*Top doctor says Winnipeg could reinvent itself and improve access to healthy choices*

* Food options limited in inner city *

https://www.winnipegfreepress.com/local/food-options-limited-in-inner-city-4...

Find report here: https://www.canada.ca/en/public-health/services/publications/chief-public-he...

OTTAWA — Canada’s top doctor says Winnipeg could be a leader for North America, by reinventing itself from a car-dominated metropolis to a city focused on public transit, walkability and affordable food.

Her comments come as new research suggests low-income Winnipeggers are using taxis to find cheaper food due to poor bus service and relying on convenience-store shelves to feed their families.

Theresa Tam, Canada’s chief public health officer, sees great challenges but also possibilities for Winnipeg, where one-tenth of residents live in “food deserts,” areas where poor people lack access to affordable, healthy food.

“I think Canadians can be real innovators in how to be active, even in the most remote, in the most cold or extremes of climates,” she said in a recent interview.

“It will challenge people to come up with some really great ideas.”

Tam took on the job, Canada’s equivalent to the United States’ surgeon general, in June. Her first annual report https://www.canada.ca/en/public-health/services/publications/chief-public-health-officer-reports-state-public-health-canada/2017-designing-healthy-living.html, published last week, details how Canadian cities have been built in ways that make Canadians physically and mentally unhealthy.

Tam, who’s lived in Saskatoon and Edmonton, says Prairie cities need to get people moving through connected streets, bike paths and good public transit, as well as areas that mix homes, shops and schools. The idea is to build smarter subdivisions and retrofit existing urban sprawl with better transit and walkable paths.

“If we could build our environments so people can use what I call the human engine — to walk or take public transport to get to the grocery store, or get to work or school — they’remore likely to be in a healthier state,” she said.

“Even within the suburb itself, you can create the right physical environment for people to be more active.”the

These interventions might slow the rise of diabetes, diagnosed in almost one-tenth of adult Canadians in 2011, a rate that almost doubles for Indigenous people in Manitoba, including in Winnipeg.

Cities can also improve mental health, Tamsays, through recreational features such as green spaces, walking paths and sports facilities. Budding research shows that murals, parks and public space (cafés, parks, libraries) can prevent isolation and promote better mental health. She even suggests building homes with front porches and yards to increase social interactions.

Part of the report offers advice for fixing food deserts, which can be affected by grocery-store locations and hours. It says cities can consider zoning restrictions that limit fast-food restaurants and convenience stores, or promote community gardens for fruit and vegetables.

Tam said that’s needed most outside of fancy condos and white-picket fences. “Whatever we do, in terms of our community design, must bear in mind that we need to serve the most vulnerable within our populations. If you are in the most disadvantaged neighbourhoods, we need to pay attention.”

Her report comes on the heels of research published by the Public Health Agency of Canada, which found nine per cent of Winnipeggers lived in food deserts in 2014.

The research said Winnipeg Transit leaves much to be desired. It found that those living close to downtown struggle to get to suburban grocery stores with more food, as buses “are often sporadic and inconvenient”.

Alarmingly, it said some poor people rely on taxis to get cheaper groceries, partially because bus fares don’t offer good discounts for a parent with children.

In the peer-reviewed studies, researchers tabulated neighbourhoods’ census-reported incomes, alongside grocery stores. They found multiple downtown areas more than 500 metres from a supermarket and similar problems in the inner parts of Inkster, Seven Oaks and Elmwood.

Yet the study found the problem is less severe than originally thought. The researchers noted that previous studies had only included national chains, which incorrectly pegged 14 per cent of Winnipeg residents as living in a food desert.

The researchers suggest how to replicate their study and get an accurate sense of where governments can intervene.

Rob Moquin, policy manager with Food Matters Manitoba, said the research is part of a growing recognition of trouble accessing food, though experts have talked about these problems for decades.

“It’s a combination of built environments and other societal, structural issues,” he said. “Social change takes a long time.”

Moquin pointed to previous research on “food swamps” where low-income neighbourhoods can only access unhealthy fast food, and more recent findings on “food mirages” where upmarket grocery stores sell products that nearby residents can’t afford.

“People in Winnipeg should have access to a full-service grocer in close proximity to where they live,” Moquin said, something that can only be done if city officials confront the biases that cause food deserts, instead of simply improving grocery-store options.

For example, Moquin said that even when food is available, it’s not always culturally appropriate. Immigrants find it difficult to find ingredients they’re familiar with (which can be harder for older, recently arrived family members), while Indigenous people used to country foods pay exorbitant amounts for conventionally farmed bison.

Tam describes her report as a call to action, one that must include cities, provinces, grocery stores, charities and businesses.

Her 70-page report uses 692 footnotes, walking readers through where decades of research align, and where studies contradict.

Her report notes diverging health outcomes for places people live, with cities experiencing lower rates of suicide, car accidents and obesity, but more pollution, stress and isolation than rural areas. The research on suburbs “is complicated and sometimes contradictory,” she notes.

dylan.robertson@freepress.mb.ca