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Health Inequalities
Levers
The “social determinants” of health (such as poverty) are translated into health inequalities in a number of ways including, for example, by creating barriers in access to services. We’ve called these factors “levers” for change.

Learning and adopting healthy behaviours
Adolescence is a critical life stage for learning and adopting healthy behaviours and avoiding behaviours that can have positive or negative health consequences. This includes participating in physical activity, eating a balanced diet, maintaining positive sleep habits and adhering to prescribed medical treatments – these are known as health promotion behaviours. For example, 14 year olds in Scotland who live in the most deprived areas are less likely to get 8 hours sleep per night compared to young people in the least deprived areas (Scottish Government, 2022).
It also includes avoiding behaviours that are likely to harm your health such as smoking, alcohol, substance misuse and unprotected sex – these are known as health risk behaviours. The likelihood of young people engaging in such behaviours is influenced by the wider context of their life. Although often presented as an individual choice, adopting healthy behaviours can be a reaction to circumstances and the wider determinants. For example, Chart L7 shows that 11-15 year olds are more likely to smoke if there are one or more members of their household who smoke. This matches with data from the Department of Health and Social Care (2021) which show that children whose parents smoke are four times as likely to take up smoking themselves.
They are also more to drink regularly if one or more members of their household are drinkers, as shown in Chart L8.
Living in a less affluent family is associated with lower levels of regular exercise for young people. This may be for a number of reasons including access to outside space. Chart L9 demonstrates this relationship.
This pattern is replicated for older young people, aged 16-24, in relation to what the Office for National Statistics calls ‘social status’. This is a socio-economic rating, indicating the kind of work undertaken by the head of the household, ranging from managerial and professional jobs through to ‘routine’ occupations such as clerical and agricultural jobs.
We also note that young mothers are more likely to smoke than mothers of other ages. This matters both for them, as young people, but also for their babies. In Scotland in 2021, 32.4% of pregnant mothers under the age of 20 and 24.5% of pregnant mothers aged 20-24 reported to be smokers, compared to just 7.8% of pregnant mothers aged 35-39. This means that pregnant young women under the age of 20 are 4 times more likely to smoke during their pregnancy compared to pregnant mothers aged 35-39 (Public Health Scotland, 2021).
All data correct as of 1st May 2022