Building the capacity of health authorities to influence land use and transportation planning: Lessons learned from the Healthy Canada by Design CLASP Project in British Columbia.

OBJECTIVES: The main objective of the Healthy Canada by Design CLASP Initiative in British Columbia (BC) was to develop, implement and evaluate a capacity-building project for health authorities. The desired outcomes of the project were as follows: 1) increased capacity of the participating health authorities to productively engage in land use and transportation planning processes; 2) new and sustained relationships or collaborations among the participating health authorities and among health authorities, local governments and other built environment stakeholders; and 3) indication of health authority influence and/or application of health evidence and tools in land use and transportation plans and policies. PARTICIPANTS: This project was designed to enhance the capacity of three regional health authorities, namely Fraser Health, Island Health and Vancouver Coastal Health, and their staff. These were considered the project's participants. SETTINGS: The BC regions served by the three health authorities cover the urban, suburban and rural spectrum across relatively large and diverse geographic areas. The populations have broad ranges in socio-economic status, demographic profiles and cultural and political backgrounds. INTERVENTION: The Initiative provided the three health authorities with a consultant who had several years of experience working on land use and transportation planning. The consultant conducted situational assessments to understand the baseline knowledge and skill gaps, assets and objectives for built environment work for each of the participating health authorities. On the basis of this information, the consultant developed customized capacity-building work plans for each of the health authorities and assisted them with implementation. Capacity-building activities were as follows: researching health and built environment strategies, policies and evidence; transferring health evidence and promising policies and practices from other jurisdictions to local planning contexts; providing training and support with regard to health and the built environment to health authority staff; bringing together public health staff with local planners for networking; and participating in land use planning processes. OUTCOMES: The project helped to expand the capacity of participating health authorities to influence land use and transportation planning decisions by increasing the content and process expertise of public health staff. The project informed structural changes within health authorities, such as staffing reallocations to advance built environment work after the project. Health authorities also forged new relationships within and across sectors, which facilitated knowledge exchange and access of the public health sector to opportunities to influence built environment decisions. By the end of the project, there was emerging evidence of a health presence in land use policy documents.
CONCLUSIONS: The project helped to prioritize, accelerate and formalize the participating health authorities' involvement in land use and transportation planning processes. In the long term, this is expected to lead to health policies and programs that consider the built environment, and to built environment policies and practices that integrate population health goals, thereby reducing the risk of chronic diseases.