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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.

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.