By law Development as a Health Promotion Strategy February 2013
Introductions Presenter: Kim Bergeron, PhD kim.bergeron@oahpp.ca Health Promotion Field Support Specialist: By law and Policy Development Assisted by: Jacquie Evans, MPH Health Promotion Coordinator 2
Webinar Features Adobe Connect technology Use landline for audio Chat function to ask questions or if you need help Lecture mode 3
Learning Objectives At the end of this session you will be able to: Contextualize by law development Recognize the effectiveness of developing municipal by laws Reflect on how this information can be applied to your work 4
What are Laws? 1 Rules of conduct Upheld by an authority Enacted by each level of government 5
Municipal Laws 1 The laws related to the operation, conduct and actions of municipal entities 6
What are Municipalities? 1 Forms of local government Governed by provincial legislation 444 municipalities in Ontario Governed by the Ontario Municipal Act 2001 Can pass by laws 7
What are By laws? 2 An order or resolution Follow a specific political process Are enforceable Resolutions are an expression of a decision or wish of council 8
By laws 2 Meet the needs of, and solve problems for citizens. 9
By laws 3 Passed by elected municipal councils Influenced by public opinion, community groups, citizens Must complement federal/provincial legislation Effective, long term, enforceable 10
Health Promotion 4 Comprehensive social and political process Focused on changing social, environmental, political and economic conditions Includes building healthy public policy
Ottawa Charter for Health Promotion 5 Ottawa Charter action areas: 1. Build healthy public policy 2. Create supportive environments 3. Strengthen community action 4. Develop personal skills 5. Re orient health services
Ontario Public Health Standards 6 Develop and implement healthy public policy to create or enhance supportive environments 13
Multiple, Complementary Strategies 7 Health communication Health education Self help/mutual aid Organizational change Community development and mobilization Advocacy Policy development Intersectoral collaboration
Why Take a By Law Approach? Awareness and educational programs may be short lived Policies are more sustainable Because they are harder to change, policies can often withstand changes in decision makers 8 15
Why Take a By Law Approach? To change the built environment to facilitate healthy behaviours and create conditions for health 9 To address policies and actions outside the health sector that can affect the health of the population 10 16
Why Take a By Law Approach? To address health inequities and social determinants of health Health inequities: Differences in health status of individuals and groups that are thought to be unfair or modifiable 11 Social determinants of health: The social and economic factors that shape the health and incidence of illness among individuals and groups 12 17
Historical Overview13, 14, 15 Public health has its roots in: Urbanization Sanitary reform Environmental law Housing Zoning 18
There are three forms: Public Health Law Research16, 17 1. Interventional public health law: Explicit aim of protecting and improving public health. 2. Incidental public health law: Primarily for purposes other than promoting public health, but nonetheless has positive or negative consequences for health. 3. Infrastructural law: Establishes the powers, duties, and features of public health agencies. 19
By law Examples Topics Focus Refreshment vehicles Parkland dedication Sidewalk/snow removal Healthy eating Physical activity Injury prevention Chronic Disease and Injury Prevention Smoke free apartments Healthy pregnancies and child development Tobacco prevention Family Health Chronic Disease Prevention Idling control Health hazard prevention Environmental Health Harm reduction Infectious diseases Communicable Diseases Emergency Planning and Response Emergency preparedness Emergency preparedness Transit Taxi Equitable access to community services Social Determinants of Health 20
Example of Zoning By laws to Promote Health 18 To guide land use patterns and densities towards a more compact and intensified built form to encourage active transportation and public transit (p. 7) Related to off street parking to create more compact physical form for the community (p. 8) That requires a minimum number of bicycle parking spaces at retail, institutional, employment, educational and residential centres (p. 13) That would restrict the location and number of fast food outlets in new developments surrounding youth and child oriented land uses (p. 38) 21
Resources on Public Health Law Centers for Disease Control and Prevention 19 Systematic Review of the Effectiveness of 52 Public Health Laws Published from 1994 to May 2007 20 Public Health Journal 2006 Vol. 120 Supplement 1 21 22
Consider the following: There are challenges related to encouraging by law development: Endorsement of a Nanny State 22 Citizens may not support their enactment Unequal protection of different rights Steep learning curve It takes a long time 23
Take Home Messages Public health organizations and municipalities have a common goal: to meet the health needs of citizens By law development is aligned with health promotion practices 24
Take Home Messages Some public health issues can be addressed using bylaw development Public health law is a new area of study Public health law interventions are happening! istockphoto.com/willselarep 25
2 Roadmap for By law Development 23 26
Tell Us What You Think! Please complete the evaluation form http://fluidsurveys.com/surveys/jenny-m/by-law-as-health-promotion-strategy-feb-6-2014/ Thank You! 27
Health Promotion Capacity Building Team: Get in Touch, Stay in Touch For service request inquiries, including consultations, tailored webinars, customized face to workshops, or to sign up for our mailing list, please go to: http://www.publichealthontario.ca/en/servicesandtools/heal thpromotionservices/pages/service request form.aspx To find out more about scheduled events, please visit our calendar at: http://www.publichealthontario.ca/en/learninganddevelopm ent/events/pages/default.aspx
