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Peel Health InitiativesHealth and Urban Form
Region of Peel Public Health
alPHa ConferenceJune 9, 2008
Gayle BurseyDirector, Chronic Disease and Injury Prevention
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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.
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OutlineOutline
Built Environment
• Background
• Initiatives
• Assessment Tool
Food Environment
• Influencing Factors
• Obesity Prevention Strategy
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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)
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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
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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)
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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
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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
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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
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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
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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
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Urban Form Health Assessment Tool: HOWUrban Form Health Assessment Tool: HOW
WALKABILITY SURFACE
LAND USE VARIABLES
TRAVEL PATTERNS
HEALTH OUTCOMES
People
Buildings
Streets
Reality
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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
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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
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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)
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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
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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
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Food Environment and Built Environment in Europe
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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
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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)
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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
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OBESITY PREVENTION STRATEGY
POLICYBuilt EnvironmentFood Environment
BehaviourGoals– Not weight loss, current population Activity, to Chronic Disease Risk (Cuban
Study) European Food Experience
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Towards walkable communities…. Towards walkable communities…. step-by-stepstep-by-step
peelregion.ca/health/urban/peelregion.ca/health/urban/
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For More Information….
www.peelregion.ca/health/urban/