Canadian Health Network

Send this to a friend Print-friendly version Past Articles Subscribe to our Healthlink newsletter

Doctor, my child has too many asthma attacks.
Take public transit twice a day, morning and night.

Doctor, I can't swim in the lake anymore.
Disconnect your gutter from the sewer and stop pouring everything down your sink.

Doctor, our small businesses are dying one after another.
Preserve your downtown architectural heritage.

Doctor, people in my neighbourhood don't talk to each other anymore.
Plant the idea of a community garden in your neighbours' minds.

Surprised by these ideas from the city's medicine cabinet? They are based on a very simple principle: environmental health and human health are flip sides of the same coin. Environmental health involves not only the physical environment but also the social and economic environment. Similarly, the World Health Organization (WHO) definition of health goes beyond our physical well being to encompass our mental and social health as well.

Clean air and safe drinking water are two concrete examples that illustrate the intimate relationship between health and the environment. But let's imagine the health of a small town where the main employer-- a factory or a mine closes down. An economic crisis can paralyze a town just as a heart attack can strike down a human being. Local businesses close. The resulting economic breakdown leads to community, family or social breakdown --even to psychological breakdown and depression at the individual level.

Conversely, this same local industry could be a major polluter that causes residents to have health problems, forcing them to take sick leave and see a doctor. This industry will place an extra burden on the health system and on taxpayers. Those who are able, may decide to escape to cleaner, safer environments. Eventually, the factory might have to stem the flow of its human resources.

This is what it takes for cities to be sustainable: a prosperous economic environment, a clean, natural environment and an equitable social environment.

Three dimensional urban health

Our physical, social and economic environments interact continuously to determine the quality of our urban life. Urban health is none other than a three dimensional quality of life: the result of a wholesome natural environment, a prosperous economic environment and an equitable social environment (see diagram opposite).

To successfully create, maintain, improve, and sustain physical, social and economic urban health, the Healthy Cities model (see sidebar below) offers a working procedure for urban health. Practically speaking, many large and small initiatives are underway throughout this country to improve the quality of urban life. Some are listed in the Réseau québécois de villes et villages en santé (RQVVS), the Ontario Healthy Communities Coalition (OHCC) or the Mouvement acadien des communautés en santé du Nouveau-Brunswick.

6 case studies in urban health

In Rouyn-Noranda, one of the first cities to have participated in RQVVS back in 1987, a downtown redevelopment project made it possible to build relations between the city and a major polluter- a local mine. Together, they helped convert an old vacant lot into a botanical garden. The city provided the lot, and the mine trucked in soil. Louis Poirier, coordinator of the RQVVS network says that collaboration at the community level opened the door to dialogue on local environmental pollution. "If they had not started by collaborating on this small project, we would never have got to the point of reducing pollution from the mine."

In Toronto, urban smog causes 1000 premature deaths and costs a billion dollars to the province every year, according to the Ontario Medical Association. Outside air quality can trigger asthma attacks and particularly affects children and elderly. For Monica Campbell of the City of Toronto Public Health Department, she believes that "certainly in terms of solutions, one of the major thrusts of a healthy model would be to ensure that we have good public transit infrastructure operating in the city and that funding and business decisions give much greater viability and
emphasis to things like public transit."

In Montreal, new carports on the outskirts of the city near bus and subway lines have led to a significant increase in public transit.

In Calgary, the tramway rapid transit system known as the C-Train, is powered by electricity produced by windmills in Southern Alberta. This makes it possible to further reduce air pollution from hydrocarbon or coal-burning steam plants.

In Halifax, the city has banned the spraying of pesticides on private property. This prevents chemicals from passing through the ground to the groundwater. Some insecticides, particularly those designed to destroy insects' nervous systems, are harmful and can cause miscarriages in pregnant women.

In Saint John, a municipal policy to protect downtown architecture has resulted in increased tourism, especially from cruise ships. It's a bit like Gastown in Vancouver" confirms Jim Bezanson, in charge of heritage development for the city of Saint John. "The city provides a grant for 20% of renovation costs up to $5,000, which costs us between $50,000-$100,000 per year. Residents are coming back so they can get to work on foot. For 6 years, no cruise ships docked here. In 2000, over 80 ships came to Saint John."

These few examples provide just a glimpse of the many different ways to improve urban health. Whether or not they are officially part of the Healthy Cities model, these initiatives all have one thing in common: they approach the issue of health globally, on a three dimensional basis and attempt to create an environment that will make it possible to stay healthier.

An emphasis on healthy cities may also ensure a healthy bank balance for governments. In this time of belt-tightening and health care reorganization, the so-called "urban health dividend" makes economic sense. In Ontario's case, for example, investing in smog prevention could save one billion dollars a year in health care costs.

When we protect Canada's physical, social and economic urban health, we protect the health of 80% of Canadians. Although the stakes are high, the solutions have never been more exciting.