10/24/2015. Obesity Trends* Among U.S. Adults BRFSS, 1990 (*BMI 30, or ~ 30 lbs overweight for 5 4 woman)

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Building an Active City WHY ACTIVE CITIES? Designed to Move Karen K. Lee, MD, MHSc.. Today s Leading Causes of Death: WHY ACTIVE CITIES? 1. COMMUNITY HEALTH & WELLBEING.

1 Building an Active City WHY ACTIVE CITIES? Designed to Move Karen K. Lee, MD, MHSc.. Today s Leading Causes of Death: WHY ACTIVE CITIES? 1. COMMUNITY HEALTH & WELLBEING. Non Communicable Diseases (including Heart Disease & Strokes, Cancers, Diabetes, Chronic Lung Disease) Chronic Diseases #1 cause of death globally (36 million deaths/y). Leading Risk Factors accounting for large % of deaths: Tobacco (6m deaths/y) Physical Inactivity (3.2m deaths/y) Unhealthy Diets Harmful Use of Alcohol (2.3m deaths/y) High Blood Pressure (7.5m deaths/y) Overweight and obesity (2.8m deaths/y) High Cholesterol (2.6m deaths/y) Cancer associated infections (2m deaths/y) WHO, 2010 see OBESITY is a GLOBAL EPIDEMIC Worldwide obesity has more than doubled since Obesity Trends* Among U.S. Adults BRFSS, 1990 (*BMI 30, or ~ 30 lbs overweight for 5 4 woman) In 2014, more than 1.9 billion adults, 18 years and older, were overweight (39%). Of these over 600 million were obese (13%). 42 million children under the age of 5 were overweight or obese in World Health Organization, 2015 No Data <10% 10% 14% Source: U.S. Centers for Disease Control and Prevention (CDC) 1

2 Obesity Trends* Among U.S. Adults BRFSS, 1995 (*BMI 30, or ~ 30 lbs overweight for 5 4 woman) Obesity Trends* Among U.S. Adults BRFSS, 2000 (*BMI 30, or ~ 30 lbs overweight for 5 4 woman) No Data <10% 10% 14% 15%-19% Source: U.S. Centers for Disease Control and Prevention (CDC) No Data <10% 10% 14% 15%-19% 20%+ Source: U.S. Centers for Disease Control and Prevention (CDC). Obesity Trends* Among U.S. Adults BRFSS, 2005 (*BMI 30, or ~ 30 lbs overweight for 5 4 woman) Obesity Trends* Among U.S. Adults BRFSS, 2010 (*BMI 30, or ~ 30 lbs overweight for 5 4 woman) No Data <10% 10% 14% 15%-19% 20%-24% 25%-29% 30%+ Source: U.S. Centers for Disease Control and Prevention (CDC) No Data <10% 10% 14% 15%-19% 20%-24% 25%-29% 30%+ Source: U.S. Centers for Disease Control and Prevention (CDC) Diabetes trends among U.S. adults No Data <4.5% % % % >9.0% Source: CDC s Division of Diabetes Translation. National Diabetes Surveillance System available at According to the CDC the medical costs attributable to obesity today in the U.S. are estimated to be $147 billion per year. By 2030, if obesity trends continue as shown, the total attributable healthcare costs will be $860 $956 billion per year. 2

Obesity Trends Among Canadian Adults Obesity Trends Among Canadian Adults Obesity Trends Among Canadian Adults HEALTHY VS UNHEALTHY FOOD ACCESS IS KEY ALSO Obesity in Children has Risen Even

In 2012, >1/3 of children and adolescents were overweight or obese. http://www.cdc.gov/healthyyouth/obesity/facts.

8% of 5 11 year olds were overweight or obese (WHO Approach) Excess weight in childhood has been linked to type 2 diabetes, hypertension, poor emotional health, and diminished social well being.

htm For more information or assistance, or permission to use information from this presentation, contact Dr.

