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21 feb 2021 · Kathan Gandevikar Personal Information. Date of Birth: 01 05 1998 Nationality: Indian Languages: English, Hindi, Marathi, Gujarati. Online portfolio available here. Contact. Phone: +91 9426159806 ...
Masterplan - Mrunmayi Pandit The sensorial hub will encourage community involvement in achieving the goal of effective planning. It will create a place for the stimulation of the senses through green spaces. It will also provide a platform for self-created employment opportunities and sell them.
- A message from Canada's Chief Public Health Officer
- Table of Contents
- Acknowledgements
- Key messages
- Section 1: What this report is about
- Section 2: Canadian communities
- Section 3: Building blocks for healthy living
- Section 4: Design features for specific populations
- Children and Youth
- Older adults
Without being aware of it, our neighbourhoods and how they are built influence how healthy we are.
I chose designing healthy living as the topic for my first report as Canada’s Chief Public Health Officer because of the tremendous potential that changing our built environment has for helping Canadians live healthier lives.
Chronic diseases like diabetes, cancer and cardiovascular disease are the leading causes of death in Canada. It is alarming that in 2011, almost 2.7 million or 1 in 10 Canadians 20 years and older were living with diabetes. Rising rates of type II diabetes can be considered a red flag for poor health as they are associated with higher rates of other diseases and conditions and linked to an unhealthy diet, low physical activity and higher rates of overweight and obesity. Rates of type II diabetes and other chronic diseases in Canada could be reduced by seamlessly integrating healthy living into our daily lives which can be achieved, in part, by designing and redesigning our communities.
Improving public health and preventing disease through changes to our environment is a well-founded concept. For example, infectious disease rates in the last century were reduced not just through scientific innovation and vaccination, but also through infrastructure planning by improving sanitation and addressing overcrowding in residential neighbourhoods.
This report answers many questions but also raises several others. We need better information if we are to measure the health impacts of community design to incorporate evidence-based strategies into community planning. This report will raise awareness among Canadians about the unique aspects of their communities that they could take advantage of to improve their health. It will also encourage more dialogue across the many disciplines involved in community planning and health promotion so that neighbourhood design considers and promotes physical activity, healthy diets and mental wellness.
Dr. Theresa Tam
•Acknowledgements
•Key messages
•Section 1: What this report is about
•Section 2: Canadian communities
•Section 3: Building blocks for healthy living
•3A: Active neighbourhoods
Many individuals and organizations have contributed to the development of The Chief Public Health Officer's Report on the State of Public Health in Canada, 2017: Designing Healthy Living.
I would like to express my appreciation to the consultants who provided invaluable expert advice:
•Dr. Cory Neudorf, Chief Medical Health Officer, Saskatoon Health Region, University of Saskatchewan
•Dr. David Mowat, Canadian Partnership Against Cancer
•Dr. Daryl Pullman, Memorial University
•Dr. Elizabeth Saewyc, University of British Columbia
This Report raises awareness about how our built environment provides a foundation for healthy living and ultimately our health.
It is possible to improve or worsen the health of populations by changing our physical world. Conditions and chronic diseases linked to unhealthy living are increasing in Canada. For example, over 7.8 million Canadians 18 years and older were living with obesity in 2015, which is more than a quarter of this population. Obesity increases the risk for premature death and chronic diseases, such as cardiovascular disease, cancer and diabetes.
The relationship between the built environment, healthy living, people’s behaviour and health status is complex. Even so, cities and communities can be designed and built to set people up for success so that healthy choices are the easier choices.
The majority of Canadians – about 80% – live in urban or suburban areas. While there are trends, the health of a population varies within the same geographic area. The rise of urban sprawl is a concern as it has been linked to sedentary lifestyles, easy access to unhealthy food, more time spent driving, less physical activity and higher rates of obesity.
While we know that changing the built environment can be a cost-effective way to increase physical activity, less is known about how to improve healthy diets and mental wellness through neighbourhood design as these are newer fields of study.
Improving the opportunity to cycle, walk or take public transit to work or school by changing the built environment is a growing area of research. Changing the built environment could significantly influence people’s daily physical activity. Community design features, such as connected streets, a mix of residential, commercial, educational and employment areas, bike paths, and good public transit can support being active to get to work or other places; whereas green spaces, waterways, walking paths, trails and recreation facilities can promote recreational physical activity.
This Report raises awareness about how our built environment provides a foundation for healthy living and ultimately our health.
