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.

We all have our heroes, those who inspire and motivate us. They may be historic or contemporary, known through books, film or via the news. Quite possibly we may have actually met or even worked alongside someone who we view as a hero. Many of us, if we think about it, will have a considerable number of heroes, and every country, city and profession provides its own candidates, though many are disputed and once established heroes can find themselves out of favour as views and understanding changes. Many of course never receive much in the way of acknowledgement or reward, quiet heroes going about their work without fanfare. Of course, the field of health improvement provides us with a rich list of famous names to choose from, Hippocrates, Jenner, Pasteur, Fleming, Snow (who I will return to), Bazalgette, Bevan. I am sure you could all add many, many more. This list is of course historic, and I want to ponder a moment on who might be celebrated as a hero in 20, 50 or 100 years.

Like another 1.5 million Londoners my commute to and from work regularly involves reading the Evening Standard, a free newspaper that enjoys a rich heritage and is almost a part of the fabric of the City. This despite its politics and editorial stance often being at odds with London’s inclinations. It does benefit from some quality journalism and has a breadth of coverage which reflects London’s status as a world city. Last Monday there were three articles which ensured I didn’t doze off on my journey, and which captured three of the key issues facing our major global centres.

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.

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.
Monday, July 29, 2019
I write this on a day when London is experiencing, what is for us, exceptional temperatures. Overhead power lines and train tracks have warped. On some routes passengers have been advised to avoid travelling if possible, and many employers have encouraged staff to work from home. I suspect many who did travel to their workplaces were drawn by the prospect of effective air conditioning as much as personal work ethic. This great City was unusually quiet, apart from the pubs and bars who were doing a roaring trade. Who would begrudge people a pint of beer or a glass of wine when it’s so damn warm, especially when by delaying travelling an hour or two, the journey home may be made a little more tolerable?

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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.