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Carol Craig is the Centre's Chief Executive. She is author of The Scots' Crisis of Confidence, Creating Confidence: A Handbook for Professionals Working with Young People, The Tears that Made the Clyde: Well-being in Glasgow and The Great Takeover: How materialism, the media and markets now dominate our lives. Her latest book is Hiding in Plain Sight: Exploring Scotland's ill health. She is Commissioning editor for the Postcards from Scotland series. Carol blogs on confidence, well-being, inequality, every day life and some of the great challenges of our time. The views she expresses are her own unless she specifically states that they reflect the Centre's thinking.

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Posted 22/11/2010

Given I wrote a book recently on why Glasgow's may have particular challenges on a range of health and social outcomes I read with interest  a report which came out last week called 'The Scottish Health Survey: The Glasgow Effect'.

This Scottish Government report, written by Rebecca Landy, David Walsh and Julie Ramsay, set out 'to investigate whether residence in Glasgow was independently associated with poorer health outcomes and worse health behaviours compared to the rest of Scotland, after controlling for socio-economic, behavioural, biological and other health-related risk factors.'

The researchers used data collected by the 2008 and 2009 Scottish Health Surveys, a combined dataset of 18,353 individuals.  The comparison was 'Glasgow' (more of this later) with the rest of Scotland.

The researchers found that most of the differences between 'Glasgow' and the rest of the country could be accounted for by socio-economic and other variable such as deprivation. However there were four differences between 'Glasgow' and the rest of Scotland. The first is anxiety. Those living in 'Glasgow' had a '92% higher risk of anxiety than those living elsewhere' (after controlling for deprivation).  Another difference was that people in "Glasgow'' had '42% increased odds of having a doctor-diagnosed heart attack' again after adjusting for socio-economic and other variables. "Glasgow ' folk also scored higher scores (worse) than those in the rest of Scotland on the General Health Questionnaire (GHQ-12). High scores can indicate 'possible psychiatric disorder'. Finally men in "Glasgow' were more likely to be overweight.

There is one major flaw in this study which means that it is telling us practically nothing about 'the Glasgow effect'. The geographical unit used to compare the city with rest of Scotland is not Glasgow City, it is not even Greater Glasgow – including areas which are adjacent to the city such as Eastwood or Milngavie – but Greater Glasgow and Clyde Health Board Area.  Apart from the City of Glasgow itself this includes: East Dunbartonshire, West Dunbartonshire,  Renfrewshire, East Renfrewshire, South Lanarkshire, North Lanarkshire and Inverclyde.  By no stretch of the imagination would people ever see Gourock, East Kilbride or Hamilton as Glasgow yet they are part of this study and being classed as 'Glasgow' for the purposes of the 'Glasgow Effect' title.

In truth this report is a study of a densely populated part of the West of Scotland. What is being measured is not 'the Glasgow Effect' but 'the West of Scotland effect'. 

A secondary problem is that the analysis relies mainly on self-report. So, for example,  instead of looking at hospital admissions for alcohol related disease or incidents the researchers rely on people's estimates of how much they drink. So according to this research the slightly  higher levels of 'binge drinking' and 'potential problem drinking' in 'Glasgow' found in this study can be explained by 'differing age and sex distributions'.  Yet just last year a team of researchers from Glasgow University and the Medical Research Council produced  an 'alcohol death map' showing mortality rates across the country.  Greater Glasgow and Clyde (the area the researchers are using in the Glasgow Effect paper) has more people treated in hospitals for alcohol related conditions than the rest of Scotland combined. The particular problem area was Glasgow. This research also showed that in some areas in Glasgow (Maryhill and Shettleston, for example) the death rate from alcohol is six to ten times the UK average for men and four times for women.  Is this not what we mean by 'the Glasgow effect' I ask myself.  

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