It is possible to improve or worsen the health of populations by changing our physical world. The percentage of Canadians who report they are obese, living with diabetes, or a mood disorder has been increasing in Canada.Footnote 11,Footnote 12 These health issues have a serious impact on quality of life and are linked to some of the leading causes of death, including cancer, cardiovascular disease and respiratory disease.Footnote 13
Lifestyle factors, such as a lack of physical activity, sedentary behaviour, poor diet and lack of social connection can increase the risk for poor health outcomes.Footnote 14-18 For example, evidence suggests that about 30% of cancers can be prevented by adopting a healthy lifestyle.Footnote 19 While healthy behaviour is shaped by many forces, these lifestyle factors are all influenced by our built environment.
What is the built environment? For the purposes of this report, the built environment is defined as the external physical environment where we live, work, study and play. It includes buildings, roads, public transit systems, parks, and other types of infrastructure. It is linked to how we design, plan and build our communities.Footnote 20
This report focusses on the built environment and healthy living in terms of physical activity, healthy diets and mental wellness (including social connectedness). Although this report addresses these topics separately, it is recognized that they interact and influence health together. For example, a healthy diet and physical activity can lead to weight loss and reduced risk for obesity separately, but are more effective in combination.Footnote 21
There are many other ways that the built environment can impact health including through its role in air pollution, safety (e.g., injuries), housing, heat, UV exposure, climate change and natural disasters.
This section provides a snapshot of broad factors that differ across Canada and that also relate to the built environment.
While the majority of Canadians, about 80%, live in urban areas, Canada’s considerable geographic expanse creates communities with unique characteristics and needs. This diversity and how it is changing are important to consider when thinking about the built environment and its impacts on health.
3A: Active neighbourhoods
This section explores research on how we can build active communities to improve health. The majority of Canadians do not get enough exercise.Footnote 115 Being physically active is an essential component to good health, yet Canadians are generally not active enough to gain optimal health benefits. How can we increase physical activity? Building communities that make being active an easy choice is an important step. Figure 3 shows how the complexity of neighbourhood features is likely linked to better health by increasing physical activity. Figure 3: Overview of how the built environment influences physical activity to influence health. (adapted fromFootnote 72)
Physical activity and health
Globally, physical inactivity is thought to cause 6% to 10% of non-communicable diseases.Footnote 117 At least 30 minutes of moderate physical activity a day can decrease the risk of premature death by at least 19%.Footnote 118 Being physically active is strongly linked toFootnote 119-145 Better muscle strength, cardiovascular function and mental health. Healthy development in children and youth. Healthy aging. Reduced risk for premature death, even with a small increase in physical activity. Reduced risk of diseases and conditions such as obesity, heart disease, some types of cancer, diabetes, dementia, osteoporosis, and cardiovascular issues. Better health in people who are living with various diseases and conditions (e.g., cancer, diabetes, mood disorders). Did you know? In 2013, only 10% of Canadian children and youth and 20% of Canadian adults met the Canadian Physical Activity Guidelines when their activity levels were measured via accelerometers.Footnote 115 The Guidelines recommend that: Toddlers should do at least three hours of physical activity over each day of any intensity. Children and youth should do: At least one hour a day of moderate to vigorous aerobic activity. Muscle and bone strengthening exercise at least three times a week. Several hours of light activity per day. Adults should do: At least 150 minutes of moderate to vigorous aerobic activity per week. Muscle and bone strengthening exercise at least twice a week. These are recommended levels; however, people can still achieve health benefits from lower levels of activity. Health benefits of increasing activity may be greatest for those who are inactive.Footnote 116
Building neighbourhoods that promote physical activity
Neighbourhoods can be designed to promote utilitarian (activity to get somewhere or do something), recreational (activity during leisure time) physical activity or both. Both types of activity can be important contributors for meeting physical activity guidelines and are linked to similar and different types of neighbourhood features. At a population level, efforts have focused on harnessing the built environment to build communities that encourage active transportation in the forms of walking, cycling and using public transit, as well as recreational physical activity. In some situations, the relationship between the built environment and physical activity has been linked to better health, such as lower body mass index and body fat; improved cardiovascular disease risk factors; lower risk for cancer; lower risk for premature death from all causes; better mental health; and a stronger sense of community belonging.Footnote 146-168 Encouraging active transportation: Walking and cycling are common forms of physical activity and active transportation Walking is popular and considered to be a great way to be physically active for all ages. It is often a better choice in busy, dense areas.Footnote 169-170 Cycling is an efficient way of being moderately to vigorously active and allows people to travel farther distances than walking. It often has less infrastructure to support it than has walking.Footnote 169,Footnote 177 What is active transportation? Active transportation is the use of human powered transportation to get places. Examples include biking or walking to work.Footnote 171 Public transit is also a form of active transportation as people walk to access public transit or to their destination at the end of their trip.Footnote 172-176 Active transportation can contribute to people’s daily physical activity.Footnote 