Introduction: A Profile of Promising Practices from Canada and Abroad

Why is it important to include a health perspective in planning processes related to the built environment? The most obvious example is the increasing incidence of obesity across Canada and globally. Some experts suggest that the impact of this problem is comparable with climate change, and similarly requires action across all of society due to its complexity.^{Footnote 2} There is ample evidence proving that declining physical activity levels, together with limited access to healthy food, contribute to the rising incidence of obesity and associated problems such as diabetes, hypertension, and cardiovascular disease.^{Footnote 3 Footnote 4} It is now also recognized that a key determining factor to promote physical activity and prevent obesity is the built environment. The built environment includes buildings, parks, schools, road systems, and other infrastructure that we encounter in our daily lives.^{Footnote 5}

Urban planning decisions can advance or hamper health goals. However, as with any complex issue, progress will require inter-sectoral action. This means that planners and health officials need to work together to strengthen the health promoting features of land use, community and transportation planning.

This report profiles case studies of 13 Canadian communities where collaborative approaches to improve health outcomes have been a key consideration in planning decisions related to the built environment. This focus on collaboration was chosen to profile different types of projects so that their successes (and lessons learned) could be shared with other communities. With one case study from each province and territory it provides a pan-Canadian perspective. Two international examples highlight similar work abroad. By and large, the case studies address healthy eating and physical activity related to the built environment – two priorities identified by the Healthy Living Issue Group – although it is recognized that many other aspects of the built environment affect population health, including environmental pollution, injury prevention, housing, and access and inclusion. The case studies profiled in this report include:

• BRITISH COLUMBIA: Provincial Health Services Authority
  The Healthy Built Environment Alliance is a hub of knowledge exchange across BC
• ALBERTA: Alberta Health Services
  Population health professionals are getting involved in land use decision-making to put health on the planning agenda
• SASKATCHEWAN: Yorkton Active Transportation Collaboration
  A variety of sectors are mobilizing to promote community and recreational cycling and walking within Yorkton
• MANITOBA: WHO Age-Friendly Cities Pilot Project
  The community of Portage la Prairie is making their city a better, healthier and safer place for seniors to live
• ONTARIO: Peel Public Health
  Peel Health is re-forging the historical relationship between planning and health
• QUÉBEC: On the Move to School!
  A program to improve walking and cycling conditions for elementary school children in Québec
• NEW BRUNSWICK: Fredericton Active Transportation Committee
  Formed to identify, educate, and plan for active transportation issues in the community
• NOVA SCOTIA: Healthy Housing, Healthy Community Project
  Health professionals, residents, planners and developers are at the table talking in a meaningful way
• PRINCE EDWARD ISLAND: Charlottetown Active Transportation Initiative
  Walking and cycling improvements are taking shape in downtown Charlottetown
• NEWFOUNDLAND AND LABRADOR: St. Francis School Greenhouse
  Local students have hands-on involvement in growing food and preparing healthy snacks
• YUKON: Millennium Trail
  The Yukon’s first accessible multi-use trail
• NORTHWEST TERRITORIES: Inuvik Community Greenhouse
  Building a strong sense of community through recreational gardening, food production, knowledge sharing, and volunteer support
• NUNAVUT/NORTHWEST TERRITORIES: Healthy Foods North
  A culturally appropriate and community-based program to promote healthy eating and lifestyle
• INTERNATIONAL: Children’s Tracks Program, Norway
  Bringing children’s knowledge of community open spaces and trails into the municipal land use planning process
• INTERNATIONAL: Go for Health! Collaborative, California (USA)
  An innovative program to increase healthy nutrition and regular physical activity among youth in Santa Cruz County

These case studies provide insight into key approaches to including the health "lens" to improve planning decisions, such as:

• how inter-sectoral collaboration was initiated and fostered;
• how innovative approaches have been introduced to the planning process;
• how non-traditional partners have been integrated;
• what has been accomplished;
• what challenges exist; and
• what supports and resources are needed.

This pan-Canadian snapshot presents many successful projects as a foundation for future efforts. These stories capture the diversity of our country’s many built environments, partnerships and promising practices. The lessons learned suggest how these initiatives can be repeated in other communities.

This is not an exhaustive sampling but rather a selection of innovative projects that provide pertinent and varied lessons. Their common theme is strategic collaboration that includes health outcomes as part of the planning goal. The intent of this report is to strengthen the “evidence to practice” link so that health promotion concepts will influence decisions around the built environment.

The first part of this report includes a summary of key findings. The next provides insights from planners who have worked with various projects across the country. This is followed with a discussion of how the case studies were solicited and written. The bulk of the report contains the case studies. The final section provides concluding remarks and next steps. Much work is already occurring across the country and internationally through research and various initiatives. The Appendix lists key reports, reference materials and other case study documents as further resources to advance work in this area.