Ill

When asked for the main reason poorer people tend to have worse health, just under half (47%) pointed to lifestyle factors. Diet, smoking and alcohol use came up most often. Yet the full picture is more layered.

People in the most deprived 20% of areas most often cited smoking, drinking and stress. Those in the least deprived areas were around ten percentage points more likely to highlight poor diet instead. This gap likely reflects real differences in local environments. Tobacco, alcohol and fast food outlets cluster in Scotland’s more disadvantaged urban areas. Access shapes behaviour, and behaviour shapes health.

People from minority ethnic backgrounds focused less on diet. They were more likely to point to poor housing and difficulties accessing healthcare as the root causes driving health inequalities Scotland continues to face.

Researchers warn against treating any mention of lifestyle as evidence that people hold purely individual explanations. Qualitative studies in Scotland show that when people explain their thinking at greater length, smoking and drinking tend to be framed as responses to poverty and stress, not personal weakness.

Prevention vs Crisis: The Public Wants Progress on Health Inequality in Scotland

The survey explored whether people back a shift towards prevention in public spending. The Scottish Government has promoted this goal since the 2011 Christie Commission. In practice, progress has been slow.

On healthcare, 63% of respondents favoured an equal split between preventing illness and treating those already unwell. A further 26% wanted the balance to tip towards prevention. Just 11% prioritised treatment alone. Housing responses followed a similar pattern. There, 62% backed equal spending on prevention and crisis support, while 23% called for greater investment in preventing homelessness.

People in the most deprived areas were the exception. They leaned more towards keeping crisis services well-funded. Researchers link this to the sharper, more immediate pressures those communities face day to day.

Poverty, Not Punishment: Public Views on Drugs and Alcohol Deaths

Scotland holds the highest rate of drug-related deaths in Western Europe. The country also ranks among the worst for alcohol-related mortality. Men account for around 70% of deaths from drugs, alcohol and suicide combined.

The survey asked how best to reduce these deaths. The public saw health inequalities in Scotland as central to the problem. Reducing poverty was the most popular answer, chosen by 24%. Increased spending on mental health services came second at 21%.

Punitive approaches had almost no support. Just 1% of respondents chose tougher laws, sentencing or enforcement as the best option. Virtually no one picked restricting benefits.

Men were more likely than women to back poverty reduction as the primary lever. Women gave slightly more weight to mental health investment. People from minority ethnic backgrounds stood apart from the Scottish average. They gave greater priority to education and public awareness campaigns, as well as to making drugs and alcohol harder to access.

Suicide: Mental Health Spending Leads the Response

For deaths from suicide, views were more concentrated. Over half of all respondents (53%) said increased investment in mental health services would be the most effective step. Reducing poverty came second at 16%. Education and awareness campaigns came third at 15%.

That strong preference for mental health services likely reflects growing public concern about long waiting times for treatment across Scotland. Among 16 to 44-year-olds, the gender gap was notable. Just 46% of men in that age group chose mental health services, compared with 62% of women.

People from minority ethnic backgrounds again stood out. A striking 41% chose education and awareness campaigns, compared with 15% across the general population. Researchers suggest this reflects experiences of stigma and documented barriers to seeking support in some communities.

Housing and Work: No Single Fix for Health Inequalities Scotland Faces

The survey also covered the national housing emergency and the challenge of getting long-term economically inactive people back into employment.

On the causes of Scotland’s housing shortage, 37% pointed to affordability. They cited either housebuilders setting unaffordable prices or rents running too high. A further 21% blamed insufficient social housing. Only 18% felt that migration was the main driver. Just 1% chose the option about housing going to migrants or benefit claimants.

On poor-quality housing, respondents were split across several solutions. Enforcing existing quality standards came in at 29%, as did investing in social housing. Introducing stronger landlord regulation attracted 19% support. The spread was similar for employment. Respondents were roughly divided between supporting people with disabilities back into work, encouraging employers to hire them, and making childcare more affordable.

That spread of opinion points to public support for a broad, multi-strand approach rather than one headline solution.

Fair Treatment: A Mixed Picture

Most people in Scotland said they had been treated fairly by public services and employers over the past year. Around 85% described their experience of public services as fair or neutral. The same proportion said so about their treatment at work.

Unfair treatment was not evenly spread, though. People in the most deprived 20% of areas most often reported being treated unfairly by public services. This aligns with qualitative research where marginalised communities describe feeling deprioritised and stigmatised. People from minority ethnic backgrounds reported lower than average rates of unfair treatment, both in public services and at work. Researchers describe this as unexpected, given separate survey evidence of widespread racial discrimination in Scotland.

Three possible explanations are offered. Chronic unfair treatment can become normalised over time. Some communities may be reluctant to report discrimination. The survey data may also carry a selection bias, since 19% of working-age people from minority ethnic backgrounds said they had not worked in a long time and were excluded from the employment question, compared with just 5% of the wider population.

A Signal to Policymakers

Health inequality in Scotland remains a pressing concern, and the public knows it. The survey shows clear demand for action that combines poverty reduction, better housing, stronger employment support and a genuine shift towards prevention. People also want crisis services to remain funded and accessible, particularly those living through the sharpest end of inequality.

SHERU researchers argue that parties and policymakers most likely to resonate with the public will be those who treat these priorities as urgent and interconnected rather than competing. Scotland faces real fiscal pressure. But 94% of a country rarely agrees on anything, and this survey shows they agree on this.

Source: dbrecoveryresources