178 Not many people currently use active transportation.Footnote 167 At a population level, active transportation has good potential to increase people’s activity levels and improve their health.Footnote 168 It is one way to Address people’s lack of time to be physically active. Reduce the amount of time Canadians spend driving. Help people reach recommended levels of physical activity. The built environment can play an important role in active transportation. Generally, areas with higher population density, a mix of residential, commercial, educational and employment areas, connected streets, good access to destinations, good public transit and attractiveness have been linked to more active transportation or reduced driving, although the strength of this link is unclear.Footnote 179-187 In Canada, active transportation has been linked to havingFootnote 179,Footnote 188,Footnote 189-192 A public transit stop nearby. A choice of destinations within a reasonable distance. Well-maintained sidewalks. Dedicated areas for cycling. Affordable recreation facilities. Safe traffic. For cycling, examples of features that have been linked to active transportation include bike paths close to where people live; bike paths that provide access to a variety of destinations in a short distance; good connections between roads and routes; safe cycling routes; safe places to park bikes, including near railway or bus stations; available short-term bike rentals; signals and traffic lights for cyclists; and routes with fewer hills and safer traffic. Footnote 49,Footnote 169,Footnote 177,Footnote 193-205 Examples of initiatives on active transportation in Canada can be found here: Public Health Agency of Canada. Did you know? In 2011Footnote 188 62% of Canadians said there were stores within walking distance of their home. 78% had free or low-cost recreational facilities and areas nearby. 72% had a transit stop within a 15 minute walk of their home. 70% said they lived in an attractive neighbourhood. Canadians were more likely to be active if their neighbourhoods had places to walk to (e.g., stores), free or low cost recreational facilities or areas specifically for cycling, good sidewalks, interesting features and a higher level of safety.Footnote 188 There are other factors to consider in terms of active transportation. For example, providing employment opportunities closer to where people live and making driving a less appealing choice than active transportation.Footnote 180,Footnote 181,Footnote 200 Examples of strategies that have led to less traffic on the roads include car free zones or days, increasing the cost of driving and free or low cost public transit.Footnote 209-216 Places like Canada where residents can have long distances to travel and rely heavily on motor vehicles may have difficulty implementing some of these strategies. Promoting recreational physical activity: Physical activity during leisure time is not always linked to the same neighbourhood features as active transportation.Footnote 166,Footnote 191,Footnote 217 Some evidence also suggests that people who live in walkable neighbourhoods and are more likely to use active transportation may be less likely to be active during their leisure time.Footnote 185,Footnote 190 Recreational walking is linked to neighbourhood features such as destinations (e.g., lakes, waterways, sports and cultural destinations), attractiveness, good street lighting, good sidewalks, paths and trails, nearby recreational areas and facilities and green space.Footnote 54,Footnote 217-223 Canadians who live in neighbourhoods with these features were more likely to be active during their leisure time. Traffic and safety can also influence leisure time activity.Footnote 188 A role for raising awareness: Believing that a neighbourhood is walkable, whether or not it actually is, is linked to more walking and better health.Footnote 206-208 This suggests that raising awareness about a neighbourhood’s walkability could be an important way to increase physical activity.
This section explores how design features of the built environment impact healthy living in children, youth and older adults as well as their role in health inequities.
Most research on the impact of the built environment on healthy living, and health in general has focused on adults. Research on children, youth, older adults and marginalized groups is limited despite known health risks and inequities for these groups. There is also limited research on how the built environment may affect gender differently. Some research suggests that there may be gender differences, but results are mixed and overall conclusions remain elusive.Footnote 520
Physical activity: In 2014, Canadian data showed that 31% of boys and 22% of girls in Grade 6 were physically active every day for at least 60 minutes. This dropped to 22% of boys and 10% of girls by Grade 10. Students in Grades 6 to 10 are more likely to participate in team sports than individual sports.Footnote 521 It appears that a greater proportion of Canadian students in Grades 6 to 10 are spending more of their leisure time playing video games and on the computer than in the past.Footnote 521,Footnote 522
The presence of parks and green spaces may play an important role in increasing physical activity in children in urban areas, although some evidence shows that neighbourhoods with destinations, such as recreation facilities, parks, playgrounds and features linked to walking are associated with lower levels of physical activity in children.Footnote 523,Footnote 524 A key factor for physical activity may be the availability of undeveloped areas that allow for unstructured play.Footnote 525
The need for challenging play: Challenging play is important for children’s development as well as their physical and mental health. This type of play encourages children to evaluate their environment and its challenges before taking action. It has also been linked to helping children learn about assessing and managing risks, to be more independent and to develop better learning and judgment skills.Footnote 526 Footnote 527
Living in suburbs or small towns was linked to the highest levels of physical activity in children while living in urban areas was linked to the lowest. Children living in rural areas were more likely to spend time outdoors and in unstructured play than children living in urban areas.Footnote 528 This may be linked to how safe rural neighbourhoods, in terms of both traffic and crime, are perceived to be.
