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Peel Diabetes Atlas

The diabetes rate in the Region of Peel almost doubled between 1995 and 2005. During this time, Peel welcomed more than 200,000 immigrants, many of whom are considered to be at high risk for developing diabetes.

The Diabetes Atlas for the Region of Peel provides a geographic perspective on the patterns and relationships between diabetes and neighbourhood characteristics, including socioeconomic status, ethnicity and immigration, and the built environment. Special attention is paid to access to healthy foods and features that encourage or discourage physical activity.

The results will be used by Region of Peel decision-makers to identify target groups, implement programs, address the burden of obesity and chronic disease, and adopt policies that will favour healthy active living and healthy food choices.

The atlas maps:

  • the age- and sex-related prevalence of diabetes in Peel Region, including complications and risk factors
  • socio-economic status, ethnicity and diabetes in Peel Region
  • the relations among diabetes, land use and transportation choices
  • opportunities for active recreation in Peel Region and levels of physical activity
  • healthy food choices and the locations of grocery stores, markets, fast food outlets and other food sources
  • locations of health services
  • the results attained by Peel Region on the Activity-Friendly Index
  • the results attained by Peel Region on the Healthy Resources Index

Peel Healthy Urban Development Tool

The Region of Peel is growing faster than any other municipality in Ontario. Because the built environment is a key determinant of health, with impacts on physical activity levels, body weights and the development of diabetes, CRUNCH has partnered with scientists at the Centre for Research on Inner City Health and staff at the Region of Peel to develop a practical tool to assess the future health impacts of urban design proposals submitted by residential developers.

The tool focuses on how street connectivity, land use mix, and population density can encourage physical activity and reduce obesity. 

We also identify bylaws that may conflict with the tool’s recommended standards (e.g. for population density) and recommend policy amendments to support health-oriented planning (e.g. facilitating the appeal process when a developer wants to implement characteristics that are positive for health but that may contravene existing requirements).

Realist Review of Built Environment Interventions

Population and public health studies investigate questions that are complex. Relationships cannot be reduced to a simple dose-reponse--they are as rich and varied as the populations, communities and individuals being investigated.

The Region of Peel's Public Health department has sponsored research that examines the relationship between the built environment and health outcomes. And while there is evidence that the urban built form impacts public health outcomes and risk factors, such as healthy body weights and obesity, air pollution, pedestrian safety, and mental health, there is little evidence from actual interventions or longitudinal studies. This, of course, leaves open the possibility that the association is not causal.

The "realist review" is a relatively new strategy used by population and public health researchers and policy makers to evaluate the answers to complex research questions.

A realist review synthesizes findings from a number of studies by examining why complex programs succeed (or fail) in various settings. Causation is determined by looking at the ways the intervention and outcome(s) being investigated are connected, and by examining the relevant context. The idea is to uncover why, when and for whom do the interventions work. 

Using a realist review approach, the project seeks to answer the important question: Does living in a more walkable neighbourhood mean residents are more physically active and less obese?

To answer this question, the project first describes the defining features of complex interventions and examines the limitations of realist reviews. Then it outlines the evidence for the relationship between the built environment and obesity and offers a realist review of this evidence.