Glasgow Centre for Population Health

@thegcph.bsky.social

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Generating insights and evidence and supporting new approaches to improve health and tackle inequality. monthly e-update: gcph.co.uk/eupdate

Eco-ableism is when environmental policies, campaigns, or expectations unintentionally disadvantage or exclude disabled people and those with long-term health conditions. It happens when green initiatives assume everyone can adopt eco-friendly behaviors, like walking, cycling, or using public transport, without considering different abilities or access needs. This can create barriers and reinforce exclusion. Addressing eco-ableism ensures climate action is inclusive, equitable, and supports a just transition for all.
Census data show that LGBT+ people experience persistent inequalities in housing, employment and education. Compared with heterosexual populations, they are less likely to own their home and more likely to live in private rented or rent-free accommodation. These patterns may reflect hidden homelessness, including couch surfing or temporary stays with others. LGBT+ populations also experience higher unemployment and are overrepresented at both the highest and lowest occupational levels, indicating a polarised labour market. While LGB+ people are more likely to hold degree-level qualifications than heterosexual populations, lower educational attainment is seen among some trans groups. These findings highlight the need to routinely collect sexual orientation and gender identity data to better identify inequalities and support inclusive policy, services and workforce planning.
The document highlights significant health disparities faced by transgender and non-binary individuals, including higher rates of poor health, disability, and complex health needs. Pronounced Health Inequalities in Trans Groups Trans individuals report much worse health status, with 61.5% feeling "bad" or "very bad" compared to 8% of cisgender people. Higher Disability and Learning Difficulties Almost half of some trans subgroups experience disability, with developmental and learning difficulties over ten times more common than in cisgender populations. Additional Complex Health Challenges Trans and non-binary people face overlapping issues like speech and vision impairments, especially among non-binary individuals, indicating multiple health inequalities.
Image of Glasgow Botanic Gardens
LGBT+ people face significantly higher rates of mental health conditions compared to the general population. Prevalence ranges from 26% in gay or lesbian groups to 60% in 'Other trans' groups, while heterosexual and cisgender populations report 12% and 13% respectively. Bisexual and 'Other sexual orientation' individuals have the highest rates among LGB+ groups at 41%. Within trans populations, non-binary (56%) and 'Other trans status or history' (60%) individuals are most affected. These disparities are linked to stigma, discrimination, exclusion, and barriers to accessing inclusive, affirming services, which worsen social isolation and mental wellbeing.
The Scottish Census shows that LGBT+ identification is much more common among younger people than older adults. This likely reflects greater social acceptance, visibility, and legal equality, enabling more people to openly express their identity. Some older trans people may no longer identify as trans after living for many years in their affirmed gender. Evidence also suggests LGB+ people experience higher all-cause mortality than heterosexual people. These findings highlight the need for public health services to support a growing, more diverse younger population while addressing persistent health inequalities affecting older LGBT+ communities.
Heteronormativity is the assumption that heterosexual relationships and binary gender identities are the norm, promoting traditional gender roles and family structures. This narrow view can exclude those who don't fit, such as transgender people, single parents, same-sex couples, co-parents, and those who choose not to have children. These assumptions can unintentionally create barriers to healthcare and support services, and lead to pressure to conform, anxiety, negative self-image, and difficulties expressing emotions. Addressing heteronormativity involves using inclusive, gender-neutral language, avoiding assumptions, and designing accessible services to support a more inclusive society.
Key facts infographic (full text in report)
Paige case study (full text in report)
Members of the evaluation team and Big Noise
Cover of the report
Children holding up posters
In the most recent Scottish Census, racially-minoritised groups were more likely to identify as LGBT+ than the white population. The groups most likely to identify as LGB+ were those identifying with ‘Mixed or multiple ethnic groups’ at almost 13%, and ‘Caribbean or Black’ groups at 9%. This is over 2-3x greater than in white groups. Similarly, for trans identities, people from ‘Mixed or multiple ethnic groups’ are around 4x more likely to identify as trans, and ‘Caribbean or Black’ individuals around 2.7x more likely, compared with white populations. Evidence also shows that LGBT+ people from racially-minoritised groups face additional inequalities across housing, employment, and education. However, there remains limited research in Scotland and the UK on these intersecting inequalities, underscoring the need for more inclusive data and analysis to better understand and address these disparities.
