First paragraph: Compared with other Western European countries, Scotland has the highest mortality rate and lowest life expectancy. Scotland is also characterised by marked inequalities, with men from the poorest communities dying 13 years earlier and experiencing seven more years in poor health than men from the most affluent communities. Similarly, women from Scotland's poorest communities die nine years earlier and experience nine more years in poor health than women from the most affluent communities. There has been little change in these markers of health inequalities over the past decade, in spite of a plethora of public health policies and programmes - which to date have largely focused on changing individual lifestyles rather than the broader social determinants of health. Indeed, there is substantial evidence that health inequalities in youth and younger adults have increased, initially in males and, more recently, in females, due to an increasing burden of ill health and death related to various forms of ‘self-harm' such as alcohol and drug abuse, violence and suicide.