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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.

Wednesday, October 30, 2019
When I hosted the first City Health conference in 2012, my hope was we might manage three or four events in different cities. I never dreamt we’d get to nine (and counting) or that City Health would reach the great city of Melbourne. Great credit must go to the Progressive Public Health Alliance for hosting a fascinating two days that provided energy, enthusiasm and challenge. Personally, I learnt a great deal and found myself questioning somehow of my own views. I met people doing amazing things in the most challenging environments. I heard of situations that made me feel a sense of despair but came away reassured that we have the knowledge, networks and commitment to positively change lives for the better.
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.

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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.