Exploring socio-cultural explanations of Glasgow’s ‘excess’ mortality

The health of the population in Glasgow and the surrounding region is known to be poorer than the similar cities of Liverpool and Manchester. A key indication of this is Glasgow’s higher (or ‘excess’) mortality in comparison to these two places despite their similar histories, population profiles and levels of deprivation. One of a number of proposed explanations for this is the ‘socio-cultural hypothesis’ that suggests the differences in health outcomes can be explained at the level of culture.

Through interviews with key informants across nine communities across the three cities, we explored aspects of local experience which related to key dimensions of culture and considered the contribution these aspects of life make to health outcomes.

Living with and responding to change was a key characteristic of the data. Three core dimensions of change were shaping experiences of community life which were reflected in local descriptions of culture. These were changes to economic aspects of life, to the wider welfare landscape and in how community and mutual support is understood, enacted and created. That the three cites appear to be on different trajectories in relation to these dimensions of change is interesting because Glasgow’s ‘excess’ mortality is premised on the idea that the three cities share similar histories and characteristics. These findings indicate their futures may be characterised more by difference than similarity.

In this report we explore these differences and discuss what contribution it makes to the task of understanding health inequalities between the three cities more broadly.