Planning Health-Promoting Development: Creation and Assessment of an Evidence-Based Index in the Region of Peel, Canada

There is mounting evidence of relationships between the built environment, health behaviours, and chronic disease. Collaborative intervention efforts aimed at improving sustainability and environmental planning are underway in many jurisdictions, but relatively few have focused on the rationale and evidence for health-promoting development. Given current rates of chronic diseases, such as diabetes, a collaborative effort between planning departments, public health professionals, and researchers was undertaken to create an evidence-based healthy development index aimed at encouraging health-promoting development in the municipality of the Region of Peel, ON, Canada. In this paper we present the review process used to establish prerequisite elements and measures in the index, and the spatial analytical methodology developed to assess these measures within existing neighbourhoods in our setting. The assessment process and results offer important insight into barriers in existing design standards, official plan policies, zoning by-laws, and technical requirements that limit health-promoting development and have hindered implementation of the index as a tool for planning policy. Our discussion highlights challenges that those seeking to undertake similar interventions in other rapidly developing suburban jurisdictions may encounter. Despite barriers to implementation of the index in the form originally intended, a variety of positive policy contributions have been made in municipal and provincial jurisdictions as a result of this work. Further study is needed to identify and address detailed barriers to policy implementation, and to document the longitudinal health impacts associated with this built environment intervention