Peel Health Initiatives Health and Urban Form

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Peel Health InitiativesHealth and Urban Form
alPHa Conference June 9, 2008
Gayle Bursey Director, Chronic Disease and Injury
Prevention

• Region of Peel Public Health

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Declaration
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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Outline

• 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 Background

• Council discussion 2002 narrow focus individual
  control
• Council Report - State of the Regions 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 Background
Council Resolution advocate for provincial
legislation to limit advertising of unhealthy
foods during children's TV programming Private
Members Bill to limit childrens food ads in
Ontario work with school boards to implement
programs and policies that support children to
eat healthy and be active Education Act
Amendment Bill 8 (Healthy Food for Healthy
Schools Act)
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Health 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
ENVIRONMENT Protection Enhancement Clean Air
INFRASTRUCTURE Roads Transit Water Sewer
URBAN FORM
PEOPLE Health Customs Values Behaviour Law
ECONOMY Taxation Incentives Development -
Eco Revenue Generation
FORM Land Use Design Buildings Public Spaces
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What have we done, what is yet to come?

• Conceptual Model Development - PHAC
• Literature Review systematic, realist view
• Feedback on Municipal Block Plans
• Mississauga Urban Form Committee
• Peel Health Position Statement in Official Plan
• Active Transportation Committee
• Good Governance Project
• Urban Form Health Assessment Tool

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Urban 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
• Promote the development of healthier built
  environments in Peel
• Using the tools statistical relationships,
  develop health and urban form policy

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Urban Form Health Assessment Tool WHY
RESULTS

• 1. Seattle Study Lawrence Frank
• A 5 increase in Walkability is associated
  with
• A 32 increase in minutes walking and biking
• A ¼ pt reduction in BMI (about ½ kilogram)
• A 6.5 reduction in per capita vehicle kilometers
  travelled
• A 5.5 reduction in ozone precursors

• 2. Atlanta Study Lawrence Frank
• Additional 30 minutes driving/day ? 3 increase
  obesity likelihood
• Additional KM walked ? 4.8 reduction in obesity
  likelihood
• AJPM/08 study
• No behaviour difference in more walkable
  community
• Crime reduced walking in walkable community

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Urban Form Health Assessment Tool HOW
LAND USE VARIABLES
People
CCHS
TTS
Buildings
Streets
TRAVEL PATTERNS
Reality
HEALTH OUTCOMES
WALKABILITY SURFACE
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Urban Form Health Assessment Tool HOW
DATA
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Urban Form Health Assessment Tool HOW

• Tool Requirements
• Ability to evaluate land development alternatives
• Ability to evaluate at a relatively small scale
  (neighbourhood)
• Flexibility to incorporate outcomes and land use
  measures based on reasearch
• Ability to incorporate health and air quality
  outcomes

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Urban Form Health Assessment Tool THE MODEL
Potential model PLACE3S

• Web-based
• GIS-based Visual Output
• Flexible
• Public engagement and collaborative decision
  making
• Meets our model requirements for Tool
• Used in other government settings (California,
  Seattle)

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Obesity Prevention Strategy

• 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)

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European Model
FOOD ENVIRONMENT
BUILT ENVIRONMENT
small portions culture and food slow food
movement buy fresh, buy local the norm
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
Household/individual/social/ demographic/economic
Dietary intakes Energy expenditures
Obesity
Psychological/behavioural
Clinical
Biological (genetic, neurochemical, etc)
Emerging adulthood
Young adulthood
Older adulthood
Childhood
Adolescence
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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 Policy

• Beyond Individual control because of Changes in
  Food
• Supply 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

• POLICY
• Built Environment
• Food Environment
• Behaviour
• Goals
• Not ? weight loss, current population
• ? Activity, to ? Chronic Disease Risk (Cuban
  Study)
• ? European Food Experience

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Towards walkable communities. step-by-step peelre
gion.ca/health/urban/
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For More Information.
www.peelregion.ca/health/urban/