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Direction de santé publique Urban environment and health Perspectives in Montreal: Examples in transportation, physical activity and food security Lise.

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Présentation au sujet: "Direction de santé publique Urban environment and health Perspectives in Montreal: Examples in transportation, physical activity and food security Lise."— Transcription de la présentation:

1 Direction de santé publique Urban environment and health Perspectives in Montreal: Examples in transportation, physical activity and food security Lise Bertrand, Anne Pelletier and François Thérien McGill Institute of Health and social policy, April 14, 2010

2 Mandate of the Montréal Public Health Department Inform the population on such issues as their state of health, priority health problems, vulnerable groups, risk factors and efficient interventions Follow the evolution of the publics health and conduct appropriate research Ensure that the required preventive measures are adopted by the appropriate authorities

3 Objective of the presentation To illustrate how the Montréal Public Health Department is working to improve the health of the Montréal population by acting on the built environment

4 The built environment: a definition 1.Land use (spatial distribution of functions and uses) 2.Design of buildings and public places 3.The transportation system: infrastructures, equipment, rolling stock, policies and service provision Source: Handy, Boarnet, Ewing and Killingsworth, 2002

5 Vision of the urban environment and health sector Montréal is a city where Indoor and outdoor air are of good quality Housing is accessible, affordable, adapted, healthy and safe and takes into account the needs of the vulnerable population Urban planning promotes safe active transportation and promotes mixity of functions and accessibility to local services Public transit allows for less dependence on the automobile and is accessible for all Green spaces are available for all Healthy food is accessible within walking distance of homes

6 Food environment, food security Why are we interested in food system ?

7 Inequalities in the food environment inequalities in health Food access in neighborhood : proximity and types of stores, diversity and quality of foods available, cost… « Food Deserts » ! ! ! ? ? ? Environmental issues – use of car for food shopping, proximity of services, proximity of production sites

8 Are there inequalities in access to healthy foods in Montreal? Source: Bertrand and coll., 2007


10 CSSS St-Léonard et Saint-Michel (Source: Bertrand and coll., 2007) Fruit and vegetable selling areas within a walking distance of 500 m ( DSP 2006) En pieds carrés

11 Actions sur la sécurité alimentaire et lapproche de développement durable à léchelle des quartiers Vitalité économique Diversifier les commerces de proximité; Revitaliser le secteur économique des quartiers; Soutenir les producteurs locaux; Faciliter lachat daliments à coût raisonnable Équité Favoriser laccès pour tous à des aliments santé de coût raisonnable; Assurer laccès aux ressources conférant des connaissances et des habiletés (jardins collectifs, cuisines collectives…); Développer la solidarité sociale. Influencer les politiques Convivialité Aménager des espaces publics, des marchés publics; Mettre en place des mécanismes de participation citoyenne; Organiser des événements de promotion des aliments du quartier. Qualité de vie Réduire la circulation motorisée; Promouvoir la préservation de la qualité des sols; Promouvoir lutilisation responsable de leau; Aménager des espaces verts, des jardins collectis; Promouvoir lachat daliments transportés sur de courtes distances; Promouvoir la consommation daliments non transformés; Implanter des stratégies de réduction des emballages. Milieu de vie Aménager des pistes cyclables, des voies piétonnières; Aménager des espaces verts, des jardins collectifs; Embellir des rues commerciales. Économie Environnement D U R A B L E Social Septembre 2007 - Direction de santé publique – Agence de la santé et des services sociaux de Montréal

12 Our actions Community mobilisation 17 local projects financed by Montréal Public Health involving multiple partners (NGOs, local health and social services centers, local municipalities, food producers…) aimed at making healthy food accessible within 500 m of walking distance from the home Research : access to healthy foods; food consumption; practices and concerns among poor families Support Nourrir Montréal, a regional assembly

13 Jardin Guybourg, Mercier-Ouest

14 Urban transportation: a question of health

15 Trends in trips: a 20-year evolution on the territory of AMT (1987 boundaries, am peak) 19872008Δ By car865 0001 203 00039% By public transit 395 000427 0008% Population2 910 0003 464 00019% (0.8% p.a.) Nb of cars1 204 7001 789 90049% (1.9% p.a.) Source : Enquête O-D 2008, Faits saillants

16 Health impacts Diseases related to air pollution Injuries and death caused by road accidents Diseases related to physical inactivity All these impacts essentially related to traffic volume (VKT)


18 The presence of air pollutants varies according to traffic volume Source: Smargiassi and coll., 2005

19 Hospitalization for respiratory problems in people aged 60 years and older Traffic category Number of cases (%) Number of controls (%) RR (IC95%) RR adjusted for SES (IC95%) <3160 vehicles 5 322 (91,7%) 36 725 (93,5%) 1.00 3160-7700 vehicles 345 (5,9%) 1 922 (4,9%) 1.24 (1.10-1.39) p<0.001 1.07 (0.95-1.20) p=0.28 >7700 vehicles 138 (2,4%) 613 (1,6%) 1.55 (1.29-1.87) p<0.001 1.30 (1.07-1.57) p=0.007 Source: Smargiassi and coll., 2006

20 The number of road injuries varies directly with traffic volume Source : P Morency, MS Cloutier, Urgences-santé 1999-2003; C. Morency. Enquête O-D 1998.

21 Pedestrians are injured at thousands of different sites! 1999-2003 : 5 082 ambulance calls Source: Morency and Cloutier, 2005

22 Strategies advocated towards sustainable transportation Reduce the number of vehicle-kilometers travelled Increase the number of trips by public and active transportation Reduce the speed of vehicles Design walkable neighbourhoods Improve mobility for all

23 Recent examples of advocacy Participation in public hearings and debates Transportation projects Notre-Dame hybrid boulevard/expressway Turcot A-25 Montréal transportation plan Road safety code Urban planning CHUM, U de M campus in Outremont Griffintown development project

24 Active transportation

25 Walking in Montréal 35% of trips shorter than 2 km are made walking Almost all (96%) walking trips are shorter than 2 km 40% to 50% of peak hour travel are walking trips in Montréal central area. It goes down to 20% in peripheral areas Enquête Origine Destination 2003

26 Walkings decrease Between1998 and 2003, proportion of 6 to 12 year old students walking to go to school went from 45% to 34% in Montréal (Enquête OD, 1998 et 2003) During the same period, car trips to school increased from 17% to 32% (Enquête OD, 1998 et 2003)

27 Biking 32,5% of the 12 to 17 year old use bike as a transportation mode at least 1h a week (Kino-Québec 2005) Use of bike decreases to 6,9% among people 18 years and over(Kino-Québec 2005) During peak hour, cycling can be more effective than a car trip for distance up to 8 km (Demers 2006)

28 Public health involvement to increase active transportation Support community projects: Aménager des quartiers durable Quartier 21 Research: Walkability audit Promotion and education: Allego Kino-Quebec campaigns and program

29 Support local communities Aménagez des quartiers durables: Financial support for eight RUI of Montreal Information and educational background Example of Mercier Est Quartier 21 Financial support joint with city of Montreal Information and education background Tools Example of Peter McGill

30 Walkbility audit method Objective grid use to characterize the urban planning and the structure of a neighbourhood (based on the evaluators judgement) Originally conceived for research purpose and advocacy groups Allow to collect qualitative as well as quantitative data

31 Research Goal: Create a tool simple enough to be used by communities and complete enough to have a comprehensive picture of the field studied. Exploratory phase during summer and fall 2008 in three RUI of Montréal Second research phase upcoming this summer integrated to a Canada-wide evaluation project

32 Thank you!

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