Side by side: a focus on Bearsden and Drumchapel

“I think, for Bearsden and Drumchapel, for being so close, there’s a huge divide,” said Alice, 42, a resident of Bearsden. “It’s literally, you could just draw a line where Bearsden ends and Drumchapel starts; it’s like where all the problems start. They look unwell, you know? They’ve got a terrible complexion, more often than not they are, you know, overweight, not working, young kids, you know? It’s just a big, vicious circle for them.” “Yes,” agreed Lauren, 50, from Drumchapel, “in that you can sort of stand two people together and say well, I can see that that’s the rich one ‘cos they look better.”

Drumchapel became part of the city of Glasgow in 1938 when council boundaries were redrawn. In the 1950s, as part of a policy to deal with severe overcrowding in the city, Glasgow Corporation built an estate – what would come to be known as ‘The Drum’ – to house more than 30,000 people. “Many saw this as their opportunity to make new lives for themselves and their families,” said Alan Craig, a community worker who has written a history of the area.

But, he added: “Others found being uprooted from their close-knit communities quite traumatic as they did not want to leave the areas where they had grown up with their parents and grandparents. In the early days, there were no amenities and travel was restricted. There was only one post office and telephone box in the village. People had to travel to Glasgow to pay the rents for their houses, or if they wanted to shop or socialise, as there were neither shops nor public houses.”

Many approaches are needed at a national and local level to address the fundamental causes of inequalities in Glasgow

A shopping centre was not completed until the early 1960s. Work came from the nearby Goodyear tyre company or with Singer, the sewing machine maker in Clydebank, Beatties Biscuits and the Clyde shipyards. But recession in the 1970s saw widespread factory closures, creating high unemployment and social deprivation in Drumchapel. Projects and initiatives were introduced to mitigate the effects, but council cutbacks meant they had little lasting effect. Poor quality housing – a feature of Drumchapel, Easterhouse, Castlemilk and Pollok; the ‘big-four’ postwar social housing schemes – contributed to the problems.

In 1995, the BBC’s Panorama featured Drumchapel in a programme examining increasing death rates among the poor in Britain. “Average life expectancy in England is 73 for a man and 79 for a woman – but not if you are poor,” said reporter Sarah Barclay. “New evidence [shows] that death rates among Britain’s poor are rising for the first time in decades. The rich are now living longer and the poor dying younger, and in some cases that gap has widened by as much as 45 per cent during the 80s.”

It sparked a national debate: “I happen to know that area very well, because I represent it,” the late Donald Dewar told the House of Commons, “so I watched the programme with considerable interest and concern. I accept that concentration on a single aspect of an area does not always give a complete picture. Drumchapel is a community with problems, but it has strengths as well: its strengths lie in its people—people who too often, and in so many ways, are obstructed rather than assisted by the system.

“The facts are familiar. Most Members of Parliament recognise the link between deprivation and health. Perhaps those facts have become too familiar, and have lost the ability to shock; it should not be so. Literally a hundred yards away is Bearsden, a leafy suburb whose economic circumstances are very different. Between 1981 and 1991, male mortality between the ages of 15 and 46 rose by 9 per cent in Drumchapel; in Bearsden, it fell by 14 per cent. It was a case not of both rates improving, or of one improving faster than the other: the mortality rate in Bearsden improved, while it deteriorated in Drumchapel.

“Young men in Drumchapel are twice as likely to die as those living in an affluent and leafy suburb. They are 75 per cent more at risk during major surgery. This may not be a pleasant subject, but it is a fact that, for a person living in a poor area such as Drumchapel who requires a bowel operation, the chances of developing complications and dying are 50 per cent higher than those of a person living in the neighbouring affluent area. The position is not academic. In an area such as Drumchapel, a man’s life expectancy can be as much as 10 years shorter than in the neighbouring area, while a woman’s can be seven years shorter.”

Previewing the programme, Dr Harry Burns, the then director of public health for Greater Glasgow Health Board, laid responsibility at the feet of policymakers: “Are not the poor always with us? In all societies some are better off than others. If some people are feckless and smoke, eat unhealthy food and drink to excess, what can be done about it? Well, quite a lot, actually. A society which wishes to generate health has to develop this sense of control and self-reliance within its members. If we consign families to live in inadequate housing, fail to educate and train them and give them no hope of ever having meaningful employment we will also burden them with ill health.

“Poverty undermines one’s sense of control. Lack of control over one’s own life leads to stress. Stress causes a wide range of physical illnesses. The association between poverty and physical ill health can be explained by sound science. Recently there have been calls for an independent inquiry into Glasgow’s health. It would show that the health service deals effectively with the avalanche of illness confronting it. An inquiry would also show how policymakers – of all political shades – have failed to understand the destructive effects that flawed education, employment, transport and housing policies have on health.”

