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.
We all know there are many factors involved in any individual’s health, there are environmental factors, the physical circumstances in which they live, their behaviours and genetics. Access to good medical services, for both prevention and treatment are also recognised as being important. But the processes by which it is decided which services are provided where, be that at a national, regional or local level are, perhaps, less frequently considered. Yet we all know there are significant variations in everything from cancer survival rates (good to be in the USA, Canada, Australia, Finland or Iceland) to access to good quality ante-natal and early years care, where Western Europe general does well as do Japan, Singapore, Hong Kong and Macau but the USA does relatively badly.