Surveillance of the Utilitarian Walking of Canadians Using Geographic Information Systems and Survey Data
The rise of obesity and sedentary behaviour in Canada is associated with increases in cases of associated chronic diseases, such as diabetes, cardiovascular diseases, and some cancers. There is increasing evidence that neighbourhood environments in Canada may either encourage or inhibit physical activity, which also makes built features of neighbourhoods a prime target for the prevention of related chronic diseases. In neighbourhoods that are more ‘walkable’ (e.g., well-connected streets, proximity to services, presence of public transit), Canadians are more likely to walk more for utilitarian purposes (e.g., walking to work, school, or for shopping) and less likely to develop conditions such as diabetes or cardiovascular disease. The goal of our project is to refine existing research and develop new tools for measuring walkability features that influence population health. To this end, we are developing a database of Geographic Information Systems (GIS)-based walkability measures for all neighbourhoods in Canada. We will link these GIS measures of walkability with often under-used national health surveys (e.g., National Population Health Survey, Canadian Community Health Survey, Canadian Health Measures Survey) to better understand the local environment’s influence on population health and rates of walking. Using this data linkage and virtual audits of neighbourhoods through Google Streetview®, we will develop novel measures of health-related features of neighbourhoods in Canada. The database and surveillance tools will be disseminated to the Canadian research community, Statistics Canada, the Public Health Agency of Canada and the Canadian Federation of Municipalities. Funded by a grant from the Public Health Agency of Canada.
Does Neighbourhood Food Environment Amplify Canadian Social Inequalities in Diet, Health and Food Insecurity?
Obesity and type 2 diabetes are profoundly socially patterned in Canada, with excess risks and disease burden for lower income Canadians and those with lower educational attainment. The food environment that one is routinely exposed to may have a bearing on the consumption of calorie-dense, but nutritionally poor, ready-made food that may put individuals at risk for poor diet, overweight and obesity, and chronic disease. Less favourable food environments can mean living in a ‘swamp’ of unhealthy, already prepared, easily accessible, calorie-dense food, or a ‘desert’ devoid of healthy options. The overarching hypothesis of this proposed project is that the food environment can amplify social gradients in diet, health outcomes, and food insecurity. We plan to study this by assessing the retail food environment in the neighbourhoods around respondents who participated in the 2015 Canadian Community Health Survey (CCHS) using GIS. The CCHS focused on nutrition and provides researchers with detailed 24-hour dietary recall information. This will allow us to assess whether or not individuals ate at fast food restaurants the day before the interview, how many calories were consumed and some detailed macro-nutrient information about the food consumed. We will be able to see, in a large population sample, whether these consumption patterns are linked to socioeconomic status, and determine whether unfavourable food environments – swamps and deserts – amplify social gradients in diet as well as health outcomes like obesity and type 2 diabetes and food insecurity. Funded by CIHR Operating Grant: Canadian Community Health Survey – Nutrition Analysis
Urban Policy Prescriptions to Increase Walking: Learning From Highly Walkable Neighbourhoods
Jurisdictions world-wide are struggling to find policy responses to rising rates of obesity and obesity-related chronic disease. Walking is a reasonably simple activity and the evidence that higher walking levels lead to substantial reductions in obesity-related chronic disease (e.g., type 2 diabetes, cardiovascular disease) is compelling. Evidence indicates that characteristics of neighbourhood environments such as well-connected streets, a variety of services, and access to public transport may increase the ‘walkability’ of places and, potentially, walking in people. The objective of this research is to identify the characteristics of neighbourhood environments in Montreal and Toronto that promote physical activity, social integration, and health in the general population. To achieve this objective, we will launch a social survey in selected urban postal codes stratified by high walkability/high walking, high walkability/low walking, low walkability/high walking and low walkability/low walking. We will also develop new ways of assessing the built environment using Google Streetview® environmental auditing. Virtual neighbourhood audits that allow for detailed surveillance of environmental features relevant for walking such as such as the presence and condition of benches, sidewalks, trees, crossing signals, walking paths, and cues of social disorganization or crime (e.g., graffiti). Funded by the Trottier Fellowship in Science and Public Policy.
Using population data linkage to study international trends for walkability and health
Given intensified urbanization worldwide, the time is right for an international evaluation of walkability as a potential mitigating factor for chronic conditions and subsequent health care burden. A small body of international research exists that provides evidence for a universally positive impact of the built environment on physical activity. However, owing to a lack of comparable environmental measures, as well as cross-country variation in health outcome variables, little work has been done to compare the impact of walkability on hospitalization in different policy environments and health care systems, and how these systems might interact with a wider range of neighborhoods to affect our health. International data linkage efforts, parallel to Canadian initiatives, offer the opportunity to study the population-wide health impacts walkability. Presently, we are maximizing our use of pre-existing administrative geocoded data from Canada, Wales, and Australia to assess walkability’s potential to be a population health intervention in a variety of social, political, and geographic settings. Funded by the Canada Research Chairs Program.