Canada’s healthiest cities 2009

Source: Best Health Magazine, March/April 2009

One year ago, Best Health took on a unique and challenging project: ranking Canadian cities from coast to coast to see which were the healthiest. We gathered exhaustive data from government agencies and some of the nation’s most esteemed non-profit organizations in 16 different categories in order to find out how a total of 20 Canadian municipalities’two from each province’measured up.

Now it’s time to check in to see how they’re doing. Using data from Statistics Canada’s 2007 Canadian Community Health Survey, we have created a report card on five aspects of healthy living that Canadians have the greatest power to change and control with regard to their own health: body weight, consumption of fruit and vegetables, amount of leisure time spent in active pursuits, stress levels and blood pressure.

Overall, we found that cities in the west did better than cities in the east’except, however, when it comes to stress levels. But right across the country there was a good degree of variability in the results’reinforcing the idea that it’s not just about where you live, but how you live.

1. Lowest rates of overweight and obese

Just as the rich get richer, it appears that, in some cases, the fit get fitter: Remarkably, Vancouver improved on its already lowest-in-the-nation numbers.

Five-time Olympian and silver-medal winner Charmaine Crooks notes that Vancouver’s vigour was part of the attraction when she moved there 17 years ago. ‘I was drawn to the natural, outdoor fitness and wellness culture of Vancouver. It’s a very inspiring place, a great place to enjoy nature. You’re always just steps away from a beautiful park,’ says Crooks, who also serves on the board of directors for Vancouver 2010 and on the executive board for the Canadian Olympic Committee. Even the city’s well-known propensity for precipitation doesn’t bother her. ‘There’s a real beauty and peacefulness to it. You just bring an umbrella and a hat!’

The push toward the 2010 Olympics, and numerous city and provincial fitness and wellness initiatives, have made this healthy city even healthier. ‘We’re trying to get our athletes on the podium,’ says Crooks. ‘But we’re also trying to put the province on top in terms of fitness.’ Crooks says this is happening through active-living programs throughout British Columbia, from the schools up to seniors.

Notably, Canada’s three largest cities make up the three slimmest. Something else we couldn’t help but notice was that the eastern Canadian cities were all in the bottom half of the rankings for this category.

1. Vancouver: 27.8*
2. Toronto: 40.4
3. Montreal: 41.5
4. Victoria: 43.8
5. Ottawa: 46.3
6. Quebec City: 46.3
7. Calgary: 47.9
8. Edmonton: 48.9
9. Saskatoon: 49.0
10. Winnipeg: 49.6
11. Brandon: 50.8
12. Halifax: 51.7
13. Regina: 52.2
14. Charlottetown: 54.7
15. Moncton: 54.7
16. Corner Brook: 54.8
17. Summerside: 56.8
18. Saint John: 57.9
19. St. John’s: 58.9
20. Lunenburg: 60.5
* Numbers indicate percentage of residents who are overweight or obese. Green indicates a decline in those percentages since last reported.

2. High consumption of fruit and vegetables

More people are eating five or more servings of fruit and vegetables daily than they were in previous years‘this was true in 15 of the 20 cities that we surveyed. This may be due in part to health experts, who have long trumpeted the importance of consuming fruit and vegetables. But perhaps the most influential force was Health Canada’s decision to replace grains and cereals with fruit and vegetables on the largest and most prominent band of Canada’s Food Guide, which was revised in 2007. ‘If you compare the new ‘rainbow’ with
the old one, you’ll see that it’s not the bagels you need more of, it’s broccoli and carrots,’ says Beth Mansfield, a registered dietitian and certified exercise physiologist.

Mansfield’s home city of Ottawa rose to number one in the updated numbers, with 47 percent eating five or more fruit and vegetables each day. Part of this is due to a big ‘buy local’ movement. ‘Everyone’s getting into this and saying, ‘Hey, we want to support our local farmers, we want to know where our food is coming from, we want a relationship with the people who are growing our fruit and vegetables,”’ explains Mansfield.

1. Ottawa: 47.0*
2. Montreal: 46.7
3. Victoria: 46.7
4. Quebec City: 44.6
5. Charlottetown: 43.8
6. Vancouver: 42.3
7. Edmonton: 39.2
8. Calgary: 39.1
9. Toronto: 39.0
10. Corner Brook: 36.4
11. Saskatoon: 36.1
12. Winnipeg: 35.9
13. Saint John: 34.5
14. Halifax: 33.3
15. Moncton: 33.0
16. Regina: 32.5
17. Summerside: 30.7
18. Lunenburg: 29.1
19. St. John’s: 25.2
20. Brandon: 23.9
* Numbers indicate percentage of residents who eat five or more servings of fruit and vegetables daily. Green indicates an increase since last reported.

3. Leisure time spent in active pursuits

The national picture in this category is a mixed bag (11 places ranked as less active than they were last year; nine are more active)’but notably, Charlottetown improved on its number of active citizens by almost 11 percentage points. It’s very likely that healthy-living initiatives have helped. For the past 10 years, an Island-wide initiative known as the PEI Active Living Alliance, led by the provincial government, has been encouraging people in the province to get physical. As well, in 2007, the City of Charlottetown signed on to become a PEI Active Community, committing to promote active households, transportation and leisure.

And, notes Sue Hendricken, manager of the city’s parks and recreation department, the city is adjusting its services to recognize residents’ busy lifestyles by moving away from structured programs to focusing on infrastructure that would encourage do-it-yourself physical activities. That means developing bikes-only roadways, improving the Confederation Trail (which runs through the spine of the city) and further developing the network of walking and bike pathways that form a web linking neighbourhoods and parks. The city is building on this groundwork, which in turn should support the continuation of this healthy trend.’For a city this size, we have a vast infrastructure that supports the active-living agenda, and we will continue to commit to providing our citizens with opportunities to live healthy lifestyles,’ says Hendricken.

