BUILDING HEALTHY COMMUNITIES ENVIRONMENTAL SCAN

Transcription

1 i BUILDING HEALTHY COMMUNITIES ENVIRONMENTAL SCAN Final Report Prepared for: Simcoe Muskoka District Health Unit As part of the Healthy Communities and the Built Environment Project Prepared by: December, 2007 This environmental scan is a component of the Healthy Communities and the Built Environment project. We would like to acknowledge the Public Health Agency of Canada s, Population Health Fund which has provided funds for the project as well as the project partners: the Ontario Healthy Communities Coalition, the Ontario Inclusion Learning Network, the Ontario Professional Planners Institute, the Ontario Public Health Association, the Ontario Smart Growth Network, the Region of Waterloo Public Health, the Simcoe Muskoka District Health Unit, and the Waterloo Region Healthy Communities Coalition. Simcoe Muskoka District Health Unit December 2007

2 ii EXECUTIVE SUMMARY The Simcoe Muskoka District Health Unit, on behalf of the Ontario Healthy Communities Coalition, was interested in gathering information on strategies, programs and practices currently being used to promote healthy communities. To this end, the aim of the Building Healthy Communities Environmental Scan Project is to understand the scope and involvement in Ontario of public health agencies, environmental groups, and community agencies in the area of land use planning and the built environment and to determine the impact those have on the health of the population. This report presents the findings from interviews conducted with representatives of 28 Health Units and 50 community / environmental organizations throughout Ontario. These findings are intended to help inform work to influence the built, natural, social and economic environments that affect the health of the population. Methodological Approach Key informant interviews were conducted with representatives from Ontario Health Units and community / environmental organizations. Respondents were asked to provide information about the activities and roles of their organization related to healthy communities and the built environment. Specifically, respondents were asked about: Awareness and communication strategies related to the issue; Current/future research, including consultation and information gathering; Current/future policies, programs and initiatives; and Current/future partnerships and knowledge sharing. Twenty-eight (28) of 36 Health Units and 50 of the 83 identified community / environment groups participated in this study. Most of the interviewed community environmental organizations had an environmental mission or were in some way committed to the protection of the environment. Representatives of Health Units included CEOs, health specialists, health promoters, health policy planners, and program managers. Representatives of community/environmental organizations were executive directors, managers, or coordinators. Interviews were between 45 minutes and two hours in duration. Key Findings The following summary highlights the pertinent findings based on the integrated results of the research completed for this environmental scan. Informants varied widely in their perspectives on public and stakeholders awareness of land use issues and healthy communities. Simcoe Muskoka District Health Unit December 2007

3 iii Sixty-one percent (61%) of Health Unit representatives thought that their local municipal Planning Departments have a good understanding of land use planning and its relation to population health, while fewer (32%) Health Unit representatives felt the same about the level of understanding of their local Transportation Department. Only 18% agreed that the impact of land use planning and the built environment on the health of a community is well understood by the local Engineering / Works Departments. Sixty-eight percent (68%) of representatives of community / environmental organizations thought their target audiences were not aware of issues related to land use planning and community health. Health Units and community / environmental organizations generally thought their staff members were aware of the issues related to the health impacts of land use planning and the built environment. The majority of respondents in Health Units (67%) and community / environmental organizations (92%) stated that their staff members were aware of issues related to the impact of land use planning and the built environment on community health. Although 33% of Health Unit representatives reported that their staff members were only somewhat aware of land use issues as they relate to healthy communities, many indicated that staff awareness of the issues is increasing. Reasons given for lack of awareness among Health Unit staff included a lack of understanding of how public health relates to land use issues as well as the perception that the subject did not fit their Health Unit s mandate. Among the four staff members in community / environmental organizations who were unaware, one organization said it was because the issues are not perceived to fit with their mandate, another organization stated that it does not focus on land use planning and the built environment. Satisfaction with the attention given to land use issues by municipal governments, provincial government, local media and community groups varied. One-half (50%) of the Health Unit representatives were satisfied with the attention given to land use issues and health by their municipal governments and 48% were satisfied with the attention given to these issues by local community / environmental organizations. Fewer (37%) were satisfied with the attention given to these issues by the provincial government, while 21% were satisfied with the attention given to these issues by local media. Representatives of community / environmental organizations expressed less satisfaction with the level of attention given to the issues by municipal governments (14% were satisfied), provincial government (22% were satisfied) and local media (31% were satisfied). Simcoe Muskoka District Health Unit December 2007

