Projects per year
Study design: Review and dialectical synthesis of evidenceMethods40 hypotheses were examined, including those identified from a systematic review. The relevance of each was assessed by means of Bradford Hill’s criteria for causality alongside – for hypotheses deemed causally linked to mortality – comparisons of exposures between Glasgow and Liverpool/Manchester, and between Scotland and the rest of Great Britain. Where gaps in the evidence base were identified, new research was undertaken. Causal chains of relevant hypotheses were created, each tested in terms of its ability to explain the many different aspects of excess mortality. The models were further tested with key informants from public health and other disciplines.
Results: In Glasgow’s case, the city was made more vulnerable to important socio-economic (deprivation, deindustrialisation) and political (detrimental economic and social policies) exposures, resulting in worse outcomes. This vulnerability was generated by a series of historical factors, processes and decisions: the lagged effects of historical overcrowding; post-war regional policy including the socially-selective relocation of population to outside the city; more detrimental processes of urban change which impacted on living conditions; and differences in local government responses to UK government policy in the 1980s which both impacted in negative terms in Glasgow and also conferred protective effects on comparator cities. Further resulting protective factors were identified (e.g. greater ‘social capital’ in Liverpool) which placed Glasgow at a further relative disadvantage. Other contributory factors were highlighted, including the inadequate measurement of deprivation. A similar ‘explanatory model’ resulted for Scotland as a whole. This included: the components of the Glasgow model, given their impact on nationally-measured outcomes; inadequate measurement of deprivation; the lagged effects of deprivation (in particular higher levels of overcrowding historically); and additional key vulnerabilities.
Conclusions: The work has helped to further understanding of the underlying causes of Glasgow’s and Scotland’s high levels of excess mortality. The implications for policy include the need to address three issues simultaneously: to protect against key exposures (e.g. poverty) which impact detrimentally across all parts of the UK; to address the existing consequences of Glasgow’s and Scotland’s vulnerability; and to mitigate against the effects of future vulnerabilities which are likely to emerge from policy responses to contemporary problems which fail sufficiently to consider and to prevent long-term, unintended social consequences.
- Scottish effect
- Glasgow effect
- excess mortality
FingerprintDive into the research topics of 'History, politics and vulnerability: Explaining excess mortality in Scotland and Glasgow'. Together they form a unique fingerprint.
- 1 Active
Collins, C., McCartney, G., Walsh, D., Batty, G. D., Levitt, I. & Taulbut, M.
16/06/08 → …
Excess mortality in Scotland and Glasgow: An unintended consequence of the pursuit of new towns policy as an ‘assumed normative’?Collins, C. & Levitt, I., 7 Apr 2022.
Research output: Contribution to conference › PaperFile
The Policy Discourses that Shaped the ‘Transformation’ of Glasgow in the Later 20th Century: 'Overspill’, ‘redeployment’ and the ‘culture of enterprise’Collins, C. & Levitt, I., 18 Dec 2019, Transforming Glasgow: Beyond the Post-Industrial City. Madgin, R. & Kintrea, K. (eds.). Bristol, UK: Policy Press, p. 21-38 18 p.
Research output: Chapter in Book/Report/Conference proceeding › Chapter › peer-review
Collins, C. & Levitt, I., 14 May 2018.
Research output: Contribution to conference › Paper › peer-review
Chik Collins (Invited speaker)28 Feb 2019
Activity: Talk or presentation › Oral presentation
The social and political determination of health in contemporary Glasgow: Findings from the Scottish Office archive
Chik Collins (Keynote speaker)9 Jan 2018
Activity: Talk or presentation › Invited talk
1 Media contribution
Chik Collins & Hartwig Pautz
1 item of Media coverage
1 item of Media coverage