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A confession. As much as I would hate to be without my iPad or laptop and can barely remember how we got by before the internet opened access to a mind-boggling range of material I still like to read and hoard hard copies of important documents. Over two decades I have built a significant collection of reports, strategies and reviews. I couldn’t call it a library (it lacks much in terms of organisation) but it’s a resource where I can find a great deal of what was happening around drug policies and allied fields during the 1990’s and into the 21st century. In terms of external validation, I have had many individuals and agencies come to me for assistance, including central government, who had somehow lost copies of their own policy documents while switching to digital formats.

Digital provides many advantages in terms of access, reducing the number of trees converted to pulp and cost of production. But there are downsides. Viewpoints, beliefs and small-scale studies compete on a near equal footing with rigorous, scientific study. Indeed, the more professional approach can be hampered by a desire to be nuanced and cautious and so lack the immediate impact of the more polemical. Digital resources can also be less robust than printed documents. The UK experienced this in 2010 when the incoming government removed vast number of useful documents from Departmental websites. It wasn’t just those of an overtly political nature. Many useful reports and practical toolkit guides intended to support local activity, disappeared over night. Most eventually reappeared in the UK web archive. But only the determined were likely to find them and they were robbed of much of their influence and value by being divorced from their “live” policy environment.

I have also been involved in a number of projects, some well-funded, which have produced useful guidance and advice. This nearly always placed on a website, which often ceased to exist within a few years. Now at a time when authoritative, useful guidance is at a premium, needed to help support front line workers whose training budgets are a slim shadow of former years, if extant at all, my frustration on this issue had reached boiling point. So, at the recent City Health conference I was delighted to Chair a parallel session on E-health and e-learning: ensuring public health and well being at a local level. We had four excellent presentations, which covered violence prevention, a practical example of how digital approaches can support effective first aid responses, ways to address the problems associated with sex addiction and one on the Sustainable dissemination of information from EU funded projects. Dorota Król’s presentation set out the problems and ways of overcoming the problem, not least thinking about legacy early on in project development.

We need to also think far more about providing credible and accessible information for public use not just our professional peer groups. Political establishments, the world of business and finance, indeed nearly all our structures, including health, are being subject to a unique degree of scepticism which often spills over into actual hostility. I would argue in the health sector that the seeds of this distrust have often been sown by a failure to engage with the populations we claim to be helping and poor, at times inaccurate, messaging.

This was brought home to me recently while watching a television debate on the increasing strength of the anti-vaccine movement across many countries (and how this maps onto support for various so-called populist parties). The presenter asked one of the contributors, who was a proponent for vaccination as to what had gone wrong. His response? “A lot of Public health practitioners are one trick pony’s. Experts are often arrogant and scare tactics can be counterproductive”. Now this is an incredibly harsh judgement on thousands of dedicated, hard working and committed individuals. But I do think there is kernel of truth in there. As we think about making better use of new technology we need to remember to communicate with people in a way that relates to them and always be on our guard against hectoring, lecturing and be wary of scaring people. We can be more than one trick ponies.

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.