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.

Health sells, not just in terms of medical care or pharmaceuticals. News about health issues is a central staple of the mainstream media, all major newspapers and tv news programmes boast a health editor and provide their customers with a regular diet of stories about the latest cures, scares and developments relating to our wellbeing. The public have a great appetite for the topic, not a surprise given that all of us have a profound interest in health. Given the nature of the media they often have a particular angle. Some outlets can be relied upon to criticise almost any new government initiative as a shocking example of the “nanny state” preventing citizens going about their lives. Others tend to the opposing position that without the strong and vigilant guidance of the state citizens are all prone to making chronically bad choices with negative consequences not just for ourselves but those around us. This is often presented as being necessary not so much for the readers or viewers of the outlet in question, who are normally assumed by the writer to be wiser than the average, but for the benefit of lesser mortals.   To be fair we all tend to think it’s someone else who needs to change their ways rather than ourselves. The media also love a controversy, it could be about the merits of substitute prescribing for opiates, whether people should pay to see a medic, the rights and wrongs of vaccination programmes, all these and more make great copy.

Nearly all cities struggle with providing good quality and affordable homes for all their citizens. In some it’s become an existential challenge, fundamentally linked to the ability to continue to succeed or even survive. Our cities often have pockets of incredibly luxurious and expensive housing, beyond the reach of even those working in relatively well paid and secure jobs. It is sadly all to frequent that you can observe fellow citizens living in doorways, parks and underpasses in close proximity to these homes for the wealthy. In all measures other than geography they live lives very distant from the urban idyll. The issue of people ending up sleeping on the streets of our cities is to be found world-wide, from Osaka to Sao Paulo, from Auckland to Stockholm. The underlying reasons that lead people to living on the streets are often multi-faceted and can be linked to particular local or regional factors. Health issues, both physical and mental are more common than in the general population. Research from the UK indicates the significant role played by alcohol and drugs. There is a strong correlation in terms of individuals who have experienced some form of significant trauma. We also cannot ignore the impact of national and municipal policies. Across the globe, policies intended to reduce government expenditure have made many millions more vulnerable to becoming homeless. 

As I write we are about to enjoy a long weekend, Monday is a public holiday and the weather forecast promises warm weather and sunshine. This will inevitably see many people enjoying a BBQ and a significant amount of alcohol consumed as people have fun with friends and family. It is also certain we will see an increase in alcohol related accidents, violence, and many of us may make another down payment on potential future health problems. Yet alcohol does play a central role in how many of us socialise and, lets be frank, we enjoy it.

In an earlier blog I mentioned that in addition to failings around mental health dual diagnosis there was another subject where lack of action made me angry. In truth on occasion it has also brought me to something approaching despair. The issue in question was Hepatitis C (HCV), a virus I have seen afflict friends and colleagues and let’s not forget the well over 100 million people worldwide living with the infection. It is a major contributor to the rising toll of liver related death.

Wednesday, October 30, 2019
When I hosted the first City Health conference in 2012, my hope was we might manage three or four events in different cities. I never dreamt we’d get to nine (and counting) or that City Health would reach the great city of Melbourne. Great credit must go to the Progressive Public Health Alliance for hosting a fascinating two days that provided energy, enthusiasm and challenge. Personally, I learnt a great deal and found myself questioning somehow of my own views. I met people doing amazing things in the most challenging environments. I heard of situations that made me feel a sense of despair but came away reassured that we have the knowledge, networks and commitment to positively change lives for the better.
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.

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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.