The Glasgow Effect: Activism as a public health issue

Ben Wray

Common Weal Policy look at a new report on The Glasgow Effect – the excess mortality that comes from living in Glasgow as compared to cities with a similar socio-economic profile – and find the role of politics and activism at the grassroots level to be influential in public health outcomes

WHY do people die younger in Glasgow than Liverpool and Manchester when the standard socio-economic analysis would suggest there should be no significant difference between the three cities? The authors of ‘History, politics and vulnerability: explaining excess mortality in Scotland and Glasgow’, published last month, set out to answer this question in order to uncover what has been dubbed ‘The Glasgow Effect’: the excess mortality, across all social classes,  that comes from living in Glasgow.

Their findings, which have been backed by a large number of academics across the UK, point to a number of factors, including potential problems in the measurements used to analyse deprivation, but what was the most striking part of their model is the emphasis placed on politics, and especially political activism, as a key “psychosocial” influence on public health.

The authors describe a demoralised and despondent Glasgow in the 1980’s under the leadership of a Labour Council which had been in power for decades and was therefore “The Establishment”. This entrenched position meant it was more willing to take a “conciliatory” approach to Margaret Thatcher’s reign than comparative cities, especially Liverpool. Weak leadership compounded historic deficiencies in housing and city planning, leading to the failed ‘New Town Programme’ of high rise flats. They add in to the mix the impact of “The Democratic Deficit” where Scotland, but especially Glasgow, continually elect Labour MPs but end up with Tory governments as a reason for heightened alienation and despair.

Liverpool, on the otherhand, developed a “strong sense of social solidarity” in the 80’s, electing a council led by Militant, the radical left wing of the Labour party at that time, that led from the front in refusing to implement Thatcher’s austerity measures, even going as far as running illegal deficit budgets as they invested massively in a council housing programme. Liverpool Council mobilised the public in this resistance movement, which became “a core component of city identity and culture”, leading to successive local authorities spending significantly more on council housing than their Glasgow counterparts.

The authors provide a number of statistics to back up the narrative that the difference in political culture, which they describe as “social capital”, between the two cities was stark at that time (some of which are re-published below), and therefore significant enough to be considered as a qualitative factor in historic “vulnerabilities” which can have a latent influence on public health today.  

Some may scoff at the idea that taking part in Anti-Thatcher protests and attending organising meetings about local housing issues could stave off mortality, but the link between mental stimulation and physical health has long since been established by health experts, just as the link between physical exercise and mental health is now taking as standard. Under conditions of material disadvantage, pyschosocial factors can play the role of exacerbating or negating health inequalities.

Political activism, as a quite intense form of mental stimulation, can therefore play a double role in terms of public health: it can stave off the damaging effects of social isolation and exclusion by establishing deep ties and bonds within communities, while at the same time having a tangible impact on government, and therefore improving public health via more socially just legislation.

In Scotland, we have just been through what is widely considered to be the biggest grassroots movement in our history – the independence movement in the run-up to the referendum in 2014. Glasgow, of course, was at that movement’s heart. Common Weal published a Yes Survey of a cross-section of independence campaigners earlier this year with Heriot-Watt University which showed that, at least up to this point, many of those people have stayed involved in activism since the referendum.

The raw materials could therefore be considered to be present to maintain an activist culture in Glasgow and elsewhere in Scotland going forward, if it can transition into a movement that can provide tangible benefits to communities. The Glasgow Effect, which the authors of the report argue has become more prevalent over time, could at least be mitigated and possibly reversed by leadership from the grassroots.

Read the report in full here.