July 29, 2016

Physical Activity — Who Cares?!?

The Lancet (an independent medical journal) has produced a series (“Physical Activity 2016“) to update their 2012 findings. It seems the authors of this series care a lot.  And yes, urban planning has a big role to play.

In 2012, The Lancet published its first Series on physical activity, which concluded that physical inactivity is as important a modifiable risk factor for chronic diseases as obesity and tobacco. Four years later, the second Series presents an update of the field, including progress in epidemiological research, global surveillance, intervention strategies, and policy actions. The papers will also feature the largest harmonised meta-analysis on the joint health effects of sedentary behaviour and physical activity, and the first global estimate of the economic burden of physical inactivity.
The Series encourages policy makers to take physical activity more seriously and to provide sufficient capacity and funding to implement national policies. Without a rapid increase in action, the WHO target of a 10% reduction in physical inactivity by 2025 will not be reached. We must continue to strive towards the longer term goal: the integration of physical activity into our daily lives.

The Series contains around 13 articles, perspectives and related content.  Those I read required free registration but not payment.
From “Scaling up physical activity interventions . . . “

Background:   Since the publication of the first Lancet Series on physical activity in 2012—which recognised physical inactivity as a global pandemic and urged all sectors of governments and societies to take immediate action— the demand for effective strategies to increase population physical activity levels has grown. A substantial body of evidence resulting from decades of research in the fields of exercise physiology, public health, epidemiology, and the behavioural sciences has shown that physical activity has broad economic and health benefits and that under scientifically controlled circumstances, behaviour change is achievable for increasing physical activity in diverse groups. . . .
. . .  Urban planning and transportation policies should prioritise actions that promote safe, equitable, and environmentally friendly active mobility and leisure options for all citizens

Caution:  this is rigorous scientific material, for the most part. Those with a low tolerance for depth and complexity, or for opinions contrary to their own, need not dig into any of it.

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Today comes this plea from three of the province’s top medical people for the region to work together and fund more transit.

Why?  Because transit has a large positive impact on population health, and health care costs.

Is transit really a public health issue or should we just stick to germs and vaccines?  The reality is that our biggest health challenges in the 21st century are injuries and chronic diseases such as cancer, diabetes, heart disease, and stroke. Together, these conditions are responsible for three quarters of the burden of disease and health care costs in British Columbia.

We know the “vaccines” that are effective against these problems: physical activity, good nutrition, not smoking, sufficient sleep, stress reduction, a healthy and safe environment, social connectedness — and sufficient income to achieve all of these things. . . .

. . .   We are writing today to urge local and provincial governments to seize this once-in-a-lifetime opportunity to fund critical transportation infrastructure and to build a modern, health-promoting transportation network. The result will be significantly fewer of our citizens burdened with avoidable illnesses and injuries — and healthier, more livable communities for all.

Dr. Perry Kendall is B.C.’s provincial health officer, Dr. Patricia Daly is chief medical health officer for Vancouver Coastal Health and Dr. Victoria Lee is chief medical health officer for Fraser Health Authority.


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Vancouver Deputy Mayor Heather Deal has a number of portfolios – usually all the ways to make sure our City is becoming delightful – including Arts & Culture. She is passionate about the topic and a Councillor Liaison to the Arts & Culture Policy Council so I asked her to tell me more. She shared stories about her conversations with Vancouverites on public art. 1. Poodle on a Stick

Poodle (no official name) by Gisele Amantea got negative media when someone from the area complained that Main Street isn’t a poodle neighbourhood. Which is awesome because public art got people talking about the identity of their neighbourhood.

There were also complaints about cost and it not being a local artist (both based on inaccurate reporting).

(TP note: How many of our public art pieces have their own Twitter account? Follow @MainStPoodle)

When people complain to me about the poodle, I ask them what piece of public art they do like.

2. A-mazing Laughter

9/10 answer: A-mazing Laughter at English Bay – a Vancouver Biennale piece. So I ask them 3 questions about it:

Does it reflect the West End?

How much did cost?

Where is the artist from?

No one can answer that. Not one person to date.

(TP: I was able to answer all 3 – including who negotiated the counteroffer and donated it.)

3. The Third Piece

Then I ask for opinions about a third piece of public art. Very few can name one. Some come up with Myfanwy MacLeod’s The Birds in Olympic Village.

