Bringing Health to the Planning Table
- A Profile of Promising Practices in Canada and Abroad

Prepared for the Healthy Living Issue Group of the Pan-Canadian Public Health Network

Table of Contents

• Acknowledgements
• Executive Summary
• Introduction
• Key Findings
• The Planners’ Perspective
• Methodology
• Case Study Profiles
  • British Columbia
  • Alberta
  • Saskatchewan
  • Manitoba
  • Ontario
  • Québec
  • New Brunswick
  • Nova Scotia
  • Prince Edward Island
  • Newfoundland And Labrador
  • Yukon
  • Northwest Territories
  • Nunavut/Northwest Territories
  • Norway
  • California (USA)
• Conclusion
• Appendix A: Additional Resources

Acknowledgements

A Profile of Promising Practices in Canada and Abroad was prepared by Erik Lees and Heidi Redman of LEES + Associates and Alex Berland of A. Berland Inc. for the Healthy Living Issue Group (HLIG) of the Pan-Canadian Public Health Network (www.phn-rsp.ca/About_e.html).

Production of this report is made possible in part through a contribution from the Public Health Agency of Canada.

Strategic Collaboration Working Group

The Strategic Collaboration Working Group (SCWG) of the HLIG helped to create the broad vision of the report and provided input and feedback throughout the project. The SCWG consists of the following members:

• Kathy Cassels
  Executive Director, DASH BC (The Directorate of Agencies for School Health BC)
• Carol Ann Cotter
  Health Promotion Consultant, Health Promotion and Wellness Division, Department of Health & Community Services, Newfoundland and Labrador
• Heidi Craswell
  Policy Analyst, Healthy Communities Division, Public Health Agency of Canada
• Keri Hoffman
  Manager, National Initiatives, Canadian Parks and Recreation Association
• Susan Irwin
  Senior Policy and Research Analyst, Federation of Canadian Municipalities
• Amanda MacNaughton
  Research Associate, Food and Nutrition Policy, Food & Consumer Products of Canada
• Lisa Mawani
  Policy Analyst, Healthy Communities Division, Public Health Agency of Canada
• Sophie Sommerer
  Senior Policy Analyst, Strategic Initiatives and Innovations Directorate, Public Health Agency of Canada
• Sharon Zeiler
  Chair of the SCWG
  Senior Manager, Nutrition Initiatives and Strategies, Canadian Diabetes Association

Key Informants

The authors wish to thank the following key informants who generously shared insights during telephone interviews and reviewed earlier versions of the case studies:

• Eva Almhjell
  Senior Adviser, Vestfold County Council, Norway
• Kate Baird
  Move this Way—Active Living Program, Recreation Division, City of Fredericton, New Brunswick
• Louise Bélanger
  Community Health Educator, Sunrise Health Region, Saskatchewan
• Harold Boone
  Trail and Project Coordinator, Parks and Trees Division, City of Fredericton, New Brunswick
• Marie S. Carlson
  Population Health Consultant, Population Health and Research, Alberta Health Services
• Tannis Cheadle
  Provincial Manager, Population & Public Health Initiatives, Provincial Health Services Authority, British Columbia
• Paulette Cumby
  Coordinator, Lower Trinity South Regional Development Association, Newfoundland and Labrador
• Elsie De Roose
  Territorial Nutritionist, Department of Health and Social Services, Northwest Territories
• Michael Haynes
  Director, TransActive Solutions, Ottawa, Ontario
• Sue Hendricken
  Manager, Parks and Recreation Department, Prince Edward Island
• Doug Hnatiuk
  Projects and Community Development Coordinator, City of Whitehorse, Yukon
• Sheila Hryniak
  Community Volunteer, Yorkton in Motion, Saskatchewan
• John Ingram
  Principal, EcoPlan International, Vancouver, British Columbia
• Sherrill Johnson
  Population Health Consultant, Population Health and Research, Alberta Health Service
• Amanda Joynt
  Chair, Inuvik Garden Society Board of Directors, Northwest Territories
• Shebreh Kalantari
  Director of Community Organizing, United Way of Santa Cruz County, USA
• George McKibbon
  Director, Policy Development, Ontario Professional Planners Institute
• Frank Quinn
  Program Coordinator, City of Charlottetown, Prince Edward Island
• Gunnar Ridderström
  Planner, Public Road Administration, Norway
• Cindy Roache
  Manager, Department of Health and Social Services, Nunavut
• Sangita Sharma
  Principal Investigator, Healthy Foods North, Nunavut and Northwest Territories
• Janet Shindle
  Councillor, City of Portage la Prairie, Manitoba
• Bhavna Sivanand
  Project Specialist, Peel Health - Chronic Disease and Injury Prevention, Ontario
• Annick St-Denis
  Active Transportation Director, Vélo Québec
• Denyce Warren
  Office Manager, Lower Trinity South Regional Development Association, Newfoundland and Labrador
• Marjorie Willison
  Project Manager, Chebucto Communities Development Association, Nova Scotia

