PEDTalk

Gayle BurseyDirector

Growth Management StrategyRegion of Peel

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AcknowledgementsImproving Health By Design – Media Launch

• Union Station (May 14, 2014)

• Resulted in 40 media spots

• Follow-up meetings with provincial decision-makers

Left to right: Dr. Ninh Tran (Hamilton), Dr. David McKeown (Toronto), Dr. David Mowat (Peel) and Dr. Charles Gardner (Simcoe Muskoka)

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This will have a huge impact on…

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This will have a huge impact on…

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…And our health

$49%

Health

$51%

EverythingElse

The Provincial Pie

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But What’s This Got to Do with Health?

Community Design Elements

Street Connectivity

Impact

Bus Transit

Health Outcomes

Diabetes

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The more things change ….

*Lowell, Mass 1903; **Chicago 1910

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…the more they remain the same

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What’s Changed is the Nature of the Leading Causes of Death

21st Century Epidemic

Chronic Diseases(e.g., diabetes, cardiovascular

diseases, some cancers)

19th Century Epidemic

Infectious Diseases(e.g., cholera, typhoid, typhus,

tuberculosis)

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Obesity & Physical Inactivity Cost $4 Billion a Year in the GTHA

CoronaryArtery

DiseaseDiabetesStroke

Breast & Colon

Cancer

How Big is the Health Problem?

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19781979

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19821983

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Prevalence of Measured Obesity, 18+, Canada

Overweight + Obesity = 62.1% of adult population (measured, 2008)Source: CIHI, PHAC. Obesity in Canada. 2011.

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Prevalence & Excess Medical Costs of Diabetes in the GTHA

200220032004200520062007200820092010201120122013201420152016201720182019202020212022202320242025202620270

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Year

%

663,842$2.6 billion

995,0671,178,574

Projected

$4.5 billion(today’s $)

Physical inactivity contributes 12,500 new cases of diabetes each year

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So what has changed?

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The Loss of Physical Activity from Daily Life

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The Preventive Power of Physical Activity(if this were a pill…)

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Sitting in a Car…

• Not just about inactivity• Motor vehicles are a major source of air pollution

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Walk?

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Bike to Work?

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Bike to School?

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Existing Plans

• Metrolinx’s multi-year plan to develop and implement an integrated transportation system for the GTHA.

• Provincial plan to address growth challenges in GTHA by building compact, vibrant and complete communities.

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Many Societal Benefits Already Identified…

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How do you assess potential health benefits?

Existing Projections

Scientific Literature Available Tools

Baseline Transit & AT

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Feasible Health Estimates

While Recognizing That Only Addressing a Portion of the Health Impact

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Conservative EstimatesItem Absolute % Change # of People↑ Public Transit Use 9.8% 337,531

↑ AT to Work & School (adults)

5% 168,845

↑ AT Instead of Short Car trips

5% 66,753

↓ Traffic Emissions (PM2.5)

33% ALL

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Projected Health Benefits*

*Under-estimate health impacts

Prevent 184 deaths/year($1.2 billion)

Prevent 1,061 cases of diabetes/year

($250 million over 10 years – lifetime costs)

Prevent 154 deaths/year($1 billion)

Prevent 90 hospitalizations/year

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A Public Health Perspective to Community Design

Advocacy

Influence provincial legislation, municipal decision-makers, media and the public

Recommendations: 1) Fund public transit2) Normalize public transit planning3) Strengthen provincial policy

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Examples of Policy Changes

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HEALTHY DEVELOPMENT INDEXA framework to provide consistent, quantifiable standards to inform planning decisions

HDI consists of seven “elements” – categories of built environment characteristics that are known to be associated with health:

Density Proximity to Services and Transit Land Use Mix Street Connectivity Road Network & Sidewalk Characteristics Parking Aesthetics & Human Scale

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• Elements are further broken down into measures, many of which are quantitative• Based on strength of evidence, measures are either Prerequisites or Credits

Example of HDI

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• City of Brampton Official Plan Amendment 43

4.10.4.7 (xiv) Development will be subject to consideration of how the design and use of the physical development positively contributes to human health.

