Nudging our unfit and obese citizenry into action can only go so far if we are to make a dent in the morbidity statistics, writes Hugh Reilly
AT THE ripe old age of 58, I am becoming aware of my mortality. Television ads promoting life insurance – with the seductive offer of a free Parker pen just for inquiring – initiate outbreaks of affirmative nodding and chin-stroking.
I harbour no fear of dying; indeed, when my body finally peters out – reaching its soul-bye date if you will – it contents me that I’ll not be taking up residence with the cloud-dwelling gated community. But nor will I be enduring a diabolical, below-stairs afterlife, desperately sourcing an asbestos onesie to make a hellfire existence a tad more tolerable.
Being a down-to-earth guy, I like to stroll through graveyards from time to time to remind myself that I’m just here for three score years and ten, if one is to believe Psalm 90:10. However, given that the Bible also contains eyewitness accounts of orating snakes and donkeys, the veracity of its prognostications regarding longevity should not be taken as gospel.
I have to say that I find a cemetery walk very uplifting. According to official records, life expectancy in 1840 was 29. To those not possessed with critical faculties, it would seem that early Victorians were popping their clogs after only one and a half score years.
Yet a five-minute macabre meandering among fading headstones reveals that many folk lived long lives during this period. Glasgow’s resting places are filled with people who blew out candles on their 70th birthday cakes. These tell-tale tombs prove that long life was not the preserve of the rich and famous such as Queen Victoria, who died aged 81, or Florence Nightingale, who achieved nonagenarian status.
The 19th-century life expectancy figure was skewed by the high number of infant and childhood deaths. Today, thanks to a cocktail of improved living conditions and the NHS, people are living longer. Well, at least some of us are.
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It’s an oft-repeated claim that a boy born today in leafy Lenzie, East Dunbartonshire, could expect to live to the age of 82, while eight miles away in Calton, in the East End of Glasgow, average life expectancy for men is just 54.
These would be shocking stats – if they were true. The reality is that Calton Boy is a straw man in any polemic regarding health inequalities. The reason for life expectancy being strikingly low in Glasgow’s East End is that this impoverished part of the city is home to the majority of homeless hostels, places such as the less-than-salubrious Bellgrove Hotel. Here, destitute men and women come to prematurely die, a cold fact that contorts local longevity data.
Health inequality is measured in two ways: mortality and morbidity. The former is simple – count up the cadavers and the ages on death certificates. Morbidity, or illness if you prefer, is more difficult to quantify. Some information can be gleaned from a variety of sources; for example, GP clinics and hospitals. However, morbidity rates are nothing more than guesstimates, given the variables at play, such as males being less likely to seek medical advice when ill.
Yesterday, a report from Holyrood’s health committee called for greater initiatives to reduce health inequalities. The group claimed that, despite numerous interventionist policies, health disparities had actually increased.
Legislation had caused the puffing middle classes to stop smoking and health awareness programmes had encouraged the better-off to eat healthily and take more exercise. This discovery chimed with my experience. When I paid council tax to East Dunbartonshire, on looking out of my bay window, it was often the case that my panoramic view of the Number 45 bus stop was despoiled by the sight of twee joggers, trendy water bottle in hand, passing by; when swarms of designer-tracksuited runners ran past, I knew the Glasgow half marathon was nigh.
After my divorce, I moved to the north-east of Glasgow on financial grounds – I was broke. Looking out of the window of my ex-council home in Springburn’s Barmulloch barrio, I saw people running, but this time usually being chased by young men equipped with weaponry.
By dint of being male and over 50, I was once asked to participate in a government-funded health initiative. At my GP practice, a kindly nurse weighed me, took blood, counted my heartbeat and asked questions about my lifestyle. The follow-up was somewhat scant; that is, I never heard from her or the practice again. I took solace that at least the good doctors had seen a welcome nudge in their remuneration package.
To some extent, the collective approach to tackling health inequalities has merit. Government has a duty to ensure that that the air we breathe is not contaminated with harmful particulates. In our city centres, hazy blue smog created largely by buses is a disgrace – inner-city Glaswegians only refuse to wear a Shanghai facemask accessory due to fears of impugning the city’s Style Mile reputation.
Political action should be taken to subsidise sports centres where price is a barrier to access. Our decision-makers could take bold steps and introduce a “fat-tax” on stodgy food. Naturally, this would upset those who believe obesity and early death is not the business of government. To be fair, these are the type of people whose forefathers decried the setting up of Victorian workhouses as being the start of a nanny-state.
In the final analysis, the individual must assume the greatest responsibility for his or her health; deciding to quit smoking, end binge-drinking and eat five-a-day is a personal choice.
Like the poor, health inequalities are ever with us, but we can narrow the gap by convincing the more vulnerable to realise that one’s health is the most important ingredient to true happiness.
I’m dying to see the day when health discrepancies are not a scar on the face of Scotland.
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