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Socio-Economic and Health Deprivation in Glasgow

1 Introduction

This exercise examines the prevalence of socio-economic and health deprivation across 129 letting sub-areas within Glasgow defined by The Glasgow Housing Association (GHA). The association between socio-economic and health deprivation is a well-known phenomenon (Townsend 1979, Townsend et. al 1988) Previous studies assessed this generally in terms of a relationship between socio-economic deprivation and standardised mortality rates (Carstairs and Morris 1990). This study considers socio-economic and health deprivation as two separate entities then derives two sets of deprivation scores (socio-economic and health deprivation) for each of the 129 letting-sub-areas based on a large number of deprivation indicators published by The Scottish Government (Scottish Executive 2004). Deprivation scores of letting sub-areas are expressed in terms of their probabilities (% chance) of occurrence. This approach enables scaling of deprivation levels and therefore comparing relative levels of deprivation between letting sub-areas within Glasgow.

The study identifies most deprived letting sub-areas, interrelationship between socio-economic and health deprivation and further their implications to Employment and Income deprivation and relationships with Comparative Mortality Factor (CMF), Comparative Illness Factor (CIF) and three main causes of premature deaths (deaths under 65 years of age), namely, Heart disease/failure, Cancer and Alcohol/drugs.

2 Definitions

Definitions of CMF, CIF, Employment deprivation and Income deprivation used in this exercise are as follows (Scottish Executive 2004):

Comparative Mortality Factor (CMF) for a sub-area depicts death rate in that sub-are relative to the Scottish death rate (100). Any CMF greater than 100 is an indication of higher death rate compared to Scottish death rate for people aged less than 65 and vice-versa.

Comparative Illness Factor (CIF)is a measure of chronic health conditions in a sub-area relative to Scottish CIF (100). It is based on Census 2001 counts of people who have a limiting long-term illness and/or poor general health. CIF greater than 100 indicates poorer health condition relative to Scotland and vice-versa. The measure takes account of people from all ages.

Employment Deprived People are adults in unemployed clamant count averaged over 12 months of those men aged under 65 and women aged under 60, incapacity benefit recipients, men aged under 65 and women aged under 60, severe disablement allowance recipients, men aged under 65 and women aged under 60 compulsory new deal participants – New Deal for the under 25s and New Deal for the 25+ not included in the unemployment claimant.

Income Deprived People are those adults with or without children in Income Support, job Seekers allowance, tax credit below a low income threshold, disability tax credit below a low income threshold.

2 Deprivation Analyses

The main findings from an analysis of socio-economic and health deprivation across letting sub-areas in Glasgow are as follows:

  • Letting sub areas with probability of Socio-Economic Deprivation 90% or higher are in order of Bluevale, Wellhouse, Waverley, Kildermorie, Bishoploch, Cairnsmore, Dalmarnock, Broadholm, Barrowfield, Hamiltonhill, South Carntyne, Blairtummock and Possilpark.
  • Letting sub areas with probability of Health Deprivation 90% or higher are in order of Bluevale, Glasgow X/Calton, Cowlairrs/Peterhill, Dalmarnock, Possilpark, Hamiltonhill, South Carntyne, Townhead/Ladywell, Windlaw, Machrie/Barlia, Bridgeton and Kildermorie.
  • Letting sub areas with probability of both Socio-Economic and Health Deprivation 90% or higher are in order of Bluevale, Dalmarnock, Hamiltonhill, South Carntyne and Possilpark
  • Letting sub areas with Comparative Mortality Factor (CMF) 190 or higher are in order of Bluevale (321), South Carntyne (271), Hamiltonhill (225), Possilpark (222), Broadholm (220), Waverley (203), Bishoploch (195) and Dalmarnock (193), where the Scottish CMF= 100.
  • Letting sub areas with Comparative Illness Factor (CIF) 190 or higher are in order of Dalmarnock (205), Broadholm (197), Possilpark (191), Kildermorie (190) and Hamiltonhill (190), where the Scottish CIF= 100.
  • The top five letting sub areas in respect of Employment Deprivation are in order of Bluevale, Dalmarnock, Broadholm, South Carntyne, Possilpark
  • The top six letting sub areas in respect of Income Deprivation are in order of Broadholm, Barrowfield, Bluevale, Wellhouse, Blairtummock and Possilpark.

