HEALTH BY NATURE Public Health and the Built Environment

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1 HEALTH BY NATURE Public Health and the Built Environment Daniel H. Leeming BA, DIP CP, MES, FCIP, RPP Partner, Urban Design and Planning 2012 Latronell Conservation Symosium - Prescription for a Healthy Environment

2 CONVERGING ISSUES - Rising Costs of Energy - Days of cheap energy are over - Aging Population - In 20 years, 1 in 4 Canadians will be Public health - Last 20years has seen a 2 or 3 times - increase in diseases, asthma diabetes, - depression, hearth disease - Climate Change - CO2 levels are the highest in 500,000 - years and growing All of these issues are linked to how we design and build our communities With the convergence of these issues, we have just one generation to make serious change before things get out of hand.

3 CONVERGING ISSUES May 25, Shelia Fraser, Auditor General, warns of the harsh choice Canadians will have to face tax hikes or program cuts due to: 1. An aging population 2. Aging infrastructure 3. Effects of climate change Shelia Fraser discusses the impacts: we can expect people will need more health care services and will be drawing on public pensions. Obviously, balancing these fiscal pressures will be a major challenge. Melting permafrost is undermining roads, buildings and pipelines and climate change could also affect key economic sectors such as forestry, mining, fisheries and agriculture.

4 CONVERGING ISSUES ENERGY - Earth s oil capacity: 2 trillion barrels - Remaining capacity at peak: 1 trillion barrels - Consumption: 27 billion barrels/year - Final consumption: 2041(37 years) - Population 1800: 1 billion - Population 2000: 6 billion

5 CONVERGING ISSUES ENERGY - At Peak oil consumption: - A 10% shortfall will triple cost of oil - Low Density Energy Costs: $ 4, Buildings $ 4, Transportation (2.5 cars/household) $ 8, Some alternative fuels not a solution. Ethanol and hydrogen have a very low return on investment (ie. Competes with food production and uses energy to produce energy). - Reducing reliance on water helps to reduce reliance on energy. Pumping water is a huge user of energy. - It took 3 million years to produce enough oil for 1 year of consumption - Typical Oil Well: - 25 barrels = 1 barrel of energy used - Oil Sands: - 5 barrels = 1 barrel of energy used

6 CONVERGING ISSUES EARTH`S RESOURCES, ONE PLANET LIVING United States * Planets Canada Planets Norway United Kingdom Planets 3 Planets Zambia Planets * Renewable ha/person One Planet Planet (balance)

7 CONVERGING ISSUES CLIMATE CHANGE - Increased demand on cooling systems & power demand; 2010 hottest summer on record. - Even Introduce if CO2 a emissions range of were housing eliminated today, it could stay options in the and atmosphere services for in up order to 200 to years. age in place - World population has doubled since 1960, and parallels the steepest climb of CO2. Rocketing economies of China & India, with more than 1 billion people each, ensures that CO2 will continue to rise.

8 CONVERGING ISSUES CLIMATE CHANGE - An increase of 1 to 2 degrees Celsius in global temperature = - Sea Coasts storms & rising sea levels cause growing erosion of coasts - Species 30% at risk of extinction; increasing coral reef death - Flooding and depleted croplands in Pakistan / Bangladesh - An increase of 4 to 5 degrees Celsius in global temperature results in `Positive Feedback Loops` = - Melting of Arctic Tundra, warming of Southern oceans & melting of ice caps - Wheat and rice crop failures - A 30% increase in China s rice needs means 50% of world production

9 CONVERGING ISSUES AGING POPULATION - Working-to-aged ratio increases from 100:44 to 100:61 by Household formation growing faster than population growth - 3 to 5 year backlog for Long-Term Care - Increasing health care costs Age 65+ Seniors % of Society % % % -Census of Canada

10 CONVERGING ISSUES AGING POPULATION Introduce a range of housing options and services in order to age in place Long Term Care Facility in Cornell, Markham; Ontario

11 CONVERGING ISSUES PUBLIC HEALTH AND WELFARE - Disease of the 19th Century TB Cholera Yellow Fever - Treatment Public Works Water Quality / Treatment

