Glasgow effect

Glasgow City Chambers in George Square, central Glasgow

The Glasgow effect refers to the unexplained poor health and low life expectancy of residents of Glasgow, Scotland, compared to the rest of the United Kingdom and Europe. The hypothesis among epidemiologists is that poverty alone does not appear to account for the disparity.[1] Equally deprived former industrial cities of the UK such as Birmingham, Liverpool and Manchester that have faced similar effects of de-industrialisation have higher life expectancies, and the wealthiest ten percent of the Glasgow population have a lower life expectancy than the same group in other cities.[2]

Various hypotheses have been proposed to account for the effect, including vitamin D deficiency, cold winters, higher levels of poverty than the figures suggest, high levels of stress, and a culture of alienation and pessimism.[3]

Mortality rates

The Red Road Flats, between Balornock and Barmulloch, are due to be demolished by 2017

Research led by David Walsh of the Glasgow Centre for Population Health in 2010 concluded that the deprivation profiles of Glasgow, Liverpool and Manchester are almost identical, but premature deaths in Glasgow are over 30 per cent higher, and all deaths around 15 per cent higher, across almost the entire population.[2]

The city's mortality rates are the highest in the UK and among the highest in Europe. With a population of 1.2 million in greater Glasgow, life expectancy at birth is 71.6 years for men, nearly seven years below the national average of 78.2 years, and 78 years for women, over four years below the national average of 82.3.[3] According to the World Health Organization in 2008, the life expectancy for men in the Calton area of Glasgow was 54 years; a local doctor attributed this to alcohol and drug abuse, and a violent gang culture.[4]

Hypotheses

Derelict tenement housing in the city

Epidemiologists are unable to explain the overall mortality gap, which did not appear until 1950 at the earliest. "It is as if a malign vapour rises from the Clyde at night and settles in the lungs of sleeping Glaswegians," according to The Economist.[5] According to Walsh et al. it appears to have widened since the 1970s.[2] Hypotheses include vitamin D deficiency caused by a lack of sunlight, more poverty than the figures suggest, cold winters, high levels of stress, a culture of alienation,[3] and pessimism brought on by either or both the lingering effects of industrialisation and the city's more recent deindustrialisation. Yet in comparison to other similarly deindustrialised European cities, Glasgow's 15 percent higher mortality rate persists.[5]

The Chief Medical Officer for Scotland, Dr Harry Burns, has referred to research suggesting that chronically activated stress responses – especially in children – affect the structure of parts of the frontal lobes of the brain, and that these determine the physical reaction to stress, which could result in chronic ill health. The ability to attain good health, he suggests, depends in part on whether people feel in control of their lives, and whether they see their environments as threatening or supportive.[6] There has as yet been no study measuring comparative levels of cortisol, a hormone involved in regulating stress, in the populations of different cities.

British University of Pennsylvania psychology Professor Adrian Raine, in an article for The Economist noted the glorification of "ned" culture in the Scottish media, and suggested that Glasgow may have a higher concentration of psychopaths than other cities in Europe. This would consequently result in more instances of depression among its citizens.[7]

See also

Notes

  1. ↑ Reid, Michael. "Behind the 'Glasgow effect', Bulletin of the World Health Organization, Volume 89, Number 10, October 2011, 701–776.
  2. ↑ 2.0 2.1 2.2 Walsh, D; Bendel, N; Jones, R; Hanlon, P (2010). "It's not 'just deprivation': Why do equally deprived UK cities experience different health outcomes?". Public health 124 (9): 487–95. doi:10.1016/j.puhe.2010.02.006. PMID 20223487.:
    • "[R]ecent research has highlighted the existence of a 'Scottish effect', a term used to describe the higher levels of poor health experienced in Scotland over and above that explained by socio-economic circumstances. Evidence of this 'excess' being concentrated in West Central Scotland has led to discussion of a more specific 'Glasgow effect'. ...

      "The deprivation profiles of Glasgow, Liverpool and Manchester are almost identical. Despite this, premature deaths in Glasgow are more than 30% higher, with all deaths approximately 15% higher. This 'excess' mortality is seen across virtually the entire population: all ages (except the very young), both males and females, in deprived and non-deprived neighbourhoods. ... Analyses of historical data suggest that it is unlikely that the deprivation profile of Glasgow has changed significantly relative to Liverpool and Manchester in recent decades; however, the mortality gap appears to have widened since the early 1970s, indicating that the 'effect' may be a relatively recent phenomenon. ...

      While deprivation is a fundamental determinant of health and, therefore, an important driver of mortality, it is only one part of a complex picture. As currently measured, deprivation does not explain the higher levels of mortality experienced by Glasgow in relation to two very similar UK cities. Thus, additional explanations are required."

  3. ↑ 3.0 3.1 3.2 Muriel, Ali. "Mystery of Glasgow's health problems", The Guardian, 6 November 2012.
  4. ↑ "GP explains life expectancy gap", BBC News, 28 August 2008.
  5. ↑ 5.0 5.1 "Unhealthy Glaswegians: No city for old men". The Economist. 25 August 2012. Retrieved 14 November 2012.
  6. ↑ Burns, Harry. How health is created: an hypothesis", Building a healthier future, Glasgow Centre for Population Health, 27 October 2004.
  7. ↑ Raine, Adrian. "21st Century Television's Faltering Moral Compass". The Economist. 8 April 2009.

Further reading