Trevor Hancock: Tools for healthier built environments

We are lucky in B.C. to have two useful initiatives to help us create healthier built environments.

The first, which I described briefly last week, is the Healthy Built Environment Linkages Toolkit. The second is a B.C. Ministry of Health-funded initiative, PlanH, which “facilitates local government learning, partnership development and planning for healthier communities.” I will describe them both here.

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(Full disclosure: PlanH was developed and is implemented on behalf of the ministry by the non-profit B.C. Healthy Communities Society, of which I am vice-chair of the board.)

For each of the five key elements of the built environment that the toolkit considers — neighbourhood design, transportation networks, natural environments, food systems and housing — it provides a chart showing the impact on the built environment and the strongest research correlations found in evidence reviews. I briefly covered the first two elements last week, so here I want to examine the others.

For the natural environment, the focus is on preserving and connecting environmentally sensitive areas, expanding natural elements across the landscape and maximizing the opportunity for everyone to access these natural environments. By doing so, we can increase the tree canopy, reduce urban air pollution and create cooler urban areas. (For a great discussion of the health benefits of trees and urban forests see the book Planet Heart by Dr. Francois Reeves, an interventionist cardiologist in Montreal.)

Among the health benefits identified in the toolkit for which there is strong evidence are reduced deaths from heart and urban heat events; improved mental health and social well-being; increased physical activity; and improved respiratory health. Other benefits include reduced health-care costs, energy savings, reduced pollution-control costs, and increased recreation and tourism.

Turning to food systems, the toolkit focuses on increasing equitable access to affordable and healthy food options, protecting agricultural land, increasing the capacity of local food systems, and supporting community-based food programs such as community gardens and community kitchens.

The health-related impacts of these approaches include improved diet quality and social well-being. Evidence suggests community kitchens, such as the Shelbourne Community Kitchen in Saanich, are particularly useful.

This small NGO provides small-group cooking, a pantry and gardening programs that help participants from low-income families acquire food skills and learn to access nutritious food affordably, while at the same time building community.

Finally, the toolkit looks at four approaches to creating healthy housing, particularly through prioritizing affordable quality housing options, especially for marginalized groups. The evidence supports the need for diverse housing forms and tenure types, located so as to avoid environmental hazards. There are many health benefits, including improved overall health and social well-being and reduced domestic abuse, crime and violence. (I will return to the topic of healthy housing in a future column.)

While the toolkit provides evidence and is intended primarily for planners, PlanH is more concerned with how to bring the health implications of decisions to the attention of municipal governments and citizens to support “leading-edge practices for collaborative local action.” It focuses on three key interconnected themes: Healthy people, a healthy society and healthy environments.

In considering healthy people, PlanH emphasizes that our health behaviours and choices are shaped by local social and environmental conditions. We need to create “vibrant places and spaces [that] cultivate belonging, inclusion, connectedness and engagement” in the context of “well-planned built environments and sustainable natural environments.”

To do so, PlanH helps local governments and their citizens learn about these issues and provides action guides and other practical resources and tools. It helps them connect and build relationships with community partners in other sectors (including regional health authorities) and with other local governments. And it helps them innovate with a funding program to support action, and by sharing success stories from around B.C. and beyond.

Together, these two initiatives give municipal governments, urban planners and citizens powerful support to help them make decisions that will improve health and well-being, which is surely one of their most important roles. So if you want healthier built environments in which to lead your life, raise a family and grow old, you might want to talk to your local government, community association and neighbours about the toolkit and PlanH.

Dr. Trevor Hancock is a retired professor and senior scholar at the University of Victoria’s School of Public Health and Social Policy.

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