12 CONVERGING ISSUES HEALTH ISSUES - Disease of the 19th Century Typhoid - Appalling typhoid death rates until; 1910 Chlorination 1914 Milk Pasteurization - American City Magazine

13 The Shift from Communicable Disease to Chronic Disease DISEASE OF THE 21 ST CENTURY CONVERGING ISSUES HEALTH ISSUES Hypertension, Diabetes, Heart Disease, Cancer, Osteoarthritis and; Depression - All have doubled or tripled in the last 20 years - 2% of Canadians are underweight; 25-30% are overweight - 9% of premature deaths are now due to obesity - Child obesity has tripled in 20 years - 3 million people have diabetes in Canada, est. cost by $17 billion Treatment - Diet & Education - Exercise, 60 minutes of moderate activity daily, for adults; 90 minutes for children - Improve / Build Environments that encourage walking / cycling / recreation at all levels

14 CONVERGING ISSUES HEALTH ISSUES DISEASE OF THE 21 ST CENTURY Respiratory Health - Transportation and buildings are the worst offenders (buildings, in the city; transportation, in the suburbs) - $1 Billion lost to direct healthcare costs and lost productivity costs - Children s asthma has dropped by 19% since 1995 Treatment - Promote alternatives to high automobile dependence - Promote alternative low emissions energy sources - Better education on land use planning & lifestyle choices

15 DISEASE OF THE 21 ST CENTURY Mental Health - Mental health disorders, depression & anxiety have tripled in the last 20 years - Depression affects 121 million people worldwide, the leading cause of disability and 4th leading contributor to global disease (WHO) - Mental disability costs Canadians $14.4 billion in treatment, medication & lost time - Social Capital (social, political, economic networks, ie. volunteer time) has dropped significantly Treatment CONVERGING ISSUES HEALTH ISSUES - Education about loneliness, inactivity, depression and commuting stress - Improve / encourage exercise opportunities - Improve opportunities for social interaction at all levels - Build better public meeting places (structured and unstructured) into communities at all scales

16 CONVERGING ISSUES CHILDREN`S HEALTH ISSUES Physical Activity Report Card Indicators - Access to community programs - Community infrastructure - Built environment - Proximity to parks - Active transportation - Neighbourhood safety and support - Municipal regulations Active Healthy Kids Canada 2011 Physical Activity Levels Report Card Grade D- Only 32% of Ontario s children meet Canada s physical activity guidelines (Public Health Agency of Canada) of 13,500 steps per day. C- for Physical Education D for Family Physical Activity A- for Proximity & Accessibility to Physical Activity Facilities C for Usage of Facilities, Programs, Parks & Playgrounds

17 CONVERGING ISSUES CHILDREN`S HEALTH ISSUES Statistics - In 1971, the average age at which children began to watch TV was 4 years; today, it is 5 months. - > 90% of kids begin watching TV before the age of 2, despite recommendations that screen time should be zero for children under 2, and limited to 1 hour for kids National data shows 15.2% of 2-5-year-olds are overweight and 6.3% are obese. - Regional data shows that 24% of children and youth use active transportation to get to and from school.

18 - Canadians of all ages are heavier, bigger-bellied, weaker and, by every conceivable measure, less fit than they were a generation ago, according to grim new data from Statistics Canada CONVERGING ISSUES CANADIAN HEALTH MEASURES SURVEY - The report on children and youth states "Children are taller, heavier, fatter and weaker than in 1981" - The Canadian Health Measures Survey released by StatsCan and the Public Health Agency of Canada involved 5,600 Canadians from ages 6 to 79. Data was collected at 15 sites across the country, including in Toronto.

