Violent behaviour in young men is closely linked to drinking in pregnancy by their mothers, according to Scotland's chief medical officer.
Dr Harry Burns told MSPs yesterday he believes foetal alcohol spectrum disorder (FASD) is a key element in behaviour problems once the babies grow up.
The problems caused by pregnant women drinking are known to include behavioural and learning difficulties as well as constrained growth for the children affected, and the health chief thinks it is directly linked to anti-social behaviour on Scotland's streets.
Dr Burns has said women should not drink at all while pregnant, though other specialist medical advice has risked confusion with the suggestion that a small amount of drinking may not harm a baby's health.
The chief medical officer was appearing before Holyrood's Health Committee, taking questions about the effects of poor parental care of babies and toddlers. He told them there is a need to find a range of ways of intervening with at-risk children, including specialist home visitors to help mothers know when their children need reassurance.
He also said there could be better psychological answers to help build resilience - or capacity to handle adverse circumstances - among those most likely to be at the wrong end of Scotland's large health inequalities.
The chief medical officer's annual report last November highlighted the cost of violence to the NHS, at roughly £400m per year, or between 3% and 6% of the NHS budget - far ahead of the estimates based on police statistics.
He said the only major study of prevalence of the FASD problem, including the more serious cases known as foetal alcohol syndrome, was carried out in Italy, which would not pick up the specific problems of Scottish drinking habits. That found up to 4% of schoolchildren were affected, or one in 25, and concluded that the Italian habit of drinking wine with meals had a similar impact to binge-drinking in other countries.
"I suspect that significantly underestimates the problem of foetal alcohol spectrum disorder in Scotland," Dr Burns said of the Italian research.
"I would bet the incidence of foetal alcohol spectrum disorder is very high in young men being violent. If you can identify the risk factors in that, that's something we can definitely intervene in."
Dr Burns yesterday praised the work of John Carnochan and Karen McCluskie from the Violence Reduction Unit in tackling this issue.
He said: "What they've shown is that to a large extent you can predict who the perpetrators and who the victims of violence are, when it will happen and even down to the streets in which most of it happens. They've adopted the approach that violence is a public-health problem."
A programme is now being devised to ensure more effective intervention with youngsters in their early years, when it is already clear they are at risk of falling into a violent lifestyle, mainly because of poor parenting.
The youngsters go on to be excluded from school and start misusing alcohol and drugs, and Dr Burns believes early action is far more effective in addressing their behaviour than only after they enter the criminal justice system.
"They wander about the centre of our cities at night, particularly at weekends and that's where gang fights start," Dr Burns said, calling for more leisure facilities including midnight football leagues. "The younger working-age male experiences the greatest health inequality and we have to find better ways of tackling that."
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