Abstract
In April 2011, a conference with invited experts from research, policy and practice was held to build consensus around policy levers to address environmental determinants of obesity. The gap between existing policy tools and what can promote health through community design is a major policy opportunity. This commentary represents a consensus of next actions towards creating built environments that support healthy active living. The policy environment and Canadian evidence are reviewed. Issues and challenges to policy change are discussed. Recommendations to create supportive built environments that encourage healthy active living in communities include the following: 1) empower planning authorities to change bylaws that impede healthy active living, protect and increase access to green space, introduce zoning to increase high density, mixed land use, and influence the location and distribution of food stores; 2) establish stable funding for infrastructure promoting active transportation and opportunities for recreation; 3) evaluate the effectiveness of programs to improve the built environment so that successful interventions can be identified and disseminated; 4) mandate health impact assessment of planning, development and transportation policies to ensure that legislative changes promote health and safety; 5) frame issues to dispel myths and to promote protection from obesity risk factors.
Key words: Child, adolescent, health status, obesity, health policy, environment design
Mots clés: enfant, adolescent, état sanitaire, obésité, politique sanitaire, conception de l’environnement
Résumé
En avril 2011, une conférence d’experts invités du monde de la recherche, des politiques et de la pratique a cherché à construire des consensus autour de leviers politiques pour aborder les déterminants environnementaux de l’obésité. Le fossé entre les outils stratégiques existants et ceux qui pourraient favoriser la santé par le design communautaire présente une importante occasion stratégique à saisir. Ce commentaire expose le consensus des experts sur les prochaines étapes en vue de la création de milieux bâtis favorisant une vie active saine. Nous passons en revue l’environnement politique et les données probantes canadiennes. Les enjeux et les difficultés des changements d’orientation sont abordés. Les recommandations en vue de créer des milieux bâtis qui encouragent une vie active saine dans les communautés sont les suivantes: 1) habiliter les responsables de la planification à changer les règlements qui nuisent à une vie active saine, à protéger et élargir l’accès aux espaces verts, et à introduire un zonage qui accroît la densité et l’utilisation mixte des sols et qui influence l’emplacement et la répartition des magasins d’alimentation; 2) établir des budgets de financement stables pour les infrastructures qui favorisent le transport actif et les possibilités de loisir; 3) évaluer l’efficacité des programmes d’amélioration du milieu bâti pour que les interventions fructueuses puissent être identifiées et disséminées; 4) ordonner l’évaluation des incidences sur la santé pour toutes les initiatives de planification et les politiques de développement et de transport, afin que les modifications législatives favorisent la santé et la sécurité; 5) présenter les enjeux de manière à déboulonner les mythes et à promouvoir la protection contre les facteurs de risque de l’obésité.
Footnotes
Acknowledgements: This research was funded by a Meeting, Planning and Dissemination grantfrom the Canadian Institutes of Health Research (CIHR). K. Raine acknowledges an Applied Public Health Chair Award from the Heart and Stroke Foundation and CIHR. The authors thank Manuel Arango, Susan Buhler, Timothy Caulfield, Diane Finegood, Samantha Hartley-Folz, Bill Jeffery, Jane Landon, Craig Larsen, Tim Lobstein, Lyne Mongeau, Suzie Pellerin, Lisa Petermann, Monique Potvin Kent, Shandy Reed and Michele Simon for their participation in the consensus conference
Conflict of Interest: None to declare
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