Sir Harry Burns, Chief medical Officer of Scotland on the science of poverty… Harry is a trustee of the STV Charity Appeal.
“A resident of a poor area can expect to die about 10 years earlier than someone who lives in a better off area and the gap in life expectancy between rich and poor has been growing for many years.
A number of explanations have been offered for the widening gap. It was originally assumed that the gap was due to the fact that, in poorer areas, people smoked more, ate less healthy diets and drank too much alcohol. While it’s true that many of them do, these behaviours, by themselves, do not fully explain the pattern of ill health we see in Scotland. Many years of careful scientific research have shown that the explanations for Scotland’s poor health are more complicated than just bad habits.
It turns out that the increased risk of heart disease, stroke, diabetes and cancer that we see in the most deprived areas has some of its origins in early life. People living in deprived circumstances will normally have chronically high levels of stress hormones. Over many years, the high stress levels causes damage to arteries and DNA, leading to increased risk of all the illnesses we see commonly in Scotland. How do these increased levels of stress hormones come about?
It turns out that our stress responses are set very early in life. Our brains consist of many billions of cells, which are densely interlinked to each other. As tiny babies the ways in which the cells are linked are constantly being shaped by the signals we get from the world around us. If those signals suggest that the world is safe and predictable then our brains, which control our response to stress and threat, set our stress responses to a low level.
Some scientists have compared the process of brain development to the process of serve and return in a game of tennis. A baby who experiences something which upsets him cries. That’s the serve. What happens next depends on the return it gets.
If the cry is met with a comforting, consistent response, usually from its mother, baby learns that the world around it is consistent, structured and predictable. Also, he learns, that the discomfort he feels can be made better.
By the time baby has experienced the serve and returns a few thousand times, he learns that he has some control over his world and his brain develops appropriately.
If, on the other hand, baby lives in a chaotic environment in which his cries for help are ignored or met with violence, the serve and return process is abnormal.
Baby learns that the world is not structured and predictable and he has little control over events. In these circumstances, baby’s brain develops in a way that sets it up for survivial in an inconsistent and threatening world. Part of this survival response is to turn up stress hormone levels.
Th survival pattern of brain growth is at the expense of the centres of the brain concerned with memory and judgement. Children who have this type of experience are less likely to do well at school and are often in trouble because of behaviour problems. Studies have shown that they often have persistently high levels of stress hormones.
One particularly well known study based in New Zealand has followed around 1000 children for 40 years. A subgroup of children was identified as living in chaotic and difficult circumstances at around age 3.
Forty years later, the researchers found that this group of children are more likely to be unemployed, have criminal convictions, especially for violence, be addicted to drugs or alcohol and, in addition, they have high levels of stress hormones, the chronic stress will make them more likely to develop heart disease and diabetes as they get older.
Another important study, which looked at the consequences of adverse events in early life, was carried out, not in deprived areas of Scotland, but in affluent Americans. Children who experienced a range of adverts events such as neglect, abuse or parental absence were more likely to become alcoholics or drug addicts, and were more likely to have been involved in violent behaviour.
It’s clear that many of the problems we see in present day Scotland have their origins in the experiences that children have in their very early life.
Poverty of affection and inconsistency of nurturing and caring behaviour towards children is a significant factor in the widening hap in health in Scotland.
Poverty in the conventional sense contributes to chaotic lifestyles in economically deprived families and it needs to be tackled if health and wellbeing in Scotland is to be transformed. However, tackling financial poverty needs to be done in conjunction with efforts to help parents develop their children. Many projects in Scotland are doing just that. The Family Nurse Partnership for example, offers teenage girls who become pregnant access to a highly trained nurse who will provide help and support during pregnancy and for the first two years of the baby’s life.
The support gives the young mother confidence in bonding with baby and enhances her sense of control over her life. Both mother and baby have significantly better psychological and physical health outcomes. There are many other parenting projects underway in Scotland at the present time and they are mainly focused on improving the attachment between parents and children while also teaching parents the basic skills of parenting. These projects are critical to improving Scotland’s health. However, investing in support for parents and children will not just improve health. It will improve educational performance in our schools, reduce crime and enhance employability and Scotland’s economic performance.
It is, in fact, a no-brainer!”
Sir Harry Burns, Chief Medical Officer of Scotland
Just two years ago we with our partners at STV established the STV Appeal and in our second year, 2012 we raised over £2m thanks to the matched funding support of First Minister Alex Salmond’s Scottish Government.
The Appeal featured a week long series of programmes and a full night’s broadcast highlighting key poverty issues but more importantly the solutions to those issues. The shocking fact remains that 220,000 children in Scotland lives in poverty. In 2012 the STV Appeal, once again, had the support of the Scottish Government which is committed to match-funding the total amount raised in 2012.
Working closely with six major Scottish charities (Aberlour, Action for Children, Barnado’s Scotland, Children 1st, Save the Children Scotland and One Parent Families Scotland) the STV Appeal supports initiatives that seek to change the lives of Scotland’s most vulnerable young people in a sustainable, long term way. All the operations costs of the STV Appeal are met by The Hunter Foundation and STV meaning that every penny donated by the public goes directly to support those children most in need.
STV Appeal is firmly established as a force for good; committed to making a real difference to the lives of children affected by poverty.