Scotland's Population Health Framework - opportunities and implications for diet and healthy weight

Earlier this fortnight, the Scottish Government, in partnership with COSLA, published their Population Health Framework. The 10-year Framework sets out their long-term collective approach to improving Scotland’s health and reducing health inequalities through the next decade.

The Framework has the dual aim to improve Scottish life expectancy whilst reducing the life expectancy gap between the 20% most deprived local areas and the national average by 2035. Significantly, the Framework has a focus on prevention and whole systems approach to improving health, indicating a shift away from treating illness and poor health.

The Framework outlines that it will create a prevention focused system to address inequalities. This is a welcome commitment, but more detail is needed on what this means and will look like in practice, particularly for addressing diet and healthy weight inequalities which we know are significant and continuing to grow.

Figure 1: Population Health Framework interconnected priorities for investment 

Source: Scottish Government (2025) Population Health Framework, page 4 

Encouragingly, improving healthy weight has been identified as one of two initial evidence-based priorities within the Framework, the other being embedding prevention in systems. Priorities outlined seek to develop a whole system approach to improve food environments; ensure that a healthy, balanced diet is accessible and affordable to all; and improve population levels of healthy weight.

For improving healthy weight, food environment and nutrition is identified as a focus area. There is a commitment to publish a two-year implementation plan of preventative actions to improve the food environment and support improvements to diet and healthy weight. Actions committed within this include: developing legislation to improve the retail food environment; action by business to reformulate foods to reduce levels of fat, salt and sugar; increasing the availability and affordability of healthy foods; adopting evidence-based interventions for tackling overweight and obesity; supporting innovation to improve the health of those affected by obesity-related conditions, including type 2 diabetes; and supporting wider government priorities such as Good Food Nation, Scottish Dietary Goals, food security, malnutrition, and the just transition to net zero to support reducing inequalities.

Figure 2: Actions and Broader Priorities Committed under the two-year implementation plan of preventative action to improve the food environment and support improvements to diet and healthy weight  

Source: Graphic created by Obesity Action Scotland, using information from the Population Health Framework

However, it remains unclear how this implementation plan links to the ambitions and commitments made within the Scottish Government’s 2018 Diet and Healthy Weight Delivery Plan, including the ambition to halve childhood obesity by 2030 and policy proposals such as on regulations on outdoor junk food adverts. Clarity is needed on these.

Further actions detailed within the Framework include action by major retailers to improve the healthiness of the products sold; action across local government and the education sector to support the provision of healthy food in early years and school settings; and action to support whole system approaches at all levels to improving healthy weight. The Framework details that these actions will be coordinated at both national and local level.

It is welcome to see a priority focus on improving healthy weight within the Framework and that the link between diet and healthy weight outcomes and prevention, inequalities and wider population health outcomes has been recognised in this way. The Framework recognises the need for and the importance of taking a whole systems approach to preventing obesity but does not set out details on how these will be achieved.  In our work on whole systems approach to diet and healthy weight, we highlight a number of evidence-based local levers to be engaged in delivering a whole systems approach. These include restricting food advertising, utilising the planning system to improve food environments, and working with the out of home (OOH) sector to reduce calories on menus. It is critical that such actions are embedded and taken forward as part of the whole system approach focus in the Framework.

Creating the right environment and conditions to drive the required change is fundamental. The Enabling Healthy Living section in the Framework talks about the need to reduce the harms associated with health harming products. It is alarming that food and drinks high in fat, salt and sugar (HFSS) are not considered as health-harming alongside tobacco, vapes, alcohol and gambling, which are detailed as health harming within the Framework. This is hugely concerning for several reasons: one, it does not align with the focus and priority the Framework claims to afford to improving diet; second, it overlooks the strong evidence that HFSS products can independently cause a range of serious health conditions and diseases, including cancer, type 2 diabetes, and coronary heart disease. There are also strong links with obesity, the second biggest risk of cancer, behind smoking, and there are strong links to deprivation and inequality.

Additionally, the Enabling Healthy Living section needs to elaborate the important policy interventions that are needed to urgently reduce this harm from HFSS products, such as advertising and marketing restrictions, actions in the OOH sector including calorie and nutrition labelling, and restricting promotions of HFSS products in retail stores, online and in the OOH sector.

The Population Health Framework presents opportunities for progressing actions to tackle Scotland’s poor diet and weight outcomes and transform the food environment. However, the Framework needs to be swiftly followed by plans that lay out in sufficient detail how its priorities will be achieved, and the policy actions and resources needed to fully grasp and progress them. Fundamental to this is recognition of HFSS products as health harming products which is currently missing from the Framework. We look forward to working with the Scottish Government and COSLA on delivering legislation within the Framework to support action to improve Scotland’s food environment, improved population diet and weight outcomes, and reduce inequalities.