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We all have our heroes, those who inspire and motivate us. They may be historic or contemporary, known through books, film or via the news. Quite possibly we may have actually met or even worked alongside someone who we view as a hero. Many of us, if we think about it, will have a considerable number of heroes, and every country, city and profession provides its own candidates, though many are disputed and once established heroes can find themselves out of favour as views and understanding changes. Many of course never receive much in the way of acknowledgement or reward, quiet heroes going about their work without fanfare. Of course, the field of health improvement provides us with a rich list of famous names to choose from, Hippocrates, Jenner, Pasteur, Fleming, Snow (who I will return to), Bazalgette, Bevan. I am sure you could all add many, many more. This list is of course historic, and I want to ponder a moment on who might be celebrated as a hero in 20, 50 or 100 years.

The current Secretary of State for Health, Matt Hancock, has certainly set some ambitious, possibly heroic, targets. He has stated that by 2035 he wants people to have an additional five years of healthy, independent life. This aspiration is kept company by others: the intention to halve childhood obesity by 2030; reduce loneliness, increase early detection of cancer, improve the use of technology and better targeting of advice at key sections of the population. Few would quibble over these being worthwhile targets. However, given recent indicators of stalling, in some groups, an actual decrease in life expectancy; levels of childhood obesity (especially in deprived areas) and the pressures on our health services and local authorities Mr Hancock may well deserve a niche in our pantheon of health heroes if his goals are achieved.

Which leads me to considering how we remember and recall our health heroes. There are of course various annual awards and talks, City Health International has its own example, notably the Alison Chesney and Eddie Killoran Memorial Lecture. Alexander Fleming has a museum named after him at the hospital where he worked. Sir Edward Jenner has an impressive memorial in London’s Kensington Gardens. Aneurin Bevan, one of the founders of the NHS, is remembered by an impressive statue in the centre of Cardiff.

One of my heroes is Dr John Snow. Born in 1813 he came from humble origins and is now an iconic figure in the development of public health and epidemiology. He is particularly famous for having identified the source of a cholera epidemic near his home in Soho and persuaded the local council to render the offending water pump inoperable. This at time when miasmic theory still prevailed and nearly twenty years before Pasteur proved the link between germs and disease. Dr Snow acted based on the available evidence and driven by his determination to improve the lot of his fellow citizens.  He is very visibly remembered by a pub named after him in Soho. Ironic given he largely avoided alcohol during his life.

A contemporary of Dr Snow was William Duncan. He was born to Scottish parents in Liverpool in 1805, after qualifying as a doctor in Edinburgh he returned to Liverpool. There, in 1847, he had the distinction of being appointed as Liverpool’s first Medical Officer of Health. This was a hugely significant appointment, a first for Britain, being an indicator of how civic authorities were taking on the challenge of health improvement for their rapidly growing populations. Dr Duncan does have a building named after him at the Faculty of Medicine, Liverpool University, but is also remembered by the Dr Duncan’s pub in the centre of the city.

It is my hope that when the City Health community gather in Liverpool around the 22 March https://cityhealthinternational.org/2019/, that some of us might manage to raise a glass (non-alcohol and sugar free - if desired) to this local hero of public health, while we consider the efforts of our colleagues and ponder the challenges we face. One thing is clear to me, that if we are going to meet the needs of our populations, make things better for all our people, and who knows, even hit the targets set by our politicians, we need some fresh inspiration, new ways of working and to share our innovations and experiences. Who knows? Maybe one of the attendees will have a pub named after them for their achievements. I will drink to that.

Monday, September 23, 2019
Sometimes things just work out. Last Monday, I was involved in three separate events which each highlighted the potential of urban areas to effectively tackle health issues when there is political leadership to do so. The day also provided a timely reminder of the importance of harm reduction, and how this needs to be at the heart of health approaches in our cities. With so many countries and agencies forgetting the lessons of harm reduction, or actively turning their back on them for narrow ideological reasons, it was uplifting to hear examples which delivered quantifiable gains in terms of lives, better health, and human rights.
Monday, September 09, 2019
With City Health 2019 in Melbourne now only weeks away, a headline in the papers caught my eye. According to the annual Global Liveability Index- whose criteria include stability, healthcare, culture, education, environment, and infrastructure- the Austrian capital Vienna narrowly beats Melbourne to the top spot. Of course, such rankings are open to debate and dependent on what you choose to measure but it’s fair to say the occupants of city halls take a degree of pride in seeing “their” cities topping the charts.
Monday, September 02, 2019
This is not the blog I was planning to write. My intention was to look at developments in managing the Night Time Economy across a number of cities, an area where there is innovation and positive developments. Instead I feel compelled to look at an issue where the UK and others are demonstrably going backwards. Battles we thought had been won in fact appear lost, progress has not just stalled but been significantly reversed. It poses hard questions for many organisations and for individuals, including myself. So, come with me as I look at drug related deaths.
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?

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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.