Figure-1 shows a correlation between socio-economic and health deprivation across 129 letting sub-areas in Glasgow is over 90%. Socio-economic deprivation indicators signify material status of the people in letting sub-areas. Indicators of employment and income included in the analysis specifically represent economic status of the people in letting sub-areas. Therefore, high socio-economic deprivation probabilities are indicative of poverty in corresponding letting sub-areas (Townsend 1979).

Figure-1Figure-2

Figure-3

A correlation over 90% between socio-economic deprivation and Comparative Illness Factor (CIF) for Glasgow is shown in Figure-2. A similar relationship between the socio-economic deprivation probabilities and Comparative Mortality Factors (CMFs) in letting sub-areas is presented in Figure-3 depicting a relationship between socio-economic and health deprivation (Carstairs and Morris 1990).

3 Premature Deaths (Age under 65)

The main findings from an analysis of premature deaths data (2002 – 2004) and causes of deaths in letting sub-areas within Glasgow are as follows:

  • About 25% of deaths per year in Glasgow are premature deaths (under 65)
  • The top 10 causes of premature deaths in order are: (1) Heart Disease and/or Failure, (2) Cancer, (3) Alcohol and/or Drug related, (4) Bronchitis and Bronchopneumonia, (5) Pneumonia, (6) Haemorrhage, (7) Liver Disease and/or Failure, (8) Septicaemia, (9) Lung Disease and (10) Respiratory Disease and/or Failure. They contribute over 75% of premature deaths in Glasgow.
  • Number of premature deaths has an increasing tendency with the increase of probabilities of Socio-Economic and/or Health Deprivation, i.e. deaths rates are higher in highly deprived areas.
  • Premature deaths due to Heart Disease and/or Failure and, Alcohol and Drugs are more common in deprived areas (probability of deprivation about 65% or higher)
  • The top five causes of premature deaths are more prevalent in Easterhouse, North, High East End, Castlemilk and East End Housing Market Areas.
  • Cancer related premature deaths are also correlated with deprivation factors but not as strongly as due to Heart Disease and/or Failure and, Alcohol and Drugs.

4 Premature Deaths per 10,000 Population per Year

In order to analyse the top three causes of premature deaths record (2002 – 2004) in the area of Glasgow published by The General Registrar Office (GRO) for Scotland, the medical definitions of the causes of deaths as in the GRO record of deaths were simplified in a more meaningful manner into categories of disease classification (e.g., Heart Disease and/or Failure).

Figure- 4Figure-5

Figure-6Figure-7

Figure-4 demonstrates the distribution of the average number premature deaths per year per 10,000 population that occur in sub-areas within Glasgow City classified by deprivation probability range at an interval of 10% and their comparisons in respect of socio-economic deprivation and health deprivation classifications. Figure-4 shows a steady rise in death rate as areas become more health and socio-economically deprived. Death rates are even higher in areas where health deprivation probabilities are 80% or higher.

Figure-5 shows the average number of fatalities caused by heart disease and/or failure, within Glasgow classified by deprivation probability range. In relation to health deprivation probability, there is a steady increase in premature deaths (per year per 10,000) as health deprivation probability rises. In areas that are likely to be 90-100% health deprived, an average of 13 in 10,000 people (under the age of 65) per year die from heart disease and/or failure. In those areas categorised as being 60-69% socio-economically deprived (as well as in areas defined as being 90-100% socio-economically deprived), an average of 10 in 10,000 people per year are likely to die from a heart condition. Indeed, the distributions of numbers of deaths per year per 10,000 population tend to be more scattered with respect to socio-economic deprivation probability.

