GROWING up in Calton, a deprived pocket in the east end of Glasgow, Steven Francis Hewitt never knew of bad habits. For him, the culture of pubs, takeaway food and palls of cigarette smoke was everyday life. "As a kid, I had bronchitis because of all the conditions I had around me," the 33-year-old told The Scotsman. "My parents did their best for me (but] I had a deprived childhood.
"You see your father having a drink or smoking and you pick it up.You don't think anything of it. You pick up bad habits because it's learned behaviour."
Mr Hewitt, currently unemployed due to illness, is trying to give up smoking, but he knows
too well the difficulty in escaping Calton's ill-health. "A few of my friends have fallen by the wayside from all sorts of social deprivation," he added.
It is a story that could be told by many of the area's residents. Calton has long been renowned in Scotland's largest city for its grim health, but now the plight of its residents has been flagged up to health practitioners around the world.
A new report by the World Health Organisation (WHO) gives prominence to a single statistic that perhaps best sums up the seriousness of the situation in Calton – 54. That, in years, is the life expectancy of a baby boy born in the region. In neighbouring Lenzie, an affluent area in East Dunbartonshire, just eight miles – or a ten-minute drive – away, the life expectancy is 82.
It is an alarming gulf which, although not new – it was first published in a Glasgow Centre for Population Health report two years ago – forms the centrepiece of the WHO's argument. Namely, discrepancies in health and life expectancy are down to social and political factors, not genetic ones.
The three-year WHO study concludes that a "toxic combination" of bad policies, economics and politics creates social injustice that is "killing people on a grand scale", with adult death rates generally 2.5 times higher in the most deprived parts of the UK than in the most affluent.
It is powerful language, but other statistics relating to Calton's health show that such emotive words are warranted. The area has double the proportion of adults who die from smoking-related illnesses, and twice the ratio of adults with long-term illnesses or disabilities.
Four times as many adults of working age in Calton are unable to work due to illness compared with the national average; nearly three times as many people are admitted to hospital; and 61 per cent of adults have no qualifications, compared with 33 per cent in Scotland overall.
For the past two decades, Dr Robert Jamieson has waged a battle many would regard as a lost cause. As a Calton GP, he witnesses ill-health among many of his 2,000 patients. "It's no surprise we have higher incidences of heart disease, strokes, mental illness, diabetes, asthma and bronchitis than Lenzie," he told The Scotsman.
"The area has the dreadful distinction of having the lowest household income in the UK. It limits the choice of my patients in all areas of life – from diet, housing and clothing to recreation."
David Walsh, the public health information manager at NHS Health Scotland, was a co-author of the original 2006 report. He warned yesterday that his findings were still relevant. In fact, he said, the differences in life expectancy between wealthy and poor areas was continuing to widen, but he said that the Scottish Government had at least started to rise to the challenge.
Mr Walsh said a range of linked factors in poorer areas, such as smoking, drinking and level of education, were behind the inequalities. But no one factor was to blame, he continued, and failure of health policy in these areas could have contributed.
He said: "Trends that we have seen in a number of reports over the last 20-25 years show that the differences in life expectancy are widening.
"If you look at the fifth most affluent area of population in Glasgow, life expectancy is improving. But if you look at the fifth most deprived, which includes Calton, it is static. It hasn't improved, so there is a widening gap between the rich and the poor."
Mr Walsh added: "You could argue there is quite a chunk of the population that has been left behind. That has happened in an area where some of the policies haven't done enough to attack that problem."
The Scottish Government hopes that will be a thing of the past. In June, it revealed an overhaul of the way in which health inequalities are tackled. Backed with fresh funding of £15 million, some £1.78 billion will be spent on the issue over the next three years. The emphasis will be on giving children the best possible start to life, with improved antenatal services and support for young families.
It is, said Dr Harry Burns, the chief medical officer, the "most insightful programme I have seen in the world". Local schemes have also been set up in the east end, targeting adults who do not visit their GPs, knocking on the doors of people who fall through the cracks of the health system.
Dr Jamieson believes there is room for optimism, however. He thinks poverty, poor housing, gang and knife cultures and drug and alcohol abuse – all "colossal contributors to an early death" – still require action via a "top-down" approach from central and local government. But he has been encouraged by the number of people taking personal responsibility for their own health, an issue not covered by the WHO report.
"Around 45 per cent of my patients smoke, but I've taken great heart from the numbers that are coming asking for help to give up," he said. "That's great and we do all we can to help, but there are other things which government can do. In recent times, we have dealt with advertising of cigarettes and then with smoking in public places. But I believe that advertising for alcohol and junk food should also be tackled.
"If we can get more genuine information about food which helps people make better choices, then we're a step closer to real change."
In Calton, 55 per cent of people claim income support and 58 per cent are "economically inactive", compared with Scottish averages of 12 and 35 per cent respectively.
David Coyne is the executive director of Glasgow Works, a partnership organisation formed to get people off benefits and into work. It has already helped about 9,000 people come off benefits and he pointed out that people in areas such as Calton want to work, with a survey showing over a third of those Glaswegians on benefits desire employment, provided necessary support is available. "It is important that the various agencies in the city band together in an innovative way to help these people on the first steps back to employment and a better life," he said.
John Mason, the newly elected SNP MP for the area, said: "These statistics are shocking, but sadly familiar. Poor health has characterised the East End of Glasgow for far too long. It is absolutely inexcusable that life expectancy in Glasgow is lower than that of India, where 80 per cent of the population live in poverty.
"Clearly, the area's challenges are complex and will not be resolved overnight, but action must be taken on the blights that have held us back for too long. For example: measures to tackle excessive alcohol consumption and a lack of exercise as well as addressing maternal health, drug and alcohol misuse and early-years provision."
