Many people in Scotland live with one or more long-term health conditions. These are health problems, also known as chronic conditions, that require ongoing management over a period of years or decades. They can include physical and mental illness.
To date, the approach in Scotland has been towards focusing on individual conditions and illnesses. Long-term health conditions include diabetes, cardiovascular (such as hypertension, angina), chronic respiratory (such as asthma, chronic obstructive pulmonary disease), chronic neurological (including multiple sclerosis), chronic pain (including arthritis), long term effects of COVID-19, and many other long-term conditions such as chronic fatigue syndrome, irritable bowel syndrome and cancer.
However, it is worth noting many people live with more than one condition (comorbidity) and long-term conditions are the leading cause of illness, disability and death in Scotland.
Prevalence
The number of people reporting a long-term health condition has risen over recent years. In 2024, half of all adults, responding to the most recent Scottish Health Survey, reported having a long-term condition and almost two in five adults reported having a long-term condition that limited their activities. Limitations most frequently related to mobility, stamina, breathing, fatigue and/or mental health.
The prevalence of long-term conditions often increases with age, and higher rates tend to be seen in women and people living in areas with the highest deprivation. In 2023, adults living in Scotland’s most deprived areas were twice as likely to report a limiting long-term illness as those living in the least deprived areas.
Future trends
Despite a projected population decline over the next two decades, Public Health Scotland has forecasted that the annual disease burden will increase by 21%. The leading causes of disease in 2043 are predicted to continue to be cancers and cardiovascular diseases.
Rank | 2043 |
|---|---|
1 | Cancers |
2 | Cardiovascular diseases |
3 | Neurological disorders |
4 | Mental health disorders |
5 | Musculoskeletal disorders |
6 | Chronic respiratory diseases |
Disease estimates up to 2044 for a number of conditions including lung cancer, colorectal cancer, female breast cancer and Alzheimer’s disease and other dementias have been published by the Scottish Burden of Disease study.
Scottish Government approach
The Scottish Government has said that its:
“current policy approach is condition-specific, with published strategies, frameworks, plans and accompanying funding that do not join up actions or prioritise according to burden of disease or impact. Whilst much has been achieved, in terms of clinical guidelines, patient and clinician information and education and service delivery, resources are not allocated as impactfully as they could be”
The Session 6 Scottish Government consulted on an integrated Long Term Conditions Framework. The consultation analysis was published in October 2025, with plans to publish the new framework and action plans before the end of 2025. However, at the time of writing (July 2026) the framework had not been published.
In response to a recent Parliamentary Question, the Minister for Mental Wellbeing, Public Health, Sport, Alcohol and Drugs said:
“The Scottish Government is committed to improving the experience of those living with long term conditions in Scotland. That is why we have committed to continue working with people with lived experience, the third sector and clinicians to develop our way forward for long term conditions.
This will build on the work undertaken by the Long Term Conditions Advisory Groups established under the previous government. We are now carefully considering the recommendations shared by various Advisory Groups, made up of key stakeholders from NHS Scotland and the third sector, to inform the best way forward. Our Programme for Government for 2026-27 will be put to the Parliament in due course.”
Whilst we wait to see the detail of the Scottish Government’s plans to improve the lives of people with long term conditions, it is clear that without concerted action around prevention and early intervention, the burden of disease from long term conditions will continue to rise.
Lizzy Burgess, Senior Researcher Health and Social Care, SPICe
For more information on healthy life expectancy see the SPICe blog Scotland’s life and healthy life expectancy: Key facts and figures and the SPICe briefing Promoting Healthy Ageing in Scotland.
Photo credit: Age without limits