Around the world, cities are increasingly concerned with not only protecting, but also improving the health of their citizens. This is driven by many factors, the link between a healthy population and economic success being one of the most politically compelling. Closely linked to this, health inequalities/inequities are recognised as barriers to cities achieving their potential. This concept has gained traction with a broad range of politicians and policy makers, even if the breadth of factors and levers to achieve these goals are perhaps less well understood. What is clear is that the delivery of a healthy city requires the involvement of agencies beyond the traditional, narrow, understanding of those which deliver medical services. We all regularly hear and chant the mantra of needing to end silo working and the virtue of adopting holistic approaches.
In 1960 one third of the global population was to be found living in urban settings. Now, more than half the population lives in cities and this trend is accelerating. The future is increasingly urban. Of course, cities are frequently viewed as a being a source of problems, be that as crime generators, dens of sin, blighted by pollution or scenes of great poverty. From the tale of Babel onwards we seem to be programmed to focus on the “big city” as being at odds with the peace, calm and implied health of the rural idyll.
Around the world many are working on how we develop support for ageing populations. In South Korea they are looking to restructure jobs to make them more suitable for older workers. Brazil has established older people’s councils to consider the issues and generate ideas. The World Health Organisation has identified ten priorities towards making 2020-2030 a decade of health ageing. One of these priorities is sharing information and experience.
We all make mistakes. These will be of varying degrees and seriousness, but all of us can look back on judgements that proved to be wrong, decisions made in error or things we would, in hindsight, have done differently. Sometimes it may be that we just didn’t understand the impact of a particular factor or event. The same also applies to organisations. Neither good intentions nor past success provides immunity. Of course, the larger and more influential an organisation, the more the consequences of mistakes are likely to be magnified. Businesses may pay for these mistakes in terms of profit, share value or even their survival. We may want to ponder the consequences when health bodies make significant errors.