Some can name Giants by OSGEMEOS on Granville Island – another biennale piece from an international artist team.

4. I love it when people talk about our city.

Art is a great place to start that conversation. Learn about the hundreds of pieces of public art in Vancouver at the City’s website here.

5. Notice art.

Think about whether you like it or don’t. Look it up and learn about the artist and their inspiration.

Did you know that the poodle was made by an artist living in the region at the time and that it was inspired by the antique shops on Main Street? (TP: I had no idea.)

We also want to encourage people to think about what they like and want in public spaces such as art (murals, pieces, etc.) and what type of programmed space, festivals, and unprogrammed squares or plazas they’d like.

Ask yourself: Do you want to be entertained? Amused? Challenged?

Reminded of something in our history, negative or positive?

Awed? Do you want to be able to interact with it?

Does it compel you to take a selfie with it?

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Jane Jacobs, urbanist and author, believed in walkable neighbourhoods, urban literacy, and cities planned by and for everybody.

We celebrate Jane’s birthday every year by leading and tagging along on Jane’s Walks. You create a walking tour of an area you’d like to talk about or celebrate and people sign up for it. It’s less of a lecture and more of a walking conversation. Leaders share their knowledge, but also encourage discussion and participation among the walkers. The whole thing is free.
It could also be a jogging tour or a bicycling tour or a skateboarding tour…
The one hour orientation session is Monday April 25 from 5:30-6:30pm at the Mount Pleasant Community Library.
Jane’s Walks, now in its 9th year, are held Friday-Sunday, May 6, 7, or 8 in 2016.

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How many times have you thought: I’d love to sit outside but it’s kinda noisy and stinky with the cars right there?

This is my fourth post in a series on transforming our shopping districts into more pleasant places to get to safely and hang out in.
We’ve reached an awkward moment in Vancouver’s history where trips by active transportation and transit are increasing without updating our shopping districts to accommodate those modes as well.
If as of May, 2015 50% of all trips in Vancouver are made by walking, bicycling, or transit and we haven’t updated the safety for those modes in any of our shopping districts yet, is this affecting how well businesses are doing? It seems it must be.
Janette Sadik-Khan, likening a City to a business for a moment, said about updating streets: “If you didn’t change your major capital asset in 50-60 years, would you still be in business?”
Now that an interesting amount of data from best practices elsewhere confirms these changes are good for business, it is time for the City to plan improving the streets in our shopping districts with updates such as wider sidewalks including bulges, raised crosswalks, mid-block crossings, protected bike lanes and intersections, better bicycle parking, car-free plazas, space for transitioning between modes, and other additions.
Successful business owners like Jimmy Pattison always talk about exceptional, friendly customer service being the most important step for companies. What they really mean is that the whole customer experience – from the first website visit, to ease of getting there and getting through the door, to the impression the place is clean and appealing indoors and out, through the direct customer experience until the good-bye/see you soon – should be at least safe and pleasant or even fun.
Every successful business also adapts to the times to continue to be desired. They adjust to new ways their customers reach them (both online and via other modes of travel). Businesses are not served well by being seen as on the wrong side of history on the issue of safer streets.
Reach out to the successful ones who intend to be there throughout and after these transitions. The businesses who do well for many years do the following:

  • keep their awnings clean, readable, and free of green fuzz,
  • ask the City to install bike racks near them by tweeting details @CityofVancouver #311,
  • make sure the doors, floors, tables, chairs and bathrooms are clean,
  • greet customers with a smile,
  • make an effort to get to know regulars,
  • are in tune with what menu items or stock their customers really want,
  • have great relationships with their suppliers to get those items on a consistent basis,
  • handle complaints graciously – often with follow-up check-ins,
  • and always say please and thank you.

What we can do to help local businesses – especially through this transition:

  • make an effort to thank and support local businesses and their owners – especially the ones who support safer streets for all,
  • avoid lecturing (or “You should…” sentences to) business owners who have no intention of changing; it’s a waste of energy; they will learn the hard way,
  • go to the business manager or owner before complaining elsewhere if you have any problems: Assume If you like us, tell your friends; if not, tell us! is the motto of every business,
  • spread the word about great experiences in person, on social media, and with your friends and co-workers,
  • every time you visit, casually mention to the server what mode you took to get there,
  • notify the City if you see loose bike racks, street lights out, plastic bags stuck in street trees, etc. by tweeting the details to @CityofVancouver #311,
  • and always say please and thank you.

