'Economics are the key to good health'

Compared with a decade or two ago, Glaswegians are less likely to smoke, more likely to eat healthy foods and are more likely to breast feed their children. They have lower cholesterol levels and are less likely to die in middle life from a heart attack or stroke.

This improved outlook is down to some forward-thinking initiatives being put in place. Free fruit in schools is changing the eating habits of a generation. Increased access to sports facilities is having an impact on heart disease.

However, a new assessment of our progress confirms that, in improving its health, Glasgow is starting from a baseline that is far worse than comparable cities in the UK and that our health is not improving as fast as it might. It is clear that we need to do more if the health of our citizens is to catch up with the rest of Britain.

Health is a by-product of a just society which allows people to take control of their lives and contribute to the wider community. People with aspirations and opportunities are healthier than those who have neither. Is this the reason Glasgow is less healthy than it should be? Has poverty and lack of opportunity blunted the aspiration of many of our residents?

There is little doubt that poverty is closely associated with ill- health and Glasgow has a far higher concentration of poor people than any other part of Scotland. The city will not see radical health improvements until all its residents live in circumstances that encourage them to fulfil their aspirations. A good start to this process would be to tackle poverty.

Most of the jobs being created in Glasgow are being filled by those who live outside the city. Those who need the jobs, whose health and well-being depend on the self-esteem and dignity that come from being a productive member of the community, are less likely to take these opportunities. Understanding why this is happening and dealing with it is absolutely vital.

Can a country whose population is shrinking afford to ignore the impact of thousands of men and women of working age who have no training, opportunity or incentive to become economically active? It can be in nobody's interest to have a large group of the population of our biggest city chronically unhealthy and dependent on incapacity benefit.

By any criteria, Glasgow City Council, Scottish Enterprise Glasgow and the NHS are delivering services to the population which are innovative and effective but, inevitably, limited by resource availability and inadequate to deal with the legacy of decades of poverty. Scotland needs an economically productive Glasgow. How we achieve that end is not for me to say. However, until we achieve it, Glasgow will remain less healthy than it could and should be.

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