Building Healthy Communities Healthy Communities & the Built Environment

1. Building Healthy CommunitiesHealthy Communities & the Built Environment Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

2. Special thanks to • Lisa Tolentino • Project Coordinator • Robb MacDonald • Consultant • Ontario Healthy Communities Coalition Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

3. Presented by: Louise Daw PARC Consultant Physical Activity Resource Centre louise@ophea.org 519.646.2121 www.parc.ophea.net Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

4. Presentation Outline • Healthy Communities Overview • Impacts of built environmenton health • Connections and history between health, land use planning & design • OHCC Healthy Communities & the Built Environment Project • Ongoing Resources and Supports • Discussion on what is happening in your community Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

5. The Physical Activity Resource Centre (PARC) Managed by Ontario Physical Health and Education Association (Ophea) Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

6. PARC services • Responding to requests for information • Referrals • Consultations – email, phone & face to face • Training to Physical Activity Promoters • Annual Physical Activity Symposium • Adaptable Workshops • Quarterly mailings • Physical Activity Monthly Matters Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

7. How to stay connected Join the PARC listserv Here’s how: http://parc.ophea.net/listserv-sign Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

8. Healthy Community Overview • World Health Organization (WHO) and Ottawa Charter of Health Promotion • Health is a state of complete physical, mental and social well-being, and not merely the absence of disease • First Healthy Cities pilot projects started in 1986 under the WHO umbrella Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

9. Healthy Community Origins • Over 7500 communities/cities, national and regional networks which have adopted the Healthy Cities/Healthy Community model • Canadian Institute of Planners, the Canadian Public Health Association, and the Federation of Canadian Municipalities • Ontario Professional Planners Institute, the Ontario Public Health Association, and the Ontario Landscape Architects were among our founding members Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

10. Ontario Healthy Communities Coalition Mission: To work with the diverse communities of Ontario to strengthen their social, environmental and economic well being Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

11. VISITwww.ophea.net/parc

12. A New Patient • 42 year old male in for check up • Complains of low energy • 28 pounds overweight • Blood pressure 145/92 • Blood glucose elevated • Urine normal • Cholesterol elevated Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

13. The Doctor Learns… • He is married with two children • Drives 85 km each way to work • Works 60 hours a week (plus 9 hours of commuting time) • Last vacation was 18 months ago, for one week, and linked to a business trip Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

14. The Doctor Recommends… • Meeting with a nutritionist • Name of a good psychotherapist • Weight loss program • Exercise club membership • Pedometer: 10,000 steps a day • Easing back on work and life commitments Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

15. After 2 MonthsPatient Reports… • Insurance only covers one visit with nutritionist & short term counselling • No place to walk • No time for exercise • Day is already too full • Marriage is on the rocks Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

16. One Year Later Patient Is Being Medicated With… • Antihypertensive medication • Oral Hypoglycemic agent • Antidepressant • Cholesterol lowering agent • E.D. medication Monthly medication costs of $385 are covered by insurance Dr. Richard Jackson, Former California State Public Health Officer at the California Department of Health Services Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

17. “When so many of our patients have the same problems, we must realize that poor health is not caused only by a lack of discipline, but may be the result of the built environments in which we live.” (Jackson, 2003) Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

18. The Determinants of Health • Income and Social Status • Social Support Networks • Education • Employment and Working Conditions • Social Environments • Physical Environment • Gender • Culture • Personal Health Practices and Skills • Healthy Child Development • Health Services • Biology and Genetic Endowment Health Canada, Population and Public Health Branch AB/NWT Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

19. Definition of Health • “Health is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.” (World Health Organization - WHO) • Health is determined by the complex interactions between individual characteristics, social and economic factors and physical environments. Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

20. The Built Environment… “…includes the land-use planning and policies that impact our communities in urban, rural, and suburban areas. It encompasses all buildings, spaces, and products that are created or modified by people. It includes our homes, schools, workplaces, parks/recreation areas, business areas and roads.” (Health Canada) Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

21. VISITwww.ophea.net/parc

22. Health Issues Today • Asthma & other respiratory illnesses • Cardiovascular disease, heart disease • Diabetes, obesity • Cancer • Arthritis, joint pain • Road collision injuries and fatalities • Depression & other mental health issues (Health Canada, Ministry of Health Promotion, Ont. Public Health Assoc., Heart & Stroke Foundation ) Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

23. Health Impacts of Sprawl • Ontario College of Family Physicians • Urban Sprawl and Public Health Report (2005) - Environmental Health Committee • Four booklets for distribution to public health departments and family physicians Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

24. Areas of Focus 1. Air Pollution 2. Road Injuries & Fatalities 3. Obesity (Healthy Weight and Physical Activity) 4. Social & Mental Health Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

25. Healthy Weight & Physical Activity • Sprawl => reduced walking or cycling • Reduced walking or cycling => reduced physical activity • Reduced physical activity => overweight • Overweight => heart disease, hypertension, arthritis/joint pain, diabetes, cancer Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