We need to actively create conditions that foster wellness and wellbeing, and support resources to enhance resilience

That was in 1995. The people quoted at the beginning of this piece, part of a study into the effects of perceived social standing on health and wellbeing, were speaking in 2011. Earlier this year, nearly two decades since the Panorama programme, the Commons debate and Sir Harry’s pioneering analysis, figures from the National Records of Scotland showed there was an increasing variation across the country in the length of time people live. While life expectancy for men and women in Scotland has risen to between 76 and 80 in the last few years, people in the most deprived areas die sooner.

East Dunbartonshire has the highest life expectancy in Scotland, while the lowest was in Glasgow. Men in East Dunbartonshire can expect to live for 80.5 years – 7.5 years longer than those in Glasgow – while women in East Dunbartonshire can expect to live for 83.9 years, 5.4 years longer than those in Glasgow. Scottish males and females have the lowest life expectancy at birth in the United Kingdom. Male life expectancy is 2.1 years lower than the UK average, with the figure at 1.8 years for women.

Tim Ellis, National Records of Scotland chief executive, said: “This report shows that life expectancy continues to vary widely across Scotland. People living in rural areas, in general, live longer than those in more urban areas. Men in the least deprived areas of Scotland may live 12.5 years longer than those in the most deprived areas while women in the least deprived areas could expect to live 8.5 years longer than those in the most deprived.”

According to Glasgow Indicators, a project developed by the Glasgow Centre for Population Health (GCPH), the gap is even greater; men in one of the more affluent neighbourhoods in Glasgow live on average 15 years longer than those in the poorest. Men in the city’s well-off south side neighbourhood of Cathcart are expected to live to 81.7-years-old compared to those in the north Glasgow areas of Possilpark and Ruchill, where the average life expectancy for men is 66.2 years. Despite the significant difference in life expectancy between the two areas, they are just 4.5 miles apart.

Females living in Cathcart or Kelvinside in the west end of the city are expected to live 11 years longer than those in Possilpark and Ruchill. The report states those areas have the “lowest life expectancy of all neighbourhoods in Glasgow” for both males and females. “The neighbourhood has a low employment rate compared with the rest of Glasgow and a high percentage of young people are not in education, employment or training. The proportion of children living in poverty is considerably higher than the Glasgow average.”

A total of 47 per cent of children in Possilpark and Ruchill are living in poverty compared with just seven per cent in Cathcart. The report from Glasgow Indicators added: “The estimates of both male and female life expectancy in Cathcart and Simshill are considerably higher than the Glasgow average. The area has a high proportion of people in good or very good health and a low proportion of people and 82 per cent of the households in Cathcart and Simshill are owner occupied.”

Bruce Whyte, public health manager at GCPH, said: “These profiles highlight demographic and health changes in Glasgow over the last ten to 15 years. While there have been improvements in health across Glasgow, health inequalities in the city remain stark. It is notable that the wide gap in life expectancy across the city’s neighbourhoods – 15 years for men and 11 years for women – remains. Many different approaches across the policy spectrum are needed at a national and local level to address the fundamental causes of these inequalities in Glasgow.”

As Burns – now Sir Harry – has argued over the years, the health agenda tends to focus on ill health and disease rather than wellness. Wellness, he contends, is not a settled ‘binary state’ – in or out – but is something that people move in and out of throughout their daily lives and is influenced by the environment and other factors. People who see their lives and environments as being manageable and meaningful develop strong coping mechanisms; those who do not are liable to experience chronic stress. People with control over their lives will be less stressed; high levels of control equate to a lower death rate. Low levels of control point to a risk of death brought on by hopelessness.

A direct biological connection can be traced between environmental factors and wellbeing. Humans need to make sense of the world around them and to learn basic cues. Exposure to adverse effects in early life leads to changes in brain development that process human responses and which trigger defence mechanisms. If the world is perceived as unpredictable this will stimulate fight or flight responses. Chronic elevation of stress responses brought about by environmental factors is known to lead to heightened levels of cortisol – verified by differing levels of cortisol being measured and distinguished across affluent and deprived communities.

“Wellness is therefore a real biological consequence and not a matter of opinion,” observed Eric Dawson, an adviser at Architecture+Design Scotland. “The way we structure society and support young people has knock-on biological effects. We need to actively create conditions that foster wellness and wellbeing, and support resources to enhance resilience. For example, family, nurturing, intelligence, work, identity, cultural stability, optimism.” There has been some investment in Drumchapel in recent years and the community – individuals and organisations – is working hard to improve people’s lives. But will another generation pass without the life expectancy gap between Drumchapel and its near neighbour Bearsden closing?