What kind of illnesses can be related to poverty? Lesson Starter What kind of illnesses can be related to poverty? Why would some areas of the country suffer from poorer health than others?

What will I learn? To identify the reasons why health inequalities exist in the UK. To explain in detail why some health inequalities are preventable whilst others are not. 2

Success Criteria List and explain the reasons for health inequalities. List facts and figures which demonstrate the health inequalities that exist in the UK.

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 Glasgow. 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.

Geographical Location Copy the diagram below Gender Lifestyle choices Geographical Location Health Inequalities Ethnicity Economic Status

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.

Geographical Inequalities 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.). All areas of high unemployment and social deprivation. These areas have less professional/managerial jobs. Former manufacturing areas.

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.

Geographical Inequalities – Caci Report Highlights the link between urban deprivation and ill health. 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 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.

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

In 2016, male life expectancy at birth in Scotland was virtually unchanged from 2013, remaining at 77.1 years. Female life expectancy at birth in Scotland 2016 also remained virtually unchanged at 81.2 years. The gap in life expectancy at birth between Scotland and the rest of the UK has grown consistently since the 1980s. Possible causes for this may be higher levels of heart disease, a greater smoking prevalence and increased levels of alcohol and drug-related deaths in Scotland compared with the other constituent countries of the UK.

Evidence of Health Inequalities – Geographic location: Comparison of Life Expectancy in Glasgow and East Dunbartonshire (2016) Difference of 6.7 years Difference of 4.6 years

Life Expectancy in the UK Poverty and Health

The UK’s sickest city Reading Activity 20 mins Split the article into 3 sections. Each person should take a section, read it thoroughly and then summarise it in a paragraph. Include key stats in your summary where possible. Share your summary with your group to complete the article in full. Add your groups nots to yours!!

The UK’s sickest city Article Qs What health issues are common in Glasgow? What can these health issues be linked to? In your own words SUMMARISE the link between geographical area and poor health (provide examples).

The Glasgow Effect

low emotional self-esteem 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 officer for Scotland. A clear consensus has emerged. Glasgow's citizens suffer more from: poor diet smoking alcohol abuse drug abuse low emotional self-esteem ‘The Glasgow Effect’ hand-out is from Modernity Scotland (John McTaggart). I have put it onto a word document and it is in the folder. This should be printed out (where possible) and given to the pupils to complete this task. https://www.youtube.com/watch?v=httIQ81X9dk

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

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

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.

The Biology of Poverty Burns believes that the ‘chaotic circumstances’ many young people grow up in impacts on their health throughout their life. Although 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.

Three Cities Report 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. Researchers note that the clear link between deprivation and high mortality is the core reason why Glasgow, and other relatively poorer cities in the UK, such as Liverpool, suffers such bad health. 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. http://www.youtube.com/watch?v=r0cJ7CX1lCA https://www.gcph.co.uk/assets/0000/3828/Three-city_survey_report_2013.pdf 24

Three Cities Report But evidence shows that when compared with Liverpool, premature mortality in Glasgow is still 30 per cent higher. Statistics suggest men in the city are ­dying a full two years earlier than might be expected from the city’s social profile. Glasgow’s cancer and heart disease rates are well above that of Liverpool and Manchester. Poverty and unemployment arguably is to blame for the city’s chronic ill health however, this report did not solely blame deprivation. It clearly indicated that lifestyle as well as poverty was to blame e.g poor education about health and wellbeing. http://www.youtube.com/watch?v=r0cJ7CX1lCA https://www.gcph.co.uk/assets/0000/3828/Three-city_survey_report_2013.pdf However, is this not the Glasgow effect? 25

Quick Questions 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’ 1.