Ontario: A Profile of Promising Practices from Canada and Abroad – Peel Public Health
“We believe a multi-disciplinary approach is the key to mitigating chronic disease, and this requires strong and committed partnerships”
Peel Public Health
Region of Peel
Region of Peel, Ontario
(Caledon, Brampton and Mississauga)
Population of Community:
Urban and semi-urban
To provide leadership, advocacy and support for integrating public health considerations in growth and development planning in the Region of Peel
Stage of Development:
Increasing diabetes rates and dependence on the automobile have brought the issue of a healthy built environment to the forefront in the Region of Peel. In 2005, a report was tabled to Peel Regional Council highlighting the impact of the built environment on population health. The Council took action and directed a formalized relationship between Peel Health and the Regional Planning Department. Peel Health now provides comments from a health perspective on development applications, and regional plans. The organization is also working on advocacy for provincial policy and knowledge transfer.
Key partners on the project include regional planning and municipal planning staff. This collaboration is not new, but is being re-forged in this generation.
At Peel, getting this collaboration off the ground required a lot of internal work, but the two sectors are now engaging in a meaningful way.
Regional Council and the Medical Officer of Health (MOH) were the key decision-makers who had to approve the project. Important to the process was the political support received through Council.
Planning & Implementation
Peel Health’s philosophy is not to focus on individual’s risk for obesity, but to take a population health approach where the physical environment is developed in a way that is conducive to active living for the community in general. This approach must be based on evidence and include other interventions besides environmental change, including institutional policy on nutrition and physical activity as well as education and health promotion. When work began in this area there were few best practices already in place, so the Health department applied public health rigor to this new project.
Outcomes of this project include:
- A set of conceptual models capturing the relationship between health and planning (see figure below);
- A literature and realist review;
- Review of development applications;
- Input into regional and municipal policies;
- Incorporating language about healthy place into planning documents; and
- Opportunities for knowledge exchange including conferences, networking and presentations.
The need to keep partnerships strong and objectives transparent was among the most important lessons learned. The forging of new partnerships has helped to create a more seamless merging of the health and planning disciplines.
Another important lesson is that it is easier to do development than it is to undo it. Thus, strong partnerships, and having health at the table at the early stages, are critical. Without established best practices to rely on, strong and committed partnerships were the key ingredient for building expertise.
In the future, Peel Health would recommend getting key stakeholders involved in the process from the start. In order to achieve this, it is imperative for organizations to have their senior management make the issue a priority. One of the supports still required is policy change at the provincial and federal level – it is important for planning to be part of discussions within the Ministry of Health and for health to be part of the discussions within the Ministry of Municipal Affairs and Housing. At a regional level, joining forces with other health units would help to strengthen the cause.
Conceptual Model: From the Built Environment to Public Health
Credit: Paul Conway, Public Health Agency of Canada
Advice to Other Communities
This approach is adaptable to other communities, but some of the tools that have been developed require local data that would need to be collected and inputted locally. Also, in rural areas, the priorities and needs are different. Consequently, rural environments may have different indicators than those developed for Peel.
The first step is to identify local strengths and capacity within a community. Identifying partnerships that can be developed between health, planners and developers is an important part of the process. This may involve partnerships between key individuals or groups. It is important to work to establish champions early on, and to determine the strengths of these champions.
Peel Neighbourhood Showing Curvilinear Design, Long Walking Distances and Low Connectivity.
Photo Credit: First Base Solutions
Evaluation and Impact
In order to evaluate the project, Peel will be pilot testing their tools and doing a thorough evaluation of the process. Determining the ultimate success of the project will require long-term evaluation. It is important to disseminate results to decision-makers and local community. Peel Health has done this through conferences and presentations and their work has generated excitement. They are creating a “buzz about health and the built environment.”
Peel Health - Chronic Disease & Injury Prevention
10 Peel Centre Drive, Suite B
PO Box 2009, STN B
Brampton, ON L6T 0E5
Telephone: 905-791-7800, ext 2168
Peel Public Health – Health and Urban Form www.peelregion.ca/health/urban
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