Income and employment: introduction
Income and employment are, along with education, key social determinants of population health and health inequalities. This has been recognised at many levels, for example by the Final Report of the WHO Commission on Social Determinants of Health, the Marmot Review in England and the Scottish Parliament report on Health Inequalities. Income and employment are considered to be so essential to official approaches to tackling inequality that income deprivation and employment deprivation are two of the main domains of the Scottish Index of Multiple Deprivation (SIMD), which provides these types of data broken down to a small area level (data zones) across the whole of Scotland.
Using the official, preferred definition of poverty, 14% of the Scottish population (730,000 people) were living in relative poverty before housing costs in 2013/14. The 2015 report on the Minimum Income Standard concluded that: "the pause in inflation has helped people on low incomes to become slightly better off relative to their needs...However, households on low incomes remain much further behind what they need than before the recession."
For working-age adults, being in employment can dramatically reduce the risk of premature mortality and morbidity. A 2011 systematic review summarised that, on average, mortality rates in the unemployed increased by 63% compared to those in continuing employment, with the association supporting a causal link from unemployment to higher mortality (Roelfs et al, 2011). This is a challenge since in 2015, 390,220 (11.3%) of the working-age population of Scotland were out of work and dependent on benefits. The chance to work is not distributed randomly across the population, but is lower among certain groups (the young, the unskilled and those with significant health problems or caring responsibilities), in certain places (deprived communities and older industrial regions) as well as during recessions and periods of weak growth.
However, jobs which increase the risks of physical or mental harm to workers, or which expose working-age people and their families to in-work poverty, are also damaging to health. Before housing costs, 210,000 Scottish working-age adults in employment were in in-work poverty in 2013/14. The European Work Conditions Survey (EWCS) has also estimated that one third of people in employment in the UK work in occupations with multiple disadvantages, characterised by a lack of control and managerial support, poor earnings and prospects (including access to training).
This section will present a range of illustrative data on levels, trends and patterns in income and employment within Scotland, while the Key data sources page provides links to related information on other websites. Given the breadth of this area, there are related pages in other parts of this site, including Deprivation. Note too that the Informing Investment to reduce health Inequalities (III) tool on this website provides evidence on the health impacts of a range of income interventions and changes in employment.