Building Healthy Communies in Coastal Health

Dr. Mark Lysyshyn, Medical Health Officer & Claire Gram, Policy Consultant and Healthy Built Environment Lead

Vancouver Coastal Healthy Communies Forum Feb 19, 2016 Overview

• What determines health? • What is a healthy community? • How do you build healthy communies? • What has been done in Vancouver Coastal Health? But why? Why is Jason in the hospital? Because he has a bad infecon in his leg. But why does he have an infecon? 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 educaon and he can't find a job. But why …? Social Determinants of Health

• The condions in which people are born, grow, live, work and age (including the health system)

• Shaped by the distribuon of money, power and resources at global, naonal and local levels, which are all influenced by policy choices

• Responsible for health inequies

Inequalies and Inequies

• Health inequalies are differences in health status or health determinants

• Health inequies are differences that are unfair, unjust, avoidable and repairable - oen through applicaon of polical 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. Acng 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 Reducon and Income Security • Housing Opons Planning & investment policies and pracces OCP, infrastructure investments, zoning, development fees

Urban paerns Density, connecvity, streetscape

Travel choices and behaviour Amount & type of walking, cycling, public transit, automobile …

Populaon health impacts Physical fitness, food choices, traffic safety, polluon exposure, community cohesion, access to facilies

Concept by Frank et al.

Healthy Communies Iniave

• Provincial program, delivered in partnership with health authories, to smulate local acons and policies to support healthy living

• Core components for healthy community acon: • Establish partnerships • Provide health experse and support • Develop effecve assessment, planning and implementaon tools and resources • Build capacity • Provide opportunies for community recognion and celebraon

Tools and Evidence Funding Data to Support Acon The Local Governments of VCH

Municipalies First Naons 1. Richmond 1. N’QuatQua 2. Vancouver 2. Le’Wat 3. District of North Van 3. Samahquam 4. City of North Van 4. Skan 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 Naons 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 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 – Communies Iniated

VCH/ FH Consultaon 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 Naons & 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 idenfy: 1. Key contacts 2. Methods to sustain the collaboraon 3. Key priority areas Healthy Built Environment Tobacco Reducon Social Connectedness

Emerging areas of interest: • Health Impact Assessments • Health and climate change Physical Acvity Healthy Eang & Food Security Road Safety Acve Transportaon VCH HEALTHY COMMUNITIES INITIATIVE

The broader context International & National

Internaonal: • Walk 21 (2011) • Pro Walk Pro Bike Pro Place (Sept 2016)

Naonal: • 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 • Foundaons • Provincial Healthy Families BC Communies commiee • Health Authority HBE commiee -

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 creang healthy populaons

Andre Picard “What we can all learn from Nunavut” Globe and Mail Nov. 27, 2008 Quesons?