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Like another 1.5 million Londoners my commute to and from work regularly involves reading the Evening Standard, a free newspaper that enjoys a rich heritage and is almost a part of the fabric of the City. This despite its politics and editorial stance often being at odds with London’s inclinations. It does benefit from some quality journalism and has a breadth of coverage which reflects London’s status as a world city. Last Monday there were three articles which ensured I didn’t doze off on my journey, and which captured three of the key issues facing our major global centres.

The first that caught my eye was the headline Megacities can offer a better standard of living to people. This was contained within the business pages, which don’t normally hold my attention, but on this occasion, there was an interesting piece based on a recent Euromonitor report. I am a sucker for good futurology and this had plenty to make me sit up. By 2030 Jakarta is to be the biggest global city (it’s currently Tokyo for those prepping for their next pub quiz) with a projected population of 35.6 million.  However, it is Africa, not Asia that will see the largest rise in megacities with Dar Es Salaam and Luanda joining Cairo and Lagos. What will it mean for the future of global cities that these advancements will be taking place in the developing world? It will certainly mean a shift in focus from New York, London, Tokyo and Paris. Certainly, there will be huge challenges, in providing infrastructure, services and utilities, but the article is upbeat in asking us to think of cities as a solution to population pressures, and as places that generate the wealth and investment to overcome their own problems and still provide attractive locations for people to live and thrive. I love an upbeat story to start the week.

However, the next item I read was anything but uplifting with its focus on the massive challenge we face in tackling homelessness and rough sleeping in London. Local authorities in London, as across the United Kingdom, have experienced an unparalleled period of reduced income while taking on new responsibilities for public health in the context of increased demand for key services. Against the backdrop of austerity over the last five years and the challenges of integrating new services it is of little surprise that the hoped-for promise of placing public health at the core of local government has yet to be realised.  That is not to say that great efforts are not being made. There are some great initiatives going on and I know of many individuals working at local, regional and national levels in a range of governmental and NGO agencies who are doing a great job. Yet you don’t have to travel far in London to see that we need to do much more to ensure that, in one of the world’s great cities, we don’t leave our citizens behind. The negative consequences of failing to address these challenges don’t just fall on the most vulnerable but impact on all citizens. The Mayor of London’s new Health Inequality Strategy sets out his ambition in this area and I dearly hope we will one day look back upon this as a watershed in improving health for all Londoners https://www.london.gov.uk/what-we-do/health/health-inequalities-strategy.

The wealth and success which cities are good at generating but, in most cases, are less adept at sharing amongst their citizens brings me to the final of the three articles. This touches on the dread subject of Brexit. I have no desire to get embroiled in that particular snake pit but Stephen King, HSBC’s Senior Economic Adviser highlights how London has political leanings and an economic nature increasingly at odds with much of England. In terms of attitudes towards the EU and immigration London is very different from other parts of the country. Though much of the wealth that London generates goes to providing services elsewhere, house prices and salaries place an increasing gap between the capital and its hinterland. Of course, many capitals and major cities have a distinct character from their surrounding regions, but as cities develop at rapid pace we need to consider the relationship between cities and nations. Unless we envisage a new world of independent city states (which was proposed tongue in cheek – I think – within the article), then the benefits they generate need to be effectively shared.

Next blog I am going to look at some of the historic heroes of urban health, starting with the memorial to Liverpool’s first Medical Officer of Health. A place I plan to visit when attending City Health 2019 in March…

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.
Wednesday, February 28, 2018
Welcome to my initial blog for City Health International. My intention over the coming months is to look at developments in research, politics and the media through the prism of urban health and what it may mean for the City Health community (so pretty much anyone reading this). While my background is in national and regional policy work around substance misuse, with a more recent interest in crime and anti-social behaviour issues, I will be looking at a much broader range of topics. Before we embark on that though I shall briefly explain how I got involved with the phenomenon that is City Health and how that helped extend my horizons beyond alcohol and drugs.
Sunday, January 27, 2019
I hope 2019 has begun well and that the year ahead proves a good one for you all. Despite the ongoing political uncertainty in the UK and increasing strain on budgets, with little hope of improvement in the near term, I remain surprisingly upbeat. It may be the result of what seems to have been a successful London Christmas alcohol campaign, once the data firms up I shall certainly share more. It could be the prospect of the forthcoming City Health International Conference in Liverpool on 22 March, which promises some great speakers. Possibly it is a result of small, but welcome, signs of a willingness to explore new ways of thinking and working to reduce health inequalities in relation to mental health and hepatitis. Perhaps it’s having just secured funding to update our Safer Nightlife guidance, which aims to reduce drug related harms in the night time economy. I am sure the money has helped, you could say it has incentivised me.
Monday, December 31, 2018
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 .

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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.