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Abstract Background Road-related injuries and deaths are among the most significant and avoidable public health problems in Canada. Modifications to the built environment (BE) can reduce injury rates for vulnerable road users (VRUs) and other priority populations who experience disproportionate risk. This paper highlights public health professionals’ experiences working in injury prevention across Ontario public health units (PHUs) navigating barriers and facilitators to BE change. Their perspectives offer valuable insights that can support future BE change work in the Ontario public health context, thus illustrating the importance of including practitioners’ voices in injury prevention research. Methods Qualitative data were collected for a larger pan-Canadian study examining barriers and facilitators to BE change from the perspectives of injury prevention and transport professionals working across a variety of sectors, including public health, using key informant interviews (KI) and virtual focus groups (VFGs). Participants (n = 9) from four PHUs are included in this present study: Peel Region; York Region; Peterborough; and Ottawa. Thematic analysis was used to organize and code the data in relation to the guiding principles of the Ontario Public Health Standards (OPHS), situating our results within the broader context of public health and road-related injury prevention in Ontario. Results Major barriers included motor vehicle prioritization and decision-making structures. Facilitators included partnerships and collaboration, champions and advocates, and access to data. Lastly, participants highlighted the important role of public health in BE change discussions and decision-making for road-related injury prevention. Conclusion Public health professionals’ insights about barriers and facilitators show that some of their work aligns with the existing OPHS. Needs of local populations are clearly identified, while local data illustrating the impact of public health interventions are lacking. There are limits to PHU’s capacities, as well as the capacities of communities, which can be strengthened through the work of champions and advocates. Partnerships, collaboration, and engagement are also significant facilitators to BE change, aligning with the OPHS, but PHUs need to be involved more in BE change processes in order to prioritize the safety needs of VRUs in local communities.

Despite Canada’s strengths and widespread acknowledgment of the importance of children and youth, this country recently ranked 30th among 38 high-income countries on indicators of their well-being (UNICEF Innocenti 2020). While there are limited data readily available for monitoring within and across jurisdictions, Alberta compares worse than Canadian averages on indicators of early development vulnerability and child abuse (PHAC 2023a). The Alberta government convened a Child and Youth Well-being Review (GOA 2021) and Action Plan (GOA 2022a) to understand and address the pandemic’s adverse impacts. Indigenous and racialized children and youth, children in low-income families and children with disabilities were highlighted as being disproportionately impacted. In addition, the review found significant gaps in mental health, education, social data and evidence along with fragmentation of data within ministries and service systems (GOA 2021). Influences on child and youth health, well-being and health inequity have social, environmental and economic origins that extend beyond health policy boundaries (Lopez et al. 2021; Vargas-Barón, Diehl and Small 2022; Clark et al. 2020; Patton et al. 2016). Yet, public policy can be a powerful intermediary between children’s conditions and outcomes (UNICEF 2020). Cross-sectoral, whole-of-society approaches are required to improve child and youth health and well-being and government ministries have important roles to play (Akseer et al. 2020; De Montigny, Desjardins and Bouchard 2019; Leppo et al. 2013). Meaningful and accessible measurement and monitoring information is required to support co-ordinated, cross-sectoral decision-making and policy strategies to improve health outcomes and reduce health inequities (OECD 2021). Information is required about child and youth material living standards, physical and mental health, social lives and learning and education (OECD 2021). While definitions of child and youth well-being vary depending on diverse perspectives and cultural, social and local contexts, many established indicators and frameworks can be tailored to local community needs and priorities (OECD 2021).

