1. 1 Lisa Mu Medical Health Officer Fraser Health Authority ACT Canada Summit Dec. 1, 2014 Healthy Built Environment Linkages Toolkit: Applying built environment principles in EH practice

2. Healthy Built Environment Alliance (HBEA; the Alliance) Members from: –Land use planning –Design fields –Provincial ministries –Health authorities –Community-based health organizations –Local government –Universities/academia Knowledge sharing network (BC) Forum for collaboration on priority activities to promote & develop built environments that encourage & support healthy living

3. What do we mean by built environment? Human-made or modified physical surroundings in which people live, work, and play Homes, communities, schools, workplaces, parks/recreational areas, business areas, and transportation systems Large-scale urban areas to smaller rural developments Directly impacts physical, social, and mental health Reflected in measures of health status 3

4. Healthy built environments: What do they look like? (A) (B) e.g., Which of these neighbourhoods is more ‘walkable’?

5. Healthy built environments: What do they look like? (A) (B) Photo credit: Tabercil e.g., Which of these eating environments is healthier? Photo credit: iStock

6. How do you decide what to do?  Examine the evidence..... Healthy built environments: How do we create them? ≠ …?

7. Purpose Why did the Alliance develop another toolkit?  How should we share health evidence that can support good planning and the HBE?  What are our key messages about the HBE? (need for common language/consistent messaging) www.phsa.ca/populationhealth

8. Physical Features of a Healthy Built Environment 8 Housing Transportation networks Transportation networks Neighbourhood design Neighbourhood design Natural environments Food environments

9. HBE Linkages Toolkit : Approach Collected, analyzed & summarized the evidence 1.Consultation with experts Advisory groups – planners and content experts 2.Evidence review methodology Literature reviews of the physical features: –Neighbourhood design –Transportation networks –Natural environments –Food systems –Housing Cluster evidence by planning principle 3.Grading system Quality assessment of findings

10. HBE Linkages Toolkit: Scope of Evidence Review/Toolkit Systematic reviews English; North America, Europe and Australia No specified time frame Context: urban, suburban, and rural Focused on large-scale, outdoor physical features & environments 10

11. HBE Linkages Toolkit: Layout  Current evidence used to identify planning principles for each of the five physical features  User guide created to encourage consideration of context

12. HBE Linkages Toolkit: What does the evidence say? Strong evidence

13. HBE Linkages Toolkit: What does the evidence say? Strong evidence New research area

14. HBE Linkages Toolkit: Components www.phsa.ca/populationhealth Planning principles for: Healthy Neighbourhood Design Healthy Transportation Networks Healthy Natural Environments Healthy Food Systems Healthy Housing

15. HBE Linkages Toolkit: Components www.phsa.ca/populationhealth Linkages Summary Briefly describes the links shown in the literature between: Planning principles Intermediate impacts Health-related outcomes

16. HBE Linkages Toolkit: Components www.phsa.ca/populationhealth Fact Sheet Highlights key aspects of the evidence behind each planning principle, and how these link to intermediate impacts & health- related outcomes

17. HBE Linkages Toolkit: Components www.phsa.ca/populationhealth Health Evidence Diagram Visually show the strength of evidence or expert opinion linking planning principles to impacts & health-related outcomes Shows areas where more research needed

18. HBE Linkages Toolkit: Limitations See User Guide! Indirect nature of evidence linking principles to health outcomes Toolkit identifies what should be done to create HBEs – it doesn’t get into the how Significantly more research is available for some physical features (e.g., neighbourhood design) vs. others (e.g., food systems) 18

19. HBE Linkages Toolkit: Using the Toolkit 1)It’s a “conversation-starter” Provides an organizing framework for presenting information and facilitating discussions between & within sectors 2)Helps users apply health evidence Provides consistent & clear messages to inform the development of other documents & support decision-making around health & the built environment 3)Identifies where more research needed Toolkit provides a roadmap for emerging and innovative evidence

20. Using the Linkages Toolkit for EH Practice Education New staff Staff new to HBE Planning Framing thinking about what to do Collaboration Start conversations with other jurisdictions Advocacy Evidence to support policy change/by-law development 20

21. Linkages Toolkit in EH Practice 21 Slide courtesy of Karen Rideout, BCCDC, NCCEH

22. 22 Slide courtesy of Karen Rideout, BCCDC, NCCEH

23. Linkages Toolkit in EH Practice Agricultural Land Reserve removal applications 23 https://www.interiorhealth.ca/YourEnvironment/HealthyBuiltEnvironment/Pages/default.aspx Slide courtesy of Karen Rideout, BCCDC, NCCEH

24. Linkages Toolkit in EH Practice New Westminster HBE Lens 24 http://www.newwestcity.ca/about_t he_city/living_in_new_westminster/ healthier-communities- partnership#healthy-built- environments Slide courtesy of Karen Rideout, BCCDC, NCCEH

25. Linkages Toolkit in EH Practice North Vancouver SpeakUp for Health 25 http://www2.cnv.org/CityShaping/papers/Vancouver%20Coastal%20Health%20- %20Position%20Paper.pdf Slide courtesy of Karen Rideout, BCCDC, NCCEH

26. Linkages Toolkit in EH Practice 26 North Vancouver SpeakUp for Health Slide courtesy of Karen Rideout, BCCDC, NCCEH

27. Linkages Toolkit in EH Practice 27 North Vancouver SpeakUp for Health Slide courtesy of Karen Rideout, BCCDC, NCCEH

28. How are you using the Toolkit? 1)Will the HBE Linkages Toolkit be useful for your work? If yes, please share some examples of how it will be useful. 2)Who will you share the HBE Linkages Toolkit with? 3)How do you think HBE Linkages Toolkit could be improved? 4)What additional HBE tools or resources would help support you in your work? 28

29. HBE Linkages Toolkit: Next Steps www.phsa.ca/populationhealth Sustainability plan Monitor the evidence base & periodically update the toolkit Develop a user guide to support evidence collection/capture Evaluation plan Track toolkit use Seek feedback from users for toolkit improvement & suggestions for other resources needed

30. Questions? Download the HBE Linkages Toolkit www.phsa.ca/populationhealth Contact: Lisa.mu@fraserhealth.caLisa.mu@fraserhealth.ca 30