3 Obesity Trends Among Canadian Adults Obesity Trends Among Canadian Adults Obesity Trends Among Canadian Adults HEALTHY VS UNHEALTHY FOOD ACCESS IS KEY ALSO Obesity in Children has Risen Even More Rapidly In the US: Childhood obesity has more than doubled in children, and quadrupled in adolescents in the past 30 years. In 2012, >1/3 of children and adolescents were overweight or obese. In CANADA: Since the late 1970s, overweight and obesity has risen among children and adolescents in Canada : 31.5% of 5 17 year olds (~1.6 million) were overweight or obese; 32.8% of 5 11 year olds were overweight or obese (WHO Approach) Excess weight in childhood has been linked to type 2 diabetes, hypertension, poor emotional health, and diminished social well being. Obese children tend to become obese adults x/ x eng.htm x/ /article/11706 eng.htm For more information or assistance, or permission to use information from this presentation, contact Dr. Karen Lee at Alberta s Chronic Disease Rates Are Increasing Diabetes trends among: Albertans adults (20+) Twice as many people are living with diabetes than 10 years ago 218,000 people now 162,000 Albertans suffering with ischemic heart disease in Over 14% diagnosed with hypertension 4.9% 7.2% 7.9% Source: Alberta (2014). Interactive Health Data Application. Retrieved from: 3

This image canno t 10/24/2015 HIGH LEVELS OF PHYSICAL INACTIVITY IN CANADA WHO Recommended Interventions Protecting people from tobacco smoke and banning smoking in public places; Warning about the

Raising taxes on alcohol; Reduce salt intake and salt content of food; Replacing trans fat in food with polyunsaturated fat; Promoting public awareness about diet and physical activity, including

4 This image canno t 10/24/2015 HIGH LEVELS OF PHYSICAL INACTIVITY IN CANADA WHO Recommended Interventions Protecting people from tobacco smoke and banning smoking in public places; Warning about the dangers of tobacco use; Enforcing bans on tobacco advertising, promotion and sponsorship; Raising taxes on tobacco; Restricting access to retailed alcohol; Enforcing bans on alcohol advertising; Raising taxes on alcohol; Reduce salt intake and salt content of food; Replacing trans fat in food with polyunsaturated fat; Promoting public awareness about diet and physical activity, including through mass media; Nicotine dependence treatment; Enforcing drink driving laws;. WHO Recommended Interventions Promoting adequate breastfeeding and complementary feeding; Restrictions on marketing of foods and beverages high in salt, fats and sugar, especially to children; Food taxes and subsidies to promote healthy diets. Healthy nutrition environments in schools; Nutrition information and counselling in health care; National physical activity guidelines; School based physical activity programs for children; Workplace programs for physical activity and healthy diets; Community programs for physical activity and healthy diets; Designing the built environment to promote physical activity. WHO, 2011 see Evidence-based Base for Improving Research Physical shows that Activity we can Increase Physical through Activity Building, through Street Building, and Neighborhood Street and Neighborhood Environments Design OOD SCALES Walking, Bicycling and Transit-oriented development Designing to increase active Designs to improve street safety and aesthetics (less crime and traffic transportation / more greening), having sidewalks and bike paths connected to destinations, mixed land use, high population density Median increase in physical activity 35% to 161% Designing to increase active recreation Designing to increase stair use Enhancing access to places for physical activity, such as creating walking trails or having onsite or nearby parks, playgrounds and exercise facilities (homes & worksites) increases leisure-time activity and weight loss Point-of-Decision stair prompts Signs placed at elevators & escalators encouraging stair use, w/ info on benefits of stair use Median 50% increase in stair use Design and aesthetic interventions Music & art in stairwells; natural lighting in stairwells For more information or Design stairs to be more convenient and visible assistance, or permission to use Skip-stop elevators 3300% increase in stair use information from this presentation, contact Dr. Karen Lee at Active Cities Strategies Improve the Environment WHY ACTIVE CITIES? 2. ENVIRONMENTAL BENEFITS Biking or walking rather than automotive transport Stairs rather than elevators and escalators Fuel / Electricity Use Air Quality Obesity/Diabetes/ Heart Disease Active recreation rather than television. 4

Active Cities Strategies Promote Safety WHY ACTIVE CITIES? 3.

Active Cities Strategies Create More Accessible Places for All Active Cities

places to walk, take transit, & for wheelchair travel Making elevators more

Dr. Karen Lee at See http:///resources/who citiesforhealth Active Cities

Better Academically Taipei, Taiwan has many neighborhood parks that are used by

We like to come here to meet friends and exercise.

