Odds stacked against Glasgow's poorest - even before birth

 

GLASGOW LETTER:ON A BITTERLY cold dawn, the streets around Glasgow Celtic’s Parkhead football ground are near-empty, with the few people about showing grey, pinched faces as they huddle to escape the rain.

For all the dreams lived inside the stadium, these are not streets of hope. Parkhead West and Barrowfield come top every time a list of Scotland’s most-deprived districts are published, despite, it must be said, some improvements in recent years.

Glasgow has always been a city of titles: the second city of empire in the days when the sun did not set – although in more recent decades the less-wanted “sick man of Europe” label has been used to describe the city’s appalling health record.

Figures last year found that men in the poorest districts of city could expect to live for 13 years fewer than richer Scots, while women could expect nine years fewer of life. Scottish men as a whole live on average for three years fewer than their English counterparts.

New research this week, though, from the University of Glasgow shows that the cards of life are dealt just weeks after conception, when methlylation takes place in the embryo. This is the process whereby chemical tags are imprinted on to DNA that govern how the body works in later life.

Methylation occurs only once. Once finished, the levels are set for life. Explaining the concept, lead researcher Dr Paul Shiels says: “If you think of your chromosomes as the hard drive of a computer and the methylation as a programme, sometimes the programme can be corrupted. If you have a poor programme, then it’s not going to work as well.

“There’s a drip effect,” he adds, “which predisposes you from birth to be less robust, therefore more prone to early-onset disease.”

Lower levels of methylation increase the chances that diabetes and cardiovascular disease will develop later in life – illnesses on which Glasgow still has the worst record, according to the 2010 Scottish Index of Multiple Deprivation.

Alcohol and cigarettes, along with the mother’s diet during pregnancy, affects the degree of methylation in the embryo in the weeks after conception, the researchers acknowledge, but the single biggest factor is the mother’s stress levels – both psychological and sociological.

Blood samples showed that methylation levels were significantly lower in the poorest districts, Dr Shiels says, caused by problems before birth – smoking, poor diet and stress later in life only slightly affects the numbers.

Prof Carol Tannahill, director of the Glasgow Centre for Population Health, says the links between deprivation and ill-health are well-known, but the route by which poverty affects future ill-health is less well understood.

“Previous findings from the study have confirmed that people with relatively low income, living in poor circumstances, have more miles on their biological clock than people of the same age in better circumstances,” she says.

The Scottish index survey highlighted stark differences.

In 2009, 347 out of every 100,000 people in Scotland spent time in hospital because of heart attacks and angina, but the numbers for Glasgow stood at 456, while Shetland Islanders were half as likely to go to hospital.

The worst rate (significantly higher than Scotland) is seen in North Barlanark and Easterhouse South, within east Glasgow, while similarly disturbing rates are found in districts in North Lanarkshire and Inverclyde.

Besides, perhaps, spurring the Scottish government and local councils to do more for pregnant mothers in districts such as Parkhead, the researchers believe tests could be created to check methylation levels to identify those most at risk of ill-health.

For John Dickie, head of the Child Poverty Action Group in Scotland, the epigenetic research is a call to arms, in that it offers “startling evidence” of the damage that poverty does to children even before they are born.

“We have long known,” Dickie says, “that children born to mothers in poverty are more likely to have significantly lower birth weight and suffer associated risks to their health, that lack of a decent income means too many mothers struggle to afford the diet that would give their babies the best start in life and that those born into poverty are more likely to die at childbirth or infancy. “That the damage may be inflicted even further back in the life-cycle, therefore, should not come as a surprise but should be no less shocking.” He adds that poverty causes “extreme stress and physical damage”.

Last month, Child Poverty Action Group produced a map illustrating the crisis, showing that one in three children in Glasgow is living in poverty, while in some districts, the figure run to one in every two.

For campaigners such as Dickie, the findings by the University of Glasgow fuel their belief that more must be done. However, the British government – which sets welfare rates for all of the UK despite devolution – is, he says, determined to cut the payments to “prospective and existing parents alike”.

“Unless we see action, future generations will continue to have their life-chances compromised whether genetically, as they develop in the womb, or as children born into a society still scarred by poverty and inequality,” he argues.