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Research Project

The Halton Region Health Department initiative “Healthy Weights: Halton Takes Action” originated from a “Call to Action” in the 2004 Ontario Chief Medical Officer of Health report. The report described an epidemic of overweight and obesity that is threatening the health of children and adults in Ontario and other regions of North America. Halton has not escaped from this trend. In Halton, 55% of residents aged 18 and over were considered overweight and obese in 2010 (Rapid Risk Factor Surveillance System, 2010, 2010 Body Mass Index (BMI) Indicator Report Adobe Portable Document Format (PDF)183KB). Unfortunately, this is not just a problem with adults. Overweight children are of particular concern because they are more likely to develop chronic health problems. However, despite well-known recommendations to be physically active and to eat nutritious foods, traditional health promotion that focused on individual behaviours has had only modest impact on the problem. As part of the Healthy Weights Initiative, the Halton Region Health Department brought together representatives from diverse sectors of the Halton community in June 2007 to explore causes and possible solutions to the obesity epidemic.

These community discussions identified 3 priorities:

  • to develop walkable and bikeable communities
  • to increase the availability of healthy food choices within the community
  • to ensure community coordination of the Healthy Weights Initiative
These priorities are consistent with a growing body of international public health evidence, which supports an increased emphasis on creating built environments where healthy nutrition and physical activity choices are the easiest choices.

To complement this process, the Health Department partnered with academic researchers to generate new information about the built environment in Halton’s neighbourhoods and allow future evaluations of their change. The Healthy Weights Study aimed to examine the relationship between grade 7 students’ weights and various individual and community level factors that had been identified in the literature as important for physical activity and nutrition. The study identified associations between the students’ overweight or obesity and low neighbourhood educational levels or individual-level risk factors, such as low physical activity, high screen time, and infrequent breakfast. Other modifiable environmental-level risk factors were not found to be associated in this study.

The results from any study can only be interpreted properly with a good understanding of the setting of the study and the limitations of the study’s methods. Caution should be used in interpreting the results of this study given the characteristics of Halton Region’s built and nutrition environments and its residents. One of the study’s limitations is that it cannot be used to explore causality and determination. Any research aiming to identify a causal association between variables needs variation across comparison groups and over time. However, this research was conducted in 2007 in a largely affluent region composed of suburbs with little diversity in the built and nutrition environments. At the time of this study, Halton’s density was below the minimum threshold that research has found is needed in order to see a shift from vehicles to transit or active modes of travel (Halton Region Health Department, 2009, Creating Walkable and Transit Supportive Communities in Halton Adobe Portable Document Format (PDF)515KB). This has important implications because there is little variability to explore the association between core variables such as levels of physical activity and the nutrition and physical activity environments. A background document describing the Healthy Weights Study in the context of the Halton Region can be accessed here.

A final report for the Healthy Weights Study is also available. The study results provide a baseline to inform program planning and future evaluations. To achieve this, the study used a cross-sectional design, which examines only one point in time. This study examined some associations between variables such as walkability index and self-reported levels of physical activity. However, to better study the effect of environmental changes on obesity, an alternative study design would look at changes over time. Increasingly, public health evidence from other studies shows that the built environment, nutrition environment, and healthy food intake are associated with obesity (Halton Region Health Department, 2009).