The Scottish riverfront city of Glasgow is a place of hilly neighborhoods and tight-knit families. There’s a strength about the people, perhaps born of hard work and long, gray winters that only give way to a few warm weeks of summer before the chill returns. And yet there’s an openness — a willingness to give a stranger directions or point them toward the perfect pub for a pint of beer at the end of a day.
For generations, a thriving shipbuilding industry provided ample jobs for workers throughout this gritty city. Life wasn’t easy, but there was a rhythm to it that one generation could confidently pass down to the next.
Then in the 1960s and ’70s, the unthinkable happened: Those heavy industry jobs vanished, leaving Glasgow and its people to suffer the impact. There were physical scars left behind and some still remain, including vacant and derelict land near where the poorest of Glaswegians live. Other kinds of scars developed too, such as the decline in the number of blue-collar jobs that came to define this once vital city.
Glasgow earned a nickname no one wanted to see on a bumper sticker: It was sadly dismissed as the “sick man of Europe,” a city plagued by post-industrial blight and poverty, with citizens prone to poor health. Wages dwindled, pride was bruised and communities struggled to maintain the well-being and solidarity they once took for granted.
“Glasgow and Pittsburgh were once twin titans of the industrial age,” says Duncan Booker, chief resilience officer for Glasgow City Council and manager of Sustainable Glasgow. In a strangely mirrored experience, these cities 3,500 miles apart have spent recent decades fighting back from the very same challenges.
Today, Pittsburgh is looking to the Glasgow Resilient Cities Project to learn how this Scottish city shed its reputation and is addressing its most dire problems, especially the physical health of its citizens.
Grant Ervin, the City of Pittsburgh’s chief resilience officer, says it’s easy to see the striking parallels.
“The loss of major employers, the loss of population, those different aspects,” he says, “create a kind of common bond.”
Pittsburgh and Glasgow are members of 100 Resilient Cities (100RC), a global network established by the Rockefeller Foundation that helps cities more effectively address their economic, social and physical challenges. The goal of 100RC is not only to prepare cities for natural disasters and other unexpected natural phenomena, but also to address social concerns such as economic and health inequality.
Health, it turns out, is a particular key to improving all aspects of a city’s resilience. In both cities, health issues increased as the industrial base declined.
“In Glasgow, we can almost date the arrival of significant heroin use in the city with the destruction of its industries,” Booker says, “and that too is a legacy with which we continue to live across generations.”
What can we learn?
“We’ve been doing this exchange,” says Dr. Ken Thompson, “essentially learning how Glasgow did what it takes to make people healthy and how they made that the core of their resilient strategy.”
Thompson is a psychiatrist who, along with Lou Ann Geremko of the Consumer Health Coalition, is Pittsburgh’s principal investigator for the Partnership, which is funded by the Robert Wood Johnson Foundation and administered by the Consumer Health Coalition.
So far, delegations from Pittsburgh and Glasgow have exchanged ideas and visited the respective cities. Thompson has found that Glasgow focused specifically on “addressing dramatic health inequities between neighborhoods,” he says.
Glasgow’s approach started by measuring life expectancy for Glaswegians. The figures were startling. Men in the most affluent areas of Glasgow had a life expectancy of 13.5 years longer than those in poorer sections; for women, the difference was 10.7 years.
To narrow that gap, Resilient Glasgow started to provide job opportunities and skill training, financial support when necessary (welfare benefits and access to grants and loans), and public health services, including physical and mental health and health monitoring, to ensure equity across subgroups.
Throughout the 10 years that they’ve been addressing these problems, Glasgow began taking a holistic approach to the city’s problems through three core tenets, says Dr. Peter Seaman, the acting associate director for the Glasgow Centre for Population Health. Those are:
- Improving the health of the most disadvantaged groups.
- Reducing the gap between the best and the worst off.
- Reducing the barriers between economic classes, so that sufficient health care is available to all.
“Improving health and addressing health inequalities is complex,” he says. But after reviewing 10 years of evidence, he says it’s clear that certain interventions that are necessary.
“It matters both what actions are taken and how things are done,” Seaman says. “The need to work in partnership to develop locally appropriate responses has been highlighted. The evidence also consistently points to the importance of human interaction and the quality of relationships fostered, requiring recognition of individuals’ circumstances.”
It’s vital to reach out to people with a human touch, and deal with the realities of their personal daily lives.
“Having services available is often only a partial solution,” he says. “We also need to ensure people are aware and able to access services when they need them. Recent activity in the city has included locating financial advice workers in maternity settings to ensure the whole range of potential needs are met.”