Building the Capacity of Health Authorities to Influence Land Use and Transportation Planning: Lessons Learned from the Healthy Canada by Design CLASP Project in British Columbia

By Miro, Alice; Perrotta, Kim et al. | Canadian Journal of Public Health, January 1, 2015 | Go to article overview

Building the Capacity of Health Authorities to Influence Land Use and Transportation Planning: Lessons Learned from the Healthy Canada by Design CLASP Project in British Columbia


Miro, Alice, Perrotta, Kim, Evans, Heather, Kishchuk, Natalie A., Gram, Claire, Stanwick, Richard S., Swinkels, Helena M., Canadian Journal of Public Health


A large body of research has identified significant associations between the built environment, which is the physical layout and infrastructure of a community, and health variables, such as physical activity,1 *"4 food choices, traffic-related injuries and mental health.5 Accordingly, several health organizations have identified the built environment as an important determinant of health.6-10

A community's built environment is the result of multiple decisions regarding land use and transportation planning and policy, operationalized over the course of many years at various levels of government. Community planning policies and decisions can be influenced by a complex and sizeable array of stakeholders outside of public health, including developers, local residents and businesses, non-governmental organizations (NGOs) and community organizations.11 * *"14 Accordingly, as with many other social determinants of health, aligning built environment policies, practices and decisions with healthpromotion objectives requires collaboration across sectors.15

Intersectoral collaboration between public health and community planners on the built environment is a relatively new phenomenon. In Canada, a substantial level of intersectoral work has been initiated in Ontario over the last decade in response to two provincial policies: the 2005 Provincial Policy Statement, which provides direction on matters of provincial interest related to land use planning and development, including a number of policies connected with the creation of healthy, livable and/or active communities; and the 2008 Ontario Public Health Standards, guidelines for the programs and services that are mandated for public health by the Ontario Ministry of Health and Long-term Care; these include built environment work under both the Chronic Diseases and Injuries Program Standards and the Environmental Health Program Standards.16

A 2011 descriptive case study documents the strategies employed by 10 of the 36 public health authorities in Ontario to bring health considerations related to physical activity, injury prevention, healthy eating, air quality, water quality and climate change into the land use and transportation planning processes in their communities. While this report makes no attempt to assess the effectiveness of these strategies, the policies and practices documented suggest that public health is effectively forging relationships with its planning counterparts, engaging in the land use and transportation planning processes, and bringing health considerations into the policies and plans in those communities.16

In New South Wales, Australia, where the health sector has been engaging in land use planning processes with the goal of creating urban environments that are more sustainable and equitable, researchers conducted a post-implementation study to evaluate the effectiveness of this approach. An audit was conducted of all correspondence between Sydney South West Area Health Services and local government and other organizations between 2005 and 2010 on issues related to land use planning documents. The researchers found that 75% of the recommendations offered by the health authority during this period were included in 77% of the revised land use planning documents, suggesting that the health sector can effectively influence land use planning processes.17

In British Columbia ( BC), public health leadership and stewardship are provided mainly by the Ministry of Health, by a provincial health authority and by five regional health authorities. In 2013, an additional health authority was established, namely the First Nations Health Authority, which runs the delivery of First Nations health programs and services. The five regional health authorities report to the Ministry of Health and are independent of local governments. Their mandate spans public health, home health and acute care, which is their primary focus.

On a parallel track, BC municipalities and regional districts have a significant degree of autonomy in making land use and transportation decisions, as well as negotiating and approving land development applications in their jurisdiction. …

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