1. Victoria: 63.5*
2. Ottawa: 57.0
3. Calgary: 56.3
4. Brandon: 55.9
5. Winnipeg: 54.1
6. Vancouver: 52.9
7. Charlottetown: 52.3
8. Edmonton: 52.2
9. Saint John: 48.4
10. Regina: 48.2
11. Halifax: 47.6
12. Lunenburg: 47.4
13. Corner Brook: 47.2
14. Saskatoon: 46.4
15. St. John’s: 45.5
16. Quebec City: 44.3
17. Montreal: 44.1
18. Summerside: 42.9
19. Toronto: 42.1
20. Moncton: 36.8
* Numbers indicate percentage of residents who participate in active pursuits. Green indicates an increase since last reported.

4. Lowest stress levels

This category revealed a very surprising trend. When asked whether they feel ‘quite a bit’ of life stress, fewer people in 15 of 20 cities reported feeling like that this time around. However, before we get too excited about our newly chill national temperament, it’s worth noting that the drop was not big in many cases’just one or two percentage points (or less) in many cities. It’s also important to note that these numbers were gathered before the economy declined.

The dip in stress levels may be a result of people’s growing ability to adapt to stressors, but Lyse Turgeon, a clinical psychologist and professor of psychology at the University of Montreal, notes the reality that pressure is mounting year by year, and that this is often most acutely felt by women. ‘They’re working more and more, as well as being responsible for the children and the domestic tasks and even for the care of their own elderly parents.’

These numbers may indicate that people are dealing with stress in a healthier way. But the picture will become clearer when we look at these numbers again next year.

1. Corner Brook: 10.7*
2. St. John’s: 11.7
3. Charlottetown: 15.3
4. Summerside: 15.3
5. Regina: 16.6
6. Vancouver: 19.4
7. Victoria: 19.4
8. Winnipeg: 19.7
9. Moncton: 19.8
10. Saint John: 19.9
11. Saskatoon: 20.4
12. Edmonton: 20.7
13. Halifax: 20.8
14. Toronto: 21.0
15. Brandon: 21.1
16. Calgary: 22.4
17. Ottawa: 23.3
18. Lunenburg: 25.3
19. Quebec City: 25.7
20. Montreal: 27.2
* Numbers indicate percentage of residents who reported perceiving most days in their lives were "quite a bit" or "extremely" stressful. Red indicates an increase since last reported.

5. Healthiest blood pressure levels

With only two exceptions (Brandon and Montreal), blood pressure is up all across the nation. But, notes Dr. Norman Campbell, professor of medicine at the University of Calgary and a national expert on hypertension, a substantial portion of the uptick may be explained by increasing awareness and diagnosis. Still, the reality, says Campbell, is that ‘in Canada, we have increasing body weight, people are not really active, and our diet habits are rather atrocious, so it’s very likely that we’re having a higher prevalence of true hypertension.’

In a disturbing trend, Campbell observes that, despite rising awareness of the condition, there’s plenty of evidence that a significant number of people are not seeking treatment, changing their attitudes or modifying their behaviour in response to high blood pressure. ‘The World Health Organization’s World Health Report says that elevated blood pressure is a leading risk for death, and that’s particularly true for women. So this is an issue that women need to take into consideration,’ says Campbell.

Among other things, he recommends 30 to 60 minutes of physical activity four or more days a week; a diet filled with fresh fruit and vegetables, that is high in low-fat dairy and low in sodium and saturated fats; and limiting the consumption of alcohol to seven or fewer drinks per week for women. (Read more about how what you eat can help your blood pressure.)

1. Vancouver: 12.2*
2. Calgary: 12.3
3. Ottawa: 12.5
4. Brandon: 12.8
5. Montreal: 13.0
6. Saskatoon: 13.6
7. Edmonton: 14.8
8. Quebec City: 15.2
9. Toronto: 15.3
10. Victoria: 15.4
11. Winnipeg: 15.5
12. Halifax: 15.8
13. Regina: 16.4
14. Moncton: 17.1
15. Summerside: 17.6
16. Charlottetown: 17.8
17. Corner Brook: 18.4
18. St. John’s: 20.4
19. Lunenburg: 23.2
20. Saint John: 24.0
* Numbers indicate percentage of residents who reported high blood pressure. Red indicates an increase since last reported.

The bottom line

Regardless of where you live, it’s individuals who bear the ultimate responsibility for their own health, and day-to-day decisions really do make a difference, notes Crooks. While factors associated with heredity are obviously out of our hands, she advises Canadians to control what they can and work with their healthcare practitioners to develop a program of healthy lifestyle choices. ‘This has been a very stressful year for a lot of people, with the economic downturn,’ she observes, and sometimes the first thing to go is personal health and wellness. ‘We need to remember to take care of our physical and mental health, as well as our financial health.’

We plan to check Canada’s pulse again next year (and add more cities!). Nominate your community in our Healthy Communities Challenge by posting a comment below: Tell us why where you live should be highlighted and what you’re doing to make it a healthier place. We’ll publish the most inspiring examples.

What do you think of our survey this year? Tell us in the comments.

This article was originally titled "Canada’s Healthiest Cities: One Year Later," in the March/April 2009 of Best Health. Subscribe to Best Health today and never miss an issue!