Thank you very much.
I appreciate the opportunity to present to you today. I wish I could be there.
My talk follows perfectly on the first speaker's presentation. There is a great deal of evidence accumulating around the built environment and health in adults, and we're now beginning to learn about how it affects childhood obesity. I commend the committee for taking on your project on childhood obesity. It is extremely timely. Unfortunately, it's timely more than we wished it were.
The neighbourhood design impacts are, from what we know at present.... I'll just summarize quickly, having done a good bit of the research and presented with the Heart and Stroke Foundation on their annual report cards a couple of years ago. Basically, neighbourhood design is in terms of how mixed uses are, having shops and services nearby. The street network is very important--having a connected network, so things that are nearby we can actually access.
Cul-de-sac road network design, which prevents throughput or the ability to walk to nearby destinations, may actually have certain benefits for youth, because they play on cul-de-sacs, but it precludes the ability for communities at large to actually access destinations nearby. In fact, I think what we're seeing with the youth playing on cul-de-sacs is it's because of lack of open space and recreational amenities such as parks in these neighbourhoods that have been built in the last 20 years. So I don't think the answer is more cul-de-sacs. In fact, that's a mistake. But what we do know is that people who live in the more walkable, connected, denser, compacter neighbourhoods are significantly less likely to be obese and more likely to achieve recommended physical activity levels prescribed by the Heart and Stroke Foundation of Canada and the U.S. Surgeon General.
Now some specifics. People who live in the most walkable neighbourhoods—I did some research in Atlanta on this, and it got pretty widely circulated in Canada—are 2.4 times more likely to get the amount of physical activity recommended by the Surgeon General and Heart and Stroke Foundation. What we're learning is that these results now seem to play out fairly similarly in youth, and I'll get to that in a moment.
The other thing we know from a number of studies is on the obesity front. What we've learned is it's not just the design of the neighbourhood that relates to obesity. Of course it's the way it would affect how we get around and the travel patterns that we have as families--adults and children--and how families travel. Each additional hour spent in a car is associated with a 6% increase in the likelihood of being obese.
Now that's in a region like Atlanta...the variation in the physical form. So what I think would actually play out here in Canada, especially in a place like Vancouver, is if in Atlanta there are these enormous differences in commuting, there's not that much difference in the design of the environment in Atlanta. It's all fairly sprawling, if you will, compared to most Canadian cities. So I think in some ways we're actually, perhaps conversely to what the first presenter said—I think it's complementary—going to see more of a difference in behaviour when we study this in Canadians because of the difference in the neighbourhoods. We've got some pretty good sprawl in Canada too, but we also have a lot more walkable places. So the differences in the built environments are greater.
What we learn from the driving patterns is that this increase in obesity is related to sedentary behaviour. It consumes the amount of time we have to be active as adults. I think that then relates to youth in the household. What we know is that each additional kilometre that people walk translates into about a 5% reduction in the odds of obesity.
That's a little bit of a summary on obesity and physical activity in adults. We're learning a good bit about that. But what do we know about kids? So we're just about to release a study in about two weeks where we have 3,100 youth in our sample. This again is evidence from the U.S., but I'm doing it as a professor at UBC and then I'm going to present to you some research on Vancouver as well and some policy implications of that for Canada.
We've divided children into age categories, five to eight years old, nine to eleven, twelve to fifteen, and sixteen and older. Those break points are important, because as youth approach sixteen, a big thing happens: they then have access to a car--not always, but often.
What we've learned is that across all age groups the single factor that predicts the likelihood that a child will walk is the presence of open space and parks in their neighbourhood, meaning within a kilometre--walking distance of a kilometre. A park could be only half a kilometre, a quarter kilometre, 300 feet away, but if they can't get to it, meaning the street network is not connected, it doesn't matter, it doesn't help.
We have to have connections to the parks and open spaces that we already have that are safe, that provide crosswalks, that provide sidewalks, that are lit at night, and so forth--for adults as well. But the main issue is that it has to be within a walking distance of a kilometre. That matters for all age groups of youth. It was the single factor that was most significant. That is consistent with the findings of our first speaker. That's interesting to see.
