1. The Impact of Urban Form
on Public Health
Toronto Region Green Building Festival David Sisam, Montgomery Sisam Architects Inc.

2. 1. Some Background
2. The Health and Sustainability Iceberg
3. Definitions
4. Hype in Atlanta
5. Green in New York
6. Heat in Chicago
7. Opportunity in Toronto
Toronto Region Green Building Festival

3. 1. Some Background
Toronto Region Green Building Festival Healthcare

4. 1. Some Background
Toronto Region Green Building Festival Urban Design

5. 1. Some Background
Toronto Region Green Building Festival Green Building

6. 2. The Sustainability and Health Iceberg
• Healthcare
• Green Roofs
• Solar Panels
• LEED Buildings
• Health
• Urban Density
• Mixture of Uses
• Design Quality
Toronto Region Green Building Festival

7. 3. Definitions
Sustainable Development
“Development … that meets the needs of
the present without compromising the ability
of future generations to meet their own
needs.”
Bruntland Commission 1987
Toronto Region Green Building Festival

8. 3. Definitions
Health, as defined by the World Health
Organization
“Health is a state of complete physical,
mental and social well-being and not merely
the absence of disease or infirmity.”
Toronto Region Green Building Festival

9. 3. Definitions
“If you want to improve health, you have to
look beyond the health care system. Most
of the important policy decisions that affect
the health of the population are not made by
the Ministry of Health.”
Dr. Trevor Hancock, BC Public Health Consultant
Toronto Region Green Building Festival

10. 4. Hype in Atlanta
“Atlanta has been a quiet but significant
leader in the green building movement.”
Atlanta, November 2005, United States Green
Building Council Annual Conference
Toronto Region Green Building Festival

11. 4. Hype in Atlanta
The unmentioned reality…
Atlanta has the lowest population density of
any American metropolitan area.
Toronto Region Green Building Festival

12. 4. Hype in Atlanta
The unmentioned reality…
Between 1982 an 1997 Atlanta’s population
increased by 1,300,000 people.
Its area increased by 650,000 acres.
Toronto Region Green Building Festival

13. 4. Hype in Atlanta
The unmentioned reality…
Atlanta residents commute an average of
58 km a day.
Toronto Region Green Building Festival

14. 4. Hype in Atlanta
The unmentioned reality…
Atlanta’s obesity rate more than doubled
between 1993 and 2000 and it is now
the highest of any American city.
Toronto Region Green Building Festival

15. 4. Hype in Atlanta
Obesity Trends* Among US Adults 1990
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
Source: Centers for Disease Control and Prevention.
No Data <10% 10%–14% Behavioral Risk Factor Surveillance System Survey Data. Atlanta,
Georgia: U.S. Department of Health and Human Services, Centers
for Disease Control and Prevention, 1990-2001
Toronto Region Green Building Festival

16. 4. Hype in Atlanta
Obesity Trends* Among US Adults 1991
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
Source: Centers for Disease Control and Prevention.
No Data <10% 10%–14% 15%–19% Behavioral Risk Factor Surveillance System Survey Data. Atlanta,
Georgia: U.S. Department of Health and Human Services, Centers
for Disease Control and Prevention, 1990-2001
Toronto Region Green Building Festival

17. 4. Hype in Atlanta
Obesity Trends* Among US Adults 1993
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
Source: Centers for Disease Control and Prevention.
No Data <10% 10%–14% 15%–19% Behavioral Risk Factor Surveillance System Survey Data. Atlanta,
Georgia: U.S. Department of Health and Human Services, Centers
for Disease Control and Prevention, 1990-2001
Toronto Region Green Building Festival

18. 4. Hype in Atlanta
Obesity Trends* Among US Adults 1995
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
Source: Center for Disease Control and Prevention.
No Data <10% 10%–14% 15%–19% Behavioral Risk Factor Surveillance System Survey Data. Atlanta,
Georgia: U.S. Department of Health and Human Services, Centers
for Disease Control and Prevention, 1990-2001
Toronto Region Green Building Festival

19. 4. Hype in Atlanta
Obesity Trends* Among US Adults 1997
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
Source: Center for Disease Control and Prevention.
No Data <10% 10%–14% 15%–19% ≥20% Behavioral Risk Factor Surveillance System Survey Data. Atlanta,
Georgia: U.S. Department of Health and Human Services, Centers
for Disease Control and Prevention, 1990-2001
Toronto Region Green Building Festival

20. 4. Hype in Atlanta
Obesity Trends* Among US Adults 1999
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
Source: Center for Disease Control and Prevention.
No Data <10% 10%–14% 15%–19% ≥20% Behavioral Risk Factor Surveillance System Survey Data. Atlanta,
Georgia: U.S. Department of Health and Human Services, Centers
for Disease Control and Prevention, 1990-2001
Toronto Region Green Building Festival

21. 4. Hype in Atlanta
Obesity Trends* Among US Adults 2001
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
Source: Center for Disease Control and Prevention.
No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Behavioral Risk Factor Surveillance System Survey
Data. Atlanta, Georgia: U.S. Department of Health and
Human Services, Centers for Disease Control and
Prevention, 1990-2001
Toronto Region Green Building Festival

