Many years ago, I began work at the Department of Education. At around the same time the government of the day introduced school league tables. They were soon joined by rankings of colleges and universities as well as comparisons of different age groups. There was always great political interest in these and no little controversy. The intention was to allow comparison, inform the potential customer, and to encourage competition. They were deeply unpopular with most education professionals. In many ways they failed to highlight those institutions or individuals making the most impressive contributions, and encouraged all kinds of gamesmanship. These tables are still produced on an annual basis, attract considerable media interest, where all the associated pros and cons are revisited and debated.
Hello again to the City Health community after my few weeks away. I hope some of you have also had the opportunity to enjoy a holiday. My batteries are recharged, and I am looking forward to the City Health conference in a month’s time. If you haven’t yet, have a look at the programme, I am sure you will find topics of interest. There really isn’t another event like City Health in terms of opportunities to learn from other cities and across professional disciplines. This all helps to provide a fertile environment to reflect upon individual areas of interest and activity.
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.