City Health International


"Without knowledge action is useless and knowledge without action is futile."
Abu Bakr

I have now worked in the drugs and alcohol policy field long enough that people have started interviewing me to provide historical context. This prompts deeply ambivalent feelings. I am reminded that I am no longer in the first flush of youth, but the opportunity to reflect on developments over the last twenty years, consider what worked and why, is something to relish. Unlike the frustration at seeing the same failed idea or approach coming around the track again (and again..)

Given the current funding climate I often end up considering the opportunities presented by the massive investment in drug treatment after 1998 with the current situation. Yet it is true that while financial resources are important there are other important ingredients in improving the health and lives of our communities. From the mid 1980’s onwards the UK made massive strides in reducing drug related harm, backed with only modest financial investment but supported by significant changes in practice.

This change itself was supported by the sharing of knowledge and experience across a range of medical and social disciplines coupled with a benign political environment. This knowledge, this education, changed not only what people knew but what they did. For over a decade we enjoyed a period where health professionals, community activists, local authority officers, service users, law enforcement professionals and others could sit together and develop new and exciting services. The success of this, and the benefits of subsequent financial investment could be demonstrated by internationally low infection rates for blood borne viruses, increased numbers of people in treatment, lower rates of drug related death and reductions in crime.

Unfortunately, recent years have seen some of these gains slip and I am convinced that while reductions in funding play a part the loss of knowledge and the reduced opportunities to share experience with colleagues has also played a part. We have less opportunity to share knowledge and learning, less time to discuss our work with colleagues from other fields. This has reduced our capacity to evolve practices to tackle new challenges. For example, we are struggling with responses for our ageing drug and alcohol using populations. More sadly we have often lost the memory of what does work. To guide health interventions, we have the wonderful Cochrane Library and Public Health England provide a repository of useful info. Unfortunately, information relating to social and community issues is often much harder to locate and those outside of particular specialist silos are often unaware of closely related resources. This too often leads to resources being misdirected on ineffective or even counter- productive activities.

Let me end on a positive. In fact, two positives. Last week I was involved in an event looking at how data sharing from hospitals could help reduce violent crime. The data in question was de-personalised but could help drive a whole range of positive activity. A wide range of partners were involved. No one agency had all the picture but together a genuinely holistic understanding could be developed, and the outcomes were of greatest benefit to some of our most deprived communities. This information is being centrally supported and is accessible by all who can benefit from it.

Open source intelligence is a popular term in law enforcement but is applicable in other settings. Basically, it can be described as sharing all you can on any particular problem to enable all parties interested to most effectively respond. It is another example of knowledge helping lead action. Good quality information and debate is valuable. Never more so than in a period of restricted funding. In terms of helping support knowledge and effective action I would suggest looking at the archives of previous City Health events. Take a lunchtime to scan through these. I would recommend choosing at least one topic you are not normally involved in to broaden your knowledge. Obviously, the live event provides much greater opportunity to engage, to develop ideas and see network, so we hope to see you in Odessa. But if you can’t join us City Health International remains committed to sharing knowledge and stimulating action.


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.
Sunday, January 27, 2019
I hope 2019 has begun well and that the year ahead proves a good one for you all. Despite the ongoing political uncertainty in the UK and increasing strain on budgets, with little hope of improvement in the near term, I remain surprisingly upbeat. It may be the result of what seems to have been a successful London Christmas alcohol campaign, once the data firms up I shall certainly share more. It could be the prospect of the forthcoming City Health International Conference in Liverpool on 22 March, which promises some great speakers. Possibly it is a result of small, but welcome, signs of a willingness to explore new ways of thinking and working to reduce health inequalities in relation to mental health and hepatitis. Perhaps it’s having just secured funding to update our Safer Nightlife guidance, which aims to reduce drug related harms in the night time economy. I am sure the money has helped, you could say it has incentivised me.
Monday, December 31, 2018
Like many I have spent the last two weeks demonstrating a casual disregard for the advice provided by health organisations in terms of food and alcohol consumption. My levels of physical activity have not been all they should have been either, although I am full of good intentions for the coming year and have started to make my overfed body walk more .



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.