City Health International

BLOG
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.

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.

Previous

CITY HEALTH INTERNATIONAL EVENTS

CHI Melbourne 2019

Read more

CHI Liverpool 2019

Read more

CHI Odessa 2018

Read more

CHI Basel 2017

Read more

CHI London 2016

Read more

CHI Barcelona 2015

Read more

CHI Amsterdam 2014

Read More

CHI Glasgow 2013

Read More

CHI London 2012

Read More

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.