Community Health and the Importance of Planning Association of Municipalities of Ontario Conference – 16 August 2010 Dr. Charles Gardner, Medical Officer of Health

“We ought to plan the ideal of our city with four considerations. The first, as being the most indispensable, is health.” Aristotle, Politics (ca. 350 BC) “We shape our buildings; thereafter, our buildings shape us.” Winston Churchill Introduction

Learning Outcomes Participants will learn about:  Why and how public health and municipalities can work together to change the built environment to improve health.

Public health movement began with the built environment  Beginnings of public sanitation movement in the 19 th century  Municipal water sanitation and sewage systems  Improving incomes, housing, nutrition, working conditions  Infection control practices:  Water and food safety  Health care  Vaccination (smallpox) Dr. John Snow, cholera and the Broad St. pump

Public health  Mandate – to protect and promote the health of the population  Programs include:  Healthy Living – chronic disease prevention, healthy eating, physical activity, sun safety, schools, injury prevention, substance use, tobacco use  Family Health – reproductive health, healthy children, social determinants of health  Clinical – immunization, oral health, sexual health, communicable disease, infection control  Health Protection – food and water safety, rabies, emergency management, health hazards  Corporate – epidemiology, surveillance, evaluation, health promotion, communications, IT

Public health & local government Traditionally public health has worked with local government to protect and promote health. That relationship continues today.  Emergency planning  Pandemic influenza  Smoking bylaws  Municipal alcohol policies  Healthy nutrition options at municipal facilities  Water fluoridation  Health hazards – air and water quality  Anti-idling bylaws  Built environment - input into official plans, sustainability plans, participating on active transportation committees, etc.

Why focus on the built environment?  Increasing obesity  Aging population  Air quality  Motor vehicle collisions  Green space depletion  Increasing commuting / loss of leisure time  Climate change  Peak oil – energy security

Some health impacts related to the built environment Precursors:  Ability to be physically active  Air quality  Access to good nutrition  Access to safe / secure water Biomedical outcomes:  Obesity  Blood pressure  Injuries  Mental health  Mortality

Some related broader determinants of health  Social determinants  civic society, social capital, poverty  Security  Carbon emissions

Built Environment Built Environment

Why is this important for Ontario?  High incidence of preventable disease  Aging population  Rapid growth and development

 How this growth and development happens will dramatically impact on the health of Ontario’s population  Opportunities to strategically plan and define this growth:  Provincially  Places to Grow  Review and update of Provincial Policy Statement, 2005  Municipal receptiveness – working with public health to review official plans  Public health – momentum within the system to address this issue and to work with partners to take action

Inspiring examples from around the world… ParisBogota Stapleton, Colorado CopenhagenMontreal

And in Ontario… Sparks Street, Ottawa

Sudbury - Healthy Community Strategy Markham – Cornell Development Waterloo – Rapid Transit Development

Making a difference in Simcoe Muskoka Gravenhurst Wharf playground Barrie’s Hwy 400-Essa bridge sidewalk – before and after

Barrie’s car-free Sunday Bike lane construction in Springwater Twp Orillia’s waterfront

Working together to plan for health  Planners are knowledgeable and supportive of healthy community planning and design  Supported through their institute – Ontario Professional Planners Institute  Provincial leadership – several ministries working on healthy community resources and policies (e.g. Ministry of Municipal Affairs and Housing, Ministry of Health Promotion)

Provincial land use policies   Ontario’s long-term prosperity, environmental health and social well-being depend on wisely managing change and promoting efficient land use and development patterns. Efficient land use and development patterns support strong, liveable and healthy communities, protect the environment and public health and safety, and facilitate economic growth. (Provincial Policy Statement 2005, Part V, 1.0 Building Strong Communities)

Places to Grow – Growth Plan This plan is about building complete communities, whether urban or rural. These are communities that are well designed, offer transportation choices, accommodate people at all stages of life and have the right mix of housing, a good range of jobs, and easy access to stores and services to meet daily needs. (Places to Grow - Growth Plan 2006, p.13)

Municipalities are doing their part Regional drivers  Large and growing population  Recognition of the need for environmental, economic and socially sustainable planning.  Required compliance with provincial land-use policy.  Municipal politicians welcome health unit expertise and involvement.  Relationships based on previous joint work with municipal staff – tobacco, pandemic influenza planning.

Public health doing its part  Raising awareness of the connection between health and the built environment.  Reviewing and commenting on municipal official plans and other strategic policy documents.  Providing expertise, consultation and support to planners and municipal staff.  Participating in local, regional and provincial committees and coalitions.  Collaborating with other stakeholders and partners.  Producing resources and tools.

Healthy Community Design: Healthy Community Design: Policy Statements for Official Plans Policy Statements for Official Plans

Examples of public health work throughout Ontario to foster healthy community design.  Education and awareness raising within the public health community:  alPHa conference Feb 2007 and June 2008  ASPHIO conference May 2008  HKPRHU hosted active transportation workshop in 2010  GBHU hosted Healthy Communities Conference in May 2010  CPHA Conference had built environment content in June 2010  Upcoming OPHA Conference on the built environment in October  Regional / provincial partnerships  GTA Clean Air Council – Peel, SM, TO  Healthy design modeling / assessment tool  Peel (with Dr. Larry Frank and Dr. Jim Dunn), Grey Bruce, Haliburton

More examples of public health work in Ontario to foster healthy community design.  Clean Air Strategies / Plans (including anti-idling)  Peel, TO, Waterloo, Halton, Simcoe Muskoka  Active Transportation Plans / Bicycle Paths / Walking Strategies / Planning Tools  Peel, TO, York, Hamilton, London, St. Thomas  Green Building Strategies  TO  Municipal Official Plans / Master Transportation Plans  Simcoe Muskoka  Health Impact Assessment Frameworks / Reports  TO, Waterloo, York  Environmental Assessments  York

More examples of public health work in Ontario to foster healthy community design.  Community Energy Plan  Waterloo, York  Sustainability Strategies  York  Climate Change Mitigation and Adaptation Plans  TO, York  Transit Emissions Reduction / Smart Commute Plans  York  Comprehensive Food Strategy  TO  RRFSS Built Environment Survey Module (being developed)  APHEO  Ongoing Review and Advocacy  OPHA Built Environment Working Group

“Communities can be shaped by choice, or they can be shaped by chance. We can keep on accepting the kind of communities we get, or we can start creating the kind of communities we want.” Richard Moe, President of the National Trust for Historic Preservation, United States of America

Thank you