38 Chief Medical Officer for Scotland Annual Report 2020 -2021 CONCLUSION The levels of social, environmental and economic inequality in our society are damaging our health and wellbeing. As we emerge from the COVID-19 pandemic there is an urgent need to do things differently, and build a fairer, healthier society based on the principles of social justice. Whilst the wider social determinants of health, such as sustainable employment, access to education, nutritious food, and good quality housing have the greatest impact on health inequalities, there is often a view that our ability as health and care professionals to influence these determinants is limited. I am concerned that unless we act now the consequences of our inaction will be felt for decades to come. It is important that we fully understand the root causes of these inequalities, if we wish to understand the lives of, and provide better care for, the people who need our help the most. This will require a whole-system approach. 71 As healthcare professionals we need to understand the challenges the people we care for are facing, and continue to seek out new ways of delivering personalised care. We also need to consider how our workforce can be made more diverse, using our anchor institutions to influence and deliver change in our communities. We must recognise the power of our health and care system as an employer, asset owner, and purchaser to transform the way we support our local communities. We cannot do it alone. We need to broaden our reach and connect with those who can positively influence the wider determinants of health. Together we can focus on improving the wellbeing and quality of life of the people we care for. Public Health Scotland (PHS) , Scotland’s new national organisation for public health, is ideally placed to help us. It has produced a range of materials, measures and tools that aim to help us reduce inequalities, at national and local levels. In previous CMO Annual Reports, we have highlighted tools such as the Scottish Burden of Disease study and the Scottish Atlas of Healthcare Variation , which can help us eliminate unwarranted variation in health. On International Human Rights Day, PHS also published training materials on reducing health inequalities , which will provide useful knowledge and skills to professionals in health and care. In September, PHS published its first strategic plan and I fully support its ambition to create ‘a Scotland where everybody thrives’ . Considerations ■ What will we do to tackle health inequalities in our everyday practice? ■ What will we do to ensure more equitable access to the services we provide? ■ How can we help the people we care for, by promoting agency and supporting access to the services they need which often sit beyond healthcare?