February 25, 2021

By Michael Twigg


Over the next 15 years, Canadian communities will become older, warmer, and sicker. By 2036, 10 million Canadians will be over age 65, increasing their risk of chronic illness and disability[1]. In that same time period, total health expenditures are expected to increase by 33%[2]. More than 80% of the population will live in urban areas where parks, trees, and green spaces will be crucial for reducing the severity of health risks associated with climate change and exposure to pollutants. It will also be critical that Canadians in these urban areas have access to nature, which is shown to significantly reduce the spread of several non-communicable diseases, including heart disease, diabetes, and respiratory illnesses[3].

Against this backdrop of an ageing population and a changing climate, planning for investments in nature-based solutions are front of mind for decision-makers across the country. These types of solutions can help provide climate resilience and positive health outcomes.

As part of our ongoing work on how clean growth and climate action positively benefits human health, Smart Prosperity recently welcomed several municipalities, academic experts, and public health officials to virtually discuss their experiences using nature-based solutions (NbS) to enhance health in their communities. Representatives from BC Healthy Communities provided insight into their experience working with local governments in British Columbia to promote environmental health through community engagement, and a representative from Peel Public Health in Ontario shared how addressing climate change has catalyzed planning and programs that link health to urban greenspaces.

The event closed with a pair of talks focusing on implementation strategies. The Municipal Natural Assets Initiative shared their journey of creating a cross-Canada approach for valuing natural assets. EcoHealth Ontario highlighted preliminary findings from a recent pilot project in the City of Brampton, where they analyze the business case for increasing tree canopy cover as an effective low-cost health intervention.

Throughout the workshop, participants highlighted that nature-based approaches are becoming integrated into climate strategies. There was also a common theme highlighting how greenspaces and parks have become a vital aspect of urban planning to promote mental and physical health in their communities – a reality only further emphasized by the Covid-19 pandemic.

Here we highlight a few of the key findings from our workshop to understand the reality of the situation on the ground and keep the conversation moving forward in the right direction.


1) Current project accounting methods for NbS do not capture the full scope of benefits:

Traditional accounting methods and cost benefit analyses (CBA) used for grey infrastructure projects have become the standard for evaluating NbS aimed at improving human health. Since health considerations are not part of standard CBA, NbS are at a disadvantage when decision-makers are considering viable interventions to build healthier communities. To capture the full scope of health benefits from NbS interventions, these types of projects are better evaluated and considered in terms of their cost effectiveness (CEA) as a strategy to achieve a desired unit of improvement – e.g., the cost of street trees compared to other interventions with the aim of reducing the incidence of skin cancer. 


2) Small coalitions continue to drive collaboration around measuring the health impacts of NbS:

Coalitions of specialized stakeholders are often responsible for advancing conversations around the health benefits of NbS, yet collaboration across departments and disciplines is a significant challenge in project planning. In the absence of an integrated management structure to build a healthy urban environment, collaborating across multiple stakeholder groups - including, public health, urban planners, and park and recreation staff - can create conflict when setting objectives at the project-level. Developing a strategy for integrated management and a framework for collaboration could help reduce the costs of collaboration and extend the existing knowledge networks beyond the small coalitions currently driving the discussion.  


3) There is a need to balance the precision of data with the development of practical tools for decision-makers:

There is sufficient science-based evidence to link NbS to a range of physical and mental health outcomes. However, workshop participants identified the need for information to be better tailored to deliver the right information into the hands of those responsible for project development and budgetary planning. Developing a step-by-step guide to walk project planners through the available evidence and link specific health impacts to different types of natural infrastructure will help bridge the gap between a focus on the accuracy of measurements in the literature and how it can be applied at the project level.


Smart Prosperity will be integrating these findings into our ongoing research. This line of inquiry will explore viable strategies that highlight the capacity for NbS to reinforce physical and mental health, while also building social cohesion through the promotion of equity, diversity, and inclusion. Even though the insights gathered from our workshop series represents a diversity of viewpoints and local priorities from across Canada, a consensus emerged around the need to develop practical tools and best practice guidelines to support decision-makers. This consensus will serve as the framework for Smart Prosperity’s ongoing work on how to better integrate health considerations when using nature-based solutions.


To learn more in a Nature-Based Solutions and Health webinar in Spring 2021, sign up for our newsletter.

[1]Statistics Canada. Population Projections for Canada (2018 to 2068), Provinces and Territories (2018 to 2043). Government of Canada. Available from https://www150.statcan.gc.ca/n1/pub/91-520-x/91-520-x2019001-eng.htm (Accessed February 3, 2021)

[2]Institute for Health Metrics and Evaluation (IHME). Financing Global Health Visualization. University of Washington, 2020. Available from http://vizhub.healthdata.org/fgh/. (Accessed February3, 2021)

[3]van den Bosch, M. and Å Ode Sang. “Urban Natural Environments as Nature-Based Solutions for Improved Public Health – A Systematic Review of Reviews.” Environmental Research, 158: 373–84. https://doi.org/10.1016/j.envres.2017.05.040.