Figure-6 shows the distribution of premature deaths caused by cancer, within a socio-economic and health deprivation probabilities. Again, it is clear that as health deprivation probability increases so does the number of average premature deaths per year caused by cancer. The results show that the highest rates of death (9 in 10,000 population per year) occur in areas categorised as 70-79% likely of socio-economic and health deprivation. These sub-areas are Braidfauld, Craigdale and Duke Street, which are located in the East End and High East End Hosing Market Areas.

Figure- 7 represents the distribution of premature deaths due to alcohol and/or drugs in letting sub-areas. The main observation is that within the Glasgow population, Alcohol and/or Drug related death is the third most frequent cause of fatality. It is evident from Figure-7 that as the socio-economic and health deprivation probability scores increase so does the number of deaths due to alcohol and/or drugs. A somewhat startling result is that in areas classified as being 90-100% likely of health deprivation, the average premature death rate is 10 in 10,000 deaths per year. Likewise, in areas that fall into the categorisation of 90-100% socio-economic deprivation the alcohol and/or drug related premature death rate is 9 in 10,000 per year. The most important pattern to draw out of Figure-7 is the extent of variation of death rates between areas that are relatively affluent and those areas that are severely deprived. It seems that socio-economic and health related deprivation has a strong impact on the likelihood of premature death due to alcohol and/or drugs.

5 Conclusions

The study clearly shows that relatively poor health condition and high mortality rates in relatively poor letting sub-areas in Glasgow. Based on the above it may be concluded that poverty (broadly socio-economic deprivation) is the major contributory factor to health deprivation.

For tackling poverty in Glasgow, it is suggested that actions should be primarily focused on employment, financial inclusion and supporting tenants’ health well being. Addressing these key issues would require joint working partnerships and to support a multi agency approach for economic development with the main objectives to bring more people into the labour market and sustainable revenue generation through possibly inward investment. A successful implementation of this approach will rely mainly upon an effective implementation of the Structure Plan and Environment Strategy for the development of an improved infrastructure in deprived areas. Particular attention needs to be paid to revitalise extremely poor transport system, which acts as the major barrier against a sustainable economic development and inward investment. Attempts have been made to compensate the loss of revenue due to industrial decline in Glasgow during the last two decades or so by generating services through knowledge economy, which has been relatively successful in a sense that educational institutions in Glasgow have been attracting large number of students from all over the world. It is recommended to focus more on the business sector and international positioning of Glasgow through identifying the strength and opportunities that Glasgow city as a centre for business can offer.

Citywide Comparative Mortality Factor (CMF) is on average 70% higher relative to Scotland. In some letting sub-areas the CMFs are 3 times higher relative to Scotland.

The main causes for this are in general:

  • Low income
  • Low of educational attainment
  • Poor housing
  • Alcohol and drug misuse
  • Lack of access to facilities
  • Lack of exercise

It is therefore proposed that possible actions may be focused on such factors as Health Check, Physical Activity, Weight Management, Stress Management, Smoking Cessation, Client Support and other health awareness programmes for health promotion in Glasgow.

5 Epilogue

Recognising that the poor socio-economic state of many small areas in Glasgow is a result of gradual industrial decline, the city experienced during the last two decades or so, it is of paramount importance for all the partners to work towards common objectives with a greater sense of togetherness to face the challenge of revitalising Glasgow as a prosperous city in the country. Tackling the poverty in Glasgow should be the very first step for achieving this.

References

.

Carstairs, V and Morris, R (1990) Deprivation and Health in Scotland, Aberdeen University Press, Aberdeen.

Scottish Executive (2004) The Scottish Index of Multiple Deprivation, Scottish Executives’ Office, Edinburgh.

Townsend, P (1979) Poverty in the United Kingdom, Penguin Books Ltd, Harmondsworth.

Townsend, P; Phillimore, P and Beattie, A (1988) Health and Deprivation: Inequality and North, Croom Helm Ltd, Beckanham.

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