Firth CL, Thierry B, Shareck M, Fuller D, Winters M, Kestens Y. ‘Third places’ and their role for population health: A study in Montreal, Canada. Poster presented to: American Public Health Association Annual Meeting and Expo; October 2020; virtual meeting.

1. APHA ANNUAL MEETING 2020
Third places and their role for
population health:
A study in Montréal, Canada
5071.0: Impact of Place on Health Outcomes:
Epidemiologic Perspectives
Caislin Firth, PhD
Benoit Thierry, MSc
Martine Shareck, PhD
Daniel Fuller, PhD
Meghan Winters, PhD
Yan Kestens, PhD

2. Third places are physical locations outside of the home (first place)
or workplace (second place) that facilitate social interaction,
community building, and social support.
Public health practitioners have called for more research to
integrate third places in studies on built environment,
neighborhoods, and health.

3. Third places and health
Third places are ordinary places
• Public facilities and institutions
(sports facilities, parks)
• Commercial businesses
(restaurants/cafes, cultural, spiritual centers)
They can affect health
• Directly
(services provided, amenities)
• Indirectly
(interplay between bodies and the worlds in
which we live)

4. Objectives
1. Describe third places visited by adults in
Montréal, Canada using INTERACT cohort:
Interventions, Research, and Action in Cities
Team
2. Assess types of third places associated with
well-being

5. National team of scientists,
urban planners, and citizens
discovering the impact of
built environment
interventions on health and
equity
Started in 2017 in 4 Canadian cities
(Victoria, Vancouver, Saskatoon, Montréal)

7. Concept mapping
Online map-based
survey
Mobile sensing
Online health survey Wearable sensors Qualitative interviews
THE INTERACT TOOLKIT

8. Third places data collection
• VERITAS (Visualisation, Evaluation and Recording of Itineraries and
Activity Spaces) collects data on spatial and social patterns
• Provides detailed information on where people spend time outside
their home, how often, and with whom

9. Variable creation
• Third places are locations visited in the past month within the
categories of: park or sport facility, cultural, volunteering,
religious/spiritual, restaurant/bar
• Personal well-being index measures 7 quality of life domains using
a scale 0: ‘no satisfaction’ to 10: ‘completely satisfied’
• Covariates
• Income
• Ethnicity (white, non-white)
• Age group (18-24, 25-34, 35-44, 45-54, 65+ years)
• Gender (male, female)

10. Participants in Montréal
• Data collected June 2018-March 2019
• 814 participants
• Most surveys completed in French (84%)
• 69% women
• Median age 43 years
• Median household income $50k to <$100k
• 88% identify as white only
Percent Count
Gender
Male 31% 256
Female 69% 558
Age group
18-24 yrs 7% 54
25-34 yrs 25% 200
35-44 yrs 21% 173
45-54 yrs 16% 129
55-64 yrs 19% 154
65+ yrs 13% 104
Median income $50,000–$99,999
Ethnicity
White 88% 707
Non-white 12% 97

11. • Personal well-being median score: 7.7
• Well-being increased with household income
• Non-white participants reported lower well-being
• Adults 55+ years reported higher well-being
• No differences in well-being by gender
Well-being among adults in Montréal
0
2
4
6
8
10
<$30k $30k-50k $50k-100k $100k+
Well-being
Household income

12. • On average adults visited 6 third place locations in the past month (range: 0-22)
Third places visited in the past month, Montréal
Park
Restaurant/bar
Sports
Cultural
Volunteering
Religious/spiritual
• Restaurants were visited the most, religious locations visited the least

13. • Women visited more religious/spiritual locations
• White participants visited more cultural locations
• Adults 25-44 years visited the most parks and
restaurants
• Older adults (65+ years) visited more cultural,
spiritual, or volunteering organizations
Third place preferences

14. Median distance from home to third places
1 km 2 km 4 km3 km
Park
Religious/spiritual
Restaurant/bar
Sports
Cultural
Volunteering

15. Third places and well-being
• People who visited more third places had higher well-being
(!𝜷 0.04, 95% CI: 0.01 – 0.07)
• Specifically, visiting more sports facilities and restaurants
• Sports facility (!𝜷 0.15, 95% CI: 0.07 – 0.24)
• Restaurants (!𝜷 0.06, 95% CI: 0.00 – 0.12)
• Parks, cultural, religious/spiritual, or volunteering not associated with
well-being
• Each regression model was adjusted for income, age group, gender, ethnicity

16. Limitations
• Third place locations may be misclassified,
participants selected location types
• Sample bias: not representative of adults in
Montréal
• We measured correlations between third
places well-being, can not claim causality
• Future analysis consider ‘dose’ or frequency
of visits to third places

17. Insights
• Feasible to integrate third places into health
research, improve understanding of how the
built environment impacts health
• Results provide baseline data to be used in
future longitudinal studies
• Future studies can examine…
• How relationships between third places and
health vary by race and other socio-
demographic measures
• How accessibility to third places is
correlated with usage
• VERITAS tool captures detailed information on
participants mobility and spatial patterns

18. WWW.TEAMINTERACT.CA
caislin_leah_firth@sfu.ca
@caislinf
@TEAMINTERACTCA