The Glasgow Effect

A report by the Glasgow Centre for Population Health, University of the West of Scotland, NHS Scotland and University College of London – claims to offer evidenced reasons for so-called 'Glasgow effect' - the phenomenon which sees more people die prematurely in Glasgow than can be accounted for by poverty alone, in comparison to the rest of the UK. The mortality rate is 15 percent higher in Glasgow across all social classes and ages, while premature mortality (dying under 65) is 30 percent higher, and much higher among the poorest in the city. The so-called 'Glasgow effect' means more people die from the cancer, heart disease, strokes as well as drugs, alcohol and suicide than do in other comparable cities.

Researchers, who spent years working on the project and examined 40 different theories, claim that radical urban planning in the 1960s and 70s, aimed at promoting economic growth, was a key factor which made Glaswegians vulnerable to the devastating effects of deprivation and bad housing. The report notes that Scottish Office documents – released under the 30 year rule – show that the creation of new towns, populated by Glasgow's skilled workforce and young families, which attracted investment, led to a situation where the city was left with "the old, the very poor and the almost unemployable". Another document admits to "skimming off the cream" of Glasgow to be rehoused in new towns such as Bishopbriggs, East Kilbride and Houston. However the policy continued to be rolled out regardless, a decision which fuelled the break-up of communities and a chronic lack of investment in housing or repairs in housing schemes such as Easterhouse, Drumchapel and Castlemilk.

As well as Westminster social engineering, the report finds that a range of other factors also made Glaswegians more vulnerable to the effects of poverty and deprivation when compared with data from Liverpool and Manchester, which in the earlier part of the 20th century had similar levels of mortality to Glasgow. The Scottish city started to fall behind considerably in later years. Researchers found that the historic effect of overcrowding was an important factor and highlighted the strategies of local government, which prioritised the regeneration of the city centre over investment in the cities housing schemes as having a significant impact on the health of Glaswegians. Data shows that Glasgow authorities spent far less on housing repairs, leaving people's homes poorly maintained and subject to damp.

David Walsh, of the Glasgow Centre for Population Health, said that their work proved that poor health had political causes and could not simply be attributed to individual lifestyle choices. He added: "The principal reasons for poor health in Glasgow are poverty and deprivation, and this shouldn’t be forgotten. However, even given its very high levels of deprivation, Glasgow has much, much worse health than it should have, and much worse than in comparably deprived cities like Liverpool, Manchester and Belfast – cities that been through the same processes of de-industrialisation. Until now this has been an unexplained phenomenon: but this new research is based on assessment of a huge amount of evidence and is not speculation-based." The Scottish Office documents were particularly revealing, he claimed. "The Scottish Office embarked on a series of policies that effectively wrote off the city - they designated it a ‘declining city’ and their plans focused on economic growth elsewhere," he added. "This was a policy that went on for decades despite an awareness that this was having a massively negative impact in socio-economic terms and therefore on health."

Co-author Chik Collins, of the University of the West of Scotland said that this made Glasgow more vulnerable to the policies introduced by the Conservative Government after 1979, leaving the city with weakened industry, loss of skilled labour and very large numbers of problematic council houses in peripheral estates and high rises. He claimed Glasgow city and regional council responses further impacted on health. "It was a Scottish variant of trickle-down economics that focussed on retail and tourism, ultimately at the expense of other parts of the community which did not benefit and which did not get the help they needed from elsewhere," he added. "Glasgow got a double-dose of neoliberalism – the UK Thatcherite version, and the more local version led by the Scottish Development Agency and the Council. The ‘excess mortality’ affects the best off as well as the worst off and so all socioeconomic groups in Glasgow have reason to feel some urgency about getting to the root of that problem."

Professor Tom Devine, historian at Edinburgh University, said: "This new report is by far the most thorough and convincing attempt to date to resolve the conundrum. As a historian it is satisfying to read that many of the new explanations lie in its historical analysis of the recent past. However, the conclusions are chilling. They reveal that to a considerable extent the key causes were in the realms of public policy, housing, overspill initiatives and urban regeneration. In other words, higher death rates could have been avoided if different decisions had been made by politicians and planners at the time. Indeed, a stark warning for the future."

Satwat Rehman, Director of One Parent Families Scotland said: "Families headed by a single parent make up a quarter of families in Glasgow and sadly children in single parent families are twice as likely to live in poverty as those in two parent families. To reverse this we firmly believe in the importance of progressive policies to tackle poverty, exclusion and reduce inequality.”

Cathy McCormack, an anti-poverty campaigner from Easterhouse, first made the link between poor housing and health as a young mother. "I brought my babies home from hospital and they were bouncing with health," she recalled. "And though they were breastfed they started to get sick all the time. The health visitor couldn't understand it." In those days, she said, she was told simply to wash the black mould off the walls, which she did on a regular basis, going to war with the various fungi that sprouted all over the damp bedrooms where the family slept. "We didn't understand the damaging effect of the spores and the way they colonise your lungs," she said.

The new report into the systemic and political causes affecting the health of Glaswegians have left her "heart-broken" she told the Sunday Herald and made her angry that she had to sacrifice so much to fight what she describes as "a war against the poor". In 2005 McCormack, who is now in her early sixties, was diagnosed with chronic lung disease and in January this year suffered a heart attack. "I just can't believe that people have been so demonised," she said. "It's hard enough being poor without being blamed for it. There has been a lot of emphasis on people's health being affected by smoking and drinking. But when you've been born into poverty and oppression you're immune system is rundown. Amongst all this talk about jogging and brown bread we need to remember that this issue is really about public health. That's what this report shows and it can be easy to forget."