It’s a big, fat problem for public health officials. But Peel Region has decided to stop counting calories and start shedding the guilt as it confronts ballooning obesity rates with some radical new medicine.

Instead of scolding people to eat right and exercise, the region wants its planners and policy makers to start designing communities that intrinsically promote healthier living — with more stairs, transit, enticements to walk or cycle, and easier access to healthy food.

In the same way cities once put money and muscle into improving sanitation — building sewers and water treatment plants — to stop the spread of infectious disease, they must now play a role in preventing chronic disease, said Dr. David Mowat, Peel’s medical officer of health, who was part of a Friday gathering in Mississauga called Healthy Peel by Design.

It’s a tough proposition even in densely populated places like downtown Toronto, but presents particular challenges in sprawling, low-density communities such as Mississauga, Brampton and Caledon, say Peel public health officials.

“Sure, it’s a challenge in the suburbs but it’s not going to get any better if we don’t get everybody in the same room and try and figure it out,” said Gayle Bursey, the region’s director of chronic disease and injury prevention.

“You have to have enough density, you have to have transportation, you have to have enough mixed use (development), so there are interesting things for people to walk to,” she said.

We have engineered the physical activity out of our busy lives, Mowat pointed out. “Our rates of obesity are a normal response by normal people to an abnormal environment.”

In 2005, one in 10 Peel residents was diabetic — a ratio projected to rise to one in six by 2026.

“We’re not intending to repeat the failures of the past to arrest these issues. We’re going to do something different,” Mowat told about 450 public health experts, planners, politicians and transportation and education officials Friday. “Concentrating on weight sets everyone up for failure, so we’re going to focus on the environment.”

The conference featured a panel of New York experts who have already drawn the link between public health and urban design and acted on it.

That city’s proliferating pedestrian plazas and bike lanes have attracted international attention. But quieter measures such as buildings that give staircases more prominence than elevators are also proving effective, the conference was told.

Development incentives are attracting supermarkets to the city’s “food deserts,” and streets are being closed near schools to give children more room to play. Builders get a break if they incorporate more active living space into their designs.

The health-minded policies, many of them pushed through despite strong opposition, are starting to pay off, said Dr. Karen Lee, a Canadian who is the director of Built Environment and Active Design in the New York Department of Health and Hygiene.

She cited a 289 per cent increase in commuter cycling, a 37 percent drop in traffic fatalities, a 1.5 per cent decline in car traffic and a 5 per cent drop in car registration over the past decade. There’s even been a small reduction in the worrying statistics on childhood obesity.

Many of the ideas are environmentally friendly and accessible but not necessarily expensive, said Lee. Posting signs near elevators that read “Burn calories, not electricity” can boost stair usage by 50 per cent. Drinking safe tap water is better for the environment than expensive bottled water.

“Neighbourhoods that are well designed for pedestrians are usually well designed for people with disabilities,” she said.

One of the sites the visiting New Yorkers toured last week was Brampton’s Mount Pleasant development, which shares its name with the GO station near Mississauga Rd. and Bovaird Dr. It has an updated version of the traditional village clock tower and village square. There’s a library and recreation centre, a playground, public art and gardens — all designed to make the village centre a destination. Across the street there are hair salons and dry cleaners, small retail store handy for GO commuters and just a stroll away for residents.

But Mount Pleasant is an island amid acres of sprawling tract homes, strip malls and big-box stores.

“Look, I know we’re trying to overachieve,” acknowledged Bursey, who helped organize Friday’s conference.

She’s also behind a new document called Changing Course Creating Supportive Environments for Healthy Living in Peel. Its message is simple: Eat and move. Do it for enjoyment, do it regularly and do in a health-supportive environment.

“The issue of health and the built environment is relatively new,” said Bursey. But the link is obvious. That’s why Peel has developed a Healthy Development Index.

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It points to the land use and transportation needed to create more walkable communities.

David Burney, New York’s commissioner of Design and Construction, admitted he was worried the Big Apple experience might not translate to Peel. “But when you look at things on a people scale, the issues are the same,” he said.

Ultimately, building healthier cities will be left to local government, Burney said. Public health concerns are converging with an increasing desire by citizens to see their governments address quality of life issues.

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