4 iv The vast majority of respondent organizations are currently involved in communication strategies to promote action and increase attention to developing healthy communities through land use planning and the built environment. Most (86%) of the Health Units currently have, or recently have had involvement in a communication strategy on the issue. Types of communication strategies have included hosting community-based workshops, active involvement on advisory committees, and promotional activities related to developing active communities. Most (80%) community / environmental organizations have also had involvement in a communication strategy. These have involved activities such as hosting workshops, writing newsletters, releasing reports or informational booklets and/or developing media campaigns. Health Units and community / environmental organizations are involved in various research projects. Common research activities included literature reviews, conducting primary research and developing presentations on the topic. The four most common areas of related research being undertaken by Health Units were: - Accessible parks, paths and trails; - Alternate transportation; - Air quality; and - Water quality. The three most common areas of related research being undertaken by community / environmental organizations included: - Air quality; - Alternative transportation; and - Green space / agricultural lands. A higher proportion of Health Unit respondents than respondents in community / environmental organizations disagreed that the amount of research their organizations had done to promote healthy communities through land use planning and the built environment was adequate. Only 29% of Health Unit representatives thought their organization had adequate research and information to promote healthy communities through land use planning and the built environment. More than half (52%) of respondents in community / environmental organizations thought that the research their organizations had done was adequate. Simcoe Muskoka District Health Unit December 2007

5 v Promotion of policies, programs and initiatives related to land use planning and the built environment is currently more limited among community / environmental organizations than among Health Units. Two-thirds (67%) of Health Units and 37% of community / environmental organizations have led successful initiatives promoting healthy communities through land use planning and the built environment. Forty-eight percent (48%) of Health Unit representatives thought the level of involvement of their Health Units in developing related policies, programs and initiatives was inadequate. Similar factors were provided to account for the success of programs, policy work, and initiatives among Health Units and among community / environmental organizations. The reasons most often provided for the success of programs, policy work and initiatives led by Health Units and community / environmental organizations included the following: - Strong community awareness and support; - Strong partnerships and relationships; and - Extensive related media coverage. Identified barriers that hindered the success of policies, programs and initiatives included: - Lack of leadership; - Lack of resources (funding and human resources); - Direction or focus based on short-term goals rather than long-term goals (issues of sustainability); and - Lack of community buy-in and government support. Among those interviewed, 67% of Health Units and 62% of community/environmental organizations plan to implement new programs, strategies or initiatives on these issues within the next two years. Nearly all of the Health Units and about two-thirds of community / environmental organizations had engaged in partnerships on the topic. Ninety-three percent (93%) of Health Units were involved in a related partnership, compared to nearly two-thirds (63%) of community / environmental organizations Forty-three (43%) percent of the interviewed community / environmental organizations were involved in a partnership with their local Health Unit. Less than half of Health Units (41%), and community / environmental groups (44%) were satisfied with the current level of partnerships. Many Health Units (56%) and community / environmental organizations (58%) had plans to form partnerships with other organizations in the near future. Simcoe Muskoka District Health Unit December 2007

6 vi Health Units and community / environmental organizations identify a number of common barriers in forming successful partnerships. Commonly identified barriers to successful partnerships stated by both Health Units and community / environmental organizations included: - A lack of knowledge, particularly related to the impact of land use on public health; - Lack of resources; - Lack of communication; - Lack of leadership; and - Lack of common goals / objectives. Simcoe Muskoka District Health Unit December 2007

7 vii TABLE OF CONTENTS SECTION 1: INTRODUCTION AND METHODOLOGY PURPOSE AND OBJECTIVES METHODOLOGY Interview Guide Design Data Collection Analysis and Reporting Limitations and Cautions...4 SECTION 2: A PROFILE OF ORGANIZATIONS INTERVIEWED HEALTH UNITS COMMUNITY / ENVIRONMENTAL ORGANIZATIONS...5 SECTION 3: AWARENESS & COMMUNICATION UNDERSTANDING OF THE ISSUES Health Units Community / Environmental Groups AWARENESS ATTENTION TO LAND USE ISSUES Health Units Community / Environmental Organizations COMMUNICATION STRATEGIES Health Units Community / Environmental Organizations...13 SECTION 4: RESEARCH ACTIVITIES KEY ISSUES Health Units Community / Environmental Organizations ACCESSING AND CONDUCTING RESEARCH Health Units Environmental / Community Organizations IMPLEMENTATION Health Units Community / Environmental Organizations...20 SECTION 5: POLICIES, PROGRAMS AND INITIATIVES SUCCESSFUL POLICIES PROGRAMS AND INITIATIVES Health Units Environmental / Community Organizations LEVEL OF INVOLVEMENT Health Units Community / Environmental Organizations...24 SECTION 6: PARTNERSHIPS AND KNOWLEDGE SHARING PARTNERSHIPS Health Units Community / Environmental Organizations...27 SECTION 7: SUMMARY OF FINDINGS 30 Simcoe Muskoka District Health Unit December 2007

