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What colour would you use to describe the great advances in population health of the last hundred years? Perhaps something bright and cheery? A nice vibrant yellow, or perhaps a warm orange? As appropriate as these might seem I would argue the colour grey possesses a strong case. My reasoning? The massive increase in life expectancy we have witnessed and so the associated increase in grey heads to be seen amongst our populations.

In the 1900’s life expectancy in England and Wales was 46 for men and 50 for women. A century later these had increased to 77 and 81 respectively. Spectacular improvements by any standard. Not all countries have shared the benefits equally, progress is not even across countries or socio-economic groups. It is worth reminding ourselves that Africa saw a fall in life expectancy during the 1990’s due to the AIDS epidemic, which was only reversed when effective responses (political, social and medical) were deployed. Eastern Europe also suffered a drop-in life expectancy in the period of turmoil following the end of the Soviet era. These both serve as reminders that there is nothing inevitable about progress and improvement.

But we should celebrate this global achievement even while we consider the fresh challenges an ageing population poses. Last years City Health conference in Basel included several sessions that looked at meeting the needs of older people, helping promote physical activity, considering their needs in urban planning and public transport. These presentations were delivered by a wide range of speakers drawn from the fields of research, policy makers and service delivery. One of the insights I gained from these sessions was that issues which could be viewed as a problem can also be a valuable resource and that actions which benefit one specific group will often help others, the link between the young and the old in terms of terms of transport was particularly striking. Action to support one specific group can help improve an entire municipality.

The issue of age was something I was dwelling on during a visit to Glasgow last week. One of my reasons to be in that wonderful city was to learn more about Drink Wise Age Well. This is a fascinating project, working across England, Wales, Scotland and Northern Ireland to support people make healthier choices around their drinking as they age. There is great work going on to support service providers, communities and individuals with a clear intention to share the learning.

Hopefully this process will help prompt policy makers and service commissioners to realise that we need to improve alcohol (and drug) services for older people. In London funding pressures have seen us lose some excellent services aimed at this group at the same time as demand increases. There are of course many challenges in supporting our ageing populations, but this area is one that requires some swift action. Dealing with individuals with significant cognitive impairment, substance use problems and other health issues pose real challenges for our health systems, requiring new thinking and realigning services. If we don’t manage to improve care for all our older citizens then the great gains in life expectancy, arguably the crowning glory of the last century, will be tarnished. Our cities with their existing services and concentrations of older populations need to be at the forefront of these developments.

Wednesday, May 15, 2019
The confidence we have in our health systems is at the core of how we use and, hopefully benefit, from them. If we lack confidence in the benefits of going to see our GP for a health check, seeing a nurse about a travel vaccination or asking advice from the local pharmacist why would we bother? In terms of dealing with drug and alcohol problems the importance of a positive therapeutic relationship or alliance is recognised not just as being a pleasant “extra” but being central to aiding recovery. It has an important role across all fields of treatment. There are also benefits where a society has faith and confidence in those that oversee and provide healthcare systems and treatments at a population level. By and large, despite many complaints and challenges, the National Health Service in the UK remains a highly valued and trusted part of our society. And rightly so. But that doesn’t mean we should shy away from acknowledging where things have gone horribly wrong.
Tuesday, April 30, 2019
In England, the Easter public holidays see many of us get a four-day weekend. Schools are on holiday, roads are jammed, airports overflowing and much of the country indulges in chocolate, either in the form of eggs or bunnies. This year we also enjoyed some great weather. Fortunately, May looms, which brings another two holidays for us to recover from previous holiday excesses/hard work (delete as appropriate).
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.

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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.