PHIRN: Population Health Improvement Research Network


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Built Environment

As defined by the Public Agency of Canada [1], built environment "is part of our physical surroundings and includes the buildings, parks, schools, road systems, and other infrastructure that we encounter in our daily lives." These environments can influence physical and mental health through factors such as community design, safe water, safe neighbourhoods, and access to education, public transit, and recreation services [2]. Built environment also includes adequate housing, since it is a critical component to each individual's environment [2]. As such, housing outcomes can directly and indirectly impact health. For example, respiratory illnesses and allergies can be related to mould, damp, or poorly ventilated houses [2]. Subsequently, the built environment also provides the setting for many of the social determinants of health [3].

Evidence-Informed Decision Making

Evidence-informed decision making (EIDM) is accepted in Canada as necessary for the provision of effective health care services. The goal of the public health sector in Canada is to promote health and reduce the amount of disease, premature death, and pain and suffering in the population, through health promotion, disease and injury prevention, and health protection [4]. The effectiveness of public health services has direct implications for health system outcomes and expenditures, as the following example illustrates. In 2005, chronic diseases, such as cardiovascular disease (CVD), cancer, emphysema, and diabetes, accounted for 35 million deaths worldwide [5]; had been increasing steadily over the past two decades; and in 2002, the economic burden of CVD and cancer alone in Canada was $32.7 billion [6]. Overweight and physical inactivity, recognized risk factors for chronic diseases [7,8], have also risen steadily in the past two decades. Canadian data suggests a 10% decrease in sedentary behaviour would result in health savings of $150 million per year [9].

The growing incidence of chronic diseases has, in part, contributed to increased political and societal pressures to ensure public funds are allocated to the provision of services with known effectiveness. In other words, there is a call to action to ensure the programs and services implemented across the public health sector in Canada are effective, and that they will result in improved health outcomes for Canadians. The purpose of this commissioned work is to identify and summarize research findings on the effectiveness of population based interventions in three priority topic areas identified in the annual report of the Ontario Chief Medical Officer of Health to the legislative assembly related to: 1) community-based diet and nutrition; 2) built environment; and 3) social determinants of health.

Last Updated ( Wednesday, 01 August 2012 10:49 )