8 viii APPENDIX A- KEY INFORMANT GUIDES 35 APPENDIX B- PARTICIPATING ORGANIZATIONS 79 APPENDIX C- LIST OF RESOURCES 82 Simcoe Muskoka District Health Unit December 2007

9 1 SECTION 1: INTRODUCTION AND METHODOLOGY The impact of land use planning and the built environment on the health of communities is of growing concern in Canada. In recent years the subject has garnered increased public and stakeholder attention. The negative effects of specific types of land use planning have been the subject of research and public discussion, particularly as they relate to: Air pollution and related respiratory illnesses such as asthma; Traffic injuries and fatalities; and Lack of physical activity due to living in low-density towns and cities, and consequently, increased prevalence of obesity, diabetes and cardiovascular diseases. 1 To improve the health of Ontarians and prevent chronic diseases, the need has been identified to establish healthy communities that are safe, compact and walkable. 2 This includes the encouragement of more compact development, mixed land uses, alternate modes of transportation, more walkable communities and greater access to green space. 3 Strong public support for healthy communities, for partnerships among professional organizations to develop policies and programs based on evidence-based practice, and for health promotion and chronic disease prevention to become a political priority are all instrumental in achieving healthy communities. 4 The Ontario Healthy Communities Coalition and collaborative partners are working together to build awareness of the impacts of the built environment on human health Purpose and Objectives The Simcoe Muskoka District Health Unit, on behalf of the Ontario Healthy Communities Coalition, was interested in gathering information on strategies, programs and practices currently being used across Ontario to promote healthy communities. To this end, the aim of the Building Healthy Communities-Environmental Scan Project is to understand the scope and involvement of public health agencies, environmental groups, and community agencies in the area of land use planning and the built environment and to determine the impact these have on community health. 1 Report on Public Health and Urban Sprawl in Ontario: A Review of the Pertinent Literature. Ontario College of Family Physicians (January, 2005). 2 Healthy Communities and the Built Environment-Project Summary. Ontario Healthy Communities Coalition, Excerpt from: OPHA Letter on Planning Reform, Healthy Communities and the Built Environment-Project Summary. Ontario Healthy Communities Coalition, Healthy Communities and the Built Environment-Project Summary. Ontario Healthy Communities Coalition, Simcoe Muskoka District Health Unit December 2007

10 2 This research is also intended to gather resources, tools, documents or reports that have been developed that can be shared with other disciplines and sectors to enhance the work being done across Ontario in the area of healthy communities and the built environment. Please see Appendix C for a list of resources provided by key informants. This report presents the findings of interviews with representatives of 28 Health Units, and 50 community / environmental organizations across Ontario. These findings are intended to help inform work to influence the built, natural, social and economic environments that affect the health of the population. 1.2 Methodology Information presented in this report is a synthesis of information gathered by R.A. Malatest and Associates Ltd. through interviews with representatives from Health Units and community / environmental organizations. The research approach is provided in the following sections Interview Guide Design Two separate interview guides (included in Appendix A) were developed for this project, including one guide for representatives of Ontario Health Units and another for representatives of community / environmental organizations. Each guide was tailored to its respective target group to ensure that relevant and specific areas of knowledge and experience were accessed for each group. Interviews contained both closed- and openended questions. Respondents were asked to provide information about the activities and roles of their organization related to healthy communities and the built environment. Specifically, respondents were asked about: Awareness and communication strategies about the topic; Current / future research, including consultation and information gathering; Current / future policies, programs and initiatives; and Current / future partnerships and knowledge sharing. The interview guide was piloted on two representatives from Health Units and three representatives from community / environmental groups. Any issues emerging from these interviews were discussed and minor modifications were made to the interview guide, with SMDHU approval Data Collection Interviews were conducted with representatives from Ontario Health Units and community / environmental organizations. All Ontario Health Units were invited to participate while a sample of community / environmental organizations was developed in consultation with Ontario Healthy Communities Coalition - Healthy Communities and the Built Environment Simcoe Muskoka District Health Unit December 2007

