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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, 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.