Healthy Places in the Making

Adapting cities for health since 3000BC!

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Skara Brae, Scotland

Skara Brae

Earliest record of separate fresh- and waste-water systems.  


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400s (BC)

On Airs, Waters & Places

Hippocrates warns against swamp-living.  


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The industrial revolution

The growth of cities in Europe during this period leads to sanitation challenges, polluted streets and disease outbreaks.   


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1850s – 1890s

The Lungs of the City

Frederick Law Olmsted calls parks the “lungs of the city”. Parks become public spaces, providing opportunities for recreation and exercise regardless of socio-economic status.  

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The rise of Canadian cities

Canadian cities see substantial growth, and Montreal in particular, as a port, rail centre and industrial  centre. Immigration and domestic birth rates are high. Telephone, telegraph, skyscraper, electric light, and central heating are implemented.  Public transport develops to service middle-class suburbs made up of single house on single lots, first by horsecar, then electric streetcar.



1870s: The Canadian Constitution creates the foundation for municipal revenue generation.  

1874: Dr. Edward Playter creates The Sanitary Journal, and later becomes Canada's first Medical Officer of Health.   

1870s-1920s: Sewer investments are made in Ontario.

1880s: Provincial Boards of Health are created in Ontario and Quebec. Le journal d'hygiene is created in Quebec.  

1885: While not the only Canadian city to experience outbreaks of disease, Montreal sees the highest mortality rates from smallpox in North America in the 19th century.

1890s: “Water Closet Ames” (Herbert Brown Ames) leads a campaign against “pit privies” in Montreal.

1892: The Toronto Street Railways replaces the horsecar service with electric streetcar service.




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1910s and 1920s

The Rise of the Personal Vehicle

Personal motor vehicle use increases. Collisions increase, with backlash from concerned parents and citizens. The concept of “jaywalking” is born. Prior to the 1920s, city streets were considered public space where children played and pedestrians crossed wherever they liked. In the mid-1920s, as a result of automaker lobbying, laws were passed that restricted pedestrian movement.

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1920s and 1930s

Rural Conservation

Campaigns to protect rural environments take shape in Britain. Green belts and urban growth boundaries aim to control urban sprawl and protect agricultural land, forests, and natural, recreational spaces. Similar policies are adopted in the U.S. in the 1950s, in France in the 1960s, in South Africa in the 1970s, and in Canada and Australia in the 2000s.


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Places for People, Places for Superhighways

Jane Jacobs and Jan Gehl focus on building ‘places for people’, where people can walk, enjoy each others’ company, and frequent local businesses. Their analysis and tools contribute to the field of Planning.

Highway 401, the Don Valley Parkway and Autoroute Metropolitaine are built. Interestingly, Calgary shelves the proposed “Downtown Penetrator”. Parallel proposals to pedestrianise 8th Avenue and turn 7th Avenue into a transit-only street move forward, and exist today.    

1952: The Great Smog of London. 4,000 additional deaths over five days due to smog.

1954: The Toronto Subway is born

1964: The word "gentrification" is coined by Ruth Glass.  

1966: The Montreal Subway is born. 

1968: The idea behind Montreal's "Ruelles vertes" is born among 5 architecture students. 


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Suburban Sprawl, Stop de Kindermoord

In the 50s and 60s, planners were excited about new technology and "clean" suburbs.  By the 1970s, suburban sprawl begins in earnest in North America.  Unintentionally, this creates financial challenges: cities experience higher demands for services and infrastructure, while struggling to increase tax revenue. 

Meanwhile in the Netherlands, over 500 child fatalities in one year moves citizens to protest. Combined with the pressures of oil shortages, Dutch cities shift towards designing cities for travelling on foot and by bike. Cycling is now the most commonly used transportation mode for 36% of the population.

1978: Edmonton Light Rail Transit (LRT) is born,

1979: 1/4 Canadian children are overweight or obese.  This will rise to 1 out of 3 in the 2000s.  

1979: Portland, Oregon’s Urban Growth Boundary is created.  



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The World Health Organization World Charter

Access to health, including a healthy environment, is acknowledged as a human right.


1984: Healing properties of garden views in hospitals are discovered by Roger Ullrich.



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Vision Zero, Air Quality

Vision Zero is approved by the Swedish Parliament. Fatalities decrease 30.7% 1980-2016, and Sweden  has the lowest rate of fatalities at 27/million inhabitants. The Vision Zero movement spreads across the world.

New air quality regulations in Canada lead to substantial improvements.


“Ruelles vertes” begins in Montreal, leading to a present-day total of 346 designated laneways,  for a total of 69 kilometres of these laneways.

1995: Journal of Health and Place established.

1996: “City Repair” group is born in Portland, in response to a fatal collision with a child.  They focus on what will become known as tactical urbanism. This leads to an “Intersection Repair Ordinance” in 2003, which invites residents to paint intersections and design public spaces on their four corners, with the support of the City of Portland.

1998: Healthy Cities initiative launched by the WHO.



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Physical activity, health and the built environment

The U.S.Centre for Disease Control focuses on the relationships between built environment and physical and mental health, and funds the Healthy Design Initiative.   

2003 - London congestion charge is introduced.  

2006: Diabetes identified as “global threat” by the UN  

2006: ⅓ children are obese in Canada, up from ¼ in 1979.


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Active Neighbourhoods Canada

Active Neighbourhoods Canada is born!

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A boom of research, dissemination and action

Popular and academic writing on the links between active transportation, health and the built environment surges.  The Canadian Institute of Health Research identifies healthy cities as a priority areas.  Research reveals hours spent driving is correlated with obesity, while neighbourhood greening and walkability are negatively correlated with weight status and socio-economic status. Canadian communities accelerate policy change to encourage active transportation and experiment with tactical urbanism, cycling infrastructure, “road diets” and new speed policies.   

2011: Obesity rates triple among Canadians (1985-2011).

2014: Rates of diabetes increase by 43% in Canada, 2003-2014.    

2014: SOx emissions in Canada decrease 71%, 1990-2014, as a result of regulation.  

2014: The Journal of Transport and Health is established.

2015: The City of Edmonton adopts Vision Zero.

2015: The Cycle Track is built in Calgary, following the Peace Bridge in 2012. Cycling sees a 50% increase for work trips 2012-2018.

2015: Nike’s Designed to Move summarizes 521 findings across 17 countries on benefits of building active cities.

2016: The National Association of City Transportation Officials releases Urban Street Design Guide

2017: Chief Public Officer of Health Theresa Tam releases The State of Public Health in Canada 2017: Designing Healthy Living.

2018: The Canadian Institute of Planners releases their Healthy Communities Policy.