On 17 November, 250 members of the public and 24 speakers came together to explore what makes a city healthy, as part of the health strand of the Festival of the Future City. Five sessions with a diverse blend of speakers saw wide ranging debate on everything from the role of taxation in creating healthy places, to age segregation in cities, to how the emphasis on gross domestic product locks inequality into the way cities and places are designed, to how the most marginalised people in society can be supported to engage with leading and shaping health systems.
Chaired by Jenny Lacey, this session kicked off with an Aardman animation created for Bristol Ageing Better, exploring the experiences of older people living in the city. Panelists included sociologist Anne Karpf who wrote How to Age, Paul McGarry from Age-Friendly Manchester, University of Bristol's Helen Manchester and Guy Robertson of Positive Ageing Associates. The debate included a call for older people to 'get angry' with the way they're excluded from urban spaces through poor and thoughtless design, and explored how other countries have a healthy respect for their older citizens. The age segregation that is common in British society and urban environments was identified as a cause of the loneliness and isolation of many older people. There were encouraging examples of projects from other cities, as part of the WHO global network of age friendly cities, that are a beacon of hope for the future.
This session, chaired by University of Bristol's Professor Sarah Purdy, Director of the Avoiding Hospital Admissions HIT, focused on the indicators that could be considered in understanding a city's health. Liz Zeidler of Happy City argued that the current focus on gross domestic product as an indicator of quality of life doesn't just miss the point, but actually degrades health and happiness for the majority. Living Street's Chief Executive Joe Irvin spoke on the value of walking as the most accessible form of exercise, and how our cities often fail to support this most basic human activity. Healthy urban planning and the effect this can have on future generations was explored by Sarah Burgess of the WHO Collaborating Centre for Urban Environments at UWE. Daniella Radice, Assistant Mayor for Health at Bristol City Council, explained the data that the council is already collecting, while adding in extra indicators, like antidepressant prescribing and air pollution, that she believes give a rounded view of a city's health.
Marcus Grant, Director of SHINE, and expert advisor to WHO Healthy Cities, chaired this session, which focused on the influence housing and place has on people's health in a city. UWE's Professor Jane Powell explored how exercise and social interaction can go hand in hand if places are carefully designed to support this symbiosis. Writer and academic Professor Hugh Barton discussed the Finnish model of the 'walking city', and how house building has drastically reduced over the past 50 years, precipitating the current housing crisis. David Walker, writer and journalist with Guardian Public, argued that health and housing are political issues, and neither are likely to be improved until we move away from the collectivist ideology that dominates modern politics.
This session, chaired by Andreas Papadopoulos of Avon and Wiltshire Mental Health Partnership, focused on how mental health can be supported and improved in cities. Claire Miller of LinkAge Bristol kicked things off with a video showing how older people have benefited from LinkAge's work, which helps reduce social isolation by bringing older people together with their peers and those from other age groups. UWE's Richard Kimberlee discussed the benefits of social prescribing, which helps people access local services that will benefit their mental health and wellbeing, such as community gardening. Ellen Devine of Healthwatch Bristol talked about Young Healthwatch, where young people have been involved in the recommissioning of services. Aileen Edwards of Second Step, which has been providing support and housing to people with mental health issues for 30 years, talked about how mental health services have been underfunded compared to physical health services, as well as the taboos that still surround mental health conditions.
This session was chaired by People in Health West of England's Hildegard Dumper, and it explored how leadership models could be changed to allow people a greater say and input into the way their cities and health systems are managed. Debbie Sorkin, National Director of Systems Leadership, the Leadership Centre, kicked off the session with an exploration of why it's so important that citizens are involved with leadership of places. Speaking as a citizen involved in leading several health organisations in the Bristol area, Martin Gregg described the inextricable links between health and an individual's social and economic situation. Morgan Daly of Healthwatch B&NES and Somerset, asked why marginalised people should want to engage in leading systems that have let them down. He talked about some of the engagement projects in the region that go beyond the tokenistic work that has happened in the NHS in the past. People in Health West of England's Professor David Evans wrapped the session up with a review of the successes of NIHR INVOLVE over the last 20 years, emphasising that to do meaningful patient and public involvement takes time.