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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.

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.