Glasgow - Past & Present • Big trends James Arnott • From indicators to insights Anne Scoular • Integrated public health profile David Walsh & Bruce Whyte Themes of presentations • What is improving? • What’s proving resistant to change? • What’s getting worse? • Future trends and implications Big trends 1971 CENSUS “Shipbuilding, heavy engineering, textile and chemical manufacturing predominated until recently … light engineering and electrical products now form one of the city’s most important industrial features …” FURTHERMORE … “… large numbers of workers engaged in the distributive trades, the transport and communications industry, the manufacturing of food (including bread), drink and tobacco and of clothing and footwear …” NOT TO FORGET … “… a considerable number of people in the city are engaged in professional and scientific services …” PERIOD OF CHANGE • Decline of manufacturing … • … but improved quality of employment for those in work • Loss of population … • … but increased size of 25-44 age group • The city used to follow … • … now the city leads the conurbation 25-44 AGE GROUP 1981 25-44 2001 25-44 % change Glasgow 23% 31% 35% Rest of 26% 28% 8% Area Scotland 26% 29% 12% SOCIAL CLASS I&II I&II 1981 I&II 2001 % Change Glasgow 18% 38% +111% Rest of 28% 37% +32% Area Scotland 28% 37% +32% OWNER-OCC O-O 1981 O-O 2001 % Change Glasgow 24% 49% +104% Rest of 33% 65% +97% Area Scotland 35% 63% +80% INTERPRETATION • Rapid change since 1980s involving a major period of adjustment • Closing the gap with some but not all national rates •Why? From indicators to insights from indicators to insight local context • Parkhead: Glasgow in microcosm – 4 mines in central Parkhead – Forge 1837-1976 – Decline in heavy industry • Regeneration efforts – 1957: ‘Comprehensive Development Area’ – 1976: GEAR (‘Glasgow Eastern Area Renewal’ Project) – 1980s onwards: • Areas of Priority Treatment • Priority Partnership Areas • Social Inclusion Partnerships definition of ‘Parkhead’ local context = community defined area relationship to PC sectors population estimates Total population in Parkhead, 1981, 1991 and 2001 9,000 1981 8,000 1991 2001 7,000 6,000 5,000 4,000 Population 3,000 2,000 1,000 0 All ages <65 0-14 15-44 45+ health outcomes all cause mortality* 8000 5000 7000 4500 4000 6000 3500 5000 Parkhead 3000 Parkhead 4000 NHSGG 2500 NHSGG 3000 Scotland 2000 Scotland 1500 2000 1000 1000 500 0 0 1980-82 1990-92 2000-02 1980-82 1990-92 2000-02 male female *rate/100,000 person-years at risk (standardised to 2001 NHSGG population) ischaemic heart disease mortality* 2500 1400 1200 2000 1000 1500 Parkhead 800 Parkhead NHSGG NHSGG 1000 Scotland 600 Scotland 400 500 200 0 0 1980-82 1990-92 2000-02 1980-82 1990-92 2000-02 male female *rate/100,000 person-years at risk (standardised to 2001 NHSGG population) all cancer mortality* 2000 1000 1800 900 1600 800 1400 700 1200 Parkhead 600 Parkhead 1000 NHSGG 500 NHSGG 800 Scotland 400 Scotland 600 300 400 200 200 100 0 0 1980-82 1990-92 2000-02 1980-82 1990-92 2000-02 male female *rate/100,000 person-years at risk (standardised to 2001 NHSGG population) all cancer incidence* 900 600 800 500 700 600 400 Parkhead Parkhead 500 NHSGG 300 NHSGG 400 Scotland Scotland 300 200 200 100 100 0 0 1980-82 1990-92 2000-02 1980-82 1990-92 2000-02 male female *rate/100,000 person-years at risk (standardised to European standard population) health determinants: environment commercial properties within community defined area Property type Other premises Hostel/guest house Community centre/hall Advertising station Ground Store Betting offices/churches Other community resource Public house Workshop/factory/yard Office Shop 0 20 40 60 80 100 120 140 160 180 Source: Glasgow City Council Financial Services, January 2005 Parkhead Cross Retail Profile 1 1 Food/convenience store 1 Take away 6 1 Clothing Leisure 1 Hairdresser Newsagent 1 Pharmacy Furniture Dentist 2 2 Lawyer Flowers 2 2 Source: Parkhead Cross Economic Regeneration Project Final Report, 2002 retail environment retail environment trends in vacant & derelict land 1994 1999 2005 from this…. to this… or this ? conclusions • routine data applicable to socially defined ‘place’ • determinant data –surveys – COA level • detailed health outcome data clearly show Parkhead’s health trajectory • understanding pathways & interactions • understanding lived experiences • information for action acknowledgements • Karen Lorenzetti NHSGG Tricia Richardson NHSGG Khalid Bashir NHSGG Sarah McCullough NHSGG Janice Scouller NHSGG • Lorraine Tulloch Glasgow City Council Alan Grosvenor Glasgow City Council Diane McGregor Glasgow City Council Suzie Kemsell Glasgow City Council • David Walsh Health Scotland Bruce Whyte Health Scotland • Ian Henton Health Protection Scotland • Parkhead Housing Association Parkhead Youth Project Parkhead Health Centre East End Partnership Integrated public health profile Areas of analysis • Historical context • Behaviour • Population dynamics • Pregnancy & childbirth • Economy • Children’s health • Social environment • Health & function • Physical environment • Illness & disease Historical context/ Population dynamics Population Glasgow's Population; 1801-2004 Source: Reports of Medical Officer of Health (1898, 1925,1926,1972); Registrar General of Scotland's Annual Reports (1973-2004) 1,200,000 1,000,000 800,000 600,000 Estiamted Population 400,000 Local Gov Unitary Major city Districts Councils extensions 200,000 introduced introduced 0 1801 1811 1821 1831 1841 1851 1861 1871 1881 1891 1901 1911 1921 1931 1941 1951 1961 1971 1981 1991 2001 Births Trends in Births and Births per 1,000 population in Glasgow; 1855 - 2004 Source: Reports of Medical Officer of Health (1898, 1925,1926,1972) Registrar General of Scotland's Annual Reports (1973-2004) 35000 45 1920 1914 40 30000 1947 35 25000 1962 30 20000 25 BirthsBirths 20 15000 15 Births per 1,000 population 1,000 population per per Births Births 10000 10 5000 Births 5 Births per 1,000 population 0 0 1855 1865 1875 1885 1895 1905 1915 1925 1935 1945 1955 1965 1975 1985 1995 45 40 35 30 Deaths and BirthsBirths per 1,000 p & Deaths 25 Source: Reports of Medical Of 20 Registrar General of Scotland's Annual Reports (1973-2004) Deaths15 per 1,000 population 10 5 opulation in Glas ficer of Health (1898, 1925,1926,1972); 0 Births per 1,000 population 1855 Deaths per 1,000 population 1860 1865 gow; 1855 - 2004 1870 1875 1880 1885 1890 1895 1900 1905 1910 1915 1920 1925 1930 1935 1940 1945 1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 250 200 196 Infant Deaths (under 1 250 150 Infant deaths Source: Reports of Medical Of 200 Infant deaths (per 1,000 births), 1901 - Glasgow & selected English cities 100 Registrar General of Scotland's Annual Reports (1973-2004) 150 Infant Deaths per 1,000 births Report of Medical Office year) per 1,000 births 100 50 149 50 ficer of Health (1898, 1925,1926,1972); 0 r of Health of the Ci 0 1855 149 1859 in Glasgow; 1855 - 2004 1863 ty of Glasgow, 1901 Glasgow 1867 1871 187 1875 1879 1883 London 1887 1891 188 1895 1899 1903 Birmingham 1907 1911 199 1915 1919 1923 Liverpool 1927 1931 1935 1939 1943 Manchester 1947 1951 1955 1959 1963 1967 1971 1975 1979 1983 1987 1991 7.1 1995 1999 2003 45 40 Inequalities - 1901 35 30 25 Source:Death Report ratesof the Medical in Glasgow's Officer of Health of the City of Glasgow 1901 20 20.6 Deaths per15 1,000 population 10 5 0 8.3 Glasgow Sanitary Districts; 1901 Kelvinside Langside and Mount Florida Crosshill Hillhead Pollokshields West and Bellahouston Pollokshields and Strathbungo Govanhill Kelvinhaugh and Sandyford Blythswood Possilpark and Barnhill Monteith Row Woodside Maryhill Bellgrove and Dennsitoun Exchange Kingston Springburn and Rockvilla Hutcheson Square Greenhead and London Road St Andrew Square St Rollox 40.4 Laurieston Anderston Barrowfield Bridgegate and Wynds Gorbals Calton St Enoch Square High St and Closes East High St and Closes West Port Dundas Cowcaddens Brownfield 1200 Death rates per 100,000 population, directly age standardised; 2000-2002; 1000 Inequalities - 2001 800 Source: NHS HS - Communtiy Health Profiles, 2004 (from GROS data) 600 West of Scotland and Glasgow communities 400 428 200 0 Scotland Anniesland/Bearsden/Milngavie Eastwood East Kilbride Strathkelvin Clydesdale South Ayrshire Cumbernauld Renfrew & West Renfrewshire Lomond North Ayrshire East Ayrshire Greater Shawlands Hamilton Cambuslang and Rutherglen Glasgow West End South East Glasgow 965 Community Wishaw Motherwell Clydebank & Drumchapel Inverclyde Airdrie & Coatbridge Paisley and Levern Valley Eastern Glasgow South West Glasgow Maryhill/Woodside & N Glasgow Bridgeton & Dennistoun 1600 1400 1200 GlasgowDeath & ratesWestInequalities perof Scotland 100,000 populatismall areas - 2001 1000 800 600 Source: NHS HS - Community Health Profiles, 2004 (from GROS data) Age standardised400 death rate per 100,000 200 350 on, directly age standardised 0 Scotland with 10 highest and 10 lowest rates Kilmacolm Bearsden - Kessington Clarkston Carmunnock ; 2000-2002 Cathcart Milngavie - Keystone; Dougalston Milngavie - Barloch Houston Croftfoot; Linn Park Eaglesham Ibrox 1475 Parkhead N Fullarton Ferguslie Park Townhead Ruchill Hamiltonhill Kinning Park S Dalmarnock Calton Life expectancy Expected future years of life at birth by gender for Glasgow; 1821-27 to 2001-03 Source: The Report of the Medical Officer for Health, Glasgow, 1925; ONS 2004 90 80 76.4 70 Males Females 69.1 60 52.2 50 48.4 37.7 40 36.6 32.6 34.1 35.2 30 30.9 Expected future years of life at birth