22. 4. Hype in Atlanta
The unmentioned reality…
Traffic fatality rates in Atlanta are 5 times
what they are in New York City.
Toronto Region Green Building Festival

23. 4. Hype in Atlanta
Toronto Region Green Building Festival

24. 5. Green in New York
Manhattan’s density is more than 800 times
US national average
Toronto Region Green Building Festival

25. 5. Green in New York
82% of Manhattan residents travel to work
by public transit, bicycle or on foot
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26. 5. Green in New York
If Manhattan were a state it would be the
12th most populous state and the most
energy efficient one.
Toronto Region Green Building Festival

27. 5. Green in New York
A New Yorker generates 7.1 metric tons
of greenhouse gases a year, 2/3 less than
the 24.5 metric ton average for a typical
US resident.
Toronto Region Green Building Festival

28. 5. Green in New York
Toronto Region Green Building Festival

29. 5. Green in New York
The Rocky Mountain Institute
has 4,000 sq. ft. of office
space for six people in a
thinly populated area only
accessible by car.
A second office with 12
people is located one mile
away.
Toronto Region Green Building Festival

30. 6. Heat in Chicago
1995 Heat wave July 14 – July 20
There are 739 more deaths than typical
for a hot summer week
Toronto Region Green Building Festival

31. 6. Heat in Chicago
A team of eighty researchers was brought in
from the US Centre of Disease Control and
Prevention (CDC) to see what they could learn
about preventing a reoccurrence.
Toronto Region Green Building Festival

32. 6. Heat in Chicago
The death rate in North Lawndale was
10 times that of South Lawndale
Toronto Region Green Building Festival

33. 6. Heat in Chicago
Toronto Region Green Building Festival North Lawndale

34. 6. Heat in Chicago
Toronto Region Green Building Festival South Lawndale

35. 7. Opportunity in Toronto
Toronto Region Green Building Festival

36. 7. Opportunity in Toronto
Toronto Region Green Building Festival

37. 7. Opportunity in Toronto
Toronto Region Green Building Festival

38. 7. Opportunity in Toronto
Toronto Region Green Building Festival

39. 7. Opportunity in Toronto
Toronto Region Green Building Festival

40. 7. Opportunity in Toronto
Toronto Region Green Building Festival

41. 7. Opportunity in Toronto
Toronto Region Green Building Festival

42. 7. Opportunity in Toronto
Daily Walking / Biking Trips per Person
Source: 2001 Transportation Tomorrow Survey (UofT)
Neighbourhood Environments and Resources for Healthy
Toronto Region Green Building Festival Living: A Focus on Diabetes. A Joint Initiative of St. Michael’s
Hospital and the Institute for Clinical Evaluative Sciences

43. 7. Opportunity in Toronto
Average Number of Cars per Household
Source: 2001 Transportation Tomorrow Survey (UofT)
Neighbourhood Environments and Resources for Healthy
Toronto Region Green Building Festival Living: A Focus on Diabetes. A Joint Initiative of St. Michael’s
Hospital and the Institute for Clinical Evaluative Sciences

44. 7. Opportunity in Toronto
Age-Sex-Adjusted Diabetes Rates
Source: Ontario Diabetes Database
Neighbourhood Environments and Resources for Healthy
Toronto Region Green Building Festival Living: A Focus on Diabetes. A Joint Initiative of St. Michael’s
Hospital and the Institute for Clinical Evaluative Sciences

45. 7. Opportunity in Toronto
Toronto Region Green Building Festival

46. 7. Opportunity in Toronto
Toronto Region Green Building Festival

47. 7. Opportunity in Toronto
Toronto Region Green Building Festival

48. 7. Opportunity in Toronto
Toronto Region Green Building Festival

49. 7. Opportunity in Toronto
Toronto Region Green Building Festival

50. 7. Opportunity in Toronto
Toronto Region Green Building Festival

51. 7. Opportunity in Toronto
Toronto Region Green Building Festival

52. 7. Opportunity in Toronto
Toronto Region Green Building Festival

53. 7. Opportunity in Toronto
Toronto Region Green Building Festival

54. 7. Opportunity in Toronto
Toronto Region Green Building Festival

55. 7. Opportunity in Toronto
Toronto Region Green Building Festival

56. 7. Opportunity in Toronto
Toronto Region Green Building Festival

57. 7. Opportunity in Toronto
Source: The Regent Park Collaborative Team
Toronto Region Green Building Festival

58. 7. Opportunity in Toronto
Toronto Region Green Building Festival

59. 7. Opportunity in Toronto
Toronto Region Green Building Festival

60. 7. Opportunity in Toronto
Toronto Region Green Building Festival

61. 7. Opportunity in Toronto
Toronto Region Green Building Festival

62. 7. Opportunity in Toronto
Source: Cities for a Small Planet.
Toronto Region Green Building Festival Richard Rogers and Philip Gumuchdjiam