 So, today's webinar is Enriching the CLSA with Environmental Exposure Data of the Canadian Urban Environmental Health Resource Consortium. Let me introduce our speakers. Jeffrey Brooke is the Principal Investigator and Scientist Director of Canoe and has 25 years of experience as an Environment Canada scientist working at the Science Policy Interface. During this time, he has spent 15 years as faculty at the University of Toronto where he was involved in research, lecturing, and graduate research training. He is one of Canada's leading experts in air quality, recognized at all levels of government and academically, including for his substantial contributions in air pollution health research. Dr. Brooke has led scientific assessments to inform policy nationally and internationally and advised multi-stakeholder groups shaping policy. He has led a variety of multidisciplinary research teams in government, government academic partnerships, and in academia. Recently, his efforts have expanded beyond air quality. For example, for eight years now, he has led the Environmental Working Group of the Canadian Health Infant Longitudinal Development, or Child Study, and co-led the Gene Times Environment Research Platform within the Alder Gene Network of Centers of Excellence. Eleanor Sutton is the Managing Director of Canoe. As an IJUNC Associate Professor, Eleanor most recently acted as co-director of the Spatial Sciences Research Laboratory at the University of Victoria. This role involved managing the SSRL grants staff and students in conducting a range of research related to spatial aspects of exposure to environmental pollutants as DI or CoI. A particular value to canoe is Dr. Sutton's experience in population-level environmental exposure assessment, direct experience working with large spatial and tabular datasets related to land use, pollutant emissions, and socioeconomic characteristics, and developing knowledge and pollution products about cancer in the environment. Danny Dwaran is based at Maelstrom Research Group at the Research Institute of McGill University Health Center in Montreal. Danny has worked with a number of epidemiological research consortia in Canada and Europe, helping them implement innovative solutions to facilitate multi-centered data integration and co-analysis, and provides expertise on linking environmental data to confidential health databases for canoe. So welcome all to our presenters, and now I will hand over the presentation to Dr. Brooks to begin our webinar. Thank you, Dr. Brooks. Carol, thank you very much for the introduction. It's really a pleasure to be here. Thank you to everybody on the line who's joined. I'm really excited to tell you about canoe, the Canadian Environmental Health Research Consortium. Myself, I'm based at the Dalana School of Public Health at the University of Toronto, and the Department of Chemical Engineering and Applied Chemistry at the University of Toronto. And so I'm sitting here in Toronto, and I hope that you'll find this webinar to be informative. I'm going to provide an overview of canoe and urban environmental health research to begin with, why it's important in Canada. And then I'm going to turn it over to Danny Duarall and Eleanor Sutton eventually to continue to provide more details, and then hopefully we'll have a good discussion at the end. So there you go. There's me, based in Toronto. Yes, we are called the Urban Environmental Health Research Consortium, and you will see in this diagram a large number of interacting environmental factors. Some of them can impact our health positively, others can impact our health negatively, and it's really important that we start to think about these in a more holistic manner. In this diagram, which we sort of used to guide how we bring things together in canoe, you can see across the bottom a large number of important factors that influence our urban urban, even rural areas, from population growth and economic growth to weather and climate, which can be responded to through land use planning, transportation planning, and then lead to, in this case, how a city like Ottawa is laid out or could be laid out of the future. At the same time, there is the populations that live in those areas across the top and how old they are, what their various susceptibilities, our capacities are, how they behave in terms of their movement throughout the city, that sort of leads to population distribution that varies across space and time, and that then puts them into the situation where they have differential exposures to a variety of environmental factors like air pollution, access to healthy foods, green space parks, ability for physical activity, whether it be recreational or for a purpose of getting to and from work, and so on. These all interact together. Ultimately, we all, I think, believe to be very important determinants of our health. There's been a variety of studies over many years that have looked at these factors in Canada. I think it's probably at least 20 years ago that we looked at air pollution mixtures and found that they were leading to an increased risk of dying when the levels were high, especially when mixtures of multiple pollutants were high. Also, a number of years ago, looking that at sort of the end of life, but the start of life, clear associations between air pollutants and adverse birth outcomes in Vancouver, which in terms of the pollution world, one would think of as being quite a clean city. But that's the air pollution world, and one of the big questions in the air pollution world has always been particulate matter, fine particulate matter, which is used quite a bit as a real indicator of dirty air. But not all particulate matter is created equal. More recent research that's been done in Canada and worldwide is trying to look at what features, what chemical components, what sources of particulate matter are having a greater impact on health. And you can see that there's some more recent work in this area. And these are all studies that are now working with data or have health generated data that's available in Canoe. Moving to another important issue within urban areas would be urban greenness, which has a variety of ways in which it may impact our health, whether it be through an area for exercise, an area for peace and quiet, an area for reducing air pollution. They're all perceived to be quite good benefits. And at this stage within Canoe we're housing this normalized difference vegetation index and VDI, which is derived from a satellite for use in a variety of epidemiologic studies. They mentioned exercise in terms of greenness and we have, and others in the field for many years have been quantifying factors such as walkability and whether that might entice people to get out of their cars and walk or bike more. And there are ways to quantify this using GIS data. And there's been great research done in Ontario and in Canada that's been looking at whether or not these features of our urban form indeed not only lead to more slight amounts of exercise increases, but to health outcomes, beneficial health outcomes. And this one study, this is a recent piece of work presented to us findings around metabolic risk factors, blood pressure, indicators in the blood of improved health in areas where it was more walkable. And interestingly, though, if you look here in a European study, the plus one paper, what they're showing there, it's really important to consider climate and day length and other features of the environment in terms of how they interact with people's ability to get out and enjoy walkable spaces, very complex aspects of features of our urban form. Another area that we have been bringing into the Canoe data set because of its importance has been things related to extreme weather and climate. And here's a couple examples