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PEDTalk
Gayle Bursey
Director
Growth Management Strategy
Region of Peel
Acknowledgements
Improving Health By Design –
Media Launch
• Union Station (May 14, 2014)
• Resulted in 40 media spots
• F...
3
4
5
This will have a huge impact on…
6
This will have a huge impact on…
7
…And our health
8
$
49%
Health
$
51%
Everything
Else
The Provincial Pie
But What’s This Got to Do
with Health?
9
Community Design
Elements
Street Connectivity
Impact
Bus Transit
Health Outcomes
...
The more things change ….
10
*Lowell, Mass 1903; **Chicago 1910
11
…the more they remain the same
What’s Changed is the Nature of the
Leading Causes of Death
12
21st
Century Epidemic
Chronic Diseases
(e.g., diabetes, car...
13
Obesity & Physical Inactivity Cost
$4 Billion a Year in the GTHA
14
Coronary
Artery
Disease
DiabetesStroke
Breast &
Colon
...
15
0
5
10
15
20
25
30
Prevalence of Measured Obesity, 18+, Canada
Overweight + Obesity = 62.1% of adult population (measur...
Prevalence & Excess Medical Costs of
Diabetes in the GTHA
16
0
2
4
6
8
10
12
14
16
18
2002 2004 2006 2008 2010 2012 2014 2...
So what has changed?
17
The Loss of Physical Activity from Daily Life
18
19
The Preventive Power of Physical Activity
(if this were a pill…)
20
Sitting in a Car…
• Not just about inactivity
• Motor vehicles are a major source of air pollution 21
Walk?
22
Bike to Work?
23
Bike to School?
24
Existing Plans
• Metrolinx’s multi-year plan to
develop and implement an
integrated transportation system
for the GTHA.
25...
Many Societal Benefits Already Identified…
26
How do you assess potential health
benefits?
27
Existing Projections
Scientific Literature Available Tools
Baseline Transi...
Feasible Health Estimates
28
While Recognizing That Only Addressing a
Portion of the Health Impact
29
Conservative Estimates
Item Absolute % Change # of People
↑ Public Transit Use 9.8% 337,531
↑ AT to Work &
School (adults)...
Projected Health Benefits*
31
*Under-estimate health impacts
Prevent 184 deaths/year
($1.2 billion)
Prevent 1,061 cases of...
A Public Health Perspective to
Community Design
32
Advocacy
Influence provincial legislation,
municipal decision-makers, media and
the public
Recommendations:
1) Fund public...
Examples of Policy Changes
34
HEALTHY DEVELOPMENT INDEX
A framework to provide consistent, quantifiable standards to inform planning decisions
HDI consi...
• Elements are further broken down into measures, many of which are quantitative
• Based on strength of evidence, measures...
• City of Brampton Official Plan Amendment 43
4.10.4.7 (xiv) Development will be subject to consideration of how the desig...
City of Brampton Council Resolution
• City of Brampton to reference Peel Public
Health’s Health Development Index (HDI) an...
City of Brampton Council Resolution
39
At a municipal level, applied
the HDI to:
• City of Brampton
Sustainable Developmen...
Using the Health Index Locally
Policy Changes using the Health Index:
• Strengthening policy through the Regional
Official...
Hamilton LRT
• B-line – McMaster University to the Queenston Traffic Circle
• A-line spur – James Street North
• Procureme...
New Road Characterization Categories
42
43
How do we use access control to plan for growth in an evolving
Region?
Land Use Transect (Source: Duany Plater-Zyberk &...
44
RCS Section II: Illustrative Cross Sections
• Developed design guidelines and cross sections that support the road clas...
45
Access Control Benefits: Economic & Health
• Highly connected networks benefit
property owners by creating
commercially...
Actively Designed Buildings
Council resolution:
“Create a supportive environment to reduce sedentariness
and increase acti...
Affordable Housing Active Design –
Guidelines and Standards
Regional sites:
• Mavis – Dundas
• Copper Road
• Wolfdale
• Pe...
48
49
50
51
52
Urban Design Awards
Featuring for the first time a focus on healthy
built environments
• Brampton
• Mississauga
53
16
Creditvale Mills – Mississauga
• 6000 sq ft. amenity space to promote active living activities
• Bicycle room to promot...
Design Guidelines for Bike Lanes
55
56
57
NYC Small Space – Actively Designed Parks
58
59
Shifting from…
60
To…
JHS 135, the BronxProperty of The Trust for Public Land
61
Active Parks and Playgrounds
• Lake Wabukayne Park in
Meadowvale – Mississauga
(Completed October 2014)
• Heritage / Activ...
Active Parks and Playgrounds
• School Design Days (stakeholder consultation)
– Gordon Graydon Public School
– St. Alfred P...
Active Design Schools and Workplaces
64
Retrofits
Painted walking loops
at regional building
65
Retrofits
66
Next Steps
• Moving from pilot projects to mandatory implementation:
– Evaluate the health benefits and costs
• NYC 2000 –...
Results
In New York City
5.5 percent decline in
the number of obese
schoolchildren from
2007 to 2011
68
In summary, we have engineered physical
activity out of our lives
69
More of the
same is not
going to work…
70
Key Messages
1. We are making progress
2. Good design changes behaviour
3. A Planning decision is a health decision
4. Tak...
72
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Improving Health By Design in the Greater Toronto & Hamilton Area

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We have a big problem.

