title: Application of an evidence-based tool to evaluate health impacts of changes to the built environment.
abstract: OBJECTIVE
  To create and apply an empirically based health and greenhouse gas (GHG) impact assessment tool linking detailed measures of walkability and regional accessibility with travel, physical activity, health indicators and GHG emissions.
  
  
  METHODS
  Parcel land use and transportation system characteristics were calculated within a kilometre network buffer around each Toronto postal code. Built environment measures were linked with health and demographic characteristics from the Canadian Community Health Survey and travel behaviour from the Transportation Tomorrow Survey. Results were incorporated into an existing software tool and used to predict health-related indicators and GHG emissions for the Toronto West Don Lands Redevelopment.
  
  
  RESULTS
  Walkability, regional accessibility, sidewalks, bike facilities and recreation facility access were positively associated with physical activity and negatively related to body weight, high blood pressure and transportation impacts. When applied to the West Don Lands, the software tool predicted a substantial shift from automobile use to walking, biking and transit. Walking and biking trips more than doubled, and transit trips increased by one third. Per capita automobile trips decreased by half, and vehicle kilometres travelled and GHG emissions decreased by 15% and 29%, respectively.
  
  
  CONCLUSIONS
  The results presented are novel and among the first to link health outcomes with detailed built environment features in Canada. The resulting tool is the first of its kind in Canada. This tool can help policy-makers, land use and transportation planners, and health practitioners to evaluate built environment influences on health-related indicators and GHG emissions resulting from contrasting land use and transportation policies and actions.
authors.affiliation: Urban Design 4 Health. julmer@ud4h.com.
authors.forename: Jared M
authors.initials: JM
authors.lastname: Ulmer
authors.forename: James E
authors.initials: JE
authors.lastname: Chapman
authors.forename: Suzanne E
authors.initials: SE
authors.lastname: Kershaw
authors.forename: Monica
authors.initials: M
authors.lastname: Campbell
authors.forename: Lawrence D
authors.initials: LD
authors.lastname: Frank
mesh_terms: D000328:Adult; D001334:Automobile Driving / Q000706:statistics & numerical data; D001642:Bicycling / Q000706:statistics & numerical data; D002170:Canada; D002947:Cities; D036262:Empirical Research; D004779:Environment Design / Q000706:statistics & numerical data*; D005260:Female; D005740:Gases / Q000032:analysis*; D017752:Greenhouse Effect; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012984:Software; D014186:Transportation / Q000379:methods / Q000706:statistics & numerical data; D014504:Urban Health / Q000706:statistics & numerical data*; D001335:Vehicle Emissions / Q000032:analysis; D016138:Walking / Q000706:statistics & numerical data
chemical_list: D005740:Gases; D001335:Vehicle Emissions
keywords: Environment and public health; city planning; decision support techniques; geographic information systems; health impact assessment; spatial analysis