Results from "A scoping review on the relations between urban form and health: a focus on Canadian quantitative evidence".
McCormack, G.R., Cabaj, J., Orpana, H., Blackstaffe, A., Goopy, S., Hagel, B., Keough, N., Martinson, R., Chapman, J., Lee, C., Tang, J., Fabreau, G., & Lukic, R.
Why create health supportive environments?
The World Health Organization’s 1986 Ottawa Charter for Health Promotion has acknowledged the need to create health supportive environments to reduce chronic disease risk and promote health and wellbeing (1). In Canada, approximately 34% of adults report having at least one of the five major chronic diseases (i.e., cancer, cardiovascular diseases, diabetes, chronic respiratory diseases, and mood/anxiety disorders) (2). Canada’s rapid geographic expansion has lead to increased distances between homes and destinations of interest, lower city and neighbourhood population densities, disconnected street patterns, and scattered suburban developments (3). Present day urban planning strategies have been linked to an increased risk of chronic disease due to the negative effect they have on physical activity levels through an increased dependence on cars and reduced levels of transportation walking and cycling.
The relationship between urban form and health in Canada
Findings from research on the built environment and health do not tend to focus on one specific country and are weighted towards the United States and European studies. Canada has a unique culture, political and health-care system, and therefore, requires evidence that is specific to the Canadian context. Thus, a scoping review was conducted to synthesize and map evidence from quantitative studies that have investigated the built environment and its associations with modifiable health conditions, self-reported health, quality of life, and injuries in the Canadian adult population.
Of the fifty-five included articles, majority took place in Ontario, Quebec and Alberta. The built environment was found to be associated with 11 broad health outcomes including injury, weight status, cardiovascular disease, depression/anxiety, diabetes, mortality, self-rated health, chronic conditions, metabolic conditions quality of life, and cancer. Consistent evidence was found for the association between walkability indicators and diabetes and weight, as well as between connectivity and route features (e.g., transportation route, trails, pathways, sidewalks, street pattern intersections, route characteristics) and injury. Greenspace, parks and recreation features were linked to multiple health outcomes.
A public health opportunity
Land use patterns, urban design characteristics, and transportation systems were found to be important correlates of chronic health conditions and injury in the Canadian context. Health promotion strategies directed towards creating urban environments that support health and wellbeing could mitigate the risk associated with the rapid geographic expansion of metropolitan areas.
Suggested Citation: McCormack, G.R., Cabaj, J., Orpana, H., Lukic, R., Blackstaffe, A., Goopy, S., Hagel, B., Keough, N., Martinson, R., Chapman, J., Lee, C., Tang, J., Fabreau, G. (2019). A scoping review on the relations between urban form and health: a focus on Canadian quantitative evidence. Health Promotion and Chronic Disease Prevention in Canada, 39(5), 19-32.
Written by Dalia Ghoneim, MPH, CSEP-CEP; Posted on 29/03/2019.
(1) World Health organization. The Ottawa Charter for health promotion. Health Promotion International. 1986;1:3-5.
(2) CCDI Steering Committee. The 2017 Canadian Chronic Disease Indicators. Health Promot Chronic Dis Pev Can. 2017;37(8):248-51.
(3) Frumkin H, Frank L, Jackson R. Urban sprawl and public health. Designing, planning, and building for health communities. Washington (USA): Island Press; 2004.