A new year, a renewed opportunity to improve Scotland's health

In our latest blog, Dr Rishma Maini, Consultant in Public Health and Co-lead of the Clinical Health Intelligence and Research Division at PHS, reflects on the year ahead as a chance to renew focus on the public health challenges affecting people across Scotland. Dr Maini also introduces our forthcoming ten-year strategy, designed to tackle these issues and drive meaningful change.

As we step into 2026, Scotland faces a pivotal moment.  

The new year offers a fresh opportunity to confront deep and persistent public health challenges that continue to affect people and communities across the country.  

Whilst progress has been made in some areas, such as the recently reported increases in life expectancy for both males and females, the wider conditions that shape our health continue to evolve. 

Understanding these pressures, and acting on them, is central to improving health and reducing inequalities in the decade ahead. 

Scotland’s health is shaped by a wide range of interconnected factors that act across the whole of a person’s life. While healthcare plays an important role, the conditions in which people are born, grow, live, work and age are far more influential in determining long-term health outcomes. 

One of the most significant factors is our changing population. Scotland’s population is ageing, reflecting longer life expectancy but also increasing exposure to chronic disease and multimorbidity. Whether people live these extra years in good health depends largely on earlier life experiences - including education, employment, housing and income - which accumulate over time and shape health and wellbeing in later life. 

Patterns of disease continue to present major challenges. Cardiovascular disease, cancer and neurological conditions account for a large and growing share of illness and premature deaths.  Sustaining improvements in life expectancy will depend on efforts to prevent ill health from occurring in the first place. This includes addressing shared risk factors such as smoking, physical inactivity, unhealthy diets and obesity, which continue to drive avoidable illness across Scotland. 

Economic and social conditions are equally fundamental. Poor health limits people’s ability to work, while poverty, insecure employment and financial stress increase the risk of ill health. These factors don’t affect all communities equally with some communities facing far higher levels of disadvantage than others.  

Environmental factors shape health in profound ways too. Air quality, access to green and blue spaces, transport, housing quality and the impacts of climate change all influence physical and mental wellbeing. These environmental harms tend to be felt most heavily on those already experiencing disadvantage, deepening inequality and widening the gap in health between communities. 

For Public Health Scotland, these factors underline a central message: improving Scotland’s health depends on sustained action beyond healthcare alone. A prevention-focused, whole-system approach - addressing social, economic and environmental determinants alongside high-quality care - is essential to improving health, reducing inequalities and supporting a healthier future for Scotland. 

Together We Can 

This year will be critical in shaping that future. This week, on 27 January 2026, we will publish our new ten‑year strategy: Together We Can. This important document will set out how we will work with partners across Scotland to address the challenges described above, strengthen prevention, and support communities to thrive. It will outline the collective actions needed, from national policy to local delivery, to create the conditions in which everyone in Scotland has the opportunity to live a long, healthy and fulfilling life. 

As we begin 2026, the challenges are clear - but so is the opportunity. By recognising the forces that shape our health, and by acting together across sectors and communities, we can build a healthier, fairer Scotland.