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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, 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!
Wednesday, December 18, 2019
It has been a little while since I managed to produce a blog. Workwise things have been especially hectic as we end the year. Not least in helping get another London Christmas alcohol campaign organised. You can see the resource produced here . Early next year I will share our experience of this year’s campaign. Looking back 2019 has been a year when the headlines relating to drugs have been consistently negative. Record drug related deaths, some worrying prevalence data, growing concerns around crime and financial pressure on service delivery. On the positive side there is some sense that drug issues are getting back on to the agenda. Hopefully this will continue. A personal highlight of 2019 was getting to hear and speak with so many fascinating people at City Health Melbourne.
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.

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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.