Seniors survey participant Pleson E, Nieuwendyk LM, Lee KK, Chaddah A, Nykiforuk

5 Active Cities Strategies Promote Safety WHY ACTIVE CITIES? 3. SOCIAL BENEFITS See Active Cities Strategies Create More Accessible Places for All Active Cities Strategies Can Be Used to Promote More Equitable Environments Creating safer places to walk, take transit, & for wheelchair travel Making elevators more available for those who need them See presentation, contact Dr. Karen Lee at See citiesforhealth Active Cities Strategies Can Promote Aging in Place & Healthy Aging Physically Fit Children Do Better Academically Taipei, Taiwan has many neighborhood parks that are used by seniors for physical activity and socialization. We like to come here to meet friends and exercise. It keeps us healthy, and it has become a habit to meet friends in the park. Seniors survey participant Pleson E, Nieuwendyk LM, Lee KK, Chaddah A, Nykiforuk CI, Schopflocher D. Understanding older adults usage of community green spaces in Taipei, Taiwan. Int. J. Environ. Res. Public Health 2014; 11(2): See also 5

6 WHY ACTIVE CITIES? 4. ECONOMIC BENEFITS. 2. ECONOMIC BENEFITS: Improved retail sales & rents Improved real estate values Improved tourism Improved competitiveness Decreased sickness absence and improved productivity. Active Cities Strategies Create Desirable Places to Live, Work & Play Sprawl Community : Preferred by 43% There are only single family houses on large lots There are no sidewalks Karen Lee, MD, MHSc, various sized FRCPC, lots NYC Dept. of Health & Mental Hygiene Skye Duncan, NYC Dept. of City Planning Story K. Bellows, Mayors Institute on City Design The Honorable Deke Copenhaver, Mayor, City of Augusta, GA Places such as shopping, restaurants, a library, and a school are within a few miles of your home and you have to drive most places There is enough parking when you drive to local stores, restaurants, and other places Public transportation, such as bus, subway, light rail, or commuter rail, is distant or unavailable Source: NAR National Poll, 2011 Q: In which community would you rather live? Smart Growth Community : Preferred by 56% There is a mix of single family detached houses, townhouses, apartments, and condominiums on Almost all of the streets have sidewalks Places such as shopping, restaurants, a library, and a school are within a few blocks of your home and you can either walk or drive Parking is limited when you decide to drive to local stores, restaurants, and other places Public transportation, such as bus, subway, light rail, or commuter rail, is nearby permission to use information from this presentation, contact Dr. Karen Lee at Edmontonians said They want communities that are liveable, vibrant and sustainable Accessibility, Walkability, Beauty and Community Access to public transportation (Bus and LRT) that can connect them to other parts of the city Places such as shopping, restaurants, a library, and a school are accessible and act as community hubs where neighbours can connect with each other Walkability with quick access to amenities/services, activities or recreation density and a more pedestrian lifestyle can help bring communities closer together People walking outside, kids playing and recreation opportunities Neighborhoods that are attractive and beautiful make them more livable and sustainable Source: City of Edmonton (2010) and Edmonton s Next Gen (2011) permission to use information from this presentation, contact Dr. Karen Lee at Active Cities Strategies Save Households Money Active Cities Strategies Can Reduce Infrastructure Costs for Cities More compact, walkable development patterns save money on avoided infrastructure costs Water & Sewer Laterals Required Water & Sewer Costs (billions) Road Lane Miles Required Road Land Miles Costs (billions) Sprawl Growth Scenario Compact Growth Scenario 45,866,594 $ ,044,179 $ ,245,294 $ ,855,874 $817.3 Savings 4,621,303 $12.6 (10.1%) 188,305 $109.7 (6.6%) People in walkable, transit rich neighborhoods spend only 9 percent of their monthly income on transportation costs; those in auto dependent neighborhoods spend 25 percent. Sprawl Costs: Economic Impacts of Unchecked Development, Robert W. Burchell, Anthony Downs, Barbara McCann and Sahan Mukherji, Island Press, 2005 Source: Center for Transit Oriented Development. 6