where researchers have been looking at heat waves and particularly heat waves and the impacts on gender and age and seemingly pointing towards greater risk of heat wave-related mortalities among females, elderly females in particular. And these are these are data sets that we're acquiring bringing into Canoe to make available for a variety of research questions. So it's, I think, important to sort of realize that we live in these spaces, these places, people have different experiences around them depending on where they live. And they have subtle chronic effects that can impact many different health outcomes at all different stages of life. But sometimes to see these effects, they require very large populations to be able to get the size of the power you want for the study. And even more importantly, in being able to look at multiple factors at the same time, it's really critical to have large, well-characterized populations to study the interactions that I showed in that earlier slide. And to date, many of the studies from the ones I showed really tended to focus on what's their issue, their question of interest, and looking at maybe one or two co-exposures. We do know that they're interacting together, and that's an area where we hope by by by serving as a platform for multiple different types of quantifiable exposure metrics, we can advance the science to look at interactions. And a value we see in Canoe is that a lot of those studies will have a data set, they'll have an environmental question, they'll generate the exposure data that they want to have for that time window that they've got a population they're following. And then the study's done, and that's it. They may follow up with more research, but we see that there's a need to get those types of exposure metrics out there for more use instead of people reinventing the wheel each time for a new study. And then that will lead again for us to ask these more difficult questions down the road. Now what's really enabled Canoe was a whole series of meetings workshops at CIHR held back now over five years ago to start with. There was an interest growing within CIHR and a number of the institutes to to really address environment and health in a systematic way and build on Canadian strength. And so in 2011 they had a workshop focusing on environmental exposures followed up in 2012 with a national workshop on environment genes and chronic disease. And then ultimately in 2013 with an environmental health national forum bringing together many environmental health researchers across the country with a huge variety of perspectives. But some of the key factors that they sort of came out of this with CIHR was that there really was still a need to break down the existing silos of research in the environment health field get there to be more interdisciplinary collaborations happening that the world is very complex and we need to tackle that complexity head on. We also hear that from our policy makers today that you know they understand is complex and and single risk factor studies don't inform as much as they'd like to be able to get from looking at all the interactions. And we know that you know the environment is ubiquitous around us. This also was perceived to be a need to build more research capacity in Canada and to have supporting data platforms. So that's where Canoe comes in. CIHR did announce an open call to form a consortium to enrich health research data platforms by building an environmental data research platform. And Canoe ourselves we were successful in this call and started in June 2016. So we're just a little over two years old now. We've been working closely with a number of cohorts and environmental researchers. And from that time till 2021 we've got about 4.2 million dollars to put to this cause. Now to sort of move Canoe from an idea to something in practice you can see here flow diagrams are described how we're structured really much of the work is happening on the right hand side amongst the data teams. We can see the sort of different areas that we've brought in expertise across different universities in Canada from air quality and weather and climate to a range of neighborhood factors that move over into socioeconomic issues and are not purely just physical features down to transportation which is a key element of what shapes our cities and shapes many of our behaviors as well. They're supported by a sort of conglomeration of various experts who are expressing interest in Canoe. I do point out that one of our areas is sort of integrated research around adults and that's where we sort of have sort of slated some input from CLSA into into Canoe as needed. The directors that lead Canoe are myself as a PI. We have Dr. Michael Brower at UBC, Kim McGrayle at UBC, Philip Awadala here at Dallas School Public Health, Howard Hu formally at Dallas School Public Health, PJ Subarao at Sick Kids Hospital leading the child cohort and Dave Steeve with Health Canada Knowledge Translation Expert. So I pointed out the groups of our exposures and the data teams here they are again a key goal that we have is to really you pull together the existing information that is known and can be resolved spatially to assign to people based on their their address or a six-digit postal code and again across a variety of factors and to make these data truly analysis ready for researchers to access and use and one of the really critical ways that we feel that we can make these data analysis ready is to actually link them to a variety of health data sets right up front so that they're there for a request and analysis and a whole variety of questions. So they're not it's not an independent data set while we do house with independent data set but we really target groups like CLSA to push data into the cohort and to be linked and so that's where we stand this stage. I'm going to now turn it over to Danny Duarong who will tell us a little more details about what we've done how we've linked data to to CLSA what the data are looking like and so I'll pass it over to Danny for continuation. Thank you very much. Danny are you there? Yes can you hear me? Yes I can hear you. Okay good so thanks Jeff and and thanks everyone for for being there. My name is Danny Duarong and I'm located at the Research Institute of the McGill University Health Center in Montreal. So as Jeff mentioned with its staff specialists members and leaders, Canoe is establishing a common platform of national and regional level geospatial data appropriate for epidemiological research. So over the past couple years Canoe has worked hard on developing health relevant metrics and the domains of transportation, neighbourhood factors, noise pollution, air quality, greenness and climate and weather. And in my section of this webinar I'll give you an overview of the environmental exposure data sets that are now pre-linked to CLSA baseline data and ready to be used for research projects. Many of the data sets I'll be presenting today have actually already been accessed through CLSA's regular data access procedures by investigators from across Canada. Now before I dive into the data overview I just want to quickly mention that all environmental exposures held and distributed by Canoe are indexed to the six-digit postal code. So the six-digit postal code acts as a unique link between Canoe area level exposure data sets and the health data held by cohorts such as the CLSA. So for the CLSA data sets are merged using the residential address postal code at baseline assessment. And we also plan to link environmental exposures with CLSA follow-up data in the future. So CLSA currently has three pre-linked data sets of neighbourhood factors available to researchers. First the material and social deprivation index developed at the Institut national de santé publique du Québec