Thoughts from Coimbra: the International Conference on Urban Health

Watching the thirsty Portuguese countryside slide past the windows of the train, it’s a good time to reflect on a few days at the International Conference on Urban Health.*

Cities take up just 2 per cent of the world’s landmass, but house 54 per cent of the population (up from 30 per cent in 1950, and heading for 68 per cent by 2050) and absorb 70 per cent of the resources. ‘Diseases of maladaptive modernity’, as Srinath Reddy described them, are rife (urban areas are already home to two-thirds of people with diabetes), and inequalities are stark – there is a 20-year difference in life expectancy between the wealthier and poorer parts of Baltimore, and injuries account for a fifth of male deaths in slums.

But cities can also be leaders in innovation and, while there was inevitably an element of the traditionally staid and academic at the Conference, there were plenty of practical (and fun) ideas floating around:

  • Peatonito: a walking activist when he’s not being a civil servant in Mexico City, who donned a mask to talk about tactical urbanism.

  • ‘Park prescriptions’: a step beyond prescribing exercise, as it combines physical activity with the benefits for mental health of being in green space.

  • Citizen science: I’ll be doing a blog soon about the air pollution monitor that I’ve installed back in London (and Wednesday was a particularly polluted day at home, which I’m hoping the device will reflect).

  • A ‘fail fair’ to be held soon in Washington DC, which will unpick examples of what has gone wrong in international development, rather than ignoring mistakes and leaving others to fall into identical traps.

  • A ‘food for men’ club, tackling social isolation through learning about – and sharing – good food.

  • And we all joined in with a dance session mid-way through a plenary (see photo), led by a group of enthusiastic, yellow-T-shirted students (although I am sure that the extremely eminent speakers on the stage must have been pre-schooled in the moves: they were suspiciously far ahead of my malcoordinated efforts).

If I read all the reports and websites that sounded interesting, I would have no time to do anything else for at least a month: a City Health Dashboard that the Robert Wood Johnson Foundation is developing to help US cities understand, compare and take action to improve health status, a report by C40 and Novo Nordisk on measuring the health benefits of climate action, a forthcoming online case-studies hub on workplace health by the Healthy Caribbean Coalition, the World Report on Ageing and Health, and the Global Digital Health Atlas...

Top of my list of interesting ideas was from a Portuguese politician, on bringing the Sustainable Development Goals into sharp focus. Every proposal for funding from the Council in Cascais ,near Lisbon, is required to demonstrate how it relates to the SDGs, and the Council’s 2030 SDGs Checklist has adapted the SDGs to local issues and indicators. The SDGs are relevant to all of us; we mustn’t make the mistake of thinking they are applicable primarily to lower-income countries.

Finally, thank you to the NCD Alliance for funding my attendance and for inviting me to speak on a panel on health in the workplace, on which I’ll be blogging soon for PloS One. It was a wonderful excuse to revisit Coimbra (one of my favourite places), to hear some excellent speakers, spend time thinking, and see some old friends (particularly from the New York Academy of Medicine, where I spent a few weeks in 2015).

Next year’s Conference will be in Kampala, Uganda – it’s time to start plotting how to get there…

* The Twitter hashtag was #ICUH2017, for our collective musings at the time.

The venue was a converted monastery – lunch was served in the church, coffee in the cloisters, and the final session was in what I think was once the refectory. Impeccably done – thank you to the International Society on Urban Health and Elsevier.

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