Glasgow effect
The Glasgow effect is a term used by epidemiologists to refer to the poor health and low life expectancy of Glaswegians compared to the rest of the UK and Europe.[1] Poverty alone does not appear to account for it. Equally deprived areas of the UK such as Liverpool and Manchester 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]
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]
Epidemiologists are unable to explain the overall morality gap, which according to Walsh et al 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, and a culture of alienation.[3] Dr. Harry Burns, chief medical officer for Scotland, 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.[5]
See also
Notes
- ^ Reid, Michael. "Behind the 'Glasgow effect', Bulletin of the World Health Organization, Volume 89, Number 10, October 2011, 701-776.
- ^ a b c Walsh, D et al. "It's not 'just deprivation': why do equally deprived UK cities experience different health outcomes?", Public Health, 2010 Sep;124(9):487-95:
- "[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."
- "[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'. ...
- ^ a b Muriel, Ali. "Mystery of Glasgow's health problems", The Guardian, 6 November 2012.
- "Glasgow has lowest life expectancy in UK", BBC News, 19 October 2011.
- Also see Reid, James. "Excess mortality in the Glasgow conurbation: exploring the existence of a Glasgow effect", PhD thesis, University of Glasgow Faculty of Medicine, September 2008.
- ^ "GP explains life expectancy gap", BBC News, 28 August 2008.
- "Male life expectancy at birth", BBC News, 28 August 2008.
- ^ Burns, Harry. How health is created: an hypothesis", Building a healthier future, Glasgow Centre for Population Health, 27 October 2004.
Further reading
- Currie, Alex; Leslie, Chris; and Shivers, Richard. "Glasgow effect", a documentary photography project.
- Donnelly, P.D. "Explaining the Glasgow effect: could adverse childhood experiences play a role?", Public Health, 2010 Sep;124(9):498-9.
- Gavin, A.J. et al. "The Glasgow effect: useful construct or epidemiological dead end?", Public Health, 2011 Aug;125(8):561-2.
- Gray, L. and Leyland, A.H. "Is the 'Glasgow effect' of cigarette smoking explained by socio-economic status?: a multilevel analysis", BMC Public Health, 2009 Jul 17;9:245.
- Levin, K.A. "Glasgow smiles better: an examination of adolescent mental well-being and the 'Glasgow effect'", Public Health, 2012 Feb;126(2):96-103.
- McCartney, G. et al. "Why do males in Scotland die younger than those in England? Evidence from three prospective cohort studies", PLoS One, 2012;7(7):e38860.