11 3 Steering Committee and the Building Healthy Communities (BHC) Committee at the Simcoe Muskoka District Health Unit. A knowledgeable representative who could speak to the scope of their agency s involvement in land use planning was identified from each Health Unit and community / environmental organization. Information letters detailing the purpose and authority of the project were ed to all interviewees. Key informants were interviewed by telephone, and offered the option of allowing one or two co-workers to be interviewed at the same time. All informants were ed the interview guide in advance of their interview. Interviews were between 45 minutes and two hours in duration. When it was necessary (e.g. due to a lack of time to complete an interview or a single staff member who could not complete the interview alone), respondents were given the option of completing the questions independently and faxing or ing their responses back. If an explanation was needed, the informant was contacted for clarification. Overall, 13 Health Units and 22 community / environmental groups completed the information in this fashion. Interviews were conducted from July 17 to September 21, Interviews were completed with 28 of the 36 Ontario Health Units and 50 of the 83 community / environmental organizations contacted (see Appendix B for a complete list of participating Health Units and Organizations). Potential respondents gave the following reasons for non-participation: Lack of staff availability (limited human resources); Lack of time; Staff vacations; Lack of knowledge (the identified representative could not answer the questions and did not know who at their organization was better suited for the interview); and/or The agency is not conducting nor are they planning to conduct relevant research or implement initiatives related to healthy communities and the built environment Analysis and Reporting Notes taken by research staff during the interviews was entered into CallWeb, the Consultant s secure data collection system. Quantitative data were analyzed in SPSS using descriptive statistics and crosstabulations. Informants answers to open-ended questions were analyzed by theme, and quotes were selected to illustrate key ideas. Simcoe Muskoka District Health Unit December 2007

12 Limitations and Cautions As mentioned above, there were a number of non-responding organizations. As a result, the findings of this study cannot be considered to be representative of all local Health Units and community / environmental organizations in Ontario. It should be cautioned that the findings of the study should be considered to reflect the views and knowledge of those representatives interviewed, and do not necessarily represent the views of entire organizations. Reference was repeatedly made during the interviews to the fact that staff often work quite independently. For example, it was clear that not all representatives, particularly among Health Units, could report on the research being conducted or planned by other areas of their organization. Simcoe Muskoka District Health Unit December 2007

13 5 SECTION 2: A PROFILE OF ORGANIZATIONS INTERVIEWED 2.1 Health Units Respondents from Health Units interviewed for this research represented a number of different positions within their organizations. Respondents in Health Units included health program supervisors, coordinators or managers. Others were Chief Executive Officers, health specialists and promoters and health policy planners. Interviewees worked in a variety of fields, including in the areas of obesity, environmental health, family health, disease prevention and substance abuse. Respondents length of employment within the field of community health varied greatly from 2 to 35 years, at an average of 10 years. The communities represented by interviewees were also very diverse. Respondents represented Health Units in an equal number of rural, urban and rural / urban mixed communities. Respondents represented communities of less than 10,000 residents to over 2,000,000, encompassing geographic areas of less than 2,000 km 2 to 240, 287 km 2. Three respondents stated that their communities had high numbers of French-speaking residents and six stated that they were in a very multicultural community. Two respondents said that they have a significant senior and / or aging population, and four were close to First Nations communities or served First Nations peoples. 2.2 Community / Environmental Organizations Most of the community / environmental organizations interviewed for this research had an environmental mission or were in some way committed to the protection of the environment. Others focused on sustainable development strategies or advocated for issues such as urban sprawl reduction and mixed-use development. The majority of those interviewed were senior staff such as Executive Directors, Managers or Coordinators, who were responsible for the following tasks: Program / project start-up, Strategic planning; management and delivery; Public / media relations; Research activities; Liaison to Board of Directors; and Office / staff management; Fundraising. Key informants working in community / environmental organizations stated that their main target audiences were the general public and government stakeholders at the municipal, provincial or federal levels. Fewer key informants mentioned target audiences that included educators, the private / business sector and the non-profit sector / nongovernmental organizations. Simcoe Muskoka District Health Unit December 2007

14 6 SECTION 3: AWARENESS & COMMUNICATION 3.1 Understanding of the Issues Informants from Health Units and community / environmental organizations were asked to provide their perspectives on the level of understanding among local government departments and target audiences on issues related to land use planning and its impact on health. Levels of agreement among those interviewed about the understanding of Health Units stakeholders and community / environmental organizations target audiences are presented in Figure 3-1. Figure 3-1 Level of Agreement among Health Units and Community / Environmental Organizations that the Impact of Land Use Planning and the Built Environment on the Health of Communities is Well Understood by Different Stakeholder Groups Strongly Agree Agree Disagree Strongly Disagree Don't Know/Not Sure Engineering/Works Department, n=28 4% 14% 36% 46% Transportation Department, n=28 4% 29% 32% 4% 32% Planning Department, n= 28 14% 46% 21% 18% Target Audience, n=50 12% 56% 12% 12% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Source: Health Unit Survey, B6a, B6c, B6e; Community / Environmental Organizations Survey, B6a. Health Units n=28; Organizations n=50; Missing responses not included Health Units Health Unit representatives generally believe their local Planning Department has a good understanding of issues related to land use planning and the built environment, but were less likely to feel the same about their local Transportation and Engineering / Works Departments. The majority (61%) of Health Unit representatives agreed that their local municipal Planning Departments had a good understanding of issues related to land use planning Simcoe Muskoka District Health Unit December 2007

