City Health International


Like many I have spent the last two weeks demonstrating a casual disregard for the advice provided by health organisations in terms of food and alcohol consumption. My levels of physical activity have not been all they should have been either, although I am full of good intentions for the coming year and have started to make my overfed body walk more.

On the upside I have greatly enjoyed spending time with colleagues, friends and family. Its been an opportunity to talk and to think in a more relaxed manner than working life normally allows. Inevitably, as we leave one year and look forward to 2019, I have been reflecting on what has gone on and considering what we face in the rapidly approaching future. Considering the UK’s political situation, ongoing reductions in public expenditure, the huge challenges we all face to improve the health and lives of our populations I have come to an odd realisation. Despite all apparent indications to the opposite I am feeling a sense of optimism. Those that know me will realise this is not necessarily my normal outlook. I can also confirm this is not fuelled by an excess of liquid Christmas cheer, nor even a glass of eggnog. Possibly the recent run of decent form by my football team might have had some impact but given their defeat today I think we can also discount that. So, what is behind this positive sentiment?

Fundamentally I think it’s down to changes in attitude, a growing understanding that we need to work differently and more collaboratively if we are going to sustain, let alone improve, the lives and health of our communities. While in many cases this is being driven by necessity, we should acknowledge that sometimes well-resourced funding silos are also a barrier to effective delivery. Politically there is also a greater understanding of the potential and importance of improving health and its associate, happiness. The growing recognition of the importance of tackling isolation and loneliness should help to increase understanding of the value of community assets such as lunch clubs and day centres. The potential of harm reduction, across a range of issues, also seems to be enjoying a renaissance. Again, I think this is probably, at least partly, driven by financial considerations, but the focus on the quality of individual and community life is one to be welcomed. Bringing people with us, helping them improve their own lives, beyond condemnation and lecturing, is something we should embrace and promote.

This line of thought takes me back to City Health 2018 in Odesa. I have previously mentioned the lecture delivered by David Wilson in the closing session. If you have not previously looked it up, I strongly recommend you do so. I guarantee its twenty minutes you will not regret investing. While on the City Health website also look up some of the other presentations, Geoff Gallop, Jon Sigfusson (essential for anyone with an interest in substance misuse prevention in young people) and David Vlahov stood out for me, but there really is something there for everyone. Other sessions at the conference and contacts made came in useful to me recently.

At a recent conference on Hepatitis C in London we were looking at lessons in community communication we can learn from others, including the HIV world. The work being advanced in the Ukraine, in demanding circumstances, stood out. Australia can also provide some impressive examples of reaching out to communities, in this case Aboriginal groups, demonstrating that the concept of “hard to reach” is often as much a conceptual barrier as an objective reality. At long last in London you can see the wheels are, slowly, turning to really improve our response to Hepatitis C and the potential to eradicate a virus by treatment is gaining ground in the minds of politicians and policy makers.

I am also feeling positive about the conference the London Drug and Alcohol Policy Forum is hosting with London South Bank University on 18 January, Addressing Complexity: Homelessness and Addiction. This is a new collaboration for us both and aims to bring research and practice closer together. London is experiencing high levels of rough sleeping and homelessness, but I have been delighted by the response to this event with people from local authorities, the police, charities and other agencies all wanting to come together and discuss how we can do better in helping some of our most vulnerable citizens. We have spent the grand total of £0, nothing, on marketing for this event so it also demonstrates that despite years of cuts and the loss of many excellent staff, our networks – as well as interest and enthusiasm – do endure.

The problems we all work to overcome in our work can often seem overwhelming but let’s remind ourselves that we have thousands of existing and potential allies and partners to work with. There are great networks, of which KAC is one (do get booked for City Health in Liverpool, 22 March) which provide further opportunities. If we continue to explore how we can work together and explore new approaches who knows what we might achieve in the year ahead and beyond?

So, on that unrelenting upbeat note let me wish health and happiness to you all for 2019.

Monday, May 27, 2019
The value of partnership approaches and joint working to tackle major health public policy issues is widely accepted, if more rarely practised. Even where there is engagement with other professions or disciplines there is a tendency to work with those whose outlook is not too challenging and are closest to us in practice and approach. City Health has been at the forefront in challenging this and others are also working to weaken the silo walls. In the last two weeks I have been a spectator and a participant in two very different events which highlighted how important it is to include the end user, the public, our communities when developing and delivering services.
Wednesday, May 15, 2019
The confidence we have in our health systems is at the core of how we use and, hopefully benefit, from them. If we lack confidence in the benefits of going to see our GP for a health check, seeing a nurse about a travel vaccination or asking advice from the local pharmacist why would we bother? In terms of dealing with drug and alcohol problems the importance of a positive therapeutic relationship or alliance is recognised not just as being a pleasant “extra” but being central to aiding recovery. It has an important role across all fields of treatment. There are also benefits where a society has faith and confidence in those that oversee and provide healthcare systems and treatments at a population level. By and large, despite many complaints and challenges, the National Health Service in the UK remains a highly valued and trusted part of our society. And rightly so. But that doesn’t mean we should shy away from acknowledging where things have gone horribly wrong.
Tuesday, April 30, 2019
In England, the Easter public holidays see many of us get a four-day weekend. Schools are on holiday, roads are jammed, airports overflowing and much of the country indulges in chocolate, either in the form of eggs or bunnies. This year we also enjoyed some great weather. Fortunately, May looms, which brings another two holidays for us to recover from previous holiday excesses/hard work (delete as appropriate).
Thursday, April 11, 2019
Let me start with a big thank you to Liverpool, and especially the team from John Moores University, for another outstanding City Health conference. The impressive surroundings of Liverpool Medical Institute- a monument to the 19 th century’s commitment to science as well as its obsession with ancient Greece- proved to be an ideal venue. It contains a wonderful historic library, a selection of surgical and medical tools that bring a tear to the eye, and portraits of those who have contributed to the development of public health and modern health care, including some rather fearsome looking characters.



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.