Abstract Background Concerns regarding health equity (HE) and the built environment (BE) are well established in the Canadian urban context. Transport and injury prevention professionals across sectors, such as transportation and public health, are involved in designing and implementing BE interventions that enhance the safety of vulnerable road users (VRUs). Results from a larger study examining barriers and facilitators to BE change are used to illustrate how transport and injury prevention professionals perceive HE concerns in their work in five Canadian municipalities. Broadening our understanding of how HE influences the professional BE change context is crucial when advocating for modifications that enhance the safety of equity-deserving VRUs and groups who experience marginalization. Methods Interview and focus group data were gathered from transport and injury prevention professionals working in policy/decision-making, transport, police services, public health, non-profit organizations, schools/school boards, community associations, and private sectors across five Canadian urban municipalities: Vancouver, Calgary, Peel Region, Toronto, and Montréal. Data were analyzed using thematic analysis (TA) to illustrate how equity considerations were perceived and applied in participants’ BE change work. Results The results of this study illustrate transport and injury prevention professionals’ awareness of the varying needs of VRUs, as well as the inadequacies of current BEs in the Canadian urban context and consultation processes utilized to guide change. Participants emphasized the importance of equitable community consultation strategies, as well as specific BE changes that would support the health and safety of VRUs. Overall, the results highlight how HE concerns inform transport and injury prevention professionals’ BE change work in the Canadian urban context. Conclusion For professionals working in urban Canadian transport and injury prevention sectors HE concerns influenced their perspectives of the BE and BE change. These results illustrate a growing need for HE to guide BE change work and consultation processes. Further, these results contribute to ongoing efforts in the Canadian urban context to ensure that HE is at the forefront of BE policy change and decision-making, while promoting existing strategies to ensure that the BE, and related decision-making processes, are accessible and informed by a HE lens.

Abstract Background Pedestrian related deaths have recently been on the rise in Canada. The effect of changing posted speeds on the frequency and severity of pedestrian motor vehicle collisions (PMVC) is not well studied using controlled quasi-experimental designs. The objective of this study was to examine the effect of lowering speed limits from 40 km/h to 30 km/h on PMVC on local roads in Toronto, Canada. Methods A 30 km/h speed limit on local roads in Toronto was implemented between January 2015 and December 2016. Streets that remained at a 40 km/h speed limit throughout the study period were selected as comparators. A quasi-experimental, pre-post study with a comparator group was used to evaluate the effect of the intervention on PMVC rates before and after the speed limit change using repeated measures Poisson regression. PMVC data were obtained from police reports for a minimum of two years pre- and post-intervention (2013 to 2018). Results Speed limit reductions from 40 km/h to 30 km/h were associated with a 28% decrease in the PMVC incidence rate in the City of Toronto (IRR = 0.72, 95% CI: 0.58–0.89). A non-significant 7% decrease in PMVC incidence rates were observed on comparator streets that remained at 40 km/h speed limits (IRR = 0.93, 95% CI: 0.70–1.25). Speed limit reduction also influenced injury severity, with a significant 67% decrease in major and fatal injuries in the post intervention period on streets with speed limit reductions (IRR = 0.33, 95% CI: 0.13–0.85) compared with a 31% not statistically significant decrease in major and fatal injuries on comparator streets (IRR = 0.69, 95% CI: 0.37–1.31). The interaction term for group and pre-post comparisons was not statistically significant (p = 0.14) indicating that there was no evidence to suggest a pre-post difference in IRRs between the intervention and comparator streets. Conclusions Declines in the rate of PMVC were observed on roads with posted speed limit reductions from 40 km/h to 30 km/h, although this effect was not statistically greater than reductions on comparator streets.

Introduction: Despite the accumulating Canadian evidence regarding the relations between urban form and health behaviours, less is known about the associations between urban form and health conditions. Our study aim was to undertake a scoping review to synthesize evidence from quantitative studies that have investigated the relationship between built environment and chronic health conditions, self-reported health and qual¬ity of life, and injuries in the Canadian adult population. Methods: From January to March 2017, we searched 13 databases to identify peer-reviewed quantitative studies from all years that estimated associations between the objectively-measured built environment and health conditions in Canadian adults. Studies under¬taken within urban settings only were included. Relevant studies were catalogued and synthesized in relation to their reported study and sample design, and health outcome and built environment features. Results: Fifty-five articles met the inclusion criteria, 52 of which were published after 2008. Most single province studies were undertaken in Ontario (n = 22), Quebec (n = 12), and Alberta (n = 7). Associations between the built environment features and 11 broad health outcomes emerged from the review, including injury (n = 19), weight status (n = 19), cardiovascular disease (n = 5), depression/anxiety (n = 5), diabetes (n = 5), mortality (n = 4), self-rated health (n = 2), chronic conditions (n = 2), metabolic condi¬tions (n = 2), quality of life (n = 1), and cancer (n = 1). Consistent evidence for asso-ciations between aggregate built environment indicators (e.g., walkability) and diabetes and weight and between connectivity and route features (e.g., transportation route, trails, pathways, sidewalks, street pattern, intersections, route characteristics) and injury were found. Evidence for greenspace, parks and recreation features impacting multiple health outcomes was also found. Conclusion: Within the Canadian context, the built environment is associated with a range of chronic health conditions and injury in adults, but the evidence to date has limi¬tations. More research on the built environment and health incorporating rigorous study designs are needed to provide stronger causal evidence to inform policy and practice.

