The "Glasgow Effect"

In the early 18th Century, Glasgow was described by the author Daniel Defoe as "the cleanest and beautifullest and best built city in Britain". But when the Industrial Revolution drew thousands of people from Ireland, the Lowlands and Highlands, the population exploded and for many it became a living hell.

Babies born in Glasgow are expected to live the shortest lives of any in Britain. One in four Glaswegian men won't reach their 65th birthday. Harry Burns, who until recently was the country's chief medical officer and now professor of public health at Strathclyde University., has his own theory. He compared Glaswegians to Australia's Aboriginal people. He believes deindustrialisation in a city where tens of thousands once worked in the factories and the shipyards has deeply wounded local pride. As a result, people here have much in common with demoralised indigenous communities.

"Being a welder in a shipyard was a cold and difficult and dangerous job," he says. "But it gave you cultural identity in the same way as native peoples in Australia once had a very intense history and tradition."

Burns points to a succession of graphs which show Scots do not smoke more than other Europeans nor do they suffer more heart disease. Scotland was the first part of Britain to ban smoking in public places.

“Where traditional communities lose their traditional cultural anchors," he says, "They all find the same things happening - increasing mortality from alcohol, drugs, violence. The answer is not conventional health promotion. Where you lose a sense of control over your life there's very little incentive to stop smoking or to stop drinking or whatever. The answer is to rediscover a sense of purpose and self-esteem."

Glasgow’s obesity rates are among the highest in the world. Research conducted in 2007 found that nearly one in five potential workers was on incapacity benefit and that Glasgow has a much larger number and a higher proportion of the population claiming sickness-related benefit than any other city in Britain.

The city has an alarmingly high mortality rate. A 2011 study compared it with Liverpool and Manchester, which have roughly equal levels of unemployment, deprivation and inequality. It found that residents of Glasgow are about 30% more likely to die young, and 60% of those excess deaths are triggered by just four things - drugs, alcohol, suicide and violence. Per head of population, the city has twice as many murders as London and that is after a 40% decrease since 2007. Even in the better off neighbourhoods, mortality rates are 15% higher than in similar districts of other big cities.

The Glasgow Effect is relatively new. "These causes of death have emerged really since the 1990s," says Harry Burns "And they emerged more dramatically in one particular sector of the population - men and women between the ages of 15 and 45. So it's a very specific pattern affecting people in their most productive years."

 Author Carol Craig says rapid industrialisation in Glasgow produced a toxic masculinity which destroyed family life. "I was so struck by the very nasty and aggressive relationship between men and women historically in Glasgow," Craig says. "And that was partly as a result of the terrible overcrowding - it was worse than England. Having a front room or parlour was practically unheard of." She explains that in 1891 the London County Council defined overcrowding in terms of two or more person in a room. In the metropolis one third fell below this standard but in Glasgow two thirds - or twice London's number - of residents lived in overcrowded accommodation. Enforced proximity, she argues, forced men out of their homes and into the pub. "It was a kind of survival mechanism," she says. "In the old Glasgow on a Friday when men got paid, you would see women queuing outside workplaces and pubs to retrieve any of the money. This was very much a city where men suited themselves."

According to the Glasgow and Clyde Health Board, in just two years almost half of all homes in the city will be single-adult households.

 "There is a failure of personal relationships in Glasgow that no one is facing up to," says Craig. "This is significant because what is the single most important thing for men's health? It's being married - it can account for as much as seven years of life expectancy. So if we want to find out why health in Glasgow is so poor I think one of the things that we should ask about is relationships."

Sociologist Aaron Antonovsky, has coined the term "salutogenesis" to describe an approach which focuses on a positive view of well-being rather than a negative view of disease. This takes us into the field of epigenetics - the business of genes being switched on or off depending on the environment you were brought up in. There is an epigenetic impact of the diet that your parents or grandparents were exposed to. Now we can easily find scientific explanations for this - we just haven't proved it yet." The idea that the lifestyle of your grandparents - the air they breathed, the food they ate - can directly affect you, decades later, is disorientating. Many would argue it smacks of fatalism. What is the point of trying to be healthy if you are doomed by your ancestors' bad habits? The epigenetic notion goes against conventional views that DNA carries all our heritable information and that nothing an individual does in their lifetime will be biologically passed to their children.

. "When you hug a baby you make them happy," he says. "Happiness is associated with the production of neurotransmitters in the brain. One of these neurotransmitters has an effect on a particular gene which activates the production of a protein that allows the brain to suppress the stress response. Failure to nurture a baby - failure to do something as simple as hug a child - interferes with that process."

http://www.bbc.com/news/magazine-27309446