15 7 and its impact on community health. 6 Concern was expressed that Planning Department lacked understanding of the issues, and did not adequately consult the Health Units. One respondent indicated that the relationship is growing, stating: before they didn t even see a connection or understand why Health Units should be involved. Health Unit representatives opinions of the level of understanding in their local Transportation Department were fairly evenly split. Among respondents, 36% disagreed, 32% agreed, and 32% were unsure that their local Transportation Department had a good understanding of land use planning, the built environment and its impact on health 7. Approximately one-third (36%) of Health Unit representatives thought that their local municipal Engineering / Works Department lacked a good understanding of the issues while about one-fifth (18%) thought they had a good understanding. 8 Nearly one-half (46%) of the respondents were unsure or did not know how well the Engineering / Works Department understood the impact of land use planning and the built environment on community health Community / Environmental Groups The majority (68%) of representatives in community / environmental organizations thought that their target audiences did not understand issues related to the built environment and community health 9, saying that there is little related education and it s not a top of the mind issue right now. As one respondent commented: Right now there is not a lot of change. Most people are either content, complacent or just don't know of the alternatives. 3.2 Awareness Representatives from Health Units and community / environmental organizations were asked to rate the level of awareness and understanding of their own staff, community / environmental organizations, local departments (planning, transportation and engineering / works), and their target audience, related to the impact of land use planning and the built environment on community health. Staff members are aware of issues relating to land use planning and the health of a community. The majority of respondents in Health Units (67%) and community / environmental organizations (92%) stated that their staff members were aware of issues related to the 6 With don t know/unsure responses excluded, 73% of Health Units agreed that the Planning Department has a good understanding of land use issues. 7 With don t know/unsure responses excluded, 52% of Health Units agreed that the Transportation Department has a good understanding, while 47% were dissatisfied with the Transportation Departments level of understanding of land use issues. 8 With don t know/unsure responses excluded, 33% of Health Units agreed, and 67% disagreed that the Engineering and Works Department had a good understanding of land use issues. 9 With don t know/unsure responses excluded, 78% of community / environmental organizations did not think that their targeted audience had a good understanding of land use issues and the built environment. Simcoe Muskoka District Health Unit December 2007

16 8 impact of land use planning and the built environment on community health. As demonstrated in Figure 3-2, only 8% of community / environmental organization representatives thought their staff members were somewhat or not at all aware, compared to 33% of those interviewed in Health Units. Figure 3-2 Perceived Level of Awareness among Staff of Impact of Land Use Planning and the Built Environment on the Health of Communities Very Aware Aware Somewhat Aware Not at all aware Health Unit, n=27 41% 26% 33% Community/Environment Groups, n=50 76% 16% 6% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Source: Survey of Health Units and Community / Environmental Organizations Question B1a. No Response/Don t Know responses not included in the chart. Some Health Unit representatives reported that their staff members were familiar with the issue of land use planning, but did not see how it fit with their mandate or how the issues relate to public health. Other interviewees in Health Units suggested that the issue of the impact of land use planning on the health of the community is a relatively new topic and many are only beginning to understand it. As one representative stated: the issue is only in its infancy. One respondent said that unless there is a personal knowledge, there is low [level of] knowledge. Another respondent noted that certain divisions at their organization are more aware than others. For the four staff members in community / environmental organizations who were unaware, one organization said it was because the issues are not perceived to fit with their mandate and traditionally this had not been their organization s focus. Other representatives of community / environmental organizations stated that they did not have adequate funding to educate their staff on the subject. Simcoe Muskoka District Health Unit December 2007

17 9 Respondents described a variety of sources that their staff may use to access information about land use planning and the built environment, including the following: Literature review / grey literature searches, including review of reports, newsletters, published journal, media, web-based information; Conferences; Presentations / workshops / educational events; City departments, e.g., public works department; City planners / architects; Resource centres / local groups; Committees / roundtables; Legislation / policies; Information sharing with other Health Units and/or community / environmental organizations and/or academia; Hired consultants; and Primary research. 3.3 Attention to Land Use Issues Informants were asked to comment on their satisfaction with the level of attention given to land use issues by their municipal governments, provincial government, local media, and community groups Health Units Health Units are more satisfied than dissatisfied with the level of attention given to land use issues from their municipal government and local community groups. One-half (50%) of the Health Unit representatives were satisfied with the level of attention given to land use issues by their municipal governments. Thirty-six percent (36%) were dissatisfied. The remaining 14% were unsure with the level of attention given to land use issues by the municipal government. Dissatisfaction was focused particularly on the lack of understanding of the relationship between land use issues and public health. There was also a sense that municipal decisions focus on short term gains, instead of on long-term sustainability. One informant stated, (my) experience has shown that business, development and economic concerns have greater impact on decisions than health. Forty-eight percent (48%) of Health Unit representatives were satisfied with the attention given to specific issues by community / environmental organizations, and some informants stated that local participation was generally good. Some satisfied informants Simcoe Muskoka District Health Unit December 2007

