Healthy CitiesHealthy CitiesHealthy Healthy

CommunitiesCommunities

Dr Michael Goodyear, Dept. Medicine, Dalhousie University

What we Know – and What we Don’tWhat we Know – and What we Don’tHeritage Trust, October 2007Heritage Trust, October 2007

Healthy CommunitiesHealthy Communities

Health is a state of complete physical, mental and social Health is a state of complete physical, mental and social well-being.well-being.

Social, environmental and economic factors are important Social, environmental and economic factors are important determinantsdeterminants of human health and are inter-related.of human health and are inter-related.

People People cannot achieve theircannot achieve their fullest potentialfullest potential unlessunless they they are able to are able to taketake controlcontrol of those things which determine their of those things which determine their well-beingwell-being..

All sectorsAll sectors of the community are inter-related and of the community are inter-related and shareshare their their knowledge, expertise and perspectives, knowledge, expertise and perspectives, working togetherworking together to to create a create a healthy communityhealthy community

Ottawa Charter 1986, World Health OrganizationOttawa Charter 1986, World Health Organization

Healthy CitiesHealthy Cities

Determinants of HealthDeterminants of Health

PeacePeace ShelterShelter EducationEducation FoodFood IncomeIncome A stable eco-systemA stable eco-system Sustainable resourcesSustainable resources Social justice, and equitySocial justice, and equityOttawa CharterOttawa 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 CharterOttawa Charter

Health Promotion (1)Health Promotion (1)

Health Promotion (2)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 CharterOttawa Charter

Healthy Communities and the Healthy Communities and the Built EnvironmentBuilt Environment

1992 2001

Strategic Environment Assessment Health Impact Assessment

Population and Human Health

Health Impact AssessmentHealth Impact Assessment

A combination of procedures, methods and tools by which A combination of procedures, methods and tools by which a a policypolicy, programme or project may be judged as to its , programme or project may be judged as to its potential effects on the health of a populationpotential effects on the health of a population, and the , and the distributiondistribution of those effects within a population. of those effects within a population.

WHO

European Centre for Health Policy (1999)

Gothenburg Consensus

Built EnvironmentBuilt Environment

The Rise and Fall of Public Health

1848 2007

Built EnvironmentBuilt Environment

Urban Centres and The Rise of the High Rise

Built EnvironmentBuilt EnvironmentThe built environment is part of the overall The built environment is part of the overall ecosystemecosystem of of our earth. It includes the land-use our earth. It includes the land-use planning and planning and policiespolicies that impact our communities in urban, rural, and that impact our communities in urban, rural, and suburban areas. It encompasses suburban areas. It encompasses all buildings, spaces,all buildings, spaces, and products that are created or modified by peopleand products that are created or modified by people.. It includes our homes, schools, workplaces, It includes our homes, schools, workplaces, parks/recreation areas, business areas and roads.parks/recreation areas, business areas and roads.

It extends It extends overheadoverhead in the form of electric transmission in the form of electric transmission lines, lines, undergroundunderground in the form of waste disposal sites in the form of waste disposal sites and subway trains, and across the country in the form of and subway trains, and across the country in the form of highwayshighwaysHealth Canada 1997Health Canada 1997

Built EnvironmentBuilt Environment

It impacts It impacts indoorindoor and and outdooroutdoor physical environments physical environments (e.g., climatic conditions and indoor/outdoor air quality), as (e.g., climatic conditions and indoor/outdoor air quality), as well as well as socialsocial environments (e.g., civic participation, environments (e.g., civic participation, community capacity and investment) and subsequently our community capacity and investment) and subsequently our health and quality of life.health and quality of life.

Health Canada 2002Health Canada 2002

Health and the Built EnvironmentHealth and the Built Environment

Rapidly increasing interestRapidly increasing interest Infectious diseases replaced by obesity, asthma, Infectious diseases replaced by obesity, asthma,

diabetesdiabetes Urban Sprawl and Walkability/CyclabilityUrban Sprawl and Walkability/Cyclability Climate ChangeClimate Change

First places – First places – HomesHomes Second places – Second places – WorkspaceWorkspace Third places – Third places – Meeting placesMeeting places

– Becoming scarceBecoming scarce

Built Environment and HealthBuilt Environment and Health

LightLight SpaceSpace NoiseNoise Air QualityAir Quality ViewsViews AppearanceAppearance AccessibilityAccessibility Social networksSocial networks SafetySafety

AmenitiesAmenities ServicesServices Sense of Sense of

NeighbourhoodNeighbourhood Public placesPublic places ConnectivityConnectivity Physical activityPhysical activity DensityDensity

Built EnvironmentBuilt Environment

Impact of Built EnvironmentImpact of Built Environment– Micro: Individual health Micro: Individual health – Macro: Population healthMacro: Population health

Environment and Climate ChangeEnvironment and Climate Change

Main Impact on disadvantaged – less controlMain Impact on disadvantaged – less control

- Children, Elderly, Minorities- Children, Elderly, Minorities

Built EnvironmentBuilt Environment

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

SummarySummary

The Built Environment is a major The Built Environment is a major determinant of Healthdeterminant of Health

Urban Design must assess the impact on Urban Design must assess the impact on Population and Human HealthPopulation and Human Health

Urban Design must seek to optimise Health Urban Design must seek to optimise Health

“We shape our buildings and thereafter they shape us”

Winston Churchill

mgoodyear@dal.ca