As youth become older other factors become important. For a five- to eight-year-old the only thing that matters is having open space nearby, in terms of the built environment's predicting whether or not they will walk. Walking is one measure of physical activity, but it's an important one.
The next is that for nine- to eleven-year-olds, what matters is having some density, some compactness. This becomes a school-siting policy, I believe, because what we're capturing is the number of kids who live within a half to one kilometre of school so they can actually walk to school. The policy implication there is where we put our schools...[Technical Difficulty-Editor]...and make decisions about land use around schools, so that kids can live close to schools so they can walk. That's an important implication, because once they're over about a kilometre from the school, they don't walk. That's what we find.
Parents don't want them to walk. The perception of risk among parents increases with distance to the school. It makes sense. This is what we're finding in some research here in Canada now.
The summary is that the 12- to 15-year-olds are the most built-environment sensitive. As would be expected, a young teen has interest in going to shops and services out in the neighbourhoods, and the younger kids.... The face validity of the work is really quite amazing to me, that it just came out exactly as we would expect. Those are the youth who, before they're driving.... Having shops and services nearby, having parks and open space nearby, all of that matters to the 12- to 15-year-olds. When the study gets released in a couple of weeks, I'll actually release the specific statistics that go with it so that you can have those.
I'm actually going to see if I'm able to pre-release it to the committee. It is accepted. It is ready to go out in the American Journal of Health Promotion.
Once the kid hits 16 years of age, guess what happens? The built environment becomes less important; all of a sudden the significance goes down. And then comes the effect of really having an alternative mode, so the walking becomes less significant.
I do not prescribe that the policy implications should be to raise the driving age, but one of the implications we're seeing is that the number of cars in the household is an amazingly powerful predictor on whether or not kids walk. So that could become a way that.... You know, taxation on extra cars--even a third car versus a second car--would determine if there's a lot of extra vehicle availability for youth. There's also the question about providing parking at schools or having kids walk--if we prioritize that or make it have an impact or a cost in different ways.
So there are lots of policy options for you to consider on this question. I will suggest a few of the general areas that you're probably familiar with and thinking about. As an urban planning professor, I think these are things that seem to come to the top of the array of things to consider.
Zoning and land use regulation provided to municipalities by the provinces comes with the requirement to promote the health, safety, and the welfare of the public. If our research and others' research is showing that zoning is in fact possibly not achieving or promoting public health, we need to know about that.
If we're making it so far for people to be able to walk to destinations, if they can't get physical activity through walking, that may not be health-promoting zoning. In fact, it's arguably not. Remember, there is air pollution generated from all that traffic, and increased safety risks, and pedestrian conflicts, particularly in youth.
There is also the question of financing and how development gets funded, and of lending institutions and banks that make it easier to build auto-dependent development than mixed-use projects that are more walkable. That is a huge arena. All of these things are obviously massive in scale to address, but that's the nature of the built environment. It's a big question.
Of course, health care costs may differ between more-walkable environments and less-walkable environments. Provision and delivery of services in low-density environments becomes a very big question. They cost more. Everything costs more when you spread development out.
I wanted to mention that one of the policies that you could consider is pay-as-you-drive insurance. This is a strategy in which if people don't drive they don't have to pay any insurance. However, if they drive farther they're more likely to have an accident, and they're going to be polluting more, and they're also more likely to be obese. This sends the right kind of signal, which is that you get rewarded for a behaviour that's health-promoting, and that's a good way to go.
I wanted to mention in final summary that we have a couple of papers. I was asked about food environments and about how people access food. We are working with the Robert Wood Johnson Foundation and have a number of papers coming out--three in fact--on this topic. One will come out in the next few weeks. It follows our mapping of food environments around schools. We go into food outlets and actually monitor the quality of the food provided, and we're learning a good bit. I look forward to sharing all of that with you. I have papers and other publications for you to review as you proceed.
I commend you again on taking on this important initiative.
Thank you.