The man in charge of the health of Scotland's five million people has blamed the demise of shipbuilding in the 1970s for the nation's poor health.
Chief Medical Officer Sir Harry Burns said the loss of so many jobs along the River Clyde and elsewhere left a void in the lives of former shipworkers which has since been replaced by ill health.
Speaking in Glasgow, he said Scotland had not always been the sick man of Europe and that the cure did not simply lie in healthier diets or cutting out tobacco.
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Research has linked the impact of Thatcherism on heavy industry in the west of Scotland to higher death rates. But Sir Harry went further, saying: "In the 1970s and 1980s those jobs disappeared and the men who worked those shipyards were never re-employed. Shipyards, steel works, heavy industry in west central Scotland disappeared and was never replaced the way it was in the north of England … with car factories and so on.
"A void appeared in men's lives and the void was filled with drink, drugs and fighting."
He quoted Austrian psychiatrist and holocaust survivor Viktor Frankl saying: "Those who have a 'why' to live, can bear with almost any 'how'." In the absence of a reason to live, Sir Harry suggested, people turn to heroin and alcohol.
He also warned the problems in Greece, which has the highest level of unemployment in the eurozone following a deep recession, would similarly cast a long shadow.
Sir Harry said: "The kind of things we see in Greece, the kind of upheavals, the disruption of family life, we would predict that will have long-term consequences for that population … widening health inequalities that will take generations to repair."
The cost, he said, would "pale into insignificance" the money spent bailing out banks at the start of the financial downturn.
Sir Harry told the Society for Acute Medicine conference at the SECC: "Scotland is not an inherently unhealthy place, nor are Scots inherently unhealthy."
Mortality rates in 24 council areas are in line with the average for western Europe, he said. It is the remaining few which give the country its poor health record and they are mostly clustered in west central Scotland.
Sir Harry dismissed smoking or bad diet as the reasons for the high death rates. He also cited research that shows levels of deprivation are similar in Liverpool, Manchester and Glasgow but that deaths among those of working age are much higher in Glasgow.
The Chief Medical Officer said that "60% of the excess premature mortality is due to drugs, alcohol, suicide and violence … We are not going to fix that by reducing the saturated fat content in the diet".
It is these psychological and social problems which Sir Harry believes were fuelled by job losses from shipyards and other industrial plants.
Sir Harry has long argued the psychological stress people experience when their lives feel out of control has an impact on their physical health and he outlined the results of a number of studies which support this link at the conference yesterday.
"The biology is very plain for all to see," he concluded. "The treatment is psychological and social and returning control of their lives to individuals who have been alienated from society."
He finished by saying he hoped in seven years' time he would be able to report Scotland had been able to do just that.