Peel Health InitiativesHealth and Urban Form

Region of Peel Public Health

alPHa ConferenceJune 9, 2008

Gayle BurseyDirector, Chronic Disease and Injury Prevention

DeclarationDeclaration

No part of the information and materials I am presenting today has been funded by any or the conference sponsors and I do not have an employment or funding relationship with any of the conference sponsors.

OutlineOutline

Built Environment

• Background

• Initiatives

• Assessment Tool

Food Environment

• Influencing Factors

• Obesity Prevention Strategy

Region of Peel: Caledon, Brampton and Mississauga

Rapid Growth – 1.5 million by 2031

Highest settlement in Brampton, Mississauga.

Unique Challenges: development of intensification in Mississauga; greenfield in Brampton; rural community in Caledon (Peel Planning/05)

• Rapid growth is fueling more vehicle trips (Peel Planning/05)

• Single occupant vehicle trips increasing

• Physical Activity levels are decreasing

• Obesity and related chronic diseases like diabetes, cardiovascular disease are increasing (Health Status Report/05)

Health and Urban Form: BackgroundHealth and Urban Form: Background

• Council discussion 2002 narrow focus – individual control

• Council Report - “State of the Region’s Health: Focus on Overweight, Obesity and Related Health Consequences in Adults” (2005)

• Recommendations– Marketing– School food activity environment– Policy-active/public transportation– Policy-built environment

Health and Urban Form: BackgroundHealth and Urban Form: Background

Council Resolution:

advocate for provincial legislation to limit advertising of unhealthy foods during

children's TV programmingPrivate Members Bill to limit children’s food ads in Ontario

work with school boards to implement programs and policies that support children to eat healthy and be activeEducation Act Amendment: Bill 8 (Healthy Food for Healthy Schools

Act)

Health and Urban Form: BackgroundHealth and Urban Form: Background

Council Resolution:

study and make recommendations for planning policies and processes that provide greater

opportunities for active living

advocate for policies which strengthen public and active transportation option

Active Transportation Initiative (Phase 1 = Social Marketing Campaign; Phase 2 = Plan)

Health staff to comment on any development applications that come to the Region for comment

Urban Form Health Assessment Tool

Complex Set of Factors Affect Urban Form

URBAN

FORM

INFRASTRUCTUREINFRASTRUCTURE

RoadsTransitWaterSewer

ENVIRONMENTENVIRONMENT

ProtectionEnhancement

Clean Air

PEOPLEPEOPLE

HealthCustomsValues

BehaviourLaw

FORMFORM

Land UseDesign

BuildingsPublic Spaces

ECONOMYECONOMY

TaxationIncentives

Development - EcoRevenue Generation

What have we done, what is yet to come?What have we done, what is yet to come?

1.Conceptual Model Development - PHAC

2.Literature Review – systematic, realist view

3.Feedback on Municipal Block Plans

4.Mississauga Urban Form Committee

5.Peel Health Position Statement in Official Plan

6.Active Transportation Committee

7.Good Governance Project

8.Urban Form Health Assessment Tool

Urban Form Health Assessment Tool: WHATUrban Form Health Assessment Tool: WHAT

PURPOSE

Develop an evidence-based prototype Health Assessment Tool that would systematically identify the public health impact of built environments in Peel

Goals:

1. Promote the development of healthier built environments in Peel

2. Using the tool’s statistical relationships, develop health and urban form policy

Urban Form Health Assessment Tool: WHYUrban Form Health Assessment Tool: WHY

1. Seattle Study: Lawrence Frank:

A 5% increase in Walkability is associated with:

1) A 32% increase in minutes walking and biking

2) A ¼ pt reduction in BMI (about ½ kilogram)

