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The City Health Conference in Liverpool starts in less than two weeks. I am looking forward to revisiting a City I knew well in the late 1980’s but have only visited briefly since.  The main attraction though is an opportunity to listen to a range of excellent presenters and engage with my fellow attendees. As well as hearing from those working in areas I am familiar with it will also provide an opportunity to learn about subjects I rarely get an opportunity to engage with or consider. It promises a brief escape from the community safety/drug misuse bubble I normally inhabit. However, based on previous City Health experiences I expect to come away with some inspiration and some ideas around practical application. 

And we could all benefit from some inspiration.  On a daily basis the media highlights health issues facing our communities. Just looking at a two day snap shot of the national media there are concerns around knife crime and violence, the challenges of providing effective social care for our ageing populations, questions about how we better support peoples mental health, concerns over the number of drug related deaths and questions as to why improvements in life expectancies have halted (which apparently is good news for some investment funds!).  An immense range of complex problems which those working in the communities and health sectors are expected to help improve. At a time when financial resources are scarce.

Public health is often described as being essentially interdisciplinary, yet it often seems as prone as many other fields to the allure of specialism and of creating narrow spaces where only individuals of similar training and background gather to share ideas and pontificate on what should be done. Now expertise is essential, but having a broader understanding of health issues, social policies, politics and communities can only help in terms of delivering positive change. We may all have a piece of the jigsaw but we need at least an idea of what the big picture looks like.

I recently read an excellent critique of the trend toward ultra-specialism, that the amount of information available on the internet was pushing professionals toward ever narrower, more restricted, fields where they can develop unassailable and comfortable command. This leads to deepening ruts and a failure to develop and a decrease in relevancy to rapidly changing situations. We can all help counter this by getting out into the wider world of urban health, of exploring some new territory now and again, even if it feels a little scary and odd on occasion! (I should disclose that it was the historian Norman Davies whose concerns about ultra-specialism I have “borrowed here).

As we know the breadth of challenges, we face in our urban environments is massive but so is the opportunity. We perhaps need to occasionally remind ourselves of the examples where apparently intractable and insoluble problems have in fact been countered. The venue for the conference in Liverpool is just around the corner from where the UK’s first needle and syringe programme was opened. A brave step that helped the UK become one of the international leaders in harm reduction for injecting drug users.

Currently in London one of the biggest political priorities and greatest cause of public concern is knife crime and the tragic toll of lives lost.  A recent tragedy has had a very visible impact on the area I live. Violence and the fear of violence is incredibly corrosive to communities. Naturally people are looking for an understanding of what is driving these incidents and ideas relating to prevention are at a premium.  There is a great deal of talk about the need for a public health approach, often without much comprehension of what that means or looks like. The media and others have spoken about the need to learning from the Scottish experience, and the establishment of the Violence Reduction Unit in 2005 which did oversee a dramatic reduction in knife crime. Now London’s problems are different from those that the Scottish Violence Reduction Unit (VRU) faced in Glasgow but the genuinely multi-disciplinary approach they developed and the emphasis on establishing and sharing expertise clearly paid dividends and is something to be emulated as is the key ethos that violence is preventable not inevitable.

Currently there is a well-worn path from London to Glasgow as officials and politicians travel up to improve their understanding of the VRU’s work.  Colleagues there have always been generous with their time in terms of sharing experience, and Karyn McCluskey, a former Director of the VRU is a previous recipient of the Paolo Pertica Award (always a highlight of the conference). Partnerships are core to what the VRU achieved, and of course are central to how we can respond to the other challenges we face. But partnerships need a starting point, some common understanding, shared language and values. City Health International is a great opportunity to lay some of those foundations, to help avoid the ruts and keep the wheels turning in the right direction. Hope to see you in Liverpool.  

Wednesday, April 01, 2020
Everything is changed. COVID-19 and responses to it have seen dramatic and fundamental changes to how life is lived around the globe. International travel has come to a near complete halt, much of the world is under some form of lock down with businesses, schools, shops, pubs and cafes shut. Our economic and social reality is now unrecognisable from that of only weeks ago.
Tuesday, March 10, 2020
Clearly the current health focus is strongly centred on Covid- 19 and related issues, as it has been for the past few weeks. It is a demanding situation for politicians, officials, and indeed all of us, especially those working in our healthcare system. One of the major challenges we face is increasing understanding and encouraging changes in behaviour, while also avoiding panic and overreaction. Trusted and accurate information is clearly essential, both for those who have a key role and for the general public. We are certainly seeing more of England’s Chief Medical Officer and Chief Scientific Adviser in the media than usual. In the current situation, politicians are not only keen to hear from experts, but also happy to let them step into the spotlight. While we still see sensationalist headlines, there are also visible benefits of this approach, with more measured and informed elements within the media coverage- though this is less evident on the outer reaches of the online universe. Before I move on to other topics, let us reflect on the significant additional pressures being placed on our frontline health providers. They deserve our gratitude and, in many instances, much improved terms and conditions. Let’s hope that when this coronavirus issue passes the staff that so many rely on are not overlooked.
Monday, February 10, 2020
Public health is front and centre of the media currently, with concerns about the coronavirus outbreak, which was first identified in the Chinese city of Wuhan, splashed across almost every front page. With confirmed cases now reported in numerous countries across the world, we face the possibility of a pandemic. As several experts and commentators have pointed out, in our modern, highly interconnected world no epidemic remains a local concern. This, of course, makes for frightening headlines- which, in turn, calls for calm and informed responses.
Wednesday, January 15, 2020
So here we are: 2020. Let me start by wishing all of you the very best for the year ahead. I have, occasionally, been accused of an inclination toward cynicism and a failure to look on the bright side of things. So, for my first blog of the year, at least, I am going to be determinedly upbeat. You can judge for yourself how long it lasts. This sense of optimism is influenced by the fact that the end of 2019 saw some positive signs in the world of substance misuse. While it was something of a mad scramble against time, we managed to pull together a high quality and well-supported pan-London Christmas alcohol campaign. I am very grateful to colleagues who delivered the key elements of this work and to everyone who supported it. Some, in fact, went well beyond the call of duty to engage with our colleagues in the blue light services. Although we will not have any data in terms of its reach and impact for some months (I will update you), what I can confidently say is that many individuals and organisations liked the messaging and tone. I like to think it is helping contribute to Londoners having a more considered and healthier relationship with alcohol, though there is a way to go yet!

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CITY HEALTH INTERNATIONAL EVENTS

CHI Melbourne 2019

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CHI Liverpool 2019

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CHI Odessa 2018

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CHI Basel 2017

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CHI London 2016

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CHI Barcelona 2015

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CHI Amsterdam 2014

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CHI Glasgow 2013

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CHI London 2012

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City Health International
Founded in 2012 City Health International is a network of individuals and organisations engaged in the study of and response to structural health issues and health behaviours in the urban environment.
For the first time in history the majority of the world’s population now live in urban environments and the proportion continues to grow. As national governments struggle to deal with the pressures and demands of growing urban populations against a backdrop of financial deficits and uncertainty, it is increasingly left to those working at a city level to provide the leadership and support needed to tackle key health issues.