Health · Politics · Society

Leaving Glaswegians To Die Young

A recent report by the Glasgow Centre for Population Health, in collaboration with NHS Health Scotland, University of the West of Scotland (UWS) and University College London (UCL), attempts to explain what has been commonly referred to as the ‘Glasgow Effect’. People in Glasgow are dying younger than anyone else in the rUK, will our elected officials try and help us?

Over the last few days, much has been made of the recent Glasgow Centre for Population Health (GCPH) report History, Politics and Vulnerability: Explaining Excess Mortality in Scotland and GlasgowSadly, most of the emphasis has been placed on the claim that Westminster was to blame for the ‘Glasgow Effect’ through attempted social engineering, mainly because of The Herald‘s poor choice of headline.

This unfortunate headline weakens and undervalues the importance of this report to those reading it. Glaswegians have become infamous in recent years for our notoriously poor health outcomes and life expectancy. There’s the old joke that in Glasgow you’ll die before you get your pension, and sadly, this is somewhat true for a large number of us who live here. This report attempts to help us understand what may be the contributing factors causing this ‘excess mortality’ that we face. The key features of this excess mortality are;

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The ‘excess’ mortality is the higher levels of mortality that cannot be explained after accounting for poverty and deprivation. Over and above this, something is contributing to our demise and we can’t quite figure out what, and more worrying, it is continuing to increase over time. It is also prevalent in Scotland when Scottish mortality rates are compared to England and Wales. The scale of this excess is that it accounts for an incredible 5,000 extra, unexplained deaths per year in Scotland.

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The report emphasises that Scotland has the widest mortality inequalities in Western Europe and that worryingly, the persistent high rates of mortality are amongst those of younger working ages, causing us to have the lowest life expectancy, as shown in the graph above. Premature deaths in Scotland, i.e. those who die before they are 65 years old, are 20% higher than in England and Wales. Glasgow’s premature mortality rate is said to be 30% higher than Liverpool and Manchester (these two cities are used as comparators because they are very similar to Glasgow in terms of levels of poverty, deprivation and deindustrialization). This leaves our life expectancy trailing behind our UK counterparts.

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So how bad is life expectancy in Glasgow when compared to other UK cities? It is really bad. Here is male life expectancy in Glasgow.

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Here is female life expectancy in the West of Scotland compared to other parts of Europe that have also suffered from high levels of deindustrialisation.

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Both graphs show statistics that are utterly appalling and very worrying. Glaswegian men are severely lagging behind their UK counterparts, and our women aren’t fairing much better.  It is difficult to comprehend that in a country as wealthy as Scotland people are dying so young. So what is causing this?

The GCPH report suggests several key factors that can help us understand why Glasgow, and Scotland, are susceptible to these worrying trends in health inequalities. The key term appears to be ‘vulnerability’. Historically high levels of deprivation in Glasgow and Scotland created an ‘underlying vulnerability’ to adverse health outcomes.

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The above excerpt refers to issues such as overcrowding and educational attainment in Glasgow compared to key comparator cities Liverpool and Manchester. The report also provides graphs to show the differences in levels in both categories;

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As you can see, overcrowding in Glasgow was significantly higher than in Liverpool and Manchester. In terms of educational attainment, we don’t fair much better, not only in Glasgow, but in Scotland as a whole when compared to England;

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Education and overcrowding have an huge impact on poverty and inequality. These statistics reinforce the report’s claim that there was a ‘vulnerability’ in Glasgow, making us more susceptible to negative health outcomes as a consequence of poverty and inequality.

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Another key factor, which is quite telling, was the Scottish Office’s regional policy from the late 1950s, which aimed to relocate industry and people away from Glasgow to ‘New Towns’ such as East Kilbride. Back then, Glasgow had already been described as a ‘declining city’. The report also claims that local government responses to UK economic policy in the 1980s, through inner-city gentrification and commercial development, only exacerbated the damaging impact of Government policy on an already ‘vulnerable’ population in Glasgow.

The role of the Scottish Office in implementing this strategy is something I want to flag up here. As mentioned above, I said The Herald‘s choice of headline was very poor. It read “Revealed: ‘Glasgow Effect’ mortality rate blamed on Westminster social engineering”. In the context of modern Scotland that headline only seeks to grab the attention of some Nationalists who love nothing more than blaming Westminster for everything. By putting this kind of journalistic spin on the report, it framed the report in a manner which only undermines its importance and wider significance. As a result, one of the report’s authors, Prof Chik Collins of UWS, reached out to The Herald in order to clarify the emphasis of report.

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Professor Chik Collins explained in a series of tweets why the headline was misleading.

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This is very important. It shows how journalists can spin things to suit a certain ‘narrative’. They undoubtedly did this knowing their headline would grab the attention of a certain core of online groups that would escalate its distribution. By doing this, they framed the online discussions that followed, mainly that big bad Westminster was to blame for the Glasgow Effect, giving independence seekers a new ‘stick’ to beat ‘Unionists’ with.

What Professor Collins tweets is very revealing and at the core of this report. The policies being implemented in Scotland during this time were being orchestrated by the Scottish Office with a high degree of autonomy from Westminster. Sadly, that fact doesn’t whip groups of Scots into a frenzy that ensures your website gets lots of traffic, therefore, the real emphasis of the report is sidelined to feed those aforementioned groups a certain ‘narrative’.

Right, back to the report. One of the interesting points the report makes was that Glasgow’s comparator cities, Liverpool and Manchester, were ‘protected’ from the effects of the 1980s. Remember Militant Labour in Liverpool during the 1980s? Liverpool vs Thatcher? The strengthening of community ties shielded Liverpool during this period. Manchester was protected due to its higher levels of ethnic diversity.

The important thing to learn from this report is that poverty and deprivation, and increasing inequality – linked to past and future ‘vulnerabilities’ – are inter-linked. They are related and impact upon one another.

The great thing about this report is that it provides policy proposals to tackle these inequalities.

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Under these four key headings, the GCPH lists measures that have to be taken by governing chambers in Glasgow and Holyrood to tackle these health inequalities. My personal worry is that like The Black Report – that was published in 1980 – was discarded by the then Tory Government, the same thing will be done with this report by our Scottish Government, because the policy proposals are what can be termed ‘progressive’ and not in the current Scottish Government’s political interests.

Our recent elections saw the SNP elected to form a minority government based on manifesto pledges of keeping tax levels at UK-level. There appears to be no plan to further redistribute wealth and close the inequality gap in Scotland.  Also, as I wrote previously, the Scottish Government plan to reduce Glasgow City Council’s budget by £133m over the next 2 years. If this GCPH report has shown us anything it is that Glasgow is a city that is already highly vulnerable, and, as a result of its vulnerability, susceptible to adverse health outcomes. As shown below, health inequalities are the result of wider inequality in society. Inequality in Scotland is at grotesque levels. As long as our Scottish Government continues to pass on UK Government austerity things won’t improve for Glaswegians and we’ll keep dragging Scotland down with us.

To make it more simple, we are dying young in Glasgow, we are dying and everyone knows about it yet no one with any real power is willing to take the recommended, necessary steps to help us. They are sitting back, watching our demise, and not implementing the necessary policies to help us reverse these growing trends in health inequalities.

Health Inequalities

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