Key facts from the report: -1 in 23 adults in Scotland identify as LGB+. -1 in 213 identify as trans or having a trans history. -Young people are more likely to identify as LGB+ with 1 in 8 16-24 year olds. -People from mixed or multiple ethnic backgrounds are most likely to identify as LGB+ at 12% compared to 4.3% of white people. -Those identifying as LGBT+ are more likely to report mental health conditions at just under 46% for LGBT+ groups, nearly 60% across trans subgroups, 13% of the cisgender population. This is partly due to experiences of discrimination, stigmatisation and barriers to inclusive mental health support for LGBT+ individuals. -LGB+ people are 3 to 10 times more likely to report a developmental disorder than heterosexual people. This rises to 11 times more likely for trans people compared to cisgender people. -LGB+ people are 2 to 4 times more likely to report a learning difficulty than heterosexual people. This rises to 4.6 times more likely for trans people compared to cisgender people. -Non-binary individuals and those identifying as “Other trans status/history” consistently experience the highest levels of disadvantage, demonstrating a concentration of overlapping health burdens.
Cover of the report, with a map of Glasgow and a magnifying glass on top.
Cultural humility describes a lifelong process of self-reflection and self-critique, through which individuals recognise the limits of their own knowledge and remain open to learning from others. Respect, curiosity and accountability in cross-cultural interactions are central to this concept.
Illustration of people with the words 'Public Involvement Panel'
Illustration showing 5 pillars of Community Wealth Building
Cover on sample CommonHealth Assets CLO project summary
Full text available at https://www.gcph.co.uk/latest/publications/1311-concept-explainer-whole-system-approach
Images from Glasgow City Food Plan annual event
Cryptocurrency gambling platforms Problem gambling Did you know… that cryptocurrency based gambling platforms represent an emerging and under-regulated domain of concern. These platforms offer anonymity, rapid transactions and access to offshore gambling environments. Their design often integrates gamified features that may amplify risk-taking behaviours. Cryptocurrency gambling is closely aligned with digital cultures familiar to young men, including gaming and online trading. Regulatory safeguards common in UK gambling environments are frequently absent. Empirical evidence remains limited, but early findings raise important public health questions. The pace of technological development has outstripped research and policy responses. Independent investigation and regulatory attention are urgently needed. For more information, search for ‘Gambling’ at www.gcph.co.uk Problem gambling
Social media influencers and “flexing culture” Did you know… that social media influencer culture has become an increasingly prominent context within which gambling is framed and interpreted. Influencers can lend legitimacy, familiarity and aspirational appeal to gambling related content. Flexing culture, characterised by displays of wealth, success and risk-taking, intersects with contemporary masculine norms. While direct causal evidence remains limited, plausible pathways link these narratives to gambling appeal. Young men may be particularly susceptible during periods of identity formation and social comparison. Influencer content often obscures commercial incentives and sponsorship arrangements. Problem gambling distinctions between entertainment and marketing. Further research is required to clarify impacts and inform regulation. This environment complicates For more information, search for ‘Gambling’ at www.gcph.co.uk
Did you know… that social media has become a central channel for gambling promotion, reaching young people at scale. Gambling advertising on these platforms is frequent, targeted and often embedded within an everyday content.
Gambling-like features within video games Problem gambling Did you know… that gambling-like features within video games have emerged as one of the most robustly evidenced risk factors for later problem gambling. Features such as loot boxes and skins gambling closely resemble gambling through chancebased rewards and monetised uncertainty. These features are embedded within products widely used by children and adolescents. Evidence consistently shows associations between engagement with these mechanisms and gambling-related harm, particularly among young males. Early exposure may normalise gambling behaviours before legal gambling age. Such practices raise significant ethical and safeguarding concerns. They blur the boundary between gaming and gambling. Regulatory scrutiny and child protection considerations are therefore increasingly warranted. For more information, search for ‘Gambling’ at www.gcph.co.uk Problem gambling
Did you know? Problem gambling, trauma, mental health, substance use and violence Did you know… that problem gambling is strongly associated with a wider range of harms affecting mental health, substance use and relationships. Evidence indicates higher rates of depression, anxiety, suicidality and substance dependence among individuals experiencing gambling problems. Trauma, including adverse childhood experiences and adult life stressors, is repeatedly linked to ga mbling vulnerability. Gambling can act as an unhealthy coping mechanism in response to distress or difficulties in regulating emotions. Associations with intimate partner violence highlight the relational and gendered dimensions of harm. These interconnections suggest that gambling rarely occurs in isolation. Narrow or siloed responses risk missing underlying drivers of harm. Integrated, trauma-informed approaches are therefore essential.
John Hartson, Chris Harkins and Sarah Hartson.