3) A 6.5% reduction in per capita vehicle kilometers travelled

4) A 5.5% reduction in ozone precursors

2. Atlanta Study: Lawrence Frank:

1) Additional 30 minutes driving/day 3% increase obesity likelihood

2) Additional KM walked 4.8% reduction in obesity likelihood

3) AJPM/08 study

• No behaviour difference in more walkable community

• Crime reduced walking in walkable community

RESULTSRESULTS

Urban Form Health Assessment Tool: HOWUrban Form Health Assessment Tool: HOW

WALKABILITY SURFACE

LAND USE VARIABLES

TRAVEL PATTERNS

HEALTH OUTCOMES

People

Buildings

Streets

Reality

Urban Form Health Assessment Tool: HOWUrban Form Health Assessment Tool: HOW

DATAPLANNING VARIABLES:

• Parks and Trails

• Transit routes/schedules/stops

• Greenspace

• Sidewalk Attribution

• Census information (demographic, income, HH size)

• Postal code polygons

• Building Square Footage

• Property Assessment Parcels

• Street Networks (signalized intersections)

• Traffic Zone Data

HUMAN DATA:

• Physical Activity

• Sedentary Activity

• Leisure Activity

• Obesity

• Chronic Conditions

• Stress

• Mode of travel to work

• Public Transit Use

Urban Form Health Assessment Tool: HOWUrban Form Health Assessment Tool: HOW

Tool Requirements:

1.Ability to evaluate land development alternatives

2.Ability to evaluate at a relatively small scale (neighbourhood)

3. Flexibility to incorporate outcomes and land use measures based on reasearch

4.Ability to incorporate health and air quality outcomes

Urban Form Health Assessment Tool: THE MODEL

Potential model PLACE3S

1. Web-based

2. GIS-based – Visual Output

3. Flexible

4. Public engagement and collaborative decision making

5. Meets our model requirements for Tool

6. Used in other government settings (California, Seattle)

Obesity prevention strategy reframe obesity epidemic to comprehensive health promotion interventions:

– Built environment policy

– Food environment policy then

– Behaviour change interventions, i.e. skill building (Popkin 2005)

Obesity Prevention Strategy

European Model

FOOD ENVIRONMENT

small portions

culture and food

slow food movement

buy fresh, buy local

the norm

BUILT ENVIRONMENT

proximity

pleasant streetscape

active/public transportation

transportation hubs and

smart card

Food Environment and Built Environment in Europe

Food Environment – Influencing Factors(Causal Web of influence on the prevalence of obesity – Harris, University of North Carolina)

Macro physical, cultural, economic and social environment

Dietary intakes

Energyexpenditures

Obesity

Household/individual/social/demographic/economic

Psychological/behavioural

Clinical

Biological (genetic,neurochemical, etc)

ChildhoodEmergingadulthood

Youngadulthood

OlderadulthoodAdolescence

Food Environment - Influencing Factors: The Case for Healthy Public Policy

Biological Factors• Biological drive to eat to survive• Evolutionary perspective, obesity rates predictable• Increase access to calorically-dense food• Decreased activity (clerical 300 less calories)• Eating patterns reflect caloric needs of ancestors

Other Factors• Psychological factors, satiety• Sociological, cultural, familial factors

(Bursey, Health Status Report/08)

A Case for Healthy Public PolicyBeyond Individual control because of Changes in FoodSupply and Globalization of Food Industry

• Widespread availability of cheap food• Increase portion sizes, caloric density• Increase in food marketing

• Lack of regulation of food marketing or content of food supply in relation to prevention of chronic disease• Lack of policy, i.e. government, workplace standards for small portions, flavourful, nutritious food on site

OBESITY PREVENTION STRATEGY

POLICYBuilt EnvironmentFood Environment

BehaviourGoals– Not weight loss, current population Activity, to Chronic Disease Risk (Cuban

Study) European Food Experience

Towards walkable communities…. Towards walkable communities…. step-by-stepstep-by-step

peelregion.ca/health/urban/peelregion.ca/health/urban/

For More Information….

www.peelregion.ca/health/urban/