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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, July 29, 2019
I write this on a day when London is experiencing, what is for us, exceptional temperatures. Overhead power lines and train tracks have warped. On some routes passengers have been advised to avoid travelling if possible, and many employers have encouraged staff to work from home. I suspect many who did travel to their workplaces were drawn by the prospect of effective air conditioning as much as personal work ethic. This great City was unusually quiet, apart from the pubs and bars who were doing a roaring trade. Who would begrudge people a pint of beer or a glass of wine when it’s so damn warm, especially when by delaying travelling an hour or two, the journey home may be made a little more tolerable?
Tuesday, July 16, 2019
Last week I met with someone who, having just completed a Masters in Epidemiology, is keen to work in the health field. Over a hot chocolate I outlined my perception of the current big issues relating to substance misuse, our most vulnerable populations and the policies and structures we have in place to address these issues.
Tuesday, July 02, 2019
Absolutely outstanding. That’s my carefully considered assessment of the Global Forum on Nicotine in Warsaw that I was fortunate enough to attend two weeks back. I say this despite the mosquito bites and the fact that the weather was rather warm for me. The event was one of those that provide a buzz and an energy that comes back to the workplace with you. This was fuelled by an outstanding array of speakers and a vibrant audience mix. Discussion and argument were not limited to the auditorium or breakout rooms, but instead could be heard throughout the venue, over lunch, during coffee breaks. There were attendees from every continent (well, ok, I didn’t actually meet anyone from Antarctica). Academics, clinicians, researchers, harm reduction advocates, retailers, product developers, policymakers, and- most importantly - vapers and users of other tobacco harm reduction products, all mixed together sharing views, experiences, and- as we should expect- differences of opinion. It certainly lived up to the conference strapline Its Time to Talk About Nicotine and the rich promise of a genuinely horizontal approach.
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.

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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.