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.

For the last two weeks I have been on my travels, combining a holiday with visiting friends and family. This has seen me enjoying the sunshine in Florida, the cherry blossom of Washington DC and the delights of Pittsburgh. This former steel city is visibly reinventing itself after some twenty years in the doldrums. Political and civic leadership aided by a strong academic sector, tech industries and redevelopment of its riverside has given Pittsburgh a tangible air of optimism. It so happens that my arrival here coincided with the anniversary of the development of the first successful polio vaccine at the University of Pittsburgh by Dr Jonas Salk (announced to the world on 12 April 1955). Truly a major milestone in global public health. When asked about who owned the patent to the vaccine, Dr Salk replied, “Well the people I would say. There is no patent. Could you patent the sun?” A man of great ideals as well as medical expertise.

When I was growing up in the 1970’s and ‘80’s there was a science programme on prime time television which highlighted the positive potential of new inventions and technology. In tone it was unrelentingly positive, despite the frequent mishaps as presenters and inventors experienced the challenges of demonstrating prototypes live on air. Although it attracted a degree of mockery, and no doubt much of its mass appeal did lie in watching demonstrations and experiments go wrong, it provided an upbeat vision of a future where we would all benefit. It was a distinct counterbalance against various other visions of the future we were offered via books, film or tv, which all seemed to be distinctly dystopian. There were various post nuclear apocalypse scenarios, global pandemics (the TV show Survivors had a profound impact on this eight year old) and of course there were concerns about resources running out, machines taking over, pollution threatening mankind, threats from outer space. The threats were considerable, some seeming more tangible than others. Yet you could reasonably argue that most societies looked forward with optimism (if not a little concern) and one of the big reasons for this was visible and demonstrable improvements in health.

What colour would you use to describe the great advances in population health of the last hundred years? Perhaps something bright and cheery? A nice vibrant yellow, or perhaps a warm orange? As appropriate as these might seem I would argue the colour grey possesses a strong case. My reasoning? The massive increase in life expectancy we have witnessed and so the associated increase in grey heads to be seen amongst our populations.

In the 1900’s life expectancy in England and Wales was 46 for men and 50 for women. A century later these had increased to 77 and 81 respectively. Spectacular improvements by any standard. Not all countries have shared the benefits equally, progress is not even across countries or socio-economic groups. It is worth reminding ourselves that Africa saw a fall in life expectancy during the 1990’s due to the AIDS epidemic, which was only reversed when effective responses (political, social and medical) were deployed. Eastern Europe also suffered a drop-in life expectancy in the period of turmoil following the end of the Soviet era. These both serve as reminders that there is nothing inevitable about progress and improvement.

The fact that cities and urban centres can increase stress in individuals is well recognised.  There is a correlation between living in a city and a range of mental health problems, although this doesn’t automatically mean urban life has to have a negative impact on our wellbeing.  Cities concentrate on a range of factors, both positive and negative. So, a city may suffer from pockets of deprivation, high rates of crime and pollution, but also provide good educational opportunities, access to modern medical care and stimulating public spaces.  However, as anyone who commutes through a big city will know there is a lot of stress about.

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?
Tuesday, July 16, 2019
Last week I met with someone who, having just completed a Masters in Epidemiology, is keen to work in the health field. Over a hot chocolate I outlined my perception of the current big issues relating to substance misuse, our most vulnerable populations and the policies and structures we have in place to address these issues.
Tuesday, July 02, 2019
Absolutely outstanding. That’s my carefully considered assessment of the Global Forum on Nicotine in Warsaw that I was fortunate enough to attend two weeks back. I say this despite the mosquito bites and the fact that the weather was rather warm for me. The event was one of those that provide a buzz and an energy that comes back to the workplace with you. This was fuelled by an outstanding array of speakers and a vibrant audience mix. Discussion and argument were not limited to the auditorium or breakout rooms, but instead could be heard throughout the venue, over lunch, during coffee breaks. There were attendees from every continent (well, ok, I didn’t actually meet anyone from Antarctica). Academics, clinicians, researchers, harm reduction advocates, retailers, product developers, policymakers, and- most importantly - vapers and users of other tobacco harm reduction products, all mixed together sharing views, experiences, and- as we should expect- differences of opinion. It certainly lived up to the conference strapline Its Time to Talk About Nicotine and the rich promise of a genuinely horizontal approach.
Monday, May 27, 2019
The value of partnership approaches and joint working to tackle major health public policy issues is widely accepted, if more rarely practised. Even where there is engagement with other professions or disciplines there is a tendency to work with those whose outlook is not too challenging and are closest to us in practice and approach. City Health has been at the forefront in challenging this and others are also working to weaken the silo walls. In the last two weeks I have been a spectator and a participant in two very different events which highlighted how important it is to include the end user, the public, our communities when developing and delivering services.

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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.