Our evidence base

Our Fife

Our evidence base

What the evidence tells us about Fife

  • Outcomes are not evenly shared - life expectancy, healthy life expectancy, educational outcomes and income all vary significantly by place and deprivation.
  • Child poverty is driving persistent inequalities, affecting health, attainment and long‑term employability.
  • Demand and complexity is rising - particularly for health, care and support -while resources are under sustained pressure. More people are living with multiple needs that cut across service siloes
  • Place matters - infrastructure and environment shape inclusive growth and wellbeing. Some communities face multiple, reinforcing disadvantages, while others show strong assets and resilience.

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Fife through a Marmot lens – are we doing the right things?

A Marmot Place recognises that health and health inequalities are mostly shaped by the social determinants of health (SDH): the conditions in which people are born, grow, live, work and age, and takes action to improve health and reduce health inequalities.

‘Marmot Eight’ principles:

  • Give every child the best start in life.
  • Enable all children, young people and adults to maximise their capabilities and have control over their lives.
  • Create fair employment and good work for all.
  • Ensure a healthy standard of living for all.
  • Create and develop healthy and sustainable places and communities.
  • Strengthen the role and impact of ill health prevention.
  • Tackle racism, discrimination and their outcomes.
  • Pursue environmental sustainability and health equity together.

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Looking ahead – future trends we must plan for

Across Scotland—and acutely in Fife—the next decade will be shaped by:

  • An ageing population and changing dependency ratios
  • Climate adaptation and net zero transition, with unequal local impacts
  • Labour market change, automation and skills mismatch, staff retention issues
  • Long‑term fiscal constraint, limiting reactive responses
  • Rising demand for care, health and early intervention
  • Digital and AI - balancing efficiency with inclusion, ethics, cyber security and trust
  • Polarisation and declining trust, making it harder to lead change and sustain public confidence.

Planning for today’s pressures alone will not be enough.

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Download the full "Challenge Ahead" discussion paper

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