A Review of The Glasgow Effect
I recently took a look at a study by the Glasgow Centre for Population Health as part of the Health input in the Society and Lifestyles module. The Glasgow Effect is a research study that analyses the mortality rates of Glasgow compared to Liverpool and Manchester, two cities that the researchers found to be strikingly similar to Glasgow in terms of socio-economics, population, industry etc. Despite the similar profiles, Glasgow has a significantly higher mortality rate than the other two cities: incidence of premature deaths are more than 30% higher in Glasgow, and 15% higher for overall deaths. The historical data that is available on these three cities shows very little difference between each of the three within the early 20th century, but a widening gap prominent from the 1970s onwards, suggesting that the so-called Glasgow Effect is a relatively modern phenomenon. The study explores the relationship between the three cities, and seeks to find out why this phenomenon occurs.
The excess mortality rates seen in Glasgow when compared to the two similar cities, are seen across the whole population. All ages, with the exception of the very young, show this consistency in excess mortality rates. Surprisingly, the death rate for Glasgow’s most affluent suburbs is 15% higher than that of the equivalent areas in both Liverpool and Manchester. Around half of all excess deaths are drug or alcohol related. This suggests that there is an element of the Glaswegian population that are in the “extreme” behavioural risk category, and that substance abuse may contribute significantly to the excess mortality rate of Glasgow.
The second part of this task was to consider the question “To what extent are Scottish people healthy?”. In answering this question, I took into account both my own experiences of living in Scotland, particularly compared to my experience of growing up and living in Ireland, and also results from the most recent Scottish Health Survey 2016 (SHeS).
My own experience of being a child and then an adult in Ireland, compared to my and my children’s experiences of living and growing up in Scotland, led me to conclude that Scottish people are not what I would consider healthy. However, I cannot say for certain that this is down to Scottish culture, as it is just as likely to be a generational issue, for example the decrease in the amount of time children spend playing outside nowadays compared to my generation could just as easily be down to the heightened awareness of possible dangers and the fact that the current generation of parents seem to be more risk adverse in the main than their predecessors. Certainly though, the accepted “normal” diet for children in Scotland is unlike anything I have experienced in my own childhood, and certainly less healthy than that of the children in my family who live in Ireland. There is also a much darker drinking culture in Scotland, which is surprising as alcohol-fuelled merriment is the stereotypical characteristic often attributed to the Irish. I have noticed a prevailing tendency to drink for the sake of drinking here, where across the water drinking is most definitely part of a wider experience, and rarely is drinking an activity found as more than an element of a social purpose.
In terms of official statistics, the SHeS results seem to indicate that whilst Scotland could not be mistaken for having high levels of health, the population is showing some signs of becoming healthier, when comparing the results to previous data collected. In considering risky behaviours, almost two thirds of men and 49% of females were in the lowest risk categories. Alcohol consumption has decreased for both men and women, and a reduction in the number of smokers was noted. The number of people diagnosed with COPD however, has not shown any significant change, nor has the prevalence of cardiovascular diseases, and high blood pressure (hypertension).
Data on levels of obesity and weight, based on BMI calculations, were also included in the results. However, recent research tells us that contrary to popular belief, people who fall into the overweight or obese categories actually have a higher survival rate in terms of coronary disease, hypertension, and other ailments commonly associated with higher weight (Amundson, Djurkovic and Matwiyoff, 2010), so it is difficult to comment accurately on the significance of this data.
The levels of adults and children meeting the recommended daily guidelines for fruit and vegetables seems to reinforce my stance that the typical Scottish diet is not what I would consider healthy. Only just over one fifth of adults consumed the recommended 5 portions, and even less children at 12%. Put together this, with the findings that less three quarters of Scottish children met the advised 60 minutes of physical activity per day (a decrease from 2013), and only once school activities were included in this, and it makes for a worrying conclusion on the health of the current childhood population. Considering the statistics show a significant drop in the levels of both genders by the age of 13, girls even more than boys, it does not bode well for the future adults of this country.
A notable statistic is the substantial decline in the number of children who experience second hand smoke. This could be down to recent campaigns to highlight the dangers of second hand smoke, a clear example of how society can influence health.
References:
Amundson, D.E., Djurkovic, S. and Matwiyoff, G.N., 2010. The obesity paradox. Critical care clinics, 26(4), pp.583-596.
Scottish Government (2016) The Scottish Health Survey [Online]. The Scottish health survey: 2015 edition: Summary. Available: http://www.gov.scot/Resource/0050/00505745.pdf [Accessed 16 Feb 2017].
Walsh, D., Bendel, N., Jones, R. and Hanlon, P., 2010. Investigating a ‘Glasgow Effect’: why do equally deprived UK cities experience different health outcomes. Glasgow: Glasgow Centre for Population Health.