Report cover
1 - In Scotland, the Equality Act 2010 protects individuals from discrimination (direct and indirect), harassment, and victimisation based on specific traits known as protected characteristics. These legal protections aim to ensure fairness, dignity, and equal access to opportunities in areas such as employment, education, healthcare, and public services.
Cover of the Year 4 Glasgow City Food Plan annual report, with the GCFP logo at the centre, and a selection of growing vegetables in the foreground and top corners (including carrots, tomatoes, peas, salads, etc.).
GCPH December e-update
HIA is defined by Public Health Scotland as a process which systematically judges the potential, and sometimes unintended, effects of a project, program, plan, policy, or strategy on the health of a population and the distribution of those effects within the population. HIA identifies appropriate actions to avoid or mitigate health risks and promote health opportunities.
Images of James McCune Smith, James Burn Russell and Mary Barbour
Public health is an important, if under-recognised, element of the great moral dramas of history – the struggle of peoples for better lives. – Szreter, 2020
Join the CoWBELLS Public Involvement Panel (PIP) We’re inviting community organisations to take part in an exciting new Public Involvement Panel (PIP) as part of the Community Wealth Building Evaluation Learning Lessons from Scotland (CoWBELLS) research project. CoWBELLS is a 3-year study exploring how Community Wealth Building (CWB) – an approach to creating fairer, more inclusive local economies – impacts health and reduces inequalities. CWB focuses on keeping wealth within communities through five pillars: inclusive ownership, finance, workforce, spending, and land/property. Examples include co-operative food pantries, employee-owned businesses, and community banks. This research will inform Scotland’s upcoming Community Wealth Building Bill, which will require local authorities to implement CWB strategies.
Information desk at the event
Digital exclusions occurs when individuals are unable to access and use technologies like the internet and digital devices. This might be due to not being able to afford devices and internet services, a lack of skills or confidence to use them, or living in an area with poor service availability. Many technologies are also not suitably designed for people with certain disabilities, therefore, digital exclusion can also occur on the basis of disability.
Cover of AI report and first presentation slide
During the pandemic racialized minority groups were hit harder by COVID 19
Racism as a determinant of health
Infographic of key facts from Glasgow City Ethnicity Profile
Quote saying "Overall, evidence points to racialised health inequalities and greater vulnerability to long term conditions... Despite these challenges, Glasgow’s diversity is also a source of resilience, innovation and strength, enriching the city socially, economically and culturally"
Inforgraphic on poverty and wealth in Glasgow, available from www.understandingglasgow.com
Did you know that in Scotland in 2023, 861,000 households (34% of all households) were estimated to be in fuel poverty of which 491,000 (19.4% of all households) were in extreme fuel poverty. Source: Scottish House Conditions Survey 2023
Page of the comic book titled 'The Power of Community'. You can find videos of the six comic books being read out loud here: https://www.gcph.co.uk/latest/publications/1231-our-voices-community-impact-in-action
Test saying: "Did you know? People from Black and minority ethnic backgrounds are 60% more likely to live in the most-deprived areas of Scotland than their White Scottish/British counterparts."
Page 1 of concept explainer: Poverty is more than a social issue - it is a public health emergency. It strips people of the basic conditions needed to live well, leading to poorer physical and mental health that can persist across generations. People living in poverty face higher risks of disease, disability, and premature death, simply because of where they live and what they earn.
Quote saying: " Did you know? Just 2.8% of Scotland's public sector workforce identify as belonging to a Black and minority ethnic group, despite making up 5.8% of the working-age population."
Quote saying: " Did you know? In Scotland in 2019-22, 57% of working-age adults in poverty and 69% of children in poverty lived in a working household."
Quote saying: “I feel that as a disabled person I have no choice over basic things, no sense of control. I was anxious before COVID but that has spiralled and some days I just can’t function. I don’t feel safe and feel in a heightened state of anxiety most of the time, now worrying about how I can make ends meet day to day.”
Quote from the report 'The Impact of the cost-of-living crisis on disabled people: a case for action' (2023) that says: “In this cost-of-living crisis I feel the guillotine above my head all the time, I feel it so vividly. Things [finances] were always tight before, and even through COVID, but this is different, I can’t get by, everything is so much more expensive, so much more, I have no room to move. It feels like you are condemned to a joyless life being disabled in this crisis.”
Portrait of James McCune Smith & Quote: McCune Smith’s legacy is a reminder of the importance of representation in medicine and public health. His advocacy for patient welfare and social justice remains relevant today, as certain communities continue to face barriers to accessing equitable healthcare and are underrepresented in medical leadership and research.