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This paper reviews the underlying causes of the High levels of excess mortality in Glasgow in comparison with similar post-industrial cities such as Liverpool and Manchester. The review points out the excess mortality was caused by the  vulnerability that Glasgow experienced due to a series of historical factors, processes and decisions: the lagged effects of historical overcrowding; post-war regional policy including the socially selective relocation of population to outside the city; more detrimental processes of urban change which impacted on living conditions; and differences in local government responses to UK government policy in the 1980s which both impacted in negative terms in Glasgow and also conferred protective effects on comparator cities.