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To Scotland's good health

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VOL: 97, ISSUE: 44, PAGE NO: 29

Alex Mathieson, RGN, RNMH

You can learn a lot about life on a walk through a graveyard. Take the one in my home town just north of Glasgow, for instance. Look at the ages inscribed on the headstones, particularly the ones marking men's graves. 'Died aged 53', or '47', or '61', or '41'. A man who made it into his seventies or eighties is a rarity.

You can learn a lot about life on a walk through a graveyard. Take the one in my home town just north of Glasgow, for instance. Look at the ages inscribed on the headstones, particularly the ones marking men's graves. 'Died aged 53', or '47', or '61', or '41'. A man who made it into his seventies or eighties is a rarity.

There is also an older part of the cemetery, with graves dating from the 19th century. The impression you get from looking at these headstones is that if a male child survived infancy, he stood a better chance of living into his seventies than those born in the 1930s onwards.

My impressions are backed up by recent research published in the government's Health Statistics Quarterly. It shows that Glasgow has the worst life expectancy in the UK. At birth a man in Glasgow has a life expectancy of 68.7 years, compared with 79 years in East Dorset. The respective figures for a woman are 75.4 and 83.5.

Glaswegians have a reputation for living life to the full and there is no doubt that people do die in car crashes and on the slopes of Scotland's mountains. But I knew lots of those men in the graveyard. Smokers, many of them. Drinkers, almost all of them. Men who largely gave up physical exercise after hanging up their football boots in their late twenties. They were not victims of random, unpredictable accidents, but of Scotland's 'Big Three': heart disease, stroke and cancer.

Tracy McFall argued in this column a couple of weeks ago ('Pills won't cure ills caused by poverty', October 11, p29) that the root cause of ill health is poverty, a view supported by Scotland's chief medical officer. I'm happy to support what she says, but while ill health must be tackled in a range of social and political arenas, I don't think we should underestimate the potential of action now being taken on the public health front.

A national dietary coordinator has been appointed to push the diet action plan, for example. The Health Education Board for Scotland, working with Action on Smoking and Health and other organisations, has developed imaginative campaigns to reduce smoking. We even have a national physical activity taskforce in the offing. And in nursing, a host of new community-based posts have been created with a public health remit.

Beating Scotland's health problems will depend largely on how the newly established Public Health Institute of Scotland gets to grips with the problems we face. It has an enormous task ahead of it, and will need government support on issues like housing, transport and benefits. But it might just be the right organisation to pull together the coordinated action that Ms McFall and many others crave.

In the meantime, the life expectancy figures can at least lay to rest the fatuous notion that the provision of 'free' nursing care in Scotland will herald a stampede of older people from south of the border. Tell the truth - if you lived in Dorset, would you want to move to Glasgow?

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