City Health International

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City Health International is delighted to announce we have established a blog on the website to promote debate and discussion around current issues of interest to the network. David MacKintosh, one of the founders of the network, writes a weekly piece, posted here. We also invite contributions to the blog from others with ideas and opinions on issues relating to health behaviours and urban health and well being and who wish to share with others. If you would like to contribute, please send your post to This email address is being protected from spambots. You need JavaScript enabled to view it. and we will ensure it is posted on the site and placed in the weekly City Health alerts sent to those in the network.

A confession. As much as I would hate to be without my iPad or laptop and can barely remember how we got by before the internet opened access to a mind-boggling range of material I still like to read and hoard hard copies of important documents. Over two decades I have built a significant collection of reports, strategies and reviews. I couldn’t call it a library (it lacks much in terms of organisation) but it’s a resource where I can find a great deal of what was happening around drug policies and allied fields during the 1990’s and into the 21st century. In terms of external validation, I have had many individuals and agencies come to me for assistance, including central government, who had somehow lost copies of their own policy documents while switching to digital formats.

What an excellent event the City Health 2018 conference proved to be. The seventh edition since the inaugural event at the Guildhall in the City of London in 2012 each subsequent has added to the knowledge and breadth which makes this such a fascinating and unique undertaking. The city of Odesa were great hosts and combined with the tremendous efforts of the organisers nearly 250 participants from over 20 countries gathered to discuss how we can develop healthy responses during this period of unprecedented change and challenge.

It was a great pleasure to meet so many people committed to improving urban health and be exposed to so many examples of great work. There were also some incredibly stimulating and thoughtful presentations and inputs, not just from speakers but also members of the audience. While I can’t pretend the travelling (especially the rather tight transfer times) were anything other than tiring City Health has done a wonderful job of recharging my batteries and energising me to consider how I can make use of what I have learned in Odesa and apply it and share it with colleagues in London. It certainly reminded me that many colleagues around the world face a level of challenge in delivering evidence-based approaches that some of us struggle to imagine. Also, this blog will continue, not least because 2019 will see two City Health events!

The first of these will see City Health hosted by Liverpool John Moores University on 22 March. Liverpool is not just a city with an important maritime history or being famous as being the home of The Beatles, it also enjoys a long influential history of innovation around public health, having been the first city in England to appoint a Medical Officer of Health in the mid-19th century. More recently it has also been at the forefront of developments relating to harm reduction in relation to drug use and has led much of the work in trying to improve safety in the night time economy. Get the date in your calendar now. The other City Health event is to be held in Australia in September. While exact dates are yet to be confirmed this will be a great opportunity to take City Health beyond the confines of Europe and engage with a broader range of cities. Australia has, of course, often led global developments in terms of pragmatic and humane responses to problems associated with drug use. Though in terms of the current position relating to tobacco harm reduction it perhaps reminds us that no country has a monopoly on wisdom, or that previous victories mean there are not further battles to be fought in helping our most vulnerable communities. I very much hope you are able to participate or engage in one or other of these events.

Let me return to the recent conference in Odesa. The quality of speakers and presentations was outstanding. Reflecting the ethos of City Health, the presentations are already available via the website but in addition many were filmed, and these will be added in the coming weeks. Some of the issues which caught my attention will be flagged in forthcoming blogs, but I must mention David Wilson, the World Bank’s Global HIV/AIDS Program Director, who delivered the Alison Chesney and Eddie Kiloran Memorial lecture. He provided a global and historic overview of current health challenges, highlighting the great gains achieved by improved nutrition, sanitation, vaccination and antibiotics. He then raised the question that given this why are we so many societies and individuals experiencing such anxiety? He then highlighted examples where drug and alcohol use coupled with rises in heart disease were seeing declines in health expectancy. Looking to the future he outlined the challenges posed by the current technological revolution and suggested we all need to start looking at the current and future challenges in health rather than continuing to fight the battles of the past. That poses a considerable challenge for us all.

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 main summer holiday season is coming to an end in London.  Traditionally, August is a quiet time where we catch up on long overdue administrative tasks and discuss potential collaborations for the coming months.   However, with City Health in Odesa less than two weeks away, I find myself in a reflective mood.   The last few months have seen a range of health stories in the media. Some got barely five minutes of interest, others generated coverage on television, and debate online.  What, I have been considering, are the actual impacts on our populations of this media interest?  People are exhorted to stop smoking, eat healthier, avoid sugar, drink less (if any) alcohol, be more active, avoid too much sun, and practice safe sex. No doubt there were also a few other topics that slipped passed me. How effective is this kind of advice?

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.
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.

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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.