November 21, 2012

Environment a key factor in public health

As published in The Erin Advocate

With our health care system stretched to the limit, we will soon need to rely more on the environment – both natural and "built" – to keep ourselves healthy, according to the keynote speaker at last month's Stewardship Forum, hosted by Credit Valley Conservation (CVC).

Dr. David Mowat, Medical Officer of Health in Peel Region, said the design of urban areas can help improve people's health by providing access to natural features, facilitating physical fitness and promoting local self-sufficiency. He said diabetes is increasing at such a rate that by 2025, one in six people in Peel will suffer from the disease, and in 50 years it will be one in three.

"The last time we had in our society something that affected one in three people was in the 14th century, and it was the Black Death – so this is quite serious," he said, noting that children are increasing in weight and declining in muscle strength. One third to one half of Grade 9 students in Peel do not meet minimum standards for physical fitness.

"We often, by default, think that we're ill and the system makes us well. But do we ever stop to think that we should be well. What makes us ill in the first place?" he said. Health care spending now accounts for 44 per cent of provincial expenditures.

"Clearly, very soon, the ability of our health care system to take ill people and make them well again, will be exhausted. Too often, the only way we can think to address it is to point to personal responsibility for changing behaviours. That will not do it. We need to recognize the influence of our physical, social, economic and natural environment on determining those behaviours."

Peel Public Health has a mandate from regional council to comment on new housing developments. They have emerged as one of the leaders in Canada, exploring the connections between community design and the health of residents, said Mike Puddister, CVC's Director of Restoration and Stewardship.

"Many solutions can be found in the way we plan communities," he said. "They require collaborative approaches."

The Town of Erin is now dealing with a subdivision proposal from Solmar Development Corp. that would more than double the size of Erin village in the coming decades. It is a huge opportunity to create a well-planned group of neighbourhoods.

Wellington-Dufferin-Guelph Public Health (WDGPH) has expertise in various aspects of the built environment, including promotion of physical fitness, maintaining the quality of air, soil and water, the value of urban forests and good design of parks and playgrounds. There is no formal requirement to involve the public health unit, but it would make sense to invite their advice in the Solmar planning process.

"We would like to be at the table," said Shawn Zentner, Manager of Health Protection at WDGPH. "We are well-positioned to make some evidence-based comments."

Exposure to natural elements includes parks, gardens, trees, conservation areas, trails, rivers and wetlands. While it is difficult to measure exactly, it is clear that these features improve our physical and mental health. Walking, of course, can have social as well as physical benefits. The interactions at the Fall Fair or last Friday's downtown Window Wonderland are good examples.

Dr. Mowat said it is important to "build the kind of human scale, aesthetically attractive environment that will get people out there walking – let's make our streets more livable."

Modern zoning is based partly on public health needs, with the effort to separate housing from toxic industries. But we've ended up with people stuck in their vehicles, living far from their employment, even though most do not work in heavy industry. Traffic congestion drains $6 billion annually from the GTA economy.

"Can we have people live, and work and play in the same community, so new development would be complete communities? There would be agriculture and industry and residential and transportation, all in the same moderate size community. We need to look at how we're building suburbs, and the extent to which they are still livable once you lose your driver's license, or once you can't move so fast.

"Only about 15 per cent of Canadians will regularly take part in any recreational physical activity. The vast majority of us get our physical activity by going from A to B – utilitarian. So opportunities for recreation are important, but on their own, not enough."

"We're talking about active transportation – having engineered physical activity out of our lives, to try and put it back in again."