Healthy built environment

Aspects of the built environment, including man-made and natural features, impact human health directly and indirectly through air quality, traffic injuries, and toxic substances. These aspects can also modify and influence physical activity levels, social connectedness and interactions, access to healthy foods, mobility, and housing quality. Many of these environmental and social determinants contribute to the rising prevalence of chronic diseases and related health conditions in the Canadian population. The Chief Public Health Officer’s Report on the State of Public Health in Canada 2017 – Designing Healthy Living emphasizes the linkages between the built environment and chronic diseases and conditions. Her report also advocates for collaboration between local governments and other sectors to create healthier communities through neighbourhoods and designs that support healthy behaviours and lifestyles.

This collection of resources:

• Introduces environmental health and public health practitioners to the field of healthy built environment (HBE) and the five core features: neighbourhood design, transportation networks, housing, natural environments, and food systems;
• Provides a foundational understanding of how HBE contributes to healthy communities and health outcomes and strategies to improve health via investments in HBE
• Presents the rationale for environmental health and public health involvement in promoting healthy communities.

Fundamentals in built environment and health

• Resilient urban environments (Yao, 2024)
  This book is a collection of articles written by authors ranging from urban planners, researchers, practitioners, and engineers on how urban environments impact human health, and adaptation and mitigation strategies to build healthier and more resilient urban environments.
   
• City: A web tool to support urban environmental equity and public health in Canadian communities (Doiron et al., 2024)
  This article describes a web mapping platform for users to visualize the spatial patterns of built environment indicators, vulnerable populations, and environmental inequity within over 125 Canadian cities.

• HealthyPlace.city
  This website is a public engagement tool that provides information about urban environmental conditions for neighbourhoods across all Canadian cities. The tool will provide a mapping interface that shows the spatial distribution of different health-relevant built environment factors and will also display a score for each factor that will allow users to compare different locations within the same urban area.
   

• Built environment and public health: More than 20 years of progress (Rollings et al., 2023)
  This article highlights progress in several areas including research, practice, education, and policy, toward promoting healthier built environments.
   
• The impact of the built environment on loneliness: A systematic review and narrative synthesis (Bower et al., 2023)
  This journal article examines aspects of the built environment that enhance social connectedness, reduce loneliness, and improve mental health.
   
• Supporting healthy community decision-making in municipalities: A synthesis of evidence-informed resources from across Canada (Kim et al., 2023)
  This journal article reviews 19 Canadian toolkits to synthesize knowledge that support the creation and development of healthy communities and related decision-making in Canada.
   
• Neighborhood infrastructure-related risk factors and non-communicable diseases: a systematic meta-review (Zhang et al., 2023)
  This journal article provides a comprehensive overview of the association between built environment characteristics and non-communicable disease health outcomes. This systematic review provides the evidence base for health considerations in planning and land use decisions.
   
• At the crossroads: Maximizing possibilities (Canadian Urban Institute, 2023)
  This report is a collection of contributions from a myriad of experts including planners, researchers, city councils, consultants, and many others that discuss the challenges and opportunities facing Canadian cities on various topics such as planning for growth, housing, climate change, and health.
   
• The evolution of BC’s healthy built environment teams: Learnings, successes and next steps (BC Centre for Disease Control, 2018)
  This document describes HBE teams and related work in BC health authorities, provides reflections and learnings on their evolution and process, and discusses future directions on how to move the HBE agenda forward.
   
• Healthy built environment linkages toolkit for design, planning, and health (BC Centre for Disease Control, 2018)
  Currently in its second edition, this foundational document links community design, planning, and health, and assesses the strength of evidence for links between planning principles in each of the five physical features and health impacts and outcomes.
   
• The built environment: Understanding how physical environments influence the health and well-being of First Nations peoples living on-reserve (National Collaborating Centre for Indigenous Health, 2018)
  This document summarizes how the built environment influences the health and well-being of First Nations reserve communities, focusing on five areas including: housing; water and wastewater management; food security; active living; and transportation.
   
• Community wellbeing: A framework for the design professions (Conference Board of Canada, 2018)
  This framework defines and evaluates how the built environment influences community wellbeing through social, economic, environmental, cultural, and political conditions.
   
• Healthy communities policy guide (American Planning Association, 2017)
  This guide identifies policy options for government officials and land use planners to build, improve, and promote healthy communities and man-made environments, and integrate health in planning decisions.
   
• What role for environmental public health practitioners in promoting healthy built environments? (Rideout et al., 2016)
  This peer-reviewed article discusses the intersections between environmental public health (EPH) and the built environment, and provides examples of built environment work in EPH practice as well as recommendations and opportunities for an expanded EPH role.
   
• Public health and planning 101 (Ontario Public Health Association, 2016)
  This online course aims to bridge the gaps between the understanding of health and built environment for public health and planning professionals to provide greater opportunities for partnership and the creation of HBE.

Neighbourhood design

• Built and natural environment correlates of physical activity of adults living in rural areas: a systematic review (Müller et al., 2024)
  This journal article examines neighbourhood elements that influence physical activity behaviours in adults that live in rural areas, and provides recommendations for improving neighbourhood characteristics to encourage physical activity.
   
• Walkability and urban built environments—a systematic review of health impact assessments (HIA) (Westenhöfer et al., 2023)
  This journal article reviewed health impact assessments of how neighbourhood walkability impacts health or health behaviour or health outcomes, including reductions of mortality and non-communicable diseases.
   
• Best complete streets policies (Smart Growth America, 2023)
  This report evaluates complete streets policies from around the US and spotlights communities that have adopted “complete streets” and how they made it happen.
   
