Building Healthy Communi es in Vancouver Coastal Health
Dr. Mark Lysyshyn, Medical Health Officer & Claire Gram, Policy Consultant and Healthy Built Environment Lead
Vancouver Coastal Healthy Communi es Forum Feb 19, 2016 Overview
• What determines health? • What is a healthy community? • How do you build healthy communi es? • What has been done in Vancouver Coastal Health? But why? Why is Jason in the hospital? Because he has a bad infec on in his leg. But why does he have an infec on? Because he has a cut on his leg and it got infected. But why does he have a cut on his leg? Because he was playing in the junk yard next to his apartment building and he fell on some sharp metal. But why was he playing in a junk yard? Because there are no nice parks nearby. But why does he live in that neighborhood? Because his parents can't afford a nicer place to live. But why can't his parents afford a nicer place to live? Because his Dad is unemployed and his Mom is sick. But why is his Dad unemployed? Because he doesn't have much educa on and he can't find a job. But why …? Social Determinants of Health
• The condi ons in which people are born, grow, live, work and age (including the health system)
• Shaped by the distribu on of money, power and resources at global, na onal and local levels, which are all influenced by policy choices
• Responsible for health inequi es
Inequali es and Inequi es
• Health inequali es are differences in health status or health determinants
• Health inequi es are differences that are unfair, unjust, avoidable and repairable - o en through applica on of poli cal will
Gradients and Gaps in Health Richmond
West Vancouver-Bowen Island Highest
Vancouver - Westside
Vancouver - South
Vancouver - North East
North Vancouver
Vancouver - Midtown
Howe Sound Lifeexpectancy Vancouver - City Centre
Sunshine Coast
Powell River
Vancouver - DTES Life Expectancy in VCH by Household Income (2007-2011) Income Household VCHExpectancyby Life in
Bella Coola Valley $50,000 to $80,000 greaterthan $80,000 lessthan $50,000 Central Coast Average household Average after-taxincome ($) Lowest
70.0 75.0 80.0 85.0 90.0 90.0
Life expectancy (years) at birth birth at (years) expectancy Life
2. Statistics Canada,Statistics 2. 2006 Census. Datasource:BCStatistical 1. Agency, Demographic Analysis Section, Vital Measures, February 2012. Ac ng on the Determinants of Health Aiming for Equity So How Do We Achieve Equitable Health Status for All?
• Early Childhood Development • Food Security • Built Environment • Social Connectedness • Poverty Reduc on and Income Security • Housing Op ons Planning & investment policies and prac ces OCP, infrastructure investments, zoning, development fees
Urban pa erns Density, connec vity, streetscape
Travel choices and behaviour Amount & type of walking, cycling, public transit, automobile …
Popula on health impacts Physical fitness, food choices, traffic safety, pollu on exposure, community cohesion, access to facili es
Concept by Frank et al.
Healthy Communi es Ini a ve
• Provincial program, delivered in partnership with health authori es, to s mulate local ac ons and policies to support healthy living
• Core components for healthy community ac on: • Establish partnerships • Provide health exper se and support • Develop effec ve assessment, planning and implementa on tools and resources • Build capacity • Provide opportuni es for community recogni on and celebra on
Tools and Evidence Funding Data to Support Ac on The Local Governments of VCH
Municipali es First Na ons 1. Richmond 1. N’QuatQua 2. Vancouver 2. Le’Wat 3. District of North Van 3. Samahquam 4. City of North Van 4. Ska n 5. District of West Van 5. Douglas 6. Bowen Island Mun 6. Kitasoo 7. Village of Lions Bay 7. Heiltsuk 8. Town of Gibsons 8. Nuxalk 9. District of Sechelt 9. Wuikinuxv 10. Sechelt First Na ons 10. Sechelt 11. City of Powell River 11. Lower Squamish 12. District of Squamish 12. Upper Squamish 13. Resort Mun of Whistler 13. Tsleil-Waltuth 14. Village of Pemberton 14. Musqueam Regional Districts
1. Metro Vancouver 4. Squamish Lillooet RD 2. Sunshine Coast RD 5. Central Coast RD 3. Powell River RD
VCH HEALTHY COMMUNITIES INITIATIVE The Early Days
2009 – DNV on OCP
2010 – Richmond Wellness Strategy
2011 – Healthy Families BC – Communi es Ini ated
VCH/ FH Consulta on in Whistler May 2012 VCH HEALTHY COMMUNITIES INITIATIVE Where are we now
First Signed Recently Signed In Discussions Upcoming (2010-2014) (2014-2015) (2015-2016) (2016-17)
City of Vancouver District of West Island Municipality of First Na ons & FNHA Vancouver Bowen Island
City of Richmond City of Powell River Village of Lions Bay Central Coast Regional District
City of North Vancouver Town of Gibsons Resort Municipality of Whistler
District of North Sunshine Coast Regional Village of Pemberton Vancouver District
District of Sechelt Squamish-Lillooet Regional District
District of Squamish
COLLABORATION Priority areas of Collaboration AGREEMENTS
All agreements iden fy: 1. Key contacts 2. Methods to sustain the collabora on 3. Key priority areas Healthy Built Environment Tobacco Reduc on Social Connectedness
Emerging areas of interest: • Health Impact Assessments • Health and climate change Physical Ac vity Healthy Ea ng & Food Security Road Safety Ac ve Transporta on VCH HEALTHY COMMUNITIES INITIATIVE
The broader context International & National
Interna onal: • Walk 21 (2011) • Pro Walk Pro Bike Pro Place (Sept 2016)
Na onal: • Urban Public Health Network • Healthy Canada by Design VCH HEALTHY COMMUNITIES INITIATIVE
The broader context Provincial & Regional
Provincial • BC Healthy Built Environment Alliance – • HBE Linkages toolkit • Intro to Landuse planning for Health Professionals • Founda ons • Provincial Healthy Families BC Communi es commi ee • Health Authority HBE commi ee -
Regional • Metro Vancouver • HIA Toolkit, Social Connectedness It's not enough to have a $172-billion-a-year repair shop; we need to invest in crea ng healthy popula ons
Andre Picard “What we can all learn from Nunavut” Globe and Mail Nov. 27, 2008 Ques ons?