Active Cities Strategies Create Jobs Building

more jobs per dollar invested, compared to road

STEPS TO AN ACTIVE CITY NYC & OTHER CASE EXAMPLES

City: Promoting Physical Activity Through Design

Departments NOW WE MUST ADDRESS THE EPIDEMICS OF

Departments with Visible Leadership NYC Cross

GUIDELINES: Collaboration of 12 NYC Departments

Miami, Boston, London, NSW Australia, Sao Paolo

7 Active Cities Strategies Create Jobs Building bicycle and pedestrian infrastructure creates more jobs per dollar invested, compared to road infrastructure only WHAT DO ACTIVE CITIES DO? STEPS TO AN ACTIVE CITY NYC & OTHER CASE EXAMPLES Source: Political Economy Research Institute: June Align City Departments NYC Fit City Conference WHAT DO ACTIVE CITIES DO? 1. PRIORITIZE PHYSICAL ACTIVITY AS A SOLUTION Fit City: Promoting Physical Activity Through Design Fit City 3: Promoting Physical Activity Through Design. See Cities Around the World Aligning Their Departments NOW WE MUST ADDRESS THE EPIDEMICS OF OBESITY AND CHRONIC DISEASES Aligned City Departments with Visible Leadership NYC Cross Dept Leadership Created the ACTIVE DESIGN GUIDELINES: Collaboration of 12 NYC Departments Urban Design and Building Design Strategies to Promote Physical Activity included See Fit City Conferences NYC, Miami, Boston, London, NSW Australia, Sao Paolo Co Benefits of Strategies: Community Health and Wellbeing Environmental Sustainability Universal Accessibility See permission to use information from this. 7

1. PRIORTIZE PHYSICAL ACTIVITY Aligned Leadership Building Physical Activity into the Master Plan Aligned Leadership Making City Workplaces Active Workplaces NYC City Leaders used City

Key Partners: NYC Health + NYC DDC + NYC DCAS + USGBC + Architecture Firms + LEED Consultants + Developers See http:///resources/usa and http:///projects/ Cities Across the U.S. are Aligning Their Depts 1.

Key Intergovernmental Partners in 15 Local Communities: NYC, NY ~ Boston MA ~ Cherokee Nation OK ~ Chicago IL ~ Cook County IL ~ Douglas County NE ~ Jefferson County AL ~ King County WA ~

Planning 15 Transportation 14 Education/Sc

Cities NOW WE MUST ADDRESS THE EPIDEMICS OF OBESITY AND CHRONIC DISEASES Non Governmental Partnerships in 15 Local Communities: Canadian Cities Are Aligning Across Sectors NOW WE MUST

chapter 7 American Institute of Architects local chapter 5 American Society of Landscape Architects local chapter 3 Local Architecture, Planning and Design Institutions 3 Building Owners

8 1. PRIORTIZE PHYSICAL ACTIVITY Aligned Leadership Building Physical Activity into the Master Plan Aligned Leadership Making City Workplaces Active Workplaces NYC City Leaders used City Buildings to create LEED PILOT CREDIT DESIGN FOR ACTIVE OCCUPANTS, now registered for use in >250 developments in & outside NYC. Key Partners: NYC Health + NYC DDC + NYC DCAS + USGBC + Architecture Firms + LEED Consultants + Developers See and Cities Across the U.S. are Aligning Their Depts 1. NOW PRIORITIZE WE MUST PHYSICAL ADDRESS ACTIVITY THE EPIDEMICS OF OBESITY AND CHRONIC DISEASES Cities Across the U.S. Are Aligning their Departments. Key Intergovernmental Partners in 15 Local Communities: NYC, NY ~ Boston MA ~ Cherokee Nation OK ~ Chicago IL ~ Cook County IL ~ Douglas County NE ~ Jefferson County AL ~ King County WA ~ Louisville KY ~ Miami-Dade County FL ~ Multnomah County OR ~ Nashville TN ~ Philadelphia PA ~ Pima County AZ ~ San Diego CA permission to use information from this Public Health 15 Planning 15 Transportation 14 Education/School Construction 12 Parks and Recreation 12 Public Works 8 Housing Development or Management 6 Buildings 3 Aligning Additional Partners in U.S. Cities NOW WE MUST ADDRESS THE EPIDEMICS OF OBESITY AND CHRONIC DISEASES Non Governmental Partnerships in 15 Local Communities: Canadian Cities Are Aligning Across Sectors NOW WE MUST ADDRESS THE EPIDEMICS OF OBESITY AND CHRONIC DISEASES See Community Based/Non Profit Groups 13 Environmental Organizations 9 American Planning Association local chapter 7 American Institute of Architects local chapter 5 American Society of Landscape Architects local chapter 3 Local Architecture, Planning and Design Institutions 3 Building Owners and Managers Association 1 Goal: creating healthy communities that support active transportation and physical activity Partnerships: health, planning and transportation organizations +non governmental organizations + university researchers + regional/local government authorities in 8 of the 10 provinces: B.C. (Vancouver), Saskatchewan (Regina), Manitoba (Winnipeg), Ontario (Peel Region, Toronto), Quebec (Montreal), Nova Scotia (Halifax), New Brunswick (Fredericton), Newfoundland 8

2. MAKE EXISTING RESOURCES ACTIVE RESOURCES E.g.

MAKE EXISTING RESOURCES ACTIVE RESOURCES.