The City, together with residents, business owners, employees, and our visitors will need to pitch in to improve the health, safety, economic viability, and delightfulness of our shopping districts.

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The Gastown area in downtown Vancouver – especially the 3 blocks of Water Street – will need major street rehabilitation soon. The City is not sure what they’ll find underneath the street so it could take a year or it could take longer. Gastown’s 150th Birthday is in 2017 so it’s too late to start now to be ready in time.
Nothing is confirmed yet. The vision I like the best would be to open Water Street to people, closing it to vehicles – except delivery vehicles at scheduled times. This would leave more room for café style areas, big gatherings around the Steam Clock, space for active transportation, and pop-up markets and festivals.
If that happens, part of the vision would be Cordova Street becoming a 2-way street that vehicles – including taxis, transit and tour buses – would move to. As it stands now, if you do drive west on Dundas then Powell Streets, by Carrall Street if you haven’t turned left (at the 5 corners), you find yourself on an unpleasant, slow drive through wandering tourists and zig zag bicyclists for the 3 blocks of Water Street. It’s clear most of the vehicle traffic is passing through, frustrated. Not stopping to buy anything.
What Would Janette Do? Janette Sadik-Khan says people find it hard to visualize things from boards and drawings. She says to try things to help people visualize and to see what works since the streets are already not perfect. What if before the street rehabilitation started, for late 2016 and 2017, we made Cordova a 2-way street and opened the 3 blocks of Water as a car-free space? Café tables & chairs with wine and pastries, programmed events including the 150th birthday celebrations, and no tour buses blowing dark exhaust in our faces…
Wouldn’t it be better to know what worked and what didn’t before we dig it up then rebuild it? It seems to me the consultation process after we’ve had a trial period would have more consensus about what was delightful and what wasn’t and be more valuable than varying speculations over unknown results. According to best practices in other cities, the businesses in Gastown would thrive from this. A 2-way street is better than a 1-way for business (Cordova) and no vehicles is even better (Water). If the City did intercept surveys before and after we’d have even more data.
What I know for sure is: it isn’t working well now for any mode. Making Cordova a 2-way street for 11 blocks (including re-signalling) and changing transit routes would probably take the most time. One possibility is to keep transit routes the same, allowing the #50 bus to be the only vehicle permitted on Water if necessary (besides delivery vehicles at low volume times of day) as Phase I.
The above photos are of Cardiff, Wales, UK. The middle photo with the tables and chairs could be a model for Gaoler’s Mews in Gastown.

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The Surgeon General of the US  has issued a call to action encouraging people to walk 150 minutes a week, or 20 minutes a day. Why? Because even such a moderate amount of activity can decrease the incidence of 41 diseases. Each walk boosts the immune system for 24 hours. One mile a day can reduce by 13 per cent your chance of a cognitive decline. 

And that is where those dogs come in. Rinus Jaasma did some interesting research on walking the dog in the Netherlands. On a national basis, walking the dog covers 40 per cent of all daily trips on foot as reported in the Dutch mobility research. This may actually be underreported, as most of these dog walks happen in the early morning or late night. Dog walkers stay a longer time in parks and outdoor spaces compared to the duration of trips with other motives. Because of their high numbers, Jaasma recommends that careful consideration be taken for planning pedestrian facilities in residential areas to allow for good walking for people and pooches on streets to and from park and dog areas.

study of dog owners in western Canada  from the University of Victoria concluded that dog owners walked an average of 300 minutes a week compared to non dog owners who walked 162 minutes a week. People who owned dogs participated in more physical activity. Acquiring a dog can make you more physically active, and give you  a real reason to get out walking in the rain.

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Ken Ohrn writes:


Health-care dollars are in the news – this time, with twinning of one sickening and one wonderful twist.  And a strong sense that while people can change, accountability for public attacks is really all too rare (all is fair in politics and war, and memories are short, we seem to think).

First: By Michael Mui, 24 Hours Vancouver.

A local study has shown the enormous cost of injuries to people in BC — some 456,000 injuries and $2.29 billion per year in 2010. But the article focuses on 5 percent of injuries that are recreational and, in theory, preventable (22,000 out of 456,000), and makes the absurd claim that bicycle helmet use saves health care dollars.

