1. Lesson Starter What evidence is there to suggest that the UK’s sickest city is Glasgow? Explain the Glasgow Effect. Outline the findings of the CACI report.

2. What will I learn? To identify the geographical inequalities that exist with regard to health inequalities.

3. Success Criteria List and explain 3 reasons for geographical inequalities. Outline the findings of the Caci Report. List facts and figures which demonstrate the health inequalities that exist in the UK. Watch a DVD and select important points that help illustrate what has been learned in this section.

4. What are Health Inequalities? There is a great deal of evidence to show that some groups of people are more likely to enjoy better health and have longer life expectancy than others i.e. everyone’s health is not equal. Five ways in which health inequalities can be demonstrated (life expectancy or mortality/morbidity) are by: 1. Geographic location within Scotland, the UK and also within Dundee/Tayside. 2. Social class i.e. between wealthiest and poorest. 3. Gender between males and females. 4. Ethnicity between different ethnic groups. 5. Lifestyle Choices that people make.

5. Health Inequalities Gender Lifestyle choices Lifestyle choices Geographical Location Copy the diagram below Ethnic origin Economic Status

6. Explaining Geographic Health Inequalities There is a wealth of evidence to demonstrate that the people living in the wealthiest areas of the country enjoy better health, lower death rates and longer life expectancy than those living in the poorest areas.

7. In your opinion, why do you think where you live can affect your health? Task Geographical Inequalities

9. Linked very closely to social class: Poverty greatest in west of Scotland, Wales, northern England, Northern Ireland and in large inner cities (London, Birmingham, Manchester, etc.).Poverty greatest in west of Scotland, Wales, northern England, Northern Ireland and in large inner cities (London, Birmingham, Manchester, etc.). All areas of high unemployment and social deprivation.All areas of high unemployment and social deprivation. These areas have less professional/managerial jobs. Former manufacturing areas.These areas have less professional/managerial jobs. Former manufacturing areas.

10. Geographical Inequalities – Caci Report The CACI Report (2006) - made all the headlines. Took a variety of statistics and confirmed the shockingly unhealthy lifestyles of a significant number of Scots. The report found that Scots are more likely to suffer long-term illness, take less exercise, be more overweight and spend more on cigarettes and alcohol rather than other Britons.

11. Highlights the link between urban deprivation and ill health. Also highlights the “North-South” divide. Significantly, all of the worst areas are in run down housing estates either on the periphery of a city or in the inner city. Herald newspaper summed the findings of the report - ‘Scotland the sick man of the UK with 22 of the top 25 illness areas. Emphasised the geographical divide with poverty being the main cause. Geographical Inequalities – Caci Report

12. Geographical Inequalities On the next few slides there is data showing evidence of health inequalities. Task: Make notes from the next few slides on the differences in life expectancy. Once you have done this try to some up, in a few sentences, what the evidence shows you.

13. Evidence of Health Inequalities – Geographic location: Life Expectancy in the UK Regions and by Gender

14. Evidence of Health Inequalities – Geographic location: Comparison of Life Expectancy in Glasgow and East Dunbartonshire

15. Areas with the lowest male life expectancy in the UK Local area Country / Region Life expectancy at birth Glasgow CityScotland72.6 InverclydeScotland73.7 BlackpoolNorth-west74.0 West Dunbartonshire Scotland74.1 Dundee CityScotland74.3 ManchesterNorth-west74.8 North LanarkshireScotland74.9 BelfastNorthern Ireland75.2 RenfrewshireScotland75.3 BurnleyNorth-west75.0

16. Areas with the highest male life expectancy in the UK Local area Country / Region Life expectancy at birth East DorsetSouth-west82.9 HartSouth-east82.9 South CambridgeshireEast82.8 South Northamptonshire East Midlands82.2 GuildfordSouth-east82.1 Kensington and ChelseaLondon82.1 ChilternSouth-east82.1 HarrowLondon82.0 ChristchurchSouth-west82.0 Epsom and EwellSouth-east82.0

17. Areas with the lowest female life expectancy in the UK Local area Country / Region Life expectancy at birth CorbyEast midlands80.2 West LothianScotland80.1 BlackpoolNorth-west80.0 InverclydeScotland79.9 Blaenau GwentWales79.9 ManchesterNorth-west79.5 Dundee CityScotland79.3 North LanarkshireScotland79.1 West Dunbartonshire Scotland78.7 Glasgow CityScotland78.5

