The role of public health in land use planning can be traced back to the industrial revolution. At this time, newly urbanized areas needed the infrastructure to provide healthy and sanitary conditions, which resulted in public health, land use planning and civil engineers coming together.ⁱ Over time, however, there began a separation of planning and public health. This was partially due to the emerging specialization in the planning field (e.g. environmental planning, transportation engineering and urban planning) and a concentration on individual health practices and conditions in the medical field^.ii

 

Recent research in health has returned to the thinking that health is not always decided by individual health behaviours but, rather, is largely determined by the environment in which one lives. For instance, many of today’s looming health concerns revolve around chronic disease, such as obesity, heart disease, stroke and some types of cancer. These conditions are often associated with lack of physical activity and unhealthy eating, and some with environmental exposure to air pollutants (e.g. certain types of cancer).ⁱⁱⁱ

 

In addition to specific connections with chronic diseases, the built environment and land use planning policies have the potential to impact certain populations disproportionately at the community level, thus becoming a health equity issue. For example, studies demonstrate that individuals and families living in lower socioeconomic status (SES) neighbourhoods are more likely to live close to a highway or major industrial area, hence exposing them to higher levels of air pollution and increasing their risk of suffering associated health conditions. Additionally, research has shown an association between food desserts – areas with limited access to fresh groceries – and lower SES neighbourhoods.^iv

 

As age is also an important social determinant of health, designing communities that meet the “8-80 cities” concept is critical. As a non-profit community development organization based in Toronto, 8-80 Cities has four areas of focus: Parks and Public Spaces, Sustainable and healthy mobility, People friendly public realm, and Open Streets programs.^v Each of these is linked to the concept of building a healthy community or, in this case, city. A community that is built with the 8-80 concept in mind is one that promotes and enables healthy behaviours regardless of whether you are eight (8) or 80 years old. Such a community is designed to prioritize human interaction through interconnected streets and public places where people work, learn and play.vi Ultimately, “8-80 cities encourages sustainable and healthy lifestyles for people regardless of age, gender, ability and social status”.^vi

 

The Healthy Communities movement pre-dates 8-80 Cities, however. The Ontario Healthy Communities Coalition (OHCC), which was itself established in 1992, has identified that the broader healthy communities movement has roots in the 1980’s in Ontario.^vii Arguably, the term itself became popularized after the World Health Organization’s “Healthy Cities Project” was initiated in Europe in 1986.^viii That same year, the First International Conference on Health Promotion was held in Ottawa. The Conference resulted in the “Ottawa Charter,” which was intended “to achieve Health for All by the year 2000 and beyond.”^ix The Charter indicates that "Health is created and lived by people within the settings of their everyday life; where they learn, work, play, and love."^x Today, the importance of a given place, including its intersecting natural, built, social and cultural environments, is widely understood as being a determinant of the social, health and economic outcomes of local people.