Nova Scotia: A Profile of Promising Practices from Canada and Abroad – Healthy housing, healthy community project

“Bringing together people with different viewpoints to discuss shared interests in a non-confrontational format is beneficial in breaking down barriers.”

Lead Organization:
Chebucto Communities Development Association (CCDA)

Key Partner:
Spryfield Residents’ Association

Community:
Spryfield, Nova Scotia

Population of Community:
4,460 (Spryfield)
372,679 (Halifax Regional Municipality)

Setting:
Semi-Urban

Target Group:
Residents, Planners, Developers, Health Professionals

Project Focus: Knowledge translation; dialogue

Implementation Level:
Local and Regional

Stage of Development:
Ongoing

Background

Spryfield is a suburb of the Halifax Regional Municipality (HRM), well known for its strong sense of community and history of resident participation in civic life. Recently, members of the Spryfield Residents’ Association (SRA) became concerned about development coming to their community. The Residents’ Association saw the need to give citizens a tool for assessing local development proposals for their potential impact on community health.

The Chebucto Communities Development Association’s Marjorie Willison (also a local resident on the committee) saw a link between the needs of the SRA and her organization’s mandate. With a background in population health and health promotion, she was able to make the initial connection between the SRA’s concerns and the need to increase understanding of the strong, but generally unrecognized, link between community design and the health and well-being of the public.

Seeing that more work could be done in this area, CCDA applied for funding and launched the Healthy Housing, Healthy Community (HH,HC) project in October 2005. The project revolved around an extensive engagement process with four groups who do not usually find themselves at the same table: planners, public health professionals, developers and residents. These groups were brought together for four facilitated Round Tables as well as one-on-one discussions. With input from these four stakeholder groups, and an extensive review of the literature, CCDA developed a user-friendly Healthy Development Evaluation Framework, and the Healthy Places Toolkit, both designed to help residents, health professionals, and planners assess existing and proposed developments to determine how well they support community health. The project was not part of a particular planning process, but rather about getting groups ready for the planning process.

Partnerships

To complement her background in public health promotion, Willison added an environmental planner to the HH,HC project team. This duo clicked, and the synergy of their collaboration filtered down to the participants. Their collaboration demonstrated that individuals with health and planning backgrounds could work effectively as a team.

CCDA got the players to participate simply by identifying the right people and asking them to participate. Attendance at the Round Tables was high.

Getting these groups to the same table was a successful first step, given the history of conflict related to development in HRM. After the Round Tables, the feedback from all sides was that they appreciated the chance to build something together - the Healthy Development Evaluation Framework. The Round Tables got divergent groups at the table talking in a meaningful way. Through facilitated dialogue, the residents learned about the challenges faced by developers, and health professionals and planners contributed their perspective on how housing affects health. As well, many informal one-on-one conversations took place.

The CCDA project team kept the participants engaged by sending out frequent project updates, Round Tables’ results, and requests for feedback at all stages.

Generating Buy-In

Early feedback showed some hesitancy to give full support, but by the second round of stakeholder interviews, the comments were very positive. Now in its final stages, the project enjoys a great deal of support, and has received almost universally positive reports from all the sectors involved.

The philosophy from the beginning was to focus on stakeholder input. Because the Healthy Places Toolkit was grounded in literature and then refined by the stakeholders at the Round Tables, all four groups had a say in shaping it. This contributed greatly to the buy-in and sense of ownership around the document.

It became evident during the project that while the link between the built environment and physical activity is generally understood, the link between the built environment and other factors affecting health is not as well known. In order to educate the public about the many aspects of health affected by the built environment, the CCDA returned to four strategies of health promotion:

1. Raise Awareness;
2. Change Attitudes;
3. Change Behaviours; and
4. Maintain Changed Behaviours.

Thanks to the HH,HC project, awareness and changing attitudes are taking root in Spryfield and HRM. The challenge now is to work towards changing behaviours and maintaining those changed behaviours among planners, developers, and public health professionals.