18. Areas with the highest female life expectancy in the UK Local area Country / Region Life expectancy at birth PurbeckSouth-west86.6 East DorsetSouth-west86.5 Richmond upon ThamesLondon85.9 WinchesterSouth-east85.9 South CambridgeshireEast85.9 ChilternSouth-east85.8 CotswoldSouth-west85.8 Kensington and ChelseaLondon85.8 HartSouth-east85.6 HarrowLondon85.6

19. Paired Reading Task Your teacher will give you a news article from the BBC on why Glasgow is the UK’s sickest city. Working with a partner (call yourselves A and B), split the article into equal sections (sections A and B). You must read your part of the article and then teach your partner the bit that you have read and vice versa. At the end, make a summary of what you have learned. You can use the article to help you.

20. What will I learn? To outline the meaning of the ‘Glasgow effect’.

21. Success Criteria Identify and discuss stereotypes that exist in Glasgow. List statistics that highlight Glasgow’s special health problems. Explain why it is important not to stereotype all people who live in Glasgow. Identify and explain three reasons for ‘The Glasgow Effect’. Outline the meaning of ‘biology of poverty’.

22. Copy this onto a graffiti board Individually, write down why you think depending on where you live affects your health. As a group, decide on your top 5 and be prepared to share them with the class. 1. 2. 3. 4. 5. Task

23. The Glasgow Effect The Tears That Made the Clyde is an academic study of health inequalities. Builds on the work done by Sir Harry Burns, Chief Medical expert for Scotland. A clear consensus has emerged. Glasgow's citizens suffer more from: poor diet smoking alcohol abuse drug abuse low emotional self-esteem

24. Questions 1.Using your hand out ‘The Glasgow Effect’ provide six pieces of evidence that suggests that Glasgow has special health problems. 2.In pairs, decide which pieces of evidence surprise you the most and discuss why.

25. Glasgow, the second city of the empire Why is it important not to stereotype people who live in Glasgow?

26. Glasgow

27. Drumchapel It is misleading to stereotype people from Glasgow council estates, such as Drumchapel, as being poor, workshy and drug addicted. In recent years, Drumchapel has been transformed: there are many attractive houses, a brand new secondary school and professional families from immigrant backgrounds bringing a new vibrancy to the community which has been badly misrepresented.

28. Lesson Starter 1.What is the Glasgow Effect? Outline the reasons for all the bad statistics: 1.Long term unemployment 2.Poor Housing 3.Political attitudes

29. The Biology of Poverty Burns believes that the ‘chaotic circumstances’ many young people grow up in impacts on their health throughout their life. Many middle class people have unhealthy lifestyles too. What kills the poor is the harmful messages children receive relating to parenting, employment and housing. Healthy lifestyle message can only do so much.

30. Three Cities Report It is clear that poverty is a major factor in explaining health inequalities. However, this cannot explain why the health of Scots in areas of deprivation is worse than their counterparts in England. Three Cities Report- 2010 Research examined the health and death rates of the citizens of Glasgow, Manchester and Liverpool between 2003 and 2007. These cities have broadly the same deprivation figures. Blame Glasgow effect for city’s chronic ill health- not deprivation clearly indicated that lifestyle not poverty was to blame. http://www.youtube.com/watch?v=r0cJ7CX1lCAhttp://www.youtube.com/watch?v=r0cJ7CX1lCA

31. Three Cities Report Glasgow’s cancer and heart disease rates are well above that of Glasgow and Manchester. It is clear that income and poverty are major factors in explaining health inequalities. However it cannot explain why the health of Scots in areas of deprivation is worse than similar areas in England. Lifestyle is also an important factor.

32. Quick Questions 1. 1.List statistics that highlight Glasgow’s special health problems. 2.Explain why it is important not to stereotype all people who live in Glasgow. 3.Identify and explain three reasons for ‘The Glasgow Effect’ 4.Outline the meaning of ‘biology of poverty’

33. Watch Watch the Wealth and Health Inequalities DVD from Modernity Scotland. As you watch it, take notes.

34. If you want to know more about this section, go online and access the article on Health inequalities on Modernity Scotland. http://www.modernityscotland.co.uk/cfe-social- inequality/524-article-8-healthhttp://www.modernityscotland.co.uk/cfe-social- inequality/524-article-8-health Want to know more?

35. I can… List and explain 3 reasons for geographical inequalities. Outline the findings of the Caci Report List facts and figures which demonstrate the health inequalities that exist in the UK. Watch a DVD and select important points that help illustrate what has been learned in this section.