We have engineered physical activity out of peoples’ lives by building communities that require the use of cars. This physical inactivity costs $1.4 billion dollars in healthcare expenses each year in the Greater Toronto and Hamilton Area (GTHA). What's worse, over the next 17 years these costs and congestion will increase as we add 2.2 million people and their cars to the GTHA.

This timely presentation by Gayle Bursey discusses how the design of communities can significantly impact your health.
There is no single solution to this challenge; however, Gayle will describe how city planners, engineers and health professionals are working together in New York City and in the GTHA to create communities that are well-designed, transit friendly and socially connected.

Published in: Health & Medicine
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Improving Health By Design in the Greater Toronto & Hamilton Area

  1. 1. PEDTalk Gayle Bursey Director Growth Management Strategy Region of Peel
  2. 2. Acknowledgements Improving Health By Design – Media Launch • Union Station (May 14, 2014) • Resulted in 40 media spots • Follow-up meetings with provincial decision-makers Left to right: Dr. Ninh Tran (Hamilton), Dr. David McKeown (Toronto), Dr. David Mowat (Peel) and Dr. Charles Gardner (Simcoe Muskoka) 2
  3. 3. 3
  4. 4. 4
  5. 5. 5
  6. 6. This will have a huge impact on… 6
  7. 7. This will have a huge impact on… 7
  8. 8. …And our health 8 $ 49% Health $ 51% Everything Else The Provincial Pie
  9. 9. But What’s This Got to Do with Health? 9 Community Design Elements Street Connectivity Impact Bus Transit Health Outcomes Diabetes
  10. 10. The more things change …. 10 *Lowell, Mass 1903; **Chicago 1910
  11. 11. 11 …the more they remain the same
  12. 12. What’s Changed is the Nature of the Leading Causes of Death 12 21st Century Epidemic Chronic Diseases (e.g., diabetes, cardiovascular diseases, some cancers) 19th Century Epidemic Infectious Diseases (e.g., cholera, typhoid, typhus, tuberculosis)
  13. 13. 13
  14. 14. Obesity & Physical Inactivity Cost $4 Billion a Year in the GTHA 14 Coronary Artery Disease DiabetesStroke Breast & Colon Cancer How Big is the Health Problem?
  15. 15. 15 0 5 10 15 20 25 30 Prevalence of Measured Obesity, 18+, Canada Overweight + Obesity = 62.1% of adult population (measured, 2008) Source: CIHI, PHAC. Obesity in Canada. 2011.
  16. 16. Prevalence & Excess Medical Costs of Diabetes in the GTHA 16 0 2 4 6 8 10 12 14 16 18 2002 2004 2006 2008 2010 2012 2014 2016 2018 2020 2022 2024 2026 % Year 663,842 $2.6 billion 995,067 1,178,574 Projected $4.5 billion (today’s $) Physical inactivity contributes 12,500 new cases of diabetes each year
  17. 17. So what has changed? 17
  18. 18. The Loss of Physical Activity from Daily Life 18
  19. 19. 19
  20. 20. The Preventive Power of Physical Activity (if this were a pill…) 20
  21. 21. Sitting in a Car… • Not just about inactivity • Motor vehicles are a major source of air pollution 21
  22. 22. Walk? 22
  23. 23. Bike to Work? 23
  24. 24. Bike to School? 24
  25. 25. Existing Plans • Metrolinx’s multi-year plan to develop and implement an integrated transportation system for the GTHA. 25 • Provincial plan to address growth challenges in GTHA by building compact, vibrant and complete communities.
  26. 26. Many Societal Benefits Already Identified… 26
  27. 27. How do you assess potential health benefits? 27 Existing Projections Scientific Literature Available Tools Baseline Transit & AT
  28. 28. Feasible Health Estimates 28
  29. 29. While Recognizing That Only Addressing a Portion of the Health Impact 29
  30. 30. Conservative Estimates Item Absolute % Change # of People ↑ Public Transit Use 9.8% 337,531 ↑ AT to Work & School (adults) 5% 168,845 ↑ AT Instead of Short Car trips 5% 66,753 ↓ Traffic Emissions (PM2.5) 33% ALL 30
  31. 31. Projected Health Benefits* 31 *Under-estimate health impacts Prevent 184 deaths/year ($1.2 billion) Prevent 1,061 cases of diabetes/year ($250 million over 10 years – lifetime costs) Prevent 154 deaths/year ($1 billion) Prevent 90 hospitalizations/year
  32. 32. A Public Health Perspective to Community Design 32
  33. 33. Advocacy Influence provincial legislation, municipal decision-makers, media and the public Recommendations: 1) Fund public transit 2) Normalize public transit planning 3) Strengthen provincial policy 33
  34. 34. Examples of Policy Changes 34
  35. 35. HEALTHY DEVELOPMENT INDEX A framework to provide consistent, quantifiable standards to inform planning decisions HDI consists of seven “elements” – categories of built environment characteristics that are known to be associated with health: Density  Proximity to Services and Transit  Land Use Mix  Street Connectivity Road Network & Sidewalk Characteristics  Parking  Aesthetics & Human Scale35
  36. 36. • Elements are further broken down into measures, many of which are quantitative • Based on strength of evidence, measures are either Prerequisites or Credits Example of HDI 36