Partners: NYC Depts of Transportation, Health, Parks,

NYC, Chicago SUMMER STREETS Chicago Tribune:

com/2011 10 16/news/ct met open space solutions

permission to use information from this.

63%, pedestrian injuries down 35% Air pollution also

9 2. MAKE EXISTING RESOURCES ACTIVE RESOURCES E.g. Complete Streets WHAT DO ACTIVE CITIES DO? 2. MAKE EXISTING RESOURCES ACTIVE RESOURCES.. 2. MAKE EXISTING RESOURCES ACTIVE RESOURCES E.g. Streets for Activity 2. MAKE EXISTING RESOURCES ACTIVE RESOURCES E.g. Public Spaces to Walk To NYC Partners: NYC Depts of Transportation, Health, Parks, NYPD, Schools, Community Groups See: NY Times: /presto instant playground.html?_r=1 PLAY STREETS E.g. NYC, Chicago SUMMER STREETS Chicago Tribune: /news/ct met open space solutions _1_open space parking spaces greenspace/2 permission to use information from this. Pedestrian Volumes up 11% Injuries to motorists down 63%, pedestrian injuries down 35% Air pollution also down Retail sales up 89% OF THE ROAD SPACE FOR VEHICLES, 11% FOR PEOPLE For more information or assistance, or permission to use information from this presentation, contact Dr. Karen Lee at 9

Asset Management, and Public Works, with supports from Consultants WHAT DO ACTIVE CITIES DO? 3.

+ NYC Health + NYC Housing Preservation & Development + San Antonio and Atlanta Housing Authorities + Private-Sector

DESIGN FOR PEOPLE TO BE ACTIVE Remove Barriers; Create Fresh Policies; Sustainable = Active Transport WHAT DO ACTIVE

CREATE A LEGACY OF PHYSICAL ACTIVITY In NYC: Bicycle parking now required for new buildings & public parking garages; Bike

CREATE A LEGACY OF PHYSICAL ACTIVITY Give People What They Want NYC projects from community engagement for health &

Island (working with SI DOT and Parks) Renovation of Affordable Housing building in Williamsburg to include Active Design

They Want Community Engagement in Winnipeg, Manitoba Manitoba Planner s Conference postconference Active Design Workshop

10 2. MAKE EXISTING RESOURCES ACTIVE RESOURCES E.g. Healthy Affordable Housing Peel Human Services, Health Services, Corporate Services, Real Property Asset Management, and Public Works, with supports from Consultants WHAT DO ACTIVE CITIES DO? 3. DESIGN FOR PEOPLE TO BE ACTIVE See /resources/usa Key Partners: OCAD University + Georgia Institute of Technology + NYC Health + NYC Housing Preservation & Development + San Antonio and Atlanta Housing Authorities + Private-Sector Developers. 3. DESIGN FOR PEOPLE TO BE ACTIVE Remove Barriers; Create Fresh Policies; Sustainable = Active Transport WHAT DO ACTIVE CITIES DO? 4. CREATE A LEGACY OF PHYSICAL ACTIVITY In NYC: Bicycle parking now required for new buildings & public parking garages; Bike Sharing has been created. 4. CREATE A LEGACY OF PHYSICAL ACTIVITY Give People What They Want NYC projects from community engagement for health & wellbeing: Stairwell and water fountain redesign at Innovation High School in East Harlem Mural in bus shelter in Staten Island (working with SI DOT and Parks) Renovation of Affordable Housing building in Williamsburg to include Active Design Guidelines strategies Creation of garden with access for seniors and disabled at Brooklyn Rescue Mission Give People What They Want Community Engagement in Winnipeg, Manitoba Manitoba Planner s Conference postconference Active Design Workshop with Dr. Karen Lee. The Active Design Workshop attracted a wide variety of participants; planners, members of the community, health authority staff, urban planners, and staff from local governments and NGOs across Manitoba. It provided an opportunity for sharing, learning and discussion between different sectors in Winnipeg and Manitoba about the built environment and its impact on health. Winnipeg Regional Health Authority See Brooklyn Rescue Mission Innovation High School Brooklyn Rescue Mission Innovation High School 10

4. CREATE A LEGACY OF PHYSICAL ACTIVITY Change the Infrastructure; Change the Policy New York City: Trainings of Infrastructure Department Staff on the Active Design Guidelines and the LEED Pilot

Active Design Guidelines strategies into Greening of Construction Codes and City Policies Use of City Policy Mechanisms to Address Physical Activity, Health & Wellbeing e.g. RFPs, Zoning Requirements and Incentives, Tax Incentives.