19 CONVERGING ISSUES ICES ATLAS Institute for Clinical Evaluative Sciences (Neighbourhood Environments & Resources for Healthy Living- A Focus on Diabetes in Toronto) Diabetes Prevalence Rates

20 CONVERGING ISSUES PUBLIC HEALTH ISSUES AND THE BUILT ENVIRONMENT Many communities and health care facilities continue to contribute to: - A lack of diversity of land uses and full range housing options - Require increased travel time & car dependence - Increased live-work separation - Encouraged active sports facilities over full range of facilities that reflect broader society - Promoted traditional health care, treat the disease, verses the broad-based prevention strategy

21 DEFINE THE PROBLEM STREET CONNECTIVITY

22 DEFINE THE PROBLEM OPEN SPACE

23 DEFINE THE PROBLEM STREET RIGHT-OF-WAY 20m ROW and 8m setback 15.5m ROW and 3m setback

24 DEFINE THE PROBLEM GREAT STREETS - Permeable by design; - Natural traffic calmers; - Contribute to livability of a community; - Their defined hierarchy acts to identify location in communities; and, - Provide 30% of public realm.

25 DEFINE THE PROBLEM TRANSIT PERCEPTION

26 FINDING THE ANSWERS SUSTAINABLE PROGRAMS Energy Star, OBC 2012, LEED-ND, LEED-H, LEED-NC, BREEAM, Green Globes, Green Star, One Planet Living The race is on to improve built and natural environments before the damage is out of control

27 FINDING THE ANSWERS ST. MICHAEL`S HOSPITAL HEALTHY DEVELOPMENT INDEX - In response to Peel Council s direction to comment on municipal development applications and the lack of quantifiable tools in existing literature to measure health impact of built environments - The purpose of the Index- to comprehensively evaluate land development applications from a health perspective and provide health-based rationale to inform planning decisions. - Made up of two parts designed to be used in tandem the Evaluation Tool and Scorecard, the HDI would be used for evaluating proposed communities throughout all stages of the planning process.

28 FINDING THE ANSWERS REGION OF PEEL - HEALTHY BACKGROUND STUDY

29 FINDING THE ANSWERS CORNELL COMMUNITY, MARKHAM - Major new community in Markham - Based on New Urbanist principles - Compact, connected and complete; 40,000 population - Diverse Housing Range - 5 min. walk neighbourhoods - Transit service - Diverse open Space System - Cornell centre includes: Regional Hospital, BRT/LRT system, mid-high density residential, retail, office - DE plant can support 4,000,000 ft2, opens Heating/cooling/steam hospital; heating/cooling - Cornell Centre - DE is influencing Urban Design plans for Centre Area Challenge; - Approvals process - Standards constantly challenged

30 FINDING THE ANSWERS CORNELL COMMUNITY, MARKHAM

31 FINDING THE ANSWERS CORNELL COMMUNITY LEED ND EVALUATION, MARKHAM Original Master Plan Current Master Plan Transit Oriented Locations Transit Oriented Locations Distance of Uses Parks and Recreation Diversity of Uses Intersection Density

32 FINDING THE ANSWERS REGENT PARK, TORONTO - Principle: Re-introduce Parks and Open Space - Stitch together former streets - Eyes on the Street - Defensible Spaces

33 FINDING THE ANSWERS REGENT PARK, TORONTO - Principle: Re-introduce Parks and Open Space - Major urban renewal of 1950 s public housing area, 28 ha (69 ac) - 2,500 assisted living; 2,500 market based - 50% reduction of green house gas emissions - District Energy system in basement of residential tower (Phase 1) - Significant energy savings help to finance other redevelopment projects

34 FINDING THE ANSWERS WEST DON LANDS, TORONTO - Former Brownfield - 64 ha (157acs), 883 Units - Major new community in Toronto, 42 ha (104 ac) - 6,000 units (1,200 assisted living); 15,000 population - District Energy (DE) plant combined with public uses and parkland features - District Energy plant serves the entire plan area, construction to begin late Mixed use, public transit, high order public realm, starts October 09 - City owned, mandatory hook-up; LEED-ND points were a consideration - 40% energy reduction target

35 FINDING THE ANSWERS WEST DON LANDS, TORONTO - Transit Oriented Locations - Walkable Streets - Access to Uses - Parks and Recreation - Diversity of Uses - Intersection Design

36 FINDING THE ANSWERS WEST DON LANDS, TORONTO

37 CONCLUSIONS Urban Design Sustainable Design Public Health and Safety Mixed & Diverse Housing Walkable & Transit Supportive Compact / Complete Communities Great Public Places Emerging Green Technologies Financially Viable Market Acceptance Leadership/ Determination Evolution of Change