  37. 37. • City of Brampton Official Plan Amendment 43 4.10.4.7 (xiv) Development will be subject to consideration of how the design and use of the physical development positively contributes to human health. 5.31.3 The City may require health impact studies as part of a complete development application. 5.32.2 Impact studies shall consider public health impacts. • Applying the Healthy Development Index - Ongoing Brampton’s Commitment to Health Built Environments 37
  38. 38. City of Brampton Council Resolution • City of Brampton to reference Peel Public Health’s Health Development Index (HDI) and consult Public Health staff in future transportation studies, urban design guideline studies, community improvement plans, block plans, future community planning studies. 38
  39. 39. City of Brampton Council Resolution 39 At a municipal level, applied the HDI to: • City of Brampton Sustainable Development Guidelines • Local Environmental Assessments • Municipal Secondary and Block Plans
  40. 40. Using the Health Index Locally Policy Changes using the Health Index: • Strengthening policy through the Regional Official Plan Review • Sustainability Development Guidelines • Continuing comments on: – Development applications, secondary plans – Environmental Assessments • Community Improvement Plans • Active Networks Parks and Playgrounds Pilots • Actively Designed Buildings Pilots 40
  41. 41. Hamilton LRT • B-line – McMaster University to the Queenston Traffic Circle • A-line spur – James Street North • Procurement for the LRT will start in 2017, with construction starting in 2019
  42. 42. New Road Characterization Categories 42
  43. 43. 43 How do we use access control to plan for growth in an evolving Region? Land Use Transect (Source: Duany Plater-Zyberk & Company) As Urbanization Occurs…
  44. 44. 44 RCS Section II: Illustrative Cross Sections • Developed design guidelines and cross sections that support the road classifications • Cross-sections show desired roadway components • Guidelines were determined for the dimensions of each component Some of the design elements discussed include: • Parking Lanes • Bicycle Facilities • Drainage • Medians • Sidewalks • Geometrics
  45. 45. 45 Access Control Benefits: Economic & Health • Highly connected networks benefit property owners by creating commercially valuable municipal street frontage • Increased access to the local street network reduces the amount of parking required from property owners • Creates more than one route to a destination for both cars and pedestrians Strip lots and inadequate street network: …Need more collector and local streets
  46. 46. Actively Designed Buildings Council resolution: “Create a supportive environment to reduce sedentariness and increase activity by phasing in bike parking, mobile meetings, treadmill desks, stair use signage, and other relevant programs.” 46
  47. 47. Affordable Housing Active Design – Guidelines and Standards Regional sites: • Mavis – Dundas • Copper Road • Wolfdale • Peel Manor • Twin Pines – Affordable Housing 47
  48. 48. 48
  49. 49. 49
  50. 50. 50
  51. 51. 51
  52. 52. 52
  53. 53. Urban Design Awards Featuring for the first time a focus on healthy built environments • Brampton • Mississauga 53
  54. 54. 16 Creditvale Mills – Mississauga • 6000 sq ft. amenity space to promote active living activities • Bicycle room to promote cycling • Creating neighbourhoods, streets, and outdoor spaces that encourage walking, bicycling, and active transportation Affordable Housing 54
  55. 55. Design Guidelines for Bike Lanes 55
  56. 56. 56
  57. 57. 57 NYC Small Space – Actively Designed Parks
  58. 58. 58
  59. 59. 59
  60. 60. Shifting from… 60
  61. 61. To… JHS 135, the BronxProperty of The Trust for Public Land 61
  62. 62. Active Parks and Playgrounds • Lake Wabukayne Park in Meadowvale – Mississauga (Completed October 2014) • Heritage / Active Signs – City of Mississauga and Town of Caledon (Completed in 2015) 62
  63. 63. Active Parks and Playgrounds • School Design Days (stakeholder consultation) – Gordon Graydon Public School – St. Alfred Public School • School playground enhancements at Madoc Public School (Completed June 2014) 63
  64. 64. Active Design Schools and Workplaces 64
  65. 65. Retrofits Painted walking loops at regional building 65
  66. 66. Retrofits 66
  67. 67. Next Steps • Moving from pilot projects to mandatory implementation: – Evaluate the health benefits and costs • NYC 2000 – 2010 289% increase in commuter cycling 67
  68. 68. Results In New York City 5.5 percent decline in the number of obese schoolchildren from 2007 to 2011 68
  69. 69. In summary, we have engineered physical activity out of our lives 69
  70. 70. More of the same is not going to work… 70
  71. 71. Key Messages 1. We are making progress 2. Good design changes behaviour 3. A Planning decision is a health decision 4. Take heart! If Edwin Chadwick could bring sanitation to London in the 1800’s then… 71
  72. 72. 72

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