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We are now just days from the 2018 City Health conference, where those attending will be the guests of the Alliance for Public Health (Ukraine), AFEW International (Netherlands), and the city of Odesa in association with Knowledge Action Change. Seven years ago, I had the pleasure to host the first of these events. It is a testament to the growing interest in how we make our cities better, heathier places to live- as well as the hard work of the organisers- that City Health has not only continued as an annual opportunity to hear and debate from a wide range of experts and commentators, but is now also a year round network where research, news and views are shared on a weekly basis. It’s been a pleasure to contribute to this process. For me, it’s been an enjoyable opportunity to reflect on a wide range of topics and share my thoughts with you. Many thanks to those who have responded, I apologise for having been London and substance misuse centric, but the last six months have helped broaden my knowledge beyond those confines!

 The programme for this year’s conference has an impressive breadth. There are sessions which remind us that we need to continue our efforts in tacking TB, AIDS, and the harms associated with drug use. We will be looking at the challenges of transportation and obesity, work to reduce the toll of violence, and the potential of technology to help promote inclusivity. Speakers will be looking at the needs of often neglected groups and individuals, as well as whole population level interventions. I have a particular interest in the presentations that will explore how we can best engage with our communities and harness the power of politics.

Health is not only a central concern for individuals daily but is also an important component of what makes a city, or country, successful.   There are various indices that rank the achievements and failings of nations and our major urban centres. However, in the political sphere what are the impacts of the massive variations that exist between those who enjoy the longest, healthiest lives and those who don’t?

An interesting angle on this issue is to be found in a study by Columbia University Irving Medical Centre that looked at voting patterns in the 2016 USA Presidential elections. This reveals a strong correlation between areas which experienced an increase in age-adjusted death rates and voter dissatisfaction. Much of this mortality was fuelled by alcohol and drug use. It also showed that, in general, cities were more successful at presiding over life expectancy gains than rural areas, thus starkly inverting the traditional image of the city as concentration of ill health (and sin) compared to the healthy and virtuous rural idyll. Before we celebrate this triumph of the modern city I suggest we all ponder how sure we are that the same issues don’t exist within our own conurbations and consider the inter relation of cities with their hinterland. Leaving communities behind, urban or rural, serves to guarantee future problems, both health and political.

In trying to address the issue of unequal progress between different communities, the recent interest in another area of health may help point the way. I am sure we have all seen the rapidly growing evidence which identifies the dangers and harm associated with social isolation and loneliness (the analogy that it’s equivalent to smoking 15 cigarettes a day is wonderfully engaging). Cities around the world are starting to look at how they can reduce this problem, including Amsterdam and Belfast (the WHO Global Network of Age-friendly Cities and Communities is worth a look).   Individuals benefit from social contact and networking. I would strongly suggest that cities also benefit from such interaction. We can all learn and benefit from others. City Health International provides a great opportunity to do just that.

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?
Tuesday, July 16, 2019
Last week I met with someone who, having just completed a Masters in Epidemiology, is keen to work in the health field. Over a hot chocolate I outlined my perception of the current big issues relating to substance misuse, our most vulnerable populations and the policies and structures we have in place to address these issues.
Tuesday, July 02, 2019
Absolutely outstanding. That’s my carefully considered assessment of the Global Forum on Nicotine in Warsaw that I was fortunate enough to attend two weeks back. I say this despite the mosquito bites and the fact that the weather was rather warm for me. The event was one of those that provide a buzz and an energy that comes back to the workplace with you. This was fuelled by an outstanding array of speakers and a vibrant audience mix. Discussion and argument were not limited to the auditorium or breakout rooms, but instead could be heard throughout the venue, over lunch, during coffee breaks. There were attendees from every continent (well, ok, I didn’t actually meet anyone from Antarctica). Academics, clinicians, researchers, harm reduction advocates, retailers, product developers, policymakers, and- most importantly - vapers and users of other tobacco harm reduction products, all mixed together sharing views, experiences, and- as we should expect- differences of opinion. It certainly lived up to the conference strapline Its Time to Talk About Nicotine and the rich promise of a genuinely horizontal approach.
Monday, May 27, 2019
The value of partnership approaches and joint working to tackle major health public policy issues is widely accepted, if more rarely practised. Even where there is engagement with other professions or disciplines there is a tendency to work with those whose outlook is not too challenging and are closest to us in practice and approach. City Health has been at the forefront in challenging this and others are also working to weaken the silo walls. In the last two weeks I have been a spectator and a participant in two very different events which highlighted how important it is to include the end user, the public, our communities when developing and delivering services.

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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.