Do you live a high-risk community? Snapshots of more than 2000 Canadian neighbourhoods

For attention of:  City planners and developers, The Canadian Institute of Planners (CIP), Planning & Development sectors (local and provincial), Public Health Agencies, Mayors of urban and rural communities, Members of Parliament (local, provincial, national), Local advisory committees

What is the problem: Cardiovascular disease rates vary considerably among populations, across geographic regions, and over time. The physical environment in which a person lives strongly influences the development of risk factors for several chronic diseases.

This environment also varies across populations, geography, and time. We need to examine environmental factors as the initial causes of conventional cardiovascular disease risk factors, because the environment may affect health behaviours through physical (e.g. community resources, built environment) and/or social (e.g. social support, norms) dimensions.

The environment may influence food consumption, physical activity, smoking, and other health-related behaviours. These behaviours may, directly or indirectly, increase the risk of chronic diseases such as cardiovascular disease and cancer.

What we did and why: We undertook snapshots of 2, 074 rural and urban communities across Canada. We assessed the following features: demography, public transport, availability and prices of tobacco, groceries, and alcohol and healthful restaurants.

What this study adds: Through the completion of over 2,000 community audits across Canada we found that;

  • urban communities were more accessible by public transit,
  • food prices were highest in eastern and lowest, in western Canada,
  • fruit and vegetable availability varied less, by season in urban than rural communities, cigarette prices, were highest in eastern and lowest in central provinces,
  • alcohol prices were lowest in central and highest in western provinces,
  • urban restaurants were more likely than rural restaurants to promote healthy items and provide nutrition information.

Thus, through the identification of key differences between urban and, rural communities and across provinces, we have demonstrated, the importance of considering contextual factors when, developing strategies to reduce the burden of cardiovascular disease burden in Canada.

Implications for city policy and practice: We collected extensive data on contextual factors that may influence chronic disease risk at the community level;

  • public health and built environment professionals, and government officials need to jointly consider these data,
  • federal and provincial strategies need to be developed to reduce the burden of chronic diseases across Canada, international lessons can be drawn too,
  • These data show where policies are effective (e.g. no tobacco sales in restaurants),
  • We have highlighted the gap between exposure to processed food advertising and healthful food advertising – the former outnumbers latter two-fold.

Agencies should consider these findings when developing regional, provincial or national strategies to reduce the cardiovascular disease burden.

For further information:

Commentary and debate – the story and the interactive tool: Development of an on-line interactive map to display environmental health assessments of Canadian communities: knowledge-translation to support collaborations for health

Online interactive map:
CAHHM study website:

Full article: Environmental health assessment of communities across Canada: Contextual factors study of the Canadian Alliance for Healthy Hearts and Minds

Authors: de Souza RJ, Gauvin L, Williams NC, Lear SA (@DrScottLear), Oliveira AP, Desai D, Corsi DJ (@ Djcorsi), Subramanian SV, Rana A, Arora R, Booth GL, Razak F, Brook JR, Tu JV, and Anand SS  (@DrSoniaAnand1) on behalf of The Canadian Alliance for Healthy Hearts and Minds Study Investigators (@cahhm_study)

City Know-how editor: Marcus Grant