KEVIN LAM AND JEAN WANG

SINCE John Snow mapped out the large cholera outbreak in London in 1854 relative to where people lived, it has been known that where we live, work and play strongly influences people’s health. The way our cities and towns have been built plays a large role in many of the health conditions Canadians develop.

Cities such as Montreal and Vancouver have been working to create better cycling infrastructure and public transit, with the goals of improving the quality of life and health of their citizens.

It’s a good start, but is it enough?

We need a systemic collaboration between physicians, public health departments, developers and urban planners to help Canada design the cities we want — ones that can keep us healthy.

Let’s take obesity as an example.

Among Organization for Economic Development and Co-operation (OECD) countries, Canada has one of the highest prevalence rates of obesity, with an alarming one in five Canadian adults affected. Yet despite all Canada is doing to address the lifestyle factors that contribute to obesity, many public health goals are stubbornly hard to reach and nowhere near close to targets. Ninety per cent of Canadian children don’t reach the physical activity recommendations, despite physical inactivity and sedentary lifestyles being flagged as a priority focus for the Public Health Agency of Canada.

It can be difficult tomake healthy choices in certain contexts. If our daily lives are surrounded by cities without green spaces to play or where public transit is difficult to access, it can be hard to make healthy choices in spite of all the health promoting.

So what can be done?

Current solutions are heavily focused on changing individual behaviour. A great deal of funding is spent on promoting exercise, the food guide, community weight loss programs — all with a focus on individual behaviour. But evidence demonstrates that social marketing campaigns surrounding healthy eating and exercise aren’t sufficient to address the problem.

Instead of simply telling people to spend more time exercising, we can incorporate it into their lives. We could encourage stair use instead of elevators by making stairs easier to access. We could integrate walking and biking to work — forms of active transport — or make cities more walkable in general.

This is an area where physicians and public health departments can collaborate with builtenvironment experts to influence health.

Urban planners are the experts at improving the livability of towns, cities and regions. Meanwhile, physicians see the downstream effects of a poorly built environment in their clinics, operating theatres and emergency rooms every day — from chronic diseases to motor vehicle collisions.

The future of chronic disease and obesity prevention involves professions working together to generate collaborative solutions — to create better places to live, play and work.