1. The Built Environment and Health in Ontario Dr. Charles Gardner, MD, CCFP, MHSc, FRCPC Medical Officer of Health and Chief Executive Officer Simcoe Muskoka District Health Unit Presentation to the Ministers’ Healthy Kids Working Group August 25, 2015

2. The Built Environment Anything in our physical environment that is human-created, including: Land-Use Patterns Transportation Systems Urban Design Characteristics

3. Why Does it Matter? Health issues that are impacted by community design: Physical Activity Air Quality Road Safety Social Capital Social Connectivity

4. Physical Inactivity in Canada Age GroupRecommendation 1 Per Cent (%) meeting Recommendation 2 Adults (Ages 18 – 64) 150 minutes moderate to vigorous/week 15 % Youth (Ages 12 – 17) 60 minutes moderate to vigorous/day 35 % Children (Ages 5 – 11) 60 minutes moderate to vigorous/day 6 % 1 Canadian Society for Exercise Physiology, Canadian Physical Activity Guidelines, 2011. 2 Tremblay MS, Shields M, Laviolette M, Craig CL, Janssen I, Gorber SC. Fitness of Canadian children and youth: Results from the 2007-2009 Canadian Health Measures Survey. Health Reports, 2010;21(1):7-20.

5. School Travel Trends in Elementary School Travel in the Greater Toronto-Hamilton Area, 1986 - 2006 Source: Metrolinx, Stepping it Up – Final Report, 2012.

6. Obesity – Children and Youth Measured Overweight and Obesity Using WHO BMI-For-Age Cut-Offs in Canada, Children and Youth, 1978-79 (Ages 2 – 17), 2004 (Ages 2 – 17) and 2009-11 (Ages 5 -17)

7. Walking Decreased risk of death from all causes by 22 % (29 minutes/day * 7 days/week) Decreased risk of diabetes by 30 % (2.5 hours/week) Preventive Power of Walking and Cycling Cycling Decreased risk of death from all causes by 28 % (3 hours/week * 36 weeks/year)

8. Projected Health Benefits* *Health benefits are underestimated.

9. We have engineered physical activity out of our lives.

10. Community Design is a Health Priority Opportunity to create a built environment to support our community Decades spent creating a built environment to support the automobile.

11. I.A Shared Vision for Ontario

13. II.Provincial Infrastructure Investments i.Build healthy active communities by: Requiring health assessments of provincial capital investments. Ensuring provincial capital investments favour the development of healthy active community infrastructure.

14. Example: GTA West Hydro One Corridor II.Provincial Infrastructure Investments ii.Continue investment in active transportation infrastructure and regional transit planning.

15. i.Support building of healthy active communities by: Strengthening the language in the Provincial Policy Statement and other planning policies. Setting targets and performance metrics and reporting on them. Recognizing the true cost of urban sprawl and changing policies and legislation that encourage it {TBD – still in development} III.Provincial Planning Policies

16. Municipal and Regional Examples ii. Provide Tools to Assess Health Impacts of Land Use & Transportation Planning

17. i.Build community-scaled schools that make active transportation and public transit the default choice. IV.Schools Example: Mount Pleasant Village Public School

18. ii.Mandate active transportation / public transit policies and require schools to report on progress (e.g., numbers of students using both). IV.Schools

19. iii.Support schools on active transportation policy by addressing real and perceived barriers (e.g., liability). IV.Schools

20. Questions & Discussion