18 10 stated that they were seeing signs of political will in municipalities on land use issues, although the focus did not necessarily reflect a health perspective. Less than one-third (30%) of Health Unit representatives expressed dissatisfaction with the attention given to the issues by community / environmental organizations. This dissatisfaction was generally related to community / environmental organizations lack of partnerships with Health Units, as well as the focus of these groups on other hot topic issues. One respondent explained: There is uneven involvement and it is quite political. For example, strong attention was given to the Oak Ridges Moraine and Greenbelts a few years ago. But looking on a continuum, people are unaware. Other issues are more pressing. Health Units were less satisfied with the attention given to land use issues from the provincial government. About one-third (37%) of respondents in Health Units were satisfied with the level of attention given to land use health issues by the provincial government. Some respondents said that the provincial government is on the right track in offering more financial resources, human resources, training and education related to these issues. Forty-four percent (44%) of Health Unit representatives were dissatisfied with the provincial government s level of attention to land use issues (the remaining 19% were unsure on this issue). Some respondents indicated a lack of guidance, lack of direction and lack of mechanisms to work together on the issue. A few respondents related their dissatisfaction to the fact that there is not enough push from the provincial government on the built environment and its relationship to health. As one informant explained: There is next to no discussion of the health impacts of the new planning agenda in Ontario. It's being given a very superficial treatment and there have not been any people with backgrounds in public health as part of these processes, despite organizations like Ontario Public Health Association making recommendations to the contrary over two years ago. The majority (57%) of Health Unit representatives were dissatisfied with the attention given to land use issues by local media. About one-fifth (21%) of Health Unit respondents were satisfied that local media were providing good coverage of land use issues. Another 21% of Health Unit representatives were unsure when asked about their satisfaction with media coverage of land use issues. More than half (57%) of Health Unit representatives were unsatisfied with the media s coverage of the issues. One reason given for this dissatisfaction was that the media tends to be very issue based and not focused on the big picture. One respondent commented that controversies get newspaper coverage and if it is not a hot topic the issue does not get coverage. Simcoe Muskoka District Health Unit December 2007

19 Community / Environmental Organizations Community / environmental organizations are less satisfied with the level of attention given to land use issues by their municipal government. Fourteen percent (14%) of respondents in community / environmental organizations were satisfied with their municipal governments level of attention to land use issues stating that municipalities have been supportive, willing to make changes, and have begun placing increased emphasis on the issue. The majority (61%) of interviewees in community / environmental organizations were dissatisfied with municipal governments level of attention to land use health issues. Reasons for dissatisfaction included the following: Municipal governments lack of knowledge of land use issues; A focus on short-term rather than long-term goals; and A lack of acceptance of new ideas. Twenty-five percent (25%) of the representatives of community / environmental organizations indicated that they were unsure on this issue. A majority of community / environmental organizations were dissatisfied with the attention given to land use health issues by the provincial government. Less than one-quarter (22%) of respondents in community / environmental organizations were satisfied with the level of attention given to the issue by the provincial government. One respondent noted, however: Ontario is leading the country in legislation around sustainable growth - we are very satisfied with the level of attention. Our critique is based on the effectiveness of the attention are they the right policies, deployed in the right way, etc. Over half (57%) of interviewees in community / environmental organizations were dissatisfied with the level of attention given land use health issues by the provincial government. Respondents did note that while some efforts have been made in the area, not enough has been done, and the overall vision and communication is at times contradictory. For example, one respondent said: I see things like the Greenbelt, which is a good idea, but then they go and build a 4-lane highway right through it. Does that make sense? Twenty-one percent (21%) of representatives of community / environmental organizations were unsure when asked about their satisfaction with the provincial government s attention to land use health issues. Thirty-one percent (31%) of community / environmental organizations were satisfied with the attention given to land use issues by their local media. Some (31%) respondents thought that the local media was good at covering land use health issues, while about one-half (47%) were unsatisfied with the attention of local Simcoe Muskoka District Health Unit December 2007

