Embedding health equity strategically within built environments.

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.

The effect of unilateral and bilateral strength training on the bilateral deficit and lean tissue mass in post-menopausal women.

Some have observed maximal strength of simultaneous bilateral homologous limb contraction is less than the sum of strengths of right and left limbs contracting alone; a phenomenon referred to as the bilateral deficit (BLD). There is controversy on whether there is a BLD for all exercises. We assessed whether a BLD occurs across different exercises (leg press, knee extension, and lat pull-down), whether the BLD could be altered with unilateral or bilateral training, and whether unilateral versus bilateral training was more beneficial for increasing lean tissue mass (LTM). Post-menopausal women (approximately 57 years) were randomized to bilateral (n=14) and unilateral (n=12) training, or non-training control (n=24) groups. Bilateral training involved seven exercises performed with bilateral contractions (two sets, 3 days week-1, 26 weeks). Unilateral training involved the same exercises performed with one limb at a time. A BLD was found for leg press and lat pull-down, but not for knee extension. Bilateral training decreased the BLD; whereas unilateral training had minimal effect on the BLD. The unilateral-training group had a greater increase in lower-body LTM compared to the control group (P<0.05); however, there were no differences between unilateral and bilateral training groups. Both training groups had greater increases in LTM of the upper- and whole-body compared to the control group. We conclude that the BLD is apparent for some exercises (i.e., the leg press and lat pull-down) but not others (i.e., knee extension). Bilateral training reduces the BLD; whereas unilateral training has minimal effect on the BLD.