5.31.3 The City may require health impact studies as part of a complete development application.

5.32.2 Impact studies shall consider public health impacts.

• Applying the Healthy Development Index - Ongoing

Brampton’s Commitment to Health Built Environments

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City of Brampton Council Resolution

• City of Brampton to reference Peel Public Health’s Health Development Index (HDI) and consult Public Health staff in future transportation studies, urban design guideline studies, community improvement plans, block plans, future community planning studies.

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City of Brampton Council Resolution

At a municipal level, applied the HDI to:

• City of Brampton Sustainable Development Guidelines

• Local Environmental Assessments

• Municipal Secondary and Block Plans

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Using the Health Index Locally

Policy Changes using the Health Index: • Strengthening policy through the Regional

Official Plan Review• Sustainability Development Guidelines• Continuing comments on:

– Development applications, secondary plans– Environmental Assessments

• Community Improvement Plans• Active Networks Parks and Playgrounds Pilots• Actively Designed Buildings Pilots

Hamilton LRT

• B-line – McMaster University to the Queenston Traffic Circle• A-line spur – James Street North • Procurement for the LRT will start in 2017, with construction starting in 2019

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New Road Characterization Categories

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How do we use access control to plan for growth in an evolving Region?

Land Use Transect (Source: Duany Plater-Zyberk & Company)

As Urbanization Occurs…

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RCS Section II: Illustrative Cross Sections

• Developed design guidelines and cross sections that support the road classifications• Cross-sections show desired roadway components• Guidelines were determined for the dimensions of each component

Some of the design elements discussed include:

• Parking Lanes• Bicycle Facilities• Drainage• Medians• Sidewalks• Geometrics

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Access Control Benefits: Economic & Health• Highly connected networks benefit

property owners by creating commercially valuable municipal street frontage

• Increased access to the local street network reduces the amount of parking required from property owners

• Creates more than one route to a destination for both cars and pedestrians

Strip lots and inadequate street network:

…Need more collector and local streets

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Actively Designed Buildings

Council resolution: “Create a supportive environment to reduce sedentariness and increase activity by phasing in bike parking, mobile meetings, treadmill desks, stair use signage, and other relevant programs.”

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Affordable Housing Active Design – Guidelines and Standards

Regional sites:• Mavis – Dundas• Copper Road• Wolfdale• Peel Manor• Twin Pines – Affordable Housing

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Urban Design AwardsFeaturing for the first time a focus on healthy built environments

• Brampton

• Mississauga

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Creditvale Mills – Mississauga• 6000 sq ft. amenity space to promote active living activities• Bicycle room to promote cycling• Creating neighbourhoods, streets, and outdoor spaces that

encourage walking, bicycling, and active transportation

Affordable Housing

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Design Guidelines for Bike Lanes

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NYC Small Space – Actively Designed Parks

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Shifting from…

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To…

JHS 135, the BronxProperty of The Trust for Public Land

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Active Parks and Playgrounds• Lake Wabukayne Park in

Meadowvale – Mississauga (Completed October 2014)

• Heritage / Active Signs

– City of Mississauga and Town of Caledon (Completed in 2015)

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Active Parks and Playgrounds• School Design Days (stakeholder consultation)

– Gordon Graydon Public School

– St. Alfred Public School

• School playground enhancements at Madoc Public School (Completed June 2014)

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Active Design Schools and Workplaces

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Retrofits

Painted walking loops at regional building

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Retrofits

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Next Steps• Moving from pilot projects to mandatory implementation:

– Evaluate the health benefits and costs

• NYC 2000 – 2010 289% increase in commuter cycling

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ResultsIn New York City

5.5 percent decline in

the number of obese

schoolchildren from

2007 to 2011

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In summary, we have engineered physical activity out of our lives

More of the same is not going to work…

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Key Messages

1. We are making progress2. Good design changes behaviour3. A Planning decision is a health decision4. Take heart! If Edwin Chadwick could bring

sanitation to London in the 1800’s then…

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