At the Round Tables, developers suggested that establishing a prize or award for excellence in healthy development would help to get the word out to other developers. An award would allow for peer recognition, provide publicity for healthy developments, and create visibility for developers committed to promising practices in healthy community design. The CCDA is currently working with the municipality to develop criteria for an award.

Lessons Learned

Lessons learned include:

• Identify and include all major stakeholders from the beginning. The next time around the CCDA would like to include financers (bankers) as a fifth stakeholder group;
• Ground your work in existing literature to build credibility;
• Developing trusting relationships takes time;
• Having a common focus reduces conflict;
• Senior staff within the municipality can make change happen over the long term; Councils often change with elections;
• Uptake of project results takes time; and
• Carry on in spite of setbacks.

The need to tailor your message to suit your audience has been another important lesson learned. During the project, CCDA worked to frame their key message for different audiences. For planners, they framed the issue in terms of smart growth planning and environmental sustainability. For developers, they highlighted how healthy development principles could reduce conflict-related delays and improve sales. For health professionals, they focused on relating the built environment to reducing poverty and health inequities. Finally, for residents, the key message was how they could contribute to making their communities better places to live for themselves, their children, and their grandchildren.

One unanticipated spin-off was a partnership with a Professor at Dalhousie University who is planning to map Spryfield with the indicators from the Framework using a Geographic Information System (GIS). This GIS inventory will add to other mapping layers used by the municipality. Over the coming years, health and population layers will be added to the data set and at that point they can start to see the interconnections among the built environment indicators, population information, and health status.

On the ground in Spryfield, the next step is for residents to use the tools developed during Spryfield’s planning process. While the first few months of the project seemed to move slowly, the last few months have seen an increase in momentum. Things are coming together, and local public health and planning professionals are now discussing joint training opportunities. As well, a developer in Spryfield is planning a development using the Healthy Development Evaluation Framework as a guide.

Advice to Other Communities

The HH,HC project team has already started to get the word out to other communities - hard copies of project results including the toolkits, framework,  bibliography and a CD were mailed to Mayors, Chief Administrative Officers and Directors of Planning in the 10 largest cities in each province across Canada, plus the territories. The HH,HC Healthy Places Framework graphic that was developed (see below) contains suggested indicators that can be adapted or added to those already used by towns and cities. The attributes of a healthy community, however, are not likely to change over time. The project team’s advice is to start by building evidence and bringing stakeholders together.

Evaluation and Impact

Evaluation of the project included participatory process evaluation, and impact evaluation in the form of two rounds of stakeholder interviews. Midway through the project, the feedback was positive, but tentative. By the second round of evaluation, the reviews were overwhelmingly positive.

CCDA has participated in the Community-Based Research Network through the University of Ottawa and realized in networking with others around the country that the work they are doing is innovative.

There are few approaches being employed today that specifically consider not only the link of the built environment to physical activity (access and linkages), but also sociability, nature and resources, multiple activities and uses, healthy housing and neighbourhoods, and safety, comfort and identity.

As for health outcomes related to this project, it is still too early to tell. But with Dalhousie University mapping indicator data for Spryfield into GIS, there will soon be an excellent baseline for measuring changes in population health over time.

It is known, however, that the tools developed are also being incorporated into community visioning within the Halifax Regional Municipality. In a way, the project has come full circle – the very residents who brought forward their concerns and helped to shape the Framework and Toolkit are now using the tools and are empowered to engage in the planning process.

Healthy Places Framework graphic
Image Credit: Chebucto Communities Development Association

While the HH,HC project is coming to a close, the project team feels that change will continue to occur. “Planners and Health Professionals are talking with each other – they have started going down that road and the project now has a life of its own.”

Contact

Marjorie Willison
Project Manager, Chebucto Communities Development Association
Spryfield Mall, 16 Dentith Road
Halifax NS B3R 2H9
Telephone: 902-477-0964
E-mail: ccda.willison@ns.sympatico.ca

Resources

Visit the Chebucto Communities Development Association web site to download the Healthy Development Evaluation Framework, and the Healthy Places Toolkit, in English or French