3% Traffic fatalities decreased almost 30% Air pollution levels decreased at pedestrian plazas Retail sales increased around pedestrian plazas Record numbers of tourists (>50 million annually and

. permission to use information from this POTENTIAL NEXT STEPS IN EDMONTON/ALBERTA FOR QUICK WINS (Dr.

Departments on routine integration of physical activity promoting strategies, such as those in the Active Design Guidelines and the LEED Pilot Credit Design for Active Occupants, into development,

Activity Promoting strategies into all relevant City and Provincial Policies, both administrative and legislative, including zoning codes, building codes, tax codes, guidelines and standards for new

11 4. CREATE A LEGACY OF PHYSICAL ACTIVITY Change the Infrastructure; Change the Policy New York City: Trainings of Infrastructure Department Staff on the Active Design Guidelines and the LEED Pilot Credit Design for Active Occupants Routine Inclusion of the Active Design Guidelines and LEED Pilot Credit Design for Active Occupants in City construction and City construction RFPs Integration of Active Design Guidelines strategies into Greening of Construction Codes and City Policies Use of City Policy Mechanisms to Address Physical Activity, Health & Wellbeing e.g. RFPs, Zoning Requirements and Incentives, Tax Incentives. 4. CREATE A LEGACY OF PHYSICAL ACTIVITY Track Progress & Promote Success New York City: Childhood obesity trends reversed Bicycle travel increased 126% Transit ridership into CBD increased 11.3% Traffic fatalities decreased almost 30% Air pollution levels decreased at pedestrian plazas Retail sales increased around pedestrian plazas Record numbers of tourists (>50 million annually and growing) No Physical Activity in Last 30 Days showed significant decline after no change in previous decade Life expectancy 2.2 years longer and increasing faster than U.S.. permission to use information from this POTENTIAL NEXT STEPS IN EDMONTON/ALBERTA FOR QUICK WINS (Dr. Karen Lee has Templates & Programs Already Developed for Other Cities, and a Team that can provide Technical Assistance): Implement a Training Program for all relevant Staff of Infrastructure Departments on routine integration of physical activity promoting strategies, such as those in the Active Design Guidelines and the LEED Pilot Credit Design for Active Occupants, into development, design and construction projects Implement Policies for Routine Inclusion of Physical Activity Promoting Strategies in all City & Provincial Construction and Construction RFPs Integrate Physical Activity Promoting strategies into all relevant City and Provincial Policies, both administrative and legislative, including zoning codes, building codes, tax codes, guidelines and standards for new developments and redevelopments, affordable housing, public spaces, school construction and use, and transportation projects and funding Implement Public Engagement Workshops for Youth, Parents and Seniors with Community Health & Well Being as a Key Theme and Shared Value For Upcoming Relevant Conferences in Edmonton and Alberta, include Expanded Activities such as Workshops, Trainings and Field Tours Use Future High Profile Events (E.g. the International Play Conference in Calgary in 2017; any in Edmonton?) as Milestone Events to Accelerate Progress and Promote Success, and to Engage the Public and the World s Attention ACKNOWLEDGEMENTS: Dr. Karen Lee would like to thank the many talented people from multiple cities and organizations that she has had the privilege to work with. She thanks her partners in the U.S. CDC, the City of New York, NACTO, Healthy Canada by Design, the Office of the Chief Medical Officer of Health in Alberta Health, and the World Health Organization specifically for some of the information found in the presentation. For more information, visit 11

Designing Healthier Environments to Conquer Disease Epidemics: Successes in NYC and Elsewhere. Karen K. Lee, MD, MHSc

Designing Healthier Environments to Conquer Disease Epidemics: Successes in NYC and Elsewhere Karen K. Lee, MD, MHSc Can Design Help Address Today s Health Epidemics? THE 19th CENTURY: Infectious Diseases