Medicine does not entirely ignore qualitative research but is, understandably, happier with objective measurements and with numbers to which well-established techniques of summary statistics and more sophisticated analysis can be applied. Lately, several countries, including the UK, have been trying to devise numerical performance indicators for services such as health and education, the idea being to find the equivalent of the balance sheet in the commercial sector so that hospitals and schools can be run more like businesses. The results are published, often as league tables. Forum for the Future, a UK-based charity, has recently carried out a similar ranking exercise for British cities.1 All over the urban world there is competition to be (or be perceived to be) “green,” however that is defined, and the UK is no exception. One city aims to be the greenest in Britain by 2010, another wishes to be seen as “the green capital,” while yet another has the bold ambition to be “the most sustainable city in the world.” Forum for the Future is seeking to provide some objectivity to back up aspirations like these and so “create healthy competition between cities to encourage sustainable urbanization” in a country where 90% of the population now lives in a town or city. The ranking will be an annual one so cities will move up and down just as schools and hospitals do in their yearly league tables. The urban exercise has its weaknesses, the most obvious perhaps being that there appears to be no adjustment for socioeconomic class structure. Brighton and Hove, which comes out on top in the overall ranking (and for two of the three data subsets), is a coastal city in the south–east and can fairly, if not uniformly, be described as affluent. Liverpool, in the north–west and with a port and industrial heritage, was bottom and pockets of affluence are harder to find. Indeed, the report itself concedes that “affluence helps.” The top score was 166.9 points and the bottom 76.7. The report uses 13 criteria in 3 packages called environmental impact, quality of life, and future proofing, and the criteria selected are ones where assessments are available from sources such as the UK's Environment Agency. Six examples of the criteria, two from each package, are: air quality (which can affect quality of life) and waste collected per head of population, healthy life expectancy at age 65 and attained educational level, and local authority commitment to action on climate change and the number of “green” businesses in its area. Local people, local authority staff, elected councilors, and research scientists could give different weightings to the criteria and may be tempted to play around with the figures to get different outcomes. Also, some criteria are fairly reliable measurements whereas others are a bit woollier. Forum for the Future says that there is a “long way to go” and it is critical of previous exercises in urban renaissance, labeling them “iconic trophy-collecting.” In other words, winning an architectural prize for some inner-city shopping mall and recreational development does not make a more sustainable city. So, Liverpool can take some consolation from its winning of the Forum's wooden spoon. In 2008, this city is the European City of Culture.
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