Upcoming Healthy Public Policy Webinars By law Development Series 2014: By law Development at a Glance February 24, 2014 Understanding Municipal Decision Makers & Influencers March 5, 2014 Register Now! 29
PublicHealthOntario.ca 30
Questions? Comments? Thoughts? Ideas? 31
References 1. MacLean MV, Tomlinson JR. A user s guide to municipal by laws. 2nd ed. Markham, ON: LexisNexis Canada Inc.; 2008. 2. Ontario Ministry of Municipal Affairs and Housing. Municipal Act, 2001. Toronto: Queen s Printer for Ontario; 2001. [last accessed 2013 Dec 9]. Available from: http://www.elaws.gov.on.ca/html/statutes/english/elaws_statutes_01m25_e.htm 3. Program Training and Consultation Centre, Play, Live, Be Tobacco free (PLBTF). Play, Live, Be Tobacco Free: A guide for developing tobacco free sport and recreation policies and by laws. [document on the internet. 2011 [last accessed 2013 Dec 9]. Available from: http://www.playlivebetobaccofree.ca/cco/media/pdfs/resources%20pdf/toolkit Play, Live, Be Tobacco Free.pdf 4. Public Health Agency of Canada. Core competencies for public health in Canada, release 1.0 [document on the internet]. 2007. [last accessed 2013 Dec 9]. Available from: http://www.phac aspc.gc.ca/php psp/ccph cesp/pdfs/zcard eng.pdf 5. World Health Organization. Ottawa charter for health promotion: An international conference on health promotion, the move towards a new public health 17 21 November. c1986. Available from: http://www.who.int/healthpromotion/conferences/previous/ottawa/en/ 32
References 6. Ontario Ministry of Health and Long term Care. Ontario public health standards. Toronto: Queen s Printer for Ontario; 2008. 7. Jackson F, Perkins F, Khandor K. Integrated health promotion strategies: A contribution to tackling current and future health challenges. Health Prom Int. [article on the Internet]. 2006 [last accessed 2013 Dec 9]; 21(1): 75 83. Available from: http://heapro.oxfordjournals.org/content/21/suppl_1/75.full.pdf+html 8. Ontario Agency for Health Protection and Promotion (Public Health Ontario), Chronic Disease and Injury Prevention, Health Promotion Capacity Building Services. Policy development at a glance webinar presentation November 28. 2013. Toronto; 2013. 9. Mensha GA, Goodman RA, Zaza S, et al. Law as a tool for preventing chronic disease: Expanding the spectrum of effective public health strategies. Preventing Chronic Disease: Public Health Research, Practice and Policy. [article on the Internet]. 2004 [last accessed 2013 Dec 9]; 1(1): 1 6. Available from: http://www.cdc.gov/pcd/issues/2004/jan/pdf/03_0033.pdf 10. World Health Organization and the Government of South Australia. Adelaide statement on health in all policies: Moving towards a shared governance for health and well being. [document on the Internet]. 2010 [last accessed 2013 Dec 9]. Available from: http://www.who.int/social_determinants/hiap_statement_who_sa_final.pdf 33
References 11. Public Health Agency of Canada. Reducing health inequities: A challenge for our times. [document on the Internet]. 2011 [last accessed 2013 Dec 9]. Available at: http://publications.gc.ca/collections/collection_2012/aspc phac/hp35 22 2011 eng.pdf 12. Mikkonen J, Raphael D. Social determinants of health: The Canadian facts. Toronto: York University School of Health Policy and Management [document on the Internet]. 2010 [last accessed 2013 Dec 9]. Available from: http://www.thecanadianfacts.org/the_canadian_facts.pdf 13. Bergeron K. An exploration of language, policies, and collaborative actions by planning and public health professionals to guide active community design. Queen s University, Kingston. [document on the Internet]. 2012 [last accessed 2013 Dec 9]. Available from: http://qspace.library.queensu.ca/bitstream/1974/7269/1/bergeron_kimberly_a_201205 _Phd.pdf 14. Wolfe J. Our common past: An interpretation of Canadian planning history. Plan Canada Special Edition [document on the Internet]. July, 1994 [last accessed 2013 Dec 9]. Available from: http://www.cip icu.ca/_cms/files/jeannewolfe_75article.pdf 15. Association of Local Public Health Agencies. 2010 orientation manual for BOH members. [homepage on the Internet]. 2010 [last accessed 2013 Dec 9]. Available from: http://www.simcoemuskokahealth.org/libraries/hu_aboutus/bohorientationmanual20 10.sflb.ashx 34
References 16. Gostin L. Legal foundations of public health law and its role in meeting future challenges. Public Health. 2006; 120: 8 15. 17. Burris S, Mays GP, Scutchfield FD, Ibrahim JK. Moving from intersection to integration public health law research and public health systems and service research. The Milbank Quarterly. 2012; 90(2): 375 408. 18. Hastings & Prince Edward Counties Health Unit. Building complete and sustainable communities: Healthy policies for official plans. [document on the Internet]. Dec. 2012 [last accessed 2013 Dec 9]. Belleville, ON; 1 57. Available from: http://www.pecounty.on.ca/pdf/healthypoliciesforofficialplans_final_web_1.pdf 19. Centers for Disease Control and Prevention: Public Health Law Program. Nutrition, physical activity, and obesity. [homepage on the Internet]. No Date [updated 2013 Jan 4; last accessed 2013 Dec 9]. Available from: http://www.cdc.gov/phlp/publications/topic/nutrition.html 20. Moulton AD, Mercer SL, Popovic T, et al. The scientific bases for law as a public health tool. Am J Public Health. [article on the Internet].2009 [last accessed 2013 Dec 9]; 99(1); 17 24. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/pmc2636607/ 35
References 21. Public Health Journal. Supplement 1. [homepage on the Internet]. 2006 [last accessed 2013 Dec 9]. Available from: http://www.publichealthjrnl.com/home# NOTE: Supplement 1 is dedicated to the topic of Public health law. 22. Daube M, Stafford J, Bond L. No need for nanny. Tobacco control. 2008; 17: 426 427. 23. Ontario Agency for Health Protection and Promotion (Public Health Ontario), Chronic Disease and Injury Prevention, Health Promotion Capacity Building Services. Roadmap for By Law Development. Toronto. 2013. 36
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