26. From: The Neptis Foundation – Travel and Housing Costs in the greater Toronto area 1986-1996 Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

27. Someone who spends 2 hours each day driving will, in one year, spend the equivalent of 11, 40-hour weeks sitting in their car Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

28. We need to encourage mixed land uses, more compact development, alternate modes of transportation, walkable neighbourhoods, and access to green space, so as to address many of the chronic diseases that have recently emerged and/or increased in occurrence. (Ont. Public Health Assoc.) Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

29. The Response • Healthy and sustainable community planning needs to become a priority to address significant public health issues and make the links between health, land-use planning, development and design • Collaboration across municipal/regional bodies and between professional disciplines (e.g., public health, planning, environment, education, etc.) • Establish concrete and meaningful relationships among various sectors within the community to develop policies and plans for the long-term Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

30. Healthy Communities & the Built Environment Project • Goal: "to improve the health of Ontarians and reduce health care costs through health promotion and chronic disease prevention strategies linking health and the built environment" • This project was aimed at creating healthy communities that optimize human health and prevent chronic diseases by promoting policies and practices that promote community characteristics such as: Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

31. Project Partners • Ontario Healthy Communities Coalition • Ontario Inclusion Learning Network • Ontario Public Health Association • Ontario Professional Planners Institute • Ontario Smart Growth Network • Region of Waterloo Public Health • Simcoe Muskoka District Health Unit • Waterloo Healthy Communities Coalition Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

32. Project Components • Literature review of Canadian research relating to health and the built environment • Environmental scan of current strategies and approaches to improving the built environment across Ontario • Community workshops and regional forums • Indicators of successful collaborations, and case studies of promising practices • Publication and dissemination of information • All components are available here: http://www.ohcc-ccso.ca/en/building-healthy-communities-project-components Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

33. Literature Review • Significant research emerging that addresses the connections between health and the built environment • Aim to highlight what exists and to present it in a manner that people can use in short and long term (annotat. bib. & database); among the themes that can be searched are physical activity, air pollution, collision injuries & fatalities, food choices & healthy eating, mental health • Focus on ‘evidence’ of the connections between health and the built environment/land use planning; wide range of works exploring the connections, but very complex and hard to determine cause/effect • Over & over researchers noted that there is a sufficient amount of quality evidence to call for action Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

34. Environmental Scan • Gain an understanding of the scope and involvement of public health units, environmental groups and community agencies in addressing the impacts of the built environment on health • Gather information on strategies, programs and practices (as well as any resources, tools and research) currently being used/conducted by these groups across Ontario • Initiatives covered a range of topics such as providing information on air pollution/clean air, strategies to promote physical activity (e.g., walking & cycling), community gardening, pesticide reduction, climate change, food access and shopping locally Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

35. Environmental Scan • Lack of knowledge/understanding about land use issues and their impact on health • Lack of knowledge/understanding regarding the role of public health in land use planning and policy decision-making (by the public, governments, planners/engineers, and even within some public health units themselves) Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

36. Environmental Scan Respondents described the success of policies, programs and initiatives as being attributed to: • Community support and awareness • Public buy-in and media coverage • Strong partnerships • Commitment of membership Other policies, programs and initiatives were less successful as a result of inadequate or a lack of: • Leadership • Skilled staff and resources • Budget • Follow-up programs • Professional planning resources and government support Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

37. Environmental Scan Common areas of research: • accessible parks, paths and trails • alternate transportation • water and air quality • preservation of green space / agricultural land Barriers to conducting research: • Lack of funding • Lack of human resources • Lack of organizational capacity • Lack of partnerships/community support Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

38. Active and Safe Routes to School – “Walking School Bus” Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

39. Indicators & Case Studies • Most successful initiatives aimed at improving health through changes in land use planning and policy a result of multi-sector collaboration • A set of indicators developed to assess collaborative, multi-sectoral initiatives consistent with healthy community principles and processes • Indicators can be used to assess and inform projects currently underway, as well as to assist in the design of new projects • Five to ten case studies/stories to be profiled; eight stories currently pulled together Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

40. Publication • A popular piece aimed at health promoters, planners and community volunteers • Overview of major impacts of the built environment on health (positive and negative) • Collection of modules relating to particular aspects of how the built environment impacts on health (e.g., walkable communities, injuries/fatalities, etc.) • Outline of various roles for each sector/profession • Summary of project components, learnings and conclusions with links to additional information • List of other tools and resources Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

41. Sharing • What is going on in your community? VISIThttp://parc.ophea.net

42. Ontario Healthy Communities Coalition Contact Info: Hélène Lussier (Services Coordinator) • Services Coordinator 416-408-4841 / 1-800-766-3418 ext. 3 ohcc@ohcc-ccso.ca http://www.ohcc-ccso.ca/ Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net

43. Thank you Please contact Louise Daw for further information: Louise Daw PARC Consultant louise@ophea.org 519.646.2121 Ontario Healthy Communities Coalition VISIThttp://parc.ophea.net