Parents’ concerns about safety are linked to their willingness to allow their children be active outside.Footnote 529-534 Like other age groups, children who walk or cycle are more likely to get injured than children who travel in a motor vehicle.Footnote 535 Measures to increase safety such as traffic calming and having recreation areas nearby were linked to more physical activity and fewer injuries among children. Features such as higher road density, having schools and other services nearby and crosswalks were linked to more walking, but not increased safety.Footnote 536-539 Crime is also an issue. Children living in neighbourhoods with less crime are more likely to be physically active.Footnote 540
Walking, cycling or using public transit to get to school can increase children’s and teenagers’ physical activity levels, yet many Canadian students are not using active transportation.Footnote 541-544 It appears that using active transportation in Canada is decreasing. Among students in Grades 6 to 10, rates appear to be decreasing, particularly in lower grades (see Table 1).Footnote 521,Footnote 522A survey of Canadian parents in 2012 showed that 58% walked to school as children while 28% of their own children walk to school today.Footnote 545
Communities are not always built to support aging. Most older adults want to stay in their homes and neighbourhoods as they get older. As they age, older adults are also more likely to spend more time in their neighbourhoods and to be more sensitive to changes in their environment.Footnote 584 Canada’s population is aging.Footnote 11 Ensuring that the built environment supports healthy aging is becoming increasingly important.
Older adults and falls: In Canada, about 20% to 30% of older adults fall every year. Falls are also the leading cause of hospitalization among older Canadians.Footnote 608,Footnote 609
Older adults who felt that they were part of their community and that people would help them were less likely to experience falls. Neighbourhoods that were thought to be cleaner and safer were linked to fewer falls.Footnote 610
Outdoor hazards increase the risk or the perceived risk for falls among older adults. Examples include uneven surfaces, curbs, lack of street, sidewalk and path maintenance, poor lighting, potholes, cluttered areas, unsafe traffic, unclear signs and crossings that are perceived to be unsafe.611,612
Physical activity: Even older adults who are already in poor health can benefit from being active.Footnote 585,Footnote 586 Many neighbourhood features (e.g., attractiveness, living near stores, services or friends) that are linked to more utilitarian walking in other age groups are also linked to more utilitarian walking in older adults, although research is mixed and likely influenced by other factors like mobility, income and attitudes.Footnote 587-607 Some research suggests that walkable neighbourhoods are linked to more walking even among older adults with mobility issues.Footnote 605
Some of the biggest barriers to being active for older adults include how accessible and safe their neighbourhood is (e.g., access to services, public transit, safety of sidewalks, weather, noise, lighting, street curbs, attractiveness, challenging street crossings due to short traffic lights or wide streets, proximity to destinations).Footnote 588,Footnote 611,Footnote 613,Footnote 614 Living in the suburbs is linked to many of these factors and can create a challenging situation for older adults, particularly for those who no longer drive. Concerns about safety include worries about crowds, crime, violence and traffic.Footnote 615
1 dic 2009 · Abstract. This review explores the relationship between engagement with the creative arts and health outcomes, specifically the health effects of music engagement, visual arts therapy, movement ...
This article presents a previously unpublished marble portrait of Octavia, sister of Augustus. This head, which is in a private French collection, is so close iconographically to another portrait known as the “Velletri Octavia” as to establish more securely Octavia’s portraiture and portrait typology.
Timetable for 3A - Oxford City Centre to Rose Hill (3) & Templars Square (3A)
Crawley Green Road Cemetery, Luton [2001] 2 WLR 1175241. Darker v Chief Constable of the West Midlands Police [2001] 1 AC 435285. Davis v Black (1841) 1 QB 900380. Diocese of Southwark v Coker [1998] ICR 14021. Douglas v Hello! Ltd (No 3) [2005] EWCA Civ 595, [2006] QB 12532. Durrington Cemetery [2001] Fam 33241