• Operationalising the 20-minute neighbourhood (Thornton et al., 2022)
  This journal article examines the process of using data layers to apply the 20-minute neighbourhood concept to Melbourne, Australia, to assess the projected benefits of this concept on healthy living.
   
• Time to think 15-minute cities for health and equity (Chow, 2022)
  This NCCEH evidence brief describes the 15-minute city concept, the benefits of adopting the concept, and equity considerations in the planning process.

Transportation networks

• Putting wheels on the bus: Unlocking the potential of public transit to cut carbon emissions in Canada (Environmental Defence, 2024)
  This document highlights the importance of investing in public transit to reduce carbon emissions and provides policy recommendations to increase public transit ridership, reduce reliance on personal cars, and encourage the use of zero-emission vehicles or improve fuel efficiency of gasoline cars.
   
• A meta-analytic review of the association between the built environment and integrated usage of rail transport and bike-sharing (Aghaabbasi and Chalermpong 2023)
  This journal article analyzes built environment variables that influence the use of rail transport and bike sharing services, and relevant policy implications.
   
• Complex interventions to reduce car use and change travel behaviour: An umbrella review (Cleland et al., 2023)
  This journal article compares various interventions and strategies and built environment characteristics that aim to reduce car use and increase frequency of walking and cycling. A multi-pronged systems approach is necessary to change travel behaviour.

Housing

• Blueprint for more and better housing (Task Force for Housing and Climate, 2024)
  This document provides recommendations and policy actions for federal, provincial, and municipal governments to build affordable, sustainable, safe, and resilient homes in transit-friendly communities with access to green spaces.
   
• Healthy buildings in a changing climate (Pembina Institute, 2024)
  This report discusses climate change impacts on occupants of older buildings and underscores the importance of retrofitting older buildings to protect their health, in particular from four key climate change risks: extreme heat; flooding and reduced water quality; changes in infectious agents; and wildfire smoke and reduced air quality.
   
• Ten questions concerning the environmental impacts of housing built form (Arceo et al., 2024)
  This journal article addresses ten important questions to better understand housing built forms and the associated environmental, economic, and social impacts, and how housing built forms influence human health.
   
• The four pillars of housing influencing health equity (Swope et al., 2023)
  This NCCEH blog describes the four key pillars of housing that can support or harm different health and wellbeing outcomes, and how housing contributes to health equity.
   
• Can homes affect well-being? A scoping review among housing conditions, indoor environmental quality, and mental health outcomes (Riva et al., 2022)
  This journal article discusses the impact of housing conditions such as overcrowding, noise pollution, and poor air quality and indoor environmental quality on mental health outcomes, including depression, anxiety, and stress.
   
• Pathways to policy: Lessons learned from the Coalitions Linking Action and Science for Prevention (CLASP) initiative for physical activity and built environment policy (Canadian Partnership Against Cancer, 2017)
  This report identifies and analyzes key lessons learned from CLASP products and cross-CLASP evaluation data related to policy interventions and policy changes in the areas of physical activity and built environments.

Natural environments

• A scoping review of urban planning decision support tools and processes that account for the health, environment, and economic benefits of trees and greenspace (Tefera et al., 2024)
  This journal article reviewed existing urban planning decision support tools, frameworks, and models to determine whether they considered the health, environmental, and economic benefits of trees and greenspace. This is a good resource to identify existing decision support tools and frameworks for land use planning.
   
• The power of parks to promote health: A special report (Foderaro and Klein, 2024)
  This report examines the wide range of pathways parks and green spaces contribute to better physical and mental health and describes innovative strategies and interventions from different parks boards in various US states to promote health.
   
• Canadian green spaces during COVID-19: Public health benefits and planning for resilience (Eykelbosh and Chow, 2022)
  This NCCEH evidence review explores the use of parks and green spaces during the COVID-19 pandemic, highlights some innovative uses of natural spaces and challenges associated with the use of such spaces, and implications for future planning and design.
   
• Green space and mental health: Pathways, impacts and gaps (Rugel and Ward, 2015)
  This NCCEH evidence review demonstrates the principle pathways and mechanisms linking green space and mental health, and assesses the epidemiological evidence of how green spaces impact mental health.

Food systems

• Sustainable food systems and nutrition in the 21st century: a report from the 22nd annual Harvard Nutrition Obesity Symposium (Fanzo et al., 2021)
  This report describes the food systems framework and how each aspect, ranging from food supply chains, food environments, individual factors, and consumer behaviour, affects health outcomes and influences social, economic, and environmental impacts.
   
• Food systems for health: information brief (World Health Organization, 2021)
  This document highlights how food production, distribution, availability, and safety affect health outcomes, and actions that can be undertaken to improve health.
   
• Pathways to policy: Lessons learned from the Coalitions Linking Action and Science for Prevention (CLASP) initiative for nutrition and food environment policy (Canadian Partnership Against Cancer, 2017)
  This report identifies and analyzes key lessons learned from CLASP products and cross-CLASP evaluation data related to policy interventions and policy changes in the area of food environments.
   
• Food environments: An introduction for public health practice (Rideout et al., 2015)
  This NCCEH document introduces the concept of food environments, highlights some key evidence for the relationship between food environments and health, and identifies some ways environmental public health practitioners can influence food environments.

External organizations

• Canadian Urban Environmental Health Research Consortium (CANUE)
  This multidisciplinary consortium aims to increase scientific understanding of the interactions among the physical features of the urban environment and health. CANUE is developing sharable data and tools, and helping to link data on urban, suburban and rural features with major health databases.
   
• Canadian Institute of Planners (CIP) resource library
  This website contains a collection of resources related to planning, organized by topics including healthy communities, climate change, transportation, indigenous peoples, and northern communities.