In the public health sector, we occasionally hear the expression "making the healthy choice the easy choice". This statement goes to the heart of the debate over structural determinants of health versus personal choice as causes for ill health. Making the healthy choice the easy choice effectively neutralizes the debate by pointing to the importance of structural elements in individual decision-making, and it points to the role of not just the public health sector but all citizens in influencing the way in which our society builds itself.
Indeed, it is not always the easiest, most readily available, lowest cost, most advertised, or most subsidized choice that is the most favourable to health. In many sectors, we find that making the healthy choice is increasingly difficult.
Many are now asking how and why things came to be that way, and are looking at how structural factors influence people's choices.
It is possible for public policies to take the potential or likely health effects of different options into account, thereby bringing health as a value into the equation. We could continue to focus on personal choice as the locus of health promotion, but we would be missing an important dimension.
This kind of thinking applies to the built environment, or the ensemble of buildings, transportation systems, access to healthy food, housing, how we spatially organize our lives around home, recreation, workplaces, shopping, schools, and so on. The way in which our spaces have come to be structured (both literally, in terms of the buildings, passable routes, barriers, etc.; as well as in the patterns we tend to adopt as participants in particular communities) can be examined in order to determine if the spaces we inhabit will tend to favour health or not. These spaces can strongly influence the tacit choices we make during our daily routines. Many have cumulative effects on health, and many are replicated daily by millions of Canadians.
The built environment can have a positive or negative effect on health (chronic illnesses, mental health, respiratory illnesses, sexually transmitted and blood-borne infections, etc.) inasmuch as it is tied to many of the social determinants of health (air quality, noise exposure, modes and speed of travel, injecting drugs in public, access to healthy food, etc.).
Public policies that inform the built environment and its determinants are many and diverse: housing policies, traffic policies, urban or regional planning policies, etc.
This year, we are focusing on certain public policies that, by informing the built environment, influence the movement of goods and people. In particular, we are currently developing a project on traffic calming. Various documents are being developed that will cover multiple dimensions of traffic calming. Click here to learn more.
Healthy Canada by Design
The NCCHPP is a partner the Healthy Canada by Design coalition. The main goal of this coalition is to inspire change in the ways in which the built environment is currently developed, by influencing the policies that inform it. Click here to learn more.
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