Healthy Cities Healthy Communities Dr Michael Goodyear, Dept. Medicine, Dalhousie University What we Know – and What we Don’t Heritage Trust, October 2007

Healthy Communities Health is a state of complete physical, mental and social well-being.  Social, environmental and economic factors are important determinants of human health and are inter-related.  People cannot achieve their fullest potential unless they are able to take control of those things which determine their well-being.  All sectors of the community are inter-related and share their knowledge, expertise and perspectives, working together to create a healthy community Ottawa Charter 1986, World Health Organization

Healthy Cities

Determinants of Health  Peace  Shelter  Education  Food  Income  A stable eco-system  Sustainable resources  Social justice, and equity Ottawa Charter

The prerequisites and prospects for health cannot be ensured by the health sector alone. More importantly, health promotion demands coordinated action by all concerned: by governments, by health and other social and economic sectors, by nongovernmental and voluntary organization, by local authorities, by industry and by the media. Ottawa Charter Health Promotion (1)

Health Promotion (2) People in all walks of life are involved as individuals, families and communities. Professional and social groups and health personnel have a major responsibility to mediate between differing interests in society for the pursuit of health. Health promotion strategies and programmes should be adapted to the local needs and possibilities of individual countries and regions to take into account differing social, cultural and economic systems. Ottawa Charter

Healthy Communities and the Built Environment Strategic Environment Assessment Health Impact Assessment Population and Human Health

Health Impact Assessment A combination of procedures, methods and tools by which a policy, programme or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within a population. WHO European Centre for Health Policy (1999) Gothenburg Consensus

Built Environment The Rise and Fall of Public Health

Built Environment Urban Centres and The Rise of the High Rise

Built Environment The built environment is part of the overall ecosystem of our earth. It includes the land-use planning and policies that impact our communities in urban, rural, and suburban areas. It encompasses all buildings, spaces, and products that are created or modified by people. It includes our homes, schools, workplaces, parks/recreation areas, business areas and roads. It extends overhead in the form of electric transmission lines, underground in the form of waste disposal sites and subway trains, and across the country in the form of highways Health Canada 1997

Built Environment It impacts indoor and outdoor physical environments (e.g., climatic conditions and indoor/outdoor air quality), as well as social environments (e.g., civic participation, community capacity and investment) and subsequently our health and quality of life. Health Canada 2002

Health and the Built Environment  Rapidly increasing interest  Infectious diseases replaced by obesity, asthma, diabetes  Urban Sprawl and Walkability/Cyclability  Climate Change  First places – Homes  Second places – Workspace  Third places – Meeting places –Becoming scarce

Built Environment and Health  Light  Space  Noise  Air Quality  Views  Appearance  Accessibility  Social networks  Safety  Amenities  Services  Sense of Neighbourhood  Public places  Connectivity  Physical activity  Density

Built Environment Impact of Built Environment –Micro: Individual health –Macro: Population health Environment and Climate Change Main Impact on disadvantaged – less control - Children, Elderly, Minorities

Built Environment There is growing recognition that the leading causes of illness and death, including heart disease, cancer, cerebrovascular disease, chronic lower respiratory diseases and injuries, may be exacerbated by elements within the built environment which contribute to sedentary lifestyles and harmful environments. Institute of Public Health in Ireland 2006

The Cost of Physical Inactivity in Halifax Regional Municipality 2005 Well-planned cities contribute directly to the enhanced health of a population by making activity – whether for recreational or utilitarian purposes – a true possibility for residents. Halifax’s 25-year planning process is a great opportunity to highlight the need to build communities with health in mind.

Summary  The Built Environment is a major determinant of Health  Urban Design must assess the impact on Population and Human Health  Urban Design must seek to optimise Health

“We shape our buildings and thereafter they shape us” Winston Churchill