Young men in Scotland are being failed by public policy and support systems, with too many dying prematurely from drugs, alcohol and suicide, according to a new report.
The 2025 Inequality Landscape report, produced by the Scottish Health Equity Research Unit (SHERU) – a collaboration between the University of Strathclyde’s Centre for Health Policy and the Fraser of Allander Institute, supported by the Health Foundation – warns that help is arriving too late for men at risk, particularly those aged 18-44.
Preventable deaths
Published as part of a two-part analysis of Scotland’s inequality landscape, the report highlights that while men on average fare relatively well in areas such as income and employment, this masks a subgroup of young adult men facing multiple socio-economic disadvantages who are at high risk of preventable deaths.
These include deaths from drug misuse, alcohol-related harm and suicide, which together accounted for around 70% of male deaths in these categories in 2023. This burden is particularly pronounced in Scotland’s most deprived areas, contributing to a life expectancy gap of more than 13 years between men from the most and least deprived areas.
The report identifies this group as a policy “blind spot” with many affected individuals experiencing overlapping challenges such as insecure work, low qualifications, poor mental health, homelessness, and contact with the justice system – yet they rarely receive support until a crisis point is reached.
Overlapping challenges
Emma Congreve, Deputy Director of the Fraser of Allander Institute and co-lead of SHERU, said: “Our analysis has shown that at-risk men often face multiple, overlapping challenges – from homelessness and imprisonment to poor-quality work, health crises, and social isolation.
“Strategies on drugs, alcohol and suicide talk about cross-government action, but men are still not given enough priority in wider policies on poverty, employment or housing.”
David Finch, Assistant Director at the Health Foundation, which funded the research, said: “Too many young men in Scotland are caught in cycles of insecure work, poor health, and social isolation.
Without stronger national action, the risks of poverty, marginalisation and premature death will only grow.
“Scotland has the opportunity to learn from international best practice, strengthen prevention, and build a more resilient future.”
Set against modest gains in child poverty reduction and income improvements, the report underscores the persistence of structural inequalities in housing, education and employment – drivers that continue to shape poor health outcomes.
Sustainable funding
Drawing on successful approaches from Ireland and Iceland, the report calls for person-centred use of data to better understand at-risk young adults, and for long-term, coordinated programmes that intervene well before crisis point.
Kat Smith, SHERU Co-Lead and Professor of Public Health Policy at Strathclyde, said: “These examples show that it is possible to reduce deaths from drugs, alcohol and suicide, where insights in local communities are combined with sustainable funding, high quality data and strong accountability measures at the national level.”
The report concludes that Scotland has the ambition and expertise to reduce preventable deaths – but doing so will require stronger leadership, better data, and more joined-up government decisions.