Healthy Toronto by Design: Promoting a healthier built environment.

Chronic diseases, obesity and sedentary lifestyles are some of the health challenges facing Canada today. There is increasing recognition and evidence that the way our cities are planned, designed and built can contribute to these problems. Many of the policy levers to address the built environment exist outside the health sector and at the municipal level in areas such as urban planning, transportation, parks and recreation, and housing. The challenge for the public health sector is to build and sustain partnerships and collaboration across various sectors to ensure that health is considered in built environment policies. As the public health unit for the city of Toronto and part of the municipal government, Toronto Public Health is in a unique position to provide leadership, advocacy and support for healthy municipal public policies related to the built environment. This article provides some examples of CLASP (Coalitions Linking Action and Science for Prevention) initiatives undertaken to help create support for healthy public policies in the built environment and suggests that the "Healthy Cities" approach is a useful framework to promote policy change in the built environment at the municipal level.

Should people be physically active outdoors on smog alert days?

BACKGROUND: Given the importance of physical activity to well-being, there is a need to encourage people to be physically active year-round. At the same time, many people are vulnerable to adverse health effects from air pollution, especially on smog alert days. This study was undertaken to determine when air pollution levels tend to be lowest so that the public can modify strenuous outdoor activity accordingly. METHODS: Existing hourly air pollution data for Toronto were analyzed to determine how pollutant levels varied from hour to hour throughout each 24-hour day, to identify the times when pollution levels are at their lowest on average. RESULTS: Pollutant levels vary throughout the day, with concentrations of some pollutants (such as ozone, particles and sulphur dioxide) being highest during mid-day, and others (such as carbon monoxide and nitrogen dioxide) being highest with morning rush hour. Overall, pollutant concentrations tend to be lowest before seven a.m. and after eight p.m. INTERPRETATION: The public should be encouraged to maintain regular physical activity outdoors while monitoring any air pollution-related symptoms. The intensity of outdoor activity should be reduced, or activities replaced with indoor exercise, at those Air Quality Index (AQI) levels that trigger individual symptoms and when AQI values exceed 50. Where possible, strenuous activity should be taken when and where air pollution levels tend to be lowest, namely early in the morning and in low-traffic areas. More research is required to guide development of health protective advice on exercising when air quality is poor.