What football can teach us about health

Scotland qualifying for the 2026 World Cup highlights the impact of long-term teamwork, planning and shared ambition.

In this blog, Dr Rishma Maini, Consultant in Public Health at Public Health Scotland (PHS), uses football to illustrate how improving health requires coordinated effort across the whole system, with everyone playing a role in helping people live healthier, more fulfilling lives.

A long-awaited return to the World Cup stage has brought a sense of excitement, pride and optimism that many of us are eagerly looking forward to.

Recently, I had the privilege of standing on the pitch at Hampden. Looking out across the stadium, it was impossible not to think about what it takes to get a team to the world stage. Nobody wakes up one morning and qualifies for a World Cup. It takes years of planning, investment, teamwork, resilience and belief. There are setbacks, near misses and moments when fans wonder whether it will ever happen. But when everyone pulls together behind a common goal, remarkable things can be achieved.

Seeing health as a team effort

At first glance, football and public health might not seem to have much in common. But with both, we need to be strategic about where we play the game. It’s easier if the ball is up the pitch, instead of always threatening our goalkeeper.

Imagine a football game, with the ball representing our health. At one end of the pitch stands the goalkeeper. In health terms, this is our urgent and emergency care system - the hospitals, ambulance services and clinical teams. Their work is vital, often lifesaving, and we will always need them.

But no successful team relies solely on its goalkeeper. In defence are the services that stop problems becoming crises - GPs, pharmacists, screening programmes, vaccinations and early support services. They intervene before conditions worsen and help people get the care they need sooner.

In midfield are the factors that shape our health every day - our homes, education, income, employment, transport, communities and environment. This is where much of the game is won or lost. Public health evidence consistently shows that our health is shaped long before we reach a hospital or even a GP practice. The conditions in which we are born, grow, live, work and age all influence our health.

And up front are the strikers - the actions that help people and communities truly thrive. Supporting mental wellbeing, reducing loneliness, making healthy food more accessible, helping people stay active, creating opportunities for children and young people, and strengthening communities. This is not simply about preventing illness. It’s about creating conditions that allow people to live longer, healthier and more fulfilling lives.

Moving the game up the pitch

Too often, health systems are judged by how well they respond when things go wrong. Yet the greatest gains come when we help people stay well in the first place.

This isn't the responsibility of any one profession or organisation. Just as no football team succeeds because of one star player. Better health depends on everyone playing their part. From frontline clinicians, GPs and pharmacists delivering care, local authorities shaping communities, teachers supporting children, employers creating healthy workplaces, community groups tackling isolation, and policymakers making decisions that improve people's lives. Everyone has a position on the pitch.

The challenge for all of us is to spend less time waiting for attacks to reach the goal line and more time shaping the game further up the pitch. Because while we’ll always need great goalkeepers, the ultimate aim is not to celebrate heroic saves. It’s about playing strategically with the whole team to help more people stay healthy and live well.

That is what prevention looks like. And that is a game worth playing.

Focusing on prevention

Building a prevention-focused system is one of the pillars of Together we can - our 10-year strategy to improve life expectancy and narrow health inequalities in Scotland. Find out more about how to get involved in achieving this ambition.

Watch Rishma's video at Hampden Park, featuring presenter Connie McLaughlin