A Kamloops pediatrician is hoping to drum up support for a pilot program to assist childhood health and encourage active forms of transportation to and from school.
The program was first presented to the SD73 board of education on Nov. 14, 2022, by Drs. Trent Smith and Carol Fenton on behalf of Interior Health.
According to the City of Vancouver, whose school board has implemented the program, a School Street is “a car-free block beside a school open to walking, biking and rolling during pick-up and drop-off.”
In practice, that means caregivers can no longer pull up outside a school to drop their kids off or pick them up. In addition to encouraging active transportation, the program reportedly increases safety for children, improves air quality and reduces car congestion near schools.
Trent Smith is a pediatrician who lives and works in Kamloops. His interest in child health has evolved over time to include an interest in lifestyle-related diseases, he told the school board in November.
At the meeting, Smith explained that outside of treating behavioural disorders like ADHD and chronic conditions like asthma, his practice sees a lot of conditions that traditionally affect adults, like type two diabetes, high blood pressure and fatty liver disease.
Pediatrics has evolved over time to include the treatment of lifestyle-related diseases, Smith said, while in the past pediatricians primarily treated infectious diseases.
While he spends a lot of time working to address lifestyle-related diseases in his day-to-day practice, Smith said, “doctors are not doing a very good job” of preventing children from developing them.
“I don’t think we’re the right people to address any of the lifestyle-related health conditions that our children are facing.”
Adult diseases affect children as activity levels drop
A large body of research exists to support Smith’s claim. Since 2020, the American Heart Association has advocated for introducing learning objectives that would improve lifestyle counselling competency among future physicians studying at medical schools.
The Government of Canada also reports that rates of obesity in children have nearly tripled in the last 30 years. Thirty per cent of children aged 5 to 17 are overweight or obese and children who are obese have a higher risk of developing health complications that can stick with them through adulthood.
“I recently read a headline that notes that one in five [Canadian children] have non-alcoholic fatty liver disease … a condition that wasn’t even recognized when I was in medical school,” Smith told The Wren in an April interview.
“A lot of these things [peadiatricians are currently treating] were traditionally thought of as things that people in their forties, fifties and sixties are affected by and forced to manage. Now, we’re seeing the same things show up in and affect children, preteens and teenagers,” Smith says.
In his presentation to the school board, Smith said he and his colleagues did not learn about the types of diseases pediatricians are treating today over 20 years ago as pediatric residents.
“We weren’t talking about lipid-lowering medications in children and we weren’t talking about blood pressure medications in children. We certainly weren’t talking about long-term liver disease in children, but those are all parts of my life now,” he said.
In order to better support childhood activity, Smith says the responsibility cannot rest on pediatricians alone. That’s why he felt obligated to present the School Streets pilot program to the board of education on behalf of Interior Health — because a lack of physical activity is exacerbating childhood health issues.
“I’m great at speaking with people and figuring out therapies for conditions,” he says. “I’m not so great at improving people’s ability to move their bodies. I think a lot of that comes down to city planners, architects and legislators who make the rules.”
“These people are the kinds of people who can help facilitate or impede community members ability to live an active lifestyle.”
Smith says a variety of reputable sources like the U.S. CDC confirm physical activity has been shown to treat issues in children like high blood pressure, heart and lung diseases, mental illnesses and low academic performance.
“We know children perform better in school and they are better able to concentrate when they have had some physical activity during the day … all of the lifestyle-related health conditions we have been speaking about are improved by increasing physical activity,” he told The Wren.
Type 2 diabetes, for example, can be at least temporarily reversed in young people who increase their activity levels, Smith says. For adults with the disease, reversal is much rarer.
The School Streets pilot program would be an opportunity for parents, teachers and administrators to build an environment that makes physical activity in children more automatic.
At the board of education’s public meeting in November, Smith shared a story about a first-generation Canadian family whose child he works with at a nearby obesity clinic separate from his family practice. This family lives within walking distance of the child’s school but drives him to and from the building, he recalled.
“Since the ’50s or ’60s, the focus has been on making it easy to get around by using motor vehicles,” Smith says. “Although cars are convenient and very comfortable, they’re perhaps not the best way to get around if you’re hoping to help folks live an active lifestyle.”
School Streets would help students’ guardians rethink the transportation they rely on.