Introduction. En dépit de données canadiennes abondantes sur les associations entre amé¬nagement urbain et comportements liés à la santé, nous savons peu de chose sur les associa¬tions entre aménagement urbain et problèmes de santé. Cet examen de la portée est destiné à offrir une synthèse des données tirées d’études quantitatives ayant examiné la relation entre l’environnement bâti et les problèmes de santé chroniques, l’état de santé et la qualité de vie autodéclarés ainsi que les blessures au sein de la population canadienne adulte. Méthodologie. De janvier à mars 2017, nous avons effectué des recherches dans 13 bases de données afin de sélectionner, sans égard à la date de publication, les études quantitatives ayant fait l’objet d’une évaluation par les pairs et portant sur les associations entre des mesures objectives de l’environnement bâti et divers problèmes de santé affectant les adultes cana¬diens. Seules les études menées en milieu urbain ont été incluses. Nous avons catalogué et synthétisé les études pertinentes en fonction de leur sujet et de leur plan d’étude ainsi que de leurs résultats sur le plan de la santé et des caractéristiques de l’environnement bâti. Résultats. Cinquante-cinq articles ont répondu aux critères d’inclusion, dont 52 publiés après 2008. La plupart des études menées dans une seule province ont porté sur Ontario (n = 22), le Québec (n = 12) ou l’Alberta (n = 7). L’examen a permis de dégager des associations entre les caractéristiques du milieu bâti et 11 résultats généraux en matière de santé, à savoir les blessures (n = 19), le poids (n = 19), les maladies cardiovasculaires (n = 5), la dépression et l’anxiété (n = 5), le diabète (n = 5), la mortalité (n = 4), l’état de santé autoévalué (n = 2), les problèmes de santé chroniques (n = 2), les troubles du métabolisme (n = 2), la qualité de vie (n = 1) et le cancer (n = 1). Nous avons relevé des données probantes cohérentes mon¬trant des associations entre les indicateurs agrégés de l’environnement bâti (p. ex. le potentiel piétonnier) et le diabète et le poids, ainsi qu’entre la connectivité et les caractéristiques des itinéraires (p. ex. itinéraires de transport, pistes, sentiers, trottoirs, tracés de rue, intersections) et les blessures. Nous avons également extrait des données montrant l’impact qu’ont les espaces verts, les parcs et les installations récréatives sur de multiples résultats de santé. Conclusion. En contexte canadien, l’environnement bâti est associé à un éventail de problèmes de santé chroniques et de blessures chez les adultes, mais les données probantes dis¬ponibles sont limitées. Il faut mener davantage de recherches sur l’environnement bâti et la santé fondées sur des plans d’étude rigoureux afin de produire des données probantes plus solides sur les relations causales aptes à orienter les politiques et les pratiques.

Objective: To evaluate the differences in entry errors associated with entry of prospective cohort data using a single versus a dual data entry system. Design: Cross-over trial Measurements: The database for the Canadian Intercollegiate Sport Injury Registry (CISIR) has, to date, used a dual data entry system. To test the differences in entry error, one season of injury and exposure (participation) data were entered for one sport from two participating institutions. A total of 5 data entry clerks were involved. Discrepancies between the final entries from both systems were flagged and checked against the original paper record. The number of instances where the dual entry system was correct but the single entry system was incorrect, and vice versa, were determined. Results: A total of 17,988 database fields were evaluated (15,509 text and 2,479 fixed response fields). There was a statistically significant difference in error where the dual entry system was correct but the single entry system was incorrect for 2 out of the 4 data entry modules. The percent accuracy using the single entry system was lower (99.35%) than that using the dual entry system (99.83%). Conclusions: Although the single entry system was statistically different from the dual entry system, the percent accuracy remained high and the errors did not cluster in one specific field. Given the doubling of entry costs with a dual entry system, it is recommended that a single entry system be used for the CISIR.