My opinion, and I’m not alone, is that helmet use discourages people from riding bikes (by roughly around 50 percent), and the health benefits (and ensuing lower costs of health care) exceed the risks of riding by a margin of 20:1. (See Klassen article below.)

Meanwhile, the other bogus nastiness in the article is the apparent opinion that the other 434,000 injuries are not preventable — and we all know that the largest part of these 434,000 injuries are most likely related to motor vehicle crashes.  It’s another example of the cultural blind spot we all have to the appalling death and injury toll from motor vehicle crashes. First — we just don’t “see” them; second — they’re not preventable.

So buckle up those helmets, people. And let’s just forget about road deaths and injuries altogether.

Second:  Mike Klassen writes in the Courier wanting more bike lanes, and increasing the active lifestyle, because of its large contribution to overall health, and thus to reduction of the huge medical care costs attributable to a sedentary lifestyle.



It marks, for me, a Wonderland-level change from the days when Mr. Klassen ran a scurrilous attack blog called City Caucus on behalf of the civic NPA.  In this now-defunct blog during the run-up to the bike-lane-heavy 2011 civic election, he published a vicious hatchet job on HUB, the non-profit advocacy organization for people who ride bikes. Because, ya know, the NPA was fundamentally against bike lanes and by extension, against people who ride bikes. HUB’s position, including the health benefits of an active life, were just a bunch of hooey. This position did not work in 2011 and in 2014, as the NPA lost both elections badly.

Now, it seems, Mr. Klassen understands that an active lifestyle is of huge importance to society as a whole, and as a result he advocates in favour of bike lanes, along with improvements for pedestrians.

He writes:  “While Vancouver abounds with runners, cyclists, paddlers and those taking a stroll on our cherished seawall pathways, we can do more. We could establish new jogging and walking routes, and combine them with safer traffic crossings right across the city. And notwithstanding the headaches they cause with opponents, the city should build more bike lanes, too.”

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Here, from the New York Times, is the latest of several recent articles that report how obesity is leveling off in the States:
Americans Are Finally Eating Less


Calories consumed daily by the typical American adult, which peaked around 2003, are in the midst of their first sustained decline since federal statistics began to track the subject, more than 40 years ago. The number of calories that the average American child takes in daily has fallen even more — by at least 9 percent. …

In the most striking shift, the amount of full-calorie soda drunk by the average American has dropped 25 percent since the late 1990s.

After rising for decades, calorie consumption has declined in recent years as public attitudes have shifted.


There is no single moment when American attitudes toward eating changed, but researchers point to a 1999 study as a breakthrough. That year, researchers from the Centers for Disease Control and Prevention published a paper in The Journal of the American Medical Association that turned into something of a blockbuster.

The paper included bright blue maps illustrating worsening obesity rates in the 1980s and 1990s in all 50 states. Researchers knew the obesity rate was rising, but Dr. Ali Mokdad, the paper’s lead author, said that when he presented the maps at conferences, even the experts were gasping.

A year later, he published another paper, with a similar set of maps, showing a related explosion in diabetes diagnoses. “People became more aware of it in a very visual and impactful way,” said Hank Cardello, a former food industry executive who is now a senior fellow at the Hudson Institute, a conservative policy center. “That created a lot of attention and concern.”



Shortly afterward, the surgeon general, Dr. David Satcher, issued a report — “Call to Action to Prevent and Decrease Overweight and Obesity” — modeled on the famous 1964 surgeon general’s report on tobacco. The 2001 report summarized the increasing evidence that obesity was a risk factor for several chronic diseases, and said controlling children’s weight should be a priority, to prevent the onset of obesity-related illnesses….

Slowly, the messages appear to have sunk in with the public.

However …

The recent calorie reductions appear to be good news, but they, alone, will not be enough to reverse the obesity epidemic. A paper by Kevin Hall, a researcher at the National Institutes of Health, estimated that for Americans to return to the body weights of 1978 by 2020, an average adult would need to reduce calorie consumption by 220 calories a day. The recent reductions represent just a fraction of that change.

“This was like a freight train going downhill without brakes,” Kelly Brownell, dean of the Sanford School of Public Policy at Duke University, said. “Anything slowing it down is good.”

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