“One of the most important concepts within the School Streets program is simply introducing the idea that maybe it is okay to walk or roll to school rather than drive,” Smith explains.
TRU professor says car-dependent culture exists Canada-wide
Terry Kading, an associate professor of political science at Thompson Rivers University (TRU), says Canada’s traditional city planning model creates disconnected, sprawling cities that don’t encourage active transportation.
“It’s assumed that [Canadians] have vehicles and we can just drive everywhere,” he says.
Kading says while many large urban centres in the United States were initially forced to put effort into public transit and other modes of transportation because of dense populations with different socioeconomic backgrounds, Canadian cities actually avoided density following the Second World War.
“There was this whole idea of getting away from dense cities [following the Second World War],” Kading explains, adding that people wanted to escape dense urban landscapes for suburbia.
“There was very little regard for trying to create apartments or communities with a bunch of amenities,” he says. Instead, most cities focused on expanding housing outwards.
“Because most of our cities coming out of World War II were never that big in [Canada] in the first place, driving wasn’t that hard, so city planners just kept building on that simply because fuel and everything else was cheap at the time.”
Kading explains that many cities, Kamloops included, just went with what he calls “the sprawl.”
“Everywhere you go in Canada, you can see the sprawl,” he says.
“The idea of creating communities with walkability, livability and access to a variety of amenities all concentrated in one area … wasn’t considered up until recently.”
Kading also explains that, in general, a large majority of community members — especially those who own vehicles — aren’t all that concerned with issues associated with car dependency until car dependency becomes more of a hassle than it is a convenience.
What’s next for School Streets
The School Streets program could help increase physical activity in children while also limiting issues associated with car-dependent culture, such as congestion and safety concerns, by simply encouraging families to walk or bike with their children instead of driving to school.
School Streets has already been implemented in other communities across B.C., including in Surrey, Victoria and Vancouver, and Smith has been in conversation with stakeholders in Kelowna as well.
The City of Vancouver reports that its School Streets program, which was first piloted at three elementary schools in 2021 and then expanded to five schools in total in 2022, has resulted in an overall increase in a sense of safety surrounding pilot schools and an increase in the use of active modes of transportation.
Ninety-six per cent of students said they felt safer on the School Street compared to when vehicles were present in the same area in the past. Twenty-one per cent of families reported they drove less after the pilot started, while 31 and 25 per cent of families reported they walked and biked to school more, respectively. Moreover, 77 per cent of parents reported they’d like the School Street program to continue.
Neither SD73 nor the City of Kamloops have made any public promises regarding School Streets, but Smith says he’s continuing to have conversations with city policymakers about the program.
In a letter to Smith and Fenton sent on Nov. 28, 2022, an SD73 representative stated the doctors’ presentation “is in alignment with the District’s Strategic Plan, specifically [its] vision of ‘fostering educated and resilient citizens empowered to contribute to a diverse, inclusive, caring and sustainable society.’”
However, the letter also informed Smith and Fenton that “an initiative of this size and complexity, even as a pilot project, is best undertaken by a broader group of stakeholders,” including the City of Kamloops, schools, parents and community members.
SD73 also stated it will leave operational details to senior staff and the City of Kamloops. Thus far, there’s been no sign of a concrete timeline.
Smith recognizes the program requires cooperation from a lot of different stakeholders and that there could be pushback. Ultimately, though, the pediatrician believes it’s an important part of the wider cultural shift that’s needed to help kids stay healthy.
“Culture changes don’t come easy,” he says. “There’s always going to be people upset when they’re forced to change the way they do things.”
Moving forward, Smith feels optimistic about the conversations he’s had with officials regarding the School Streets program.
“There’s been a lot of work going on behind the scenes … I will happily shout out the City of Kamloops, [which has] been more than involved in discussions concerning the program. I am very hopeful there will be a School Street in Kamloops this spring.”
In the meantime, Smith encourages parents to consider when active transportation is possible. While city spread and sprawling roadways often necessitate driving, there are moments where walking and rolling make sense too.
If walking and rolling isn’t feasible, Smith suggests families consider finding active transport methods that work for them.
“Families could even leave [home] a little early … to stop and play at the playground or move in some other sort of capacity,” before heading to their actual travel destination when out and about, Smith says.
“Cultural change happens slowly when people’s attitudes towards certain things shift — and attitudes only shift when there’s a reason to shift them.”
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