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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.

Across the world many cities face high levels of criminal violence and murder. A quick search will reveal that in terms of global league tables, certain regions dominate with Latin America, North America and Sub Saharan Africa providing the top 50 violent cities. However, a cursory glance tells us this is a complicated picture with huge variations between and within countries. Complex factors are at play, differing social, economic and legislative environments all have an influence. A brief historical perspective tells us that improvements can be made, that nations and cities can act successfully to reduce the levels of violence experienced by their citizens.

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.

Wednesday, April 01, 2020
Everything is changed. COVID-19 and responses to it have seen dramatic and fundamental changes to how life is lived around the globe. International travel has come to a near complete halt, much of the world is under some form of lock down with businesses, schools, shops, pubs and cafes shut. Our economic and social reality is now unrecognisable from that of only weeks ago.
Tuesday, March 10, 2020
Clearly the current health focus is strongly centred on Covid- 19 and related issues, as it has been for the past few weeks. It is a demanding situation for politicians, officials, and indeed all of us, especially those working in our healthcare system. One of the major challenges we face is increasing understanding and encouraging changes in behaviour, while also avoiding panic and overreaction. Trusted and accurate information is clearly essential, both for those who have a key role and for the general public. We are certainly seeing more of England’s Chief Medical Officer and Chief Scientific Adviser in the media than usual. In the current situation, politicians are not only keen to hear from experts, but also happy to let them step into the spotlight. While we still see sensationalist headlines, there are also visible benefits of this approach, with more measured and informed elements within the media coverage- though this is less evident on the outer reaches of the online universe. Before I move on to other topics, let us reflect on the significant additional pressures being placed on our frontline health providers. They deserve our gratitude and, in many instances, much improved terms and conditions. Let’s hope that when this coronavirus issue passes the staff that so many rely on are not overlooked.
Monday, February 10, 2020
Public health is front and centre of the media currently, with concerns about the coronavirus outbreak, which was first identified in the Chinese city of Wuhan, splashed across almost every front page. With confirmed cases now reported in numerous countries across the world, we face the possibility of a pandemic. As several experts and commentators have pointed out, in our modern, highly interconnected world no epidemic remains a local concern. This, of course, makes for frightening headlines- which, in turn, calls for calm and informed responses.
Wednesday, January 15, 2020
So here we are: 2020. Let me start by wishing all of you the very best for the year ahead. I have, occasionally, been accused of an inclination toward cynicism and a failure to look on the bright side of things. So, for my first blog of the year, at least, I am going to be determinedly upbeat. You can judge for yourself how long it lasts. This sense of optimism is influenced by the fact that the end of 2019 saw some positive signs in the world of substance misuse. While it was something of a mad scramble against time, we managed to pull together a high quality and well-supported pan-London Christmas alcohol campaign. I am very grateful to colleagues who delivered the key elements of this work and to everyone who supported it. Some, in fact, went well beyond the call of duty to engage with our colleagues in the blue light services. Although we will not have any data in terms of its reach and impact for some months (I will update you), what I can confidently say is that many individuals and organisations liked the messaging and tone. I like to think it is helping contribute to Londoners having a more considered and healthier relationship with alcohol, though there is a way to go yet!

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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.