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id you know that Richmond, British Columbia is the healthiest city in Canada? That's according to recent research published by Statistics Canada entitled The Health of Canada's Communities. So what is it that makes some communities healthier than others?

In order to study the health of Canadians at the community level, 139 health regions were grouped into "peer groups" sharing similar social and economic characteristics. It was found that those of us living in large metropolitan areas and urban centres enjoy the best health in the country. However, it's a much different story for residents living in Canada's north. High rates of smoking, obesity and heavy drinking combine to make people living in northern remote communities the least healthy of all.

In comparing communities, an important measure of Canadians' health is life expectancy. Life expectancy is defined as the number of years we can expect to live from the day we are born. The study found that life expectancy varied from region to region, from a low of 65.4 years in the Region du Nunavik, Quebec, to a high of 81.2 years in Richmond, BC. Why would there be such a difference? As shown by Jason's story below, understanding the determinants of health helps to answer this question.

As Jason's story suggests, health depends on a variety of factors. These factors interact with one another and affect individuals, communities and even our nation's health. Health is closely tied to the environment around us - where we live, work and play. The 'determinants of health' is the name given to factors which influence our health and well-being.

			Qualities of a healthy community:
			clean and safe physical environment peace, equity and social justice adequate access to food, water, shelter, income, safety, work and recreation for all adequate access to health care services opportunities for learning and skill development strong, mutually supportive relationship and networks workplaces that are supportive of individual and family well being wide participation of residents in decision-making strong local cultural and spiritual heritage diverse and vital economy> protection of the natural environment responsible use of resources to ensure long term sustainability Source: Ontario Healthy Communities Coalition

Here's a closer look at some of the determinants of health, their impact on community health and how Canada's cities measure up.

Babies with low birth weights are more likely to die early or have health problems later on. The period from age zero to five when a child's brain is developing more than at any other time in life, has a profound influence on health in adulthood. Children with good birth weight and positive parenting have a greater chance to grow up in a healthy way.

The Atlantic provinces win out as the best place in Canada to be born. Charlottetown, Halifax and St. John's were the top three cities ranked by childhood development. Each city had the lowest infant mortality rates and best birth weights in the country. Much of Charlottetown's success is attributed to Prince Edward Island's Reproductive Care Program, which helps promote proper nutrition and healthy lifestyles among expectant mothers.

There is a strong link between income and health. Low-income Canadians are more likely to die sooner and to suffer illness than Canadians with higher incomes. This holds true regardless of a person's age, gender, cultural background or place of residence. With each step up the income scale, our health improves.

Unemployment and stressful work are associated with poorer health. Canadians who are most likely to be out of work or who are not working as much as they want to include: people with low education levels, youth, Aboriginals, visible minorities, Canadians with mental or physical problems and people living in communities where industries have shut down.

Literacy not only involves our ability to read, write and calculate, but also includes the skills necessary to search for and evaluate information. People with high levels of literacy and education are more likely to live longer, have a job, earn more money and live in a safe neighbourhood.

The above socio-economic factors - income, employment and education, are powerful determinants of health. Among the 14 cities compared, Saskatoon ranks number one due to low unemployment and a higher-than-average median income. In contrast, Montreal has the highest proportion of under-educated workers. Also, the community is faced with high unemployment rates and the lowest median income.

We all know that getting regular exercise and eating a well-balanced diet promote good health. Most of us also know that smoking, drinking too much or not being active can cause illness or early death. How people choose to live their lives has an effect on community health.

Which community's citizens ranked first in having the healthiest behaviours? Health-conscious Vancouverites earned top spot in this category. The city enjoys the lowest rate of obesity with only 7.6% of residents considered to be significantly overweight. The smoking and excessive drinking rates in Vancouver are also low. Toronto also scored well with the second-lowest rate of obesity at 10.5% and a low rate of heavy drinking. In terms of smoking, 21.6% were reported to be daily or occasional smokers.

The physical environment affects how we live each day. Contaminants in the air, water, food and soil can cause a variety of health problems. For example, exposure to second-hand smoke is a major health hazard. Some 300 non-smokers die each year from lung cancer. Children are particularly vulnerable to the negative effects associated with exposure to second-hand tobacco smoke. Other environmental factors include green spaces for outdoor activities, safe workplaces and well designed transportation systems.

How did our 14 cities rate on environmental factors? St. John's scored well because it has the best air quality in the country. The city's smoking and bicycle helmet laws aimed at protecting health were also noted as positive influences.

Cities were also compared on civic literacy - a measure of how informed people are about their community and how involved they are in it. With high levels of civic literacy, communities may be better equipped to identify problems and find collective solutions. Measures in this category include newspaper readership and voter turnout rates. Residents of Charlottetown took first place with the highest percentage of newspaper readers and the highest voter turnout in provincial and municipal elections.

Source: National Post. "Healthy Cities Project", January 2003.

Healthy environments make for healthy communities. As individuals, there are simple steps that we can take to protect our environment. Make it a habit to practice the 3 Rs - reduce, reuse and recycle. For practical suggestions on what more you can do, check out Environment Canada's Down to Earth Choices: Tips for Making Where You Live One of Canada's Healthy Neighbourhoods.

Are you interested in starting a Healthy Communities project? If so, it is important to become familiar with your community - its resources, needs, issues, power structure and decision-making processes. A healthy community process involves:

• meeting with people who are interested in working together
• identifying emerging community issues and activities to address them
• developing a vision of the community's preferred future
• preparing an action plan
• starting with a project that is likely to succeed
• establishing a healthy communities network
• monitoring the results and impact of your work

For more information on how to make a difference in your community, see From the Ground Up: An Organizing Handbook for Healthy Communities.

Canadian Public Health Association. "Building a Healthy Future" 1999.

Health Canada. "Toward a Healthy Future: Second Report on the Health of Canadians" 1999.

Statistics Canada. "Health indicators" (semi-annual)

Statistics Canada. "How Healthy are Canadians?" 2005.

Statistics Canada. "The Canadian Community Health Survey (CCHS) - Cycle 1.1" 2002.