Executive Summary

There is ample evidence proving that declining physical activity levels, together with limited access to healthy food, contribute to the rising incidence of chronic disease in Canada. A key determining factor to promote physical activity and prevent obesity is the built environment - that is, the buildings, parks, schools, road systems, and other infrastructure that we encounter in our daily lives.¹ 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 and community 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 was chosen so that the successes (and lessons learned) of a variety of different projects 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 happening abroad.

The case studies profiled in this report include:

• BRITISH COLUMBIA: Provincial Health Services Authority
• ALBERTA: Alberta Health Services
• SASKATCHEWAN: Yorkton Active Transportation Collaboration
• MANITOBA: WHO Age-Friendly Cities Pilot Project
• ONTARIO: Peel Public Health
• QUÉBEC: On the Move to School!
• NEW BRUNSWICK: Fredericton Active Transportation Committee
• NOVA SCOTIA: Healthy Housing, Healthy Community Project
• PRINCE EDWARD ISLAND: Charlottetown Active Transportation Initiative
• NEWFOUNDLAND AND LABRADOR: St. Francis School Greenhouse
• YUKON: Millennium Trail
• NORTHWEST TERRITORIES: Inuvik Community Greenhouse
• NUNAVUT/NORTHWEST TERRITORIES: Healthy Foods North
• INTERNATIONAL: Children’s Tracks Program, Norway
• INTERNATIONAL: Go for Health! Collaborative, California (USA)

The key informants interviewed for this report offered helpful "lessons learned" from their experience. Their insights can be grouped under three general headings: cultivate effective partnerships; build commitment about the importance of the work; and maintain a focus on end results throughout implementation.

The key lessons learned include:

Cultivate effective partnerships

• Include all major stakeholders from the outset to make sure the right partners are at the table. It is important to seek partners who will enhance the program with their knowledge and diverse perspectives.
• Focus on the purpose of partnerships by encouraging everyone around the table to discuss their issues and ways of working together to address these.
• Keep your partnership goals and objectives transparent.
• Establish champions early on (either individuals or groups).
• Use the relationships developed in each project to advance your health promotion agenda, for example through invitations to other planning venues.

Build commitment about the importance of the work

• Establish early on that the project belongs to the community. A community-driven and community-owned project is more likely to be sustainable long term.
• Develop well-researched background reports and a business case to create credibility for the project, increasing buy-in at the municipal level.
• Consider funding sources early in the project. Most of the projects profiled in this report were well received. For many, the biggest challenge was funding.
• Health professionals should get involved early in the stakeholder process – do not wait until the end to make a contribution.
• Link human health benefits with other benefits of healthy built environments such as lower vehicle emissions, reduced traffic infrastructure costs, and increased tourism.

Maintain a focus on end results throughout implementation

• Start with small-scale projects and build from these. Pilot projects can inspire confidence, bring visibility, and generate excitement about a larger-scale vision.
• Use realistic goals and timelines to build partner confidence. Partners are more likely to remain engaged if they not only feel listened to but can also see tangible goals achieved through small steps along the way.
• Expect different solutions for rural locations since they have different needs and priorities.
• Be strategic as you use the media to help get the word out – ensure they understand the big picture and how each stage of the project contributes to larger goals.

This report presents many successful projects as a foundation for future efforts. These stories capture the diversity of our country’s many built environments, partnerships being developed and promising practices. Further details in the lessons learned section suggest how these initiatives can be repeated in other communities. The common theme of these innovative projects is strategic collaboration that includes health outcomes as part of the planning goal. Much work is already taking place across the country and internationally in this field. Please refer to the Appendix for a list of key reports, reference materials and other case study documents to advance work in this area.

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¹ Health Canada (2002). Division of Childhood and Adolescence. Natural and Built Environments. Ottawa: Health Canada.