OBJECTIVES: A high level of 'excess' mortality (i.e. that seemingly not explained by deprivation) has been shown for Scotland compared to England & Wales and, in particular, for its largest city, Glasgow, compared to the similarly deprived postindustrial English cities of Liverpool and Manchester. The excess has been observed across all social classes, but, for premature mortality, has been shown to be highest in comparison of those of lowest socio-economic status (SES). Many theories have been proposed to explain this phenomenon. One such suggestion relates to potential differences in social capital between the cities, given the previously evidenced links between social capital and mortality. The aim of this study was to ascertain whether any aspects of social capital differed between the cities and whether, therefore, this might be a plausible explanation for some of the excess mortality observed in Glasgow.
STUDY DESIGN: Cross-sectional study.
METHODS: A representative survey of Glasgow, Liverpool and Manchester was undertaken in 2011. Social capital was measured using an expanded version of the Office for National Statistics (ONS) core 'Social Capital Harmonised Question Set'. Differences between the cities in five sets of social capital topics (views about the local area, civic participation, social networks and support, social participation, and reciprocity and trust) were explored by means of a series of multivariate regression models, while controlling for differences in the characteristics (age, gender, SES, ethnicity etc.) of the samples.
RESULTS: Some, but not all, aspects of social capital were lower among the Glasgow sample compared to those in Liverpool and Manchester. A number of these differences were greatest among those of higher, rather than lower, SES. Levels of social participation, trust and (some measures of) reciprocity were lower in Glasgow, particularly in comparison with Liverpool. However, assessment of any potential impact of these differences is limited by the cross-sectional nature of the data.
CONCLUSIONS: The analyses suggest it is at least possible that differences in some aspects of social capital could play some part in explaining Glasgow's excess mortality, especially among particular sections of its population (e.g. those of higher SES). However, in the absence of more detailed longitudinal data, this remains speculative.
This work would not have been possible without the co-operation, participation and assistance of a number of individuals and organisations. Thanks are due, first and foremost, to all the survey respondents in Glasgow, Liverpool and Manchester for giving up their time to complete the questionnaire. Grateful thanks are also due to the following for their help, time and efforts: Jo Christensen, Paul Murphy, Jeremy Hardin, and Jodie Knight at AECOM Social and Market Research; Ruth McLaughlin, formerly of GCPH, for initial work in the development of the questionnaire; Catherine Ferrell at the MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, for help and insights in commissioning the survey; David Regan, Public Health Manchester, and Paula Grey, Liverpool Primary Care Trust, as well as Colin Cox (Public Health Manchester), Julia Taylor (formerly of Liverpool Primary Care Trust and Liverpool Healthy Cities) and Alison Petrie-Brown (Liverpool Primary Care Trust), for invaluable help in encouraging local participation in the survey; Phil Mason, Mark Livingston, and Maria Gannon, University of Glasgow, for additional statistical support and advice; and the Office of National Statistics (ONS) for use of (a modified version of) their social capital survey questions.
The survey was jointly funded by NHS Health Scotland and the Glasgow Centre for Population Health.
- Cross-Sectional Studies
- Middle Aged
- Excess Mortality
- Social Capital
- Glasgow effect