Abstract
Background
Population health approaches are visible among multidisciplinary methods used in urban design and planning, but attention to health equity is not always an explicit focus. Population and Public Health—Saskatoon Health Region recognized the need for frameworks to prioritize, integrate and measure health equity within local built environments.
Setting
A cross-department healthy built environment (HBE) initiative coordinated activities involving Health Promotion, Environmental Public Health, Public Health Observatory, and Medical Health Officers engaged with municipal, academic and community partners in Saskatoon, Saskatchewan.
Interventions
The HBE team conducted evidence reviews and consulted with partners to identify common health equity issues in built environments and best and leading practices to address them. The HBE team then prioritized and undertook projects to model a health equity approach.
Outcomes
Projects included the following: (1) developing a Health Equity in Healthy Built Environment Framework; (2) engaging in a partner campaign highlighting built environment and health equity during a municipal election; (3) producing a Health Equity Impact Assessment (HEIA) report on the City of Saskatoon’s growth plan; and (4) developing a monitoring and evaluation framework for health equity outcomes. Other outputs include making new connections between local HBE and poverty reduction efforts and promoting social inclusion guidelines in consultation processes.
Implications
Within a population health approach to HBE, an explicit focus on health equity can be a catalyst for engaging partners in cross-sectoral action for building inclusive physical and social environments.
Résumé
Contexte
Les démarches de santé des populations sont visibles parmi les méthodes pluridisciplinaires utilisées dans l’aménagement et la planification des milieux urbains, mais l’équité en santé ne reçoit pas toujours une attention explicite. Le Service de santé publique et des populations de la Région sanitaire de Saskatoon a reconnu la nécessité d’avoir des cadres pour privilégier, intégrer et mesurer l’équité en santé dans les milieux bâtis à l’échelle locale.
Lieu
Une initiative interservices de « santé du milieu bâti » (SMB) a coordonné les activités des effectifs de la promotion de la santé, de la santé publique environnementale et de l’Observatoire de la santé publique, des médecins hygiénistes et de partenaires municipaux, universitaires et associatifs à Saskatoon (Saskatchewan).
Interventions
L’équipe de la SMB a mené des examens des données probantes et consulté ses partenaires pour cerner les problèmes d’équité en santé courants dans les milieux bâtis et trouver des pratiques exemplaires pour les résoudre. L’équipe a ensuite choisi et entrepris des projets pour faire la démonstration d’une démarche d’équité en santé.
Résultats
Les projets ont consisté à : (1) élaborer un « cadre de l’équité en santé pour le milieu bâti; (2) au cours d’une élection municipale, mener en partenariat une campagne soulignant l’importance de l’équité en santé dans le milieu bâti; (3) produire un rapport d’évaluation de l’impact sur l’équité en matière de santé (EIES) du plan de croissance de la Ville de Saskatoon; et (4) élaborer un cadre de suivi-évaluation des problèmes d’équité en santé. D’autres extrants ont été l’établissement de nouveaux liens entre les démarches locales de SMB et de réduction de la pauvreté, et la promotion de lignes directrices sur l’inclusion sociale dans les processus de consultation.
Conséquences
Dans une démarche de SMB axée sur la santé des populations, un accent explicite sur l’équité en santé peut favoriser la participation de partenaires à une action intersectorielle pour créer des milieux physiques et sociaux intégrateurs.
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Notes
The original framework (Provincial Health Services Authority 2014) that PPH adapted for their purposes included a fifth area of healthy natural environments. PPH decided to integrate that area within their healthy neighbourhood design pillar given the structure of the local work as well as the limited capacity to focus on healthy natural environment as a separate pillar.
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Acknowledgements
The authors acknowledge the content contributions and manuscript review provided by Julie Kryzanowski (Medical Health Officer), Tanya Dunn-Pierce (Manager, Health Promotion) and Mel Brockman (Research Officer, Public Health Observatory).
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Janzen, C., Marko, J. & Schwandt, M. Embedding health equity strategically within built environments. Can J Public Health 109, 590–597 (2018). https://doi.org/10.17269/s41997-018-0116-8
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DOI: https://doi.org/10.17269/s41997-018-0116-8
Keywords
- Health equity
- Population and public health
- Public health
- Built environment
- Healthy built environment
- Municipality