20 12 media to land use issues. Although some thought that the media were good at highlighting certain issues such as anti-idling, they also indicated that local media coverage of the issues is sparse overall. Some stated that media portray a biased view and often report on inadequate research. One informant stated: The media, unfortunately, often fuels NIMBY-ism through inadequate research into development proposals and a lack of analysis of land use planning impacts. The media is often attracted to basic "David and Goliath" stories that put some community residents at odds with the development industry and add fuel to the fire rather than analyze real issues that can be properly addressed through consultation and compromise by all sides. 3.4 Communication Strategies Participants were asked if they were involved in any related communication strategies and, if so, which strategies they felt were successful Health Units The majority (86%) of Health Units were involved in a communication strategy to promote action and increase the attention given to developing healthy communities through land use planning and the built environment. Interviews indicated that 86% of Health Units were involved in a communication strategy to promote action and increase the attention given to developing healthy communities through land use planning and the built environment. Activities related to the communication strategies included the following: Encouraging active communities by promoting things like walking, biking and the use of trails; Hosting community-based workshops; Becoming actively involved in advisory committees, with a focus on integrating programs; and Writing columns for the Medical Officer of Health. The communication strategies described had different target audiences. As one respondent said about the audiences they targeted: They vary. We try to be very clear in our targets. The reports are targeted mostly to governments, consultants and researchers; public forums newsletters and press work have been targeted to the general public. Health Unit representatives indicated that the following initiatives / resources had been successful in informing or promoting action. Some respondents commented that these initiatives / resources had been effective in both increasing awareness and in sending a sense of urgency about relevant issues: Simcoe Muskoka District Health Unit December 2007

21 13 Go for Green resources and fact sheet; Walk ON; National Centre for Bicycling and Walking; College of Family Physicians brochures; Eat Local map detailing local farmers; Clean Air Council 2020 Campaign; Eco schools for Teachers; Strategies on physical activity, biking, paths, trails, canoeing; Strategies on food access and urban design, reurbanization; Strategies on social capital and complete community design; Strategies on greenlands, community gardens and green roofs; Strategies on air pollution, air quality, smog prevention, antiidling, and transportation planning; Pesticide education; West Nile Virus education and control; and Media coverage on climate change Community / Environmental Organizations The vast majority of community / environmental organizations were involved in a communication strategy to promote developing healthy communities through land use planning and the built environment. The majority (80%) of community / environmental organizations were involved in a communication strategy related to developing healthy communities through land use planning and the built environment. Examples of activities related to communication strategies included the following: Hosting seminars / workshops / presentations; Writing newsletters; Releasing reports or informational booklets; Becoming involved in media campaigns; Hosting or attending meetings / networking opportunities; Writing letters to the editor; and Going door-to-door informing the public. The communication strategies were said to target many different audiences, with only a few described as targeting everyone. Some community / environmental organization representatives indicated that the most successful communication strategy involved hosting seminars or workshops. One respondent explained that workshops have been successful because firstly the community (came) showing a keen interest in change. Workshops are also hands on and require participants to develop action items. We also follow-up 6 months after to see the progression made in the communities. Simcoe Muskoka District Health Unit December 2007

22 14 Others thought that their communication strategy was successful because of community wide support. As one informant stated: The grassroots approach seems to be working extremely well. It affords community buyin and puts the responsibility of environmental health into everyone's hands, not just governments. Simcoe Muskoka District Health Unit December 2007

23 15 SECTION 4: RESEARCH ACTIVITIES 4.1 Key Issues Respondents from Health Units and community / environmental organizations were asked to describe the areas in which they had engaged in research, consultation or data collection on the subject of healthy communities and the built environment. It should be noted that research was discussed by respondents in very broad terms which included many activities: literature reviews, primary research, web-searches, reading to build knowledge or to keep current, archiving of resources, writing reports, and presentations Health Units Research, consultations, and / or data collection had most often been done by Health Units related to accessible parks, paths and trails, alternate transportation, and air / water quality. Eighty-two percent (82%) of Health Unit representatives indicated that their organizations had conducted research related to accessible parks, paths and trails while 75% indicated that research had been conducted related to alternate transportation. Roughly equal proportions of Health Units had conducted research related to air quality (63% of Health Units) and water quality (64% of Health Units). The majority of Health Unit representatives (71%) indicated that their organizations had conducted reviews of effective interventions, programs, or policies designed to make the built environment more supportive of health. About four in ten (36%) respondents indicated that public health managers had been surveyed (either internally or by an outside consultant) regarding how building healthy communities would be integrated into future programming. Health Unit representatives indicated that research, consultations, or data collection done in their organizations led to the development of information tools, programs, or strategies. Seventy-three percent (73%) of Health Unit representatives stated that research, consultations, or data collection done in their organizations led to the development of information tools, programs, or strategies. Almost all (96%) of the Health Unit representatives stated that research and / or resources relevant to their organizations research could be made available to the Consultant either to inform this study or to share the information with others. When asked what they had learned from the research done, one participant commented: Not enough attention is given to health issues and environmental planning. Another stated: There is a lot of work to be done. We have no information on good solid ways to operationalize solutions. Simcoe Muskoka District Health Unit December 2007

24 16 Over one-half (54%) indicated that their organization had plans for future research related to healthy communities, land use planning and the built environment. For example, several respondents indicated that their organizations were planning to conduct surveys or impact assessments about issues related to healthy communities Community / Environmental Organizations Research, consultations, and / or data collection had most often been done by community / environmental organizations related to air quality, alternate transportation, and the preservation of green space / agricultural lands. Fifty-seven percent (57%) of community / environmental representatives indicated that their organizations had conducted research related to air quality, while equal proportions had conducted research related to alternate transportation and green space / agricultural lands. Two of these issues air quality and alternate transportation were also among the four issues most researched by Health Units. Two-thirds (66%) of respondents in community / environmental organizations indicated that their research and/or relevant resources could be made available to the Consultant either to inform this study or to share with others. Research, consultations and / or information conducted / gathered were generally targeted towards the general public, however; some organizations emphasized that research needs to target the issues of specific sub-communities (e.g. examining land use issues as they relate to the health of seniors, Aboriginals, youth, cycling groups etc.). In the following example, the importance of research on healthy communities to students was highlighted by one respondent, who said: Natural resources and environmental concerns need to be discussed in schools more. In order to do this, they need to get the kids outside to talk about it. You cannot do it inside. Unless you set foot on it, you have no idea what it is. To get an appreciation for it, you have to be there. A minority (38%) of respondents in community / environmental organizations reported that their organizations had plans for future research related to healthy communities, land use planning and the built environment. A number of representatives indicated that their organizations were planning primary research assessing impacts and analyzing costs / benefits and others stated they were planning to review research and develop policy analysis related to issues such as land use planning and green building practices. Simcoe Muskoka District Health Unit December 2007

25 17 Figure 4-1 Percentage of Organizations that have Conducted Research, Consultations, and / or Data collection on Issues Related to Building Healthy Communities 100% Health Units Community / Environmental Organizations 82% 80% 75% 71% % 60% 40% 49% 56% 64% 63% 53% 57% 59% 59% 40% 41% 44% 53% 42% 42% 41% 51% 37% 56% 33% 49% 39% 20% 0% Accessable parks, paths, trails Alternate transportation / public transportation / cycling, walking Water quality, conservation and preservation Air quality, emissions, reduction / antiidling Access to community resources, services, supports Access to food / food stores / land preservation Environmental remediation / infilling / Brownfill / Greenfill Social connection / isolation / public places Balanced communities / working where you live / commuting to employment Greenspace / Affordable safe / agriculture lands compact development housing Review of effective interventions to make the built environment more supportive of health Survey regarding the integration og healthy community issues into programming* Source: Both Surveys C1; Health Units n=28; Community / Environmental Organizations n=50. Missing responses not included. * Note: Only asked of Health Unit participants.

26 Accessing and Conducting Research Respondents were asked to comment on the availability of research to promote the built environment on the health of a community, and about barriers to conducting this research. Figure 4-2 presents respondents level of agreement that the research available to promote healthy communities through land use planning is adequate. These findings are discussed in Sections and Figure 4-2 Level of Agreement by Respondents that their Organizations had Adequate Research to Promote Healthy Communities through Land Use Planning % of Representatives 100% 80% 60% 40% 20% 0% 0% Health Units, n=28 Community/environmental organizations, n=50 2% Strongly Disagree 54% 36% 25% 38% 4% 14% 17% 10% Disagree Agree Agree Strongly Neutral/Don't Know Source: Health Units Survey, C5a; Community Environmental Organizations Survey, C7a. Health Units n=28; Community / Environmental Organizations n=50; Missing responses not included Health Units Health Units do not have adequate research and information to promote the development of healthy communities through land use planning and the built environment Fewer Health Unit representatives agreed (29%) than disagreed (54%) that their organizations had adequate research and information to promote the development of healthy communities through land use planning and the built environment. Almost all (93%) Health Units acknowledge barriers in conducting research related to healthy communities, land use, and the built environment (as well as barriers to research generally). Several barriers to research related to building healthy communities and the built environment were identified by Health Unit representatives. Some respondents highlighted the need for more community support and partnerships with other R.A. Malatest & Associates Ltd Simcoe Muskoka District Health Unit December 2007