Alberta: A Profile of Promising Practices from Canada and Abroad – Alberta Health Services

“Alberta Health Services – Edmonton area is bringing a population health perspective to many different municipal planning tables in the Edmonton region.”

Lead Organization:
Alberta Health Services - Edmonton area

Key Partner:
City of Edmonton

Community:
Greater Edmonton, Alberta

Population of Community:
1,024,263

Setting:
Urban

Target Group:
General population

Project Focus:
Knowledge Mobilization

Implementation Level:
Local

Stage of Development:
Ongoing

Background

In 2005/06, the Population Health team at Alberta Health Services - Edmonton area (AHS) embarked on a new strategic direction. This shift meant a consolidated focus targeting built and social environments; specifically an environment–centered perspective on improving population health. It also meant a greater focus on policy and regulatory mechanisms, identification of non-traditional stakeholders with whom to collaborate and new entry points for action. This work received strong support from the Medical Officer of Health (MOH), and was also endorsed at the executive level.

There is a growing body of research highlighting the health impacts of the built environment. In 2006, the team reviewed the literature and identified specific opportunities for their involvement in local land-use and transportation planning. Their first task- and a key driver of this work- was the publication and release of a 2007 issues paper called Healthy Places: Land Use Planning and Public Health which provided an evidence-based foundation for future work. The paper explored the relationship between public health and land use planning and identified appropriate avenues for public health involvement in land use decision-making. The team has since established links with municipal policy makers and other non-traditional stakeholders (e.g. developers, planners, engineers, architects) and is now actively bringing a population health perspective to a variety of “tables” within greater Edmonton.

The Population Health team has developed three key strategies for building health-promoting environments and healthy public policy.

1. Build evidence and knowledge on key issues;
2. Frame and communicate issues from a population health perspective; and
3. Advocate for health promoting environments.

Initially, their goal was to assist stakeholders to connect the dots between heath impacts and the built environment. Now that partnerships have evolved, Population Health is increasingly being recognized for contributing an important and unique health perspective to the planning process, and various stakeholders are coming back for further information and support.

Partnerships

One of Population Health’s ways of working is to cultivate effective collaborations and strategic alliances.

In 2006, the City of Edmonton initiated a review of two of its major planning instruments: the Municipal Development Plan (MDP) and the Transportation Master Plan (TMP). As one of the organizations on the City’s “key stakeholder list,” the opportunity arose for Alberta Health Services - Edmonton area to become involved as a stakeholder in these reviews.

The Medical Officer of Health was supportive of this and identified two staff – one from Environmental Health and another from Population Health – to formally represent the Public Health Division at the MDP review. Once this role was established, Population Health was subsequently invited to participate in relevant stakeholder consultations hosted by the City.

This relationship is ongoing and the team has now been involved in many other consultations at the municipal level. Some of the initiatives they have actively participated in with the City of Edmonton include:

• Transportation Master Plan Update (The Way We Move);
• Municipal Development Plan Review (The Way We Grow);
• Sidewalk Strategy;
• Bicycle Transportation Plan Update;
• Walkability Strategy consultations; and
• Design Guidelines for New Neighbourhoods Review.

In addition, the Medical Officer of Health has presented to City Councillors, and Population Health has presented at Council Hearings on planning and transportation bylaws. A team member also co-chairs the Walkable Edmonton Committee.

Added to their various consultations with the City of Edmonton, Population Health has been engaging with the private sector, other municipalities, professional associations, and universities on a number of activities:

• Presenting at conferences focusing on the built environment and design, (e.g. Alberta Association of the Canadian Institute of Planners);
• Responding to information requests from various sectors including municipal planners, architects, and transportation engineers;
• Giving ‘Lunch and Learn’ talks on the connections between health and the built environment to provincial government and the private sector;
• Collaborating with University of Alberta researchers on a study of neighbourhood walkability, food security and obesity;
• Hosting ‘Meet and Greets’ with non-traditional stakeholders (e.g. developers, engineers); and
• Participating on the Sustainable Building Symposium planning committee.

Some of the other ways of getting health to the table include networking at events and conferences, and cold calls. The Population Health group at AHS is a multi-disciplinary team. With backgrounds in geography, epidemiology, natural resource management, sociology and public health administration, the team has a broad array of skills and is linked to a diverse group of informal and professional networks.

Generating Buy-In

Cultivating strategic alliances involves, among other things, framing and communicating information on the health impacts of built environments in ways that non-health stakeholders can use to advocate for change. In collaboration with the City of Edmonton, Population Health assembles current health statistics and trends within/across the local population, as well as synthesizes information on these associations. For example, there is compelling evidence that urban sprawl and low density neighbourhoods negatively influence physical activity rates, which in turn can affect chronic disease rates and injury.

Lessons Learned

Population Health’s work has generated many lessons learned including:

• The importance of starting with an evidence base; having a foundation grounded in the research literature helps to build credibility and identify strategic linkages;
• The importance of consistent messaging - Population Health has developed a set of key messages that are used in all communications;
• Get involved early in the stakeholder consultation process – early engagement provides an opportunity to embed a population health perspective into various activities/initiatives;
• Communicate messages in multiple ways – Population Health has developed issues papers, fact sheets, PowerPoint presentations, and a video clip;
• Be explicit about the types of built environments that are health promoting and bring this information to specific discussions, be it sidewalks, age-friendly guidelines or land use planning;
• Nurture your relationships - keep up with new contacts through an informal e-mail or coffee; and
• Be proactive and strategic in terms of recognizing opportunities. As Population Health began working in this area their timing aligned with the initiation of the City of Edmonton’s Municipal Development Plan review.

The team is vigilant about scanning for other opportunities and relevant policy windows.

Advice to Other Communities

The AHS Population Health team is interested in sharing ideas and connecting with other health authorities undertaking similar work. However, they note that “unfortunately in Canada, there is not really a mechanism for health authorities to communicate laterally.”

Evaluation and Impact

Correlations between this work and local population health outcomes will be measured over the long term. Awareness of the health impacts of built environments is growing, and generating a lot of public interest.

Contact

Marie S. Carlson
Population Health Consultant
Healthy Public Policy
Health Promotion, Disease and Injury Prevention
Alberta Health Services
Main Floor, West Tower
14310 - 111 Ave.
Edmonton, AB   T5M 3Z7
Telephone: 780-342-0292
E-mail: Marie.Carlson@albertahealthservices.ca

Resources

• Environments Matter, Annual Report from Capital Health (2007)
• Designing Healthy Places – Land Use Planning and Public Health
• How Healthy Are We, Medical Officer of Health’s report
• Together, we are the answer