by Martin Murray

Scotland and especially Glasgow has an unenviable reputation for poor health. Some of this reputation is based on fact, and some parts of it are totally fictitious. Scotland is associated with poor diet and in particular with the deep-fried Mars Bar. I have seen the shop in Stonehaven where the deep-fried Mars Bar is reputed to have originated as a practical joke but the only place that I’ve seen deep fried Mars Bars on sale is in Camden Market in London – not only was there deep fried Mars Bars on sale but every kind of chocolate bar that you could think of was available fried in batter. I have never seen a deep-fried Mars Bar on sale anywhere in Scotland

Despite the myths, the people of Glasgow do experience significantly poorer health than the people of comparable post-industrial cities in the UK and in other parts of Europe. The Glaswegian health deficit is attributed to the Glasgow effect. However, no one really knows what the Glasgow effect is; no one can adequately explain why Glaswegians are less healthy than people from Leeds, Liverpool and Newcastle. The Glasgow Centre for Population Health has been investigating the causes of poor health in Glasgow for over twenty years and been trying to find the cause of the Glasgow effect; why are Glaswegians so unhealthy?

One significant factor contributing to poor health in Glasgow is inequality. This has been identified as a social determinant of poor health by both the Glasgow Centre for Population Health and by Sir Harry Burns, former clinical director of NHS Greater Glasgow and Clyde. Social, economic and educational inequality all contribute to poorer health at all levels of the population. Inequality does not just make poorer members of society less health, it has a detrimental effect on the rich, the poor and those in between. However, it has a greater impact on the health of the poor.

But it is not just lack of resources that has a detrimental impact on the health of the poor. Sir Harry has closely examined what has been missing in the poorest and most unhealthy neighbourhoods in Scotland and concluded that the most important factor was meaning and purpose: if you have a “why” to live, then you can bear with almost any “how”. Meaning and purpose allow you not just to hang on to life, but to thrive and to flourish.

In the first half of the twentieth century, the landscape from the Tail of the Bank, through Glasgow and into urban Lanarkshire, was dominated by heavy industry. Post war de-industrialisation in the west of Scotland meant that men suddenly had no jobs that gave their lives meaning and purpose. It is difficult to stay healthy when your life has no meaning and no purpose.

Health is more than just an absence of physical illness. The constitution of the World Health Organisation (1948) speaks of health as positive physical, mental and social well-being. To that I would add spiritual well-being.

The Catholic Church is the world’s biggest provider of healthcare. This apostolate is clearly linked to Jesus’ mission to bring good news to the poor, to heal the broken hearted and to bring sight to the blind. It is also grounded in Jesus’ example of healing the sick and linked to the Church’s preferential option for the poor.

In this edition of Open House, Fr Tom McGill writes about the healing ministry of Jesus and how He did more than cure physical illness but healed the whole person. Prof Peter Kevern discusses the idea of spiritual health and spiritual care. Dr Nicola James discusses religion, health and spirituality in public spaces. Rev Stuart Patterson asks what it means to be well. Fr Charles Coyle and Dr Maureen Sweeney discuss the law and ethics of assisted suicide and Martin Murray possess the question ‘Is being a Catholic good for your mental health?’ He also gives an update of the development of medically supervised injecting facilities in Glasgow and Dublin. Mary Cullen reports on the recent conference on synodality and in a separate article considers the role played by local communities in the defeat of Scotland’s assisted dying bill.

In addition, we consider Magnifica humanitas, Pope Leo's encyclical on AI - or rather, we asked AI to consider the encyclical - fascinating!

Finally, we have a film review from Fr Charles Coyle, poetry from Stephen Smyth and a music review from Paul Matheson. We also have an update of the development of medically supervised injecting facilities in Glasgow and Dublin.

Near the end of his TED Talk on pathogenesis and salutogenesis, Sir Harry Burns quotes the American Jesuit, Greg Boyle

‘What we need is a compassion that stands in awe of the burdens that the poor have to carry rather than stands in judgement at the way they carry them.’

To fully live out the preferential option for the poor we must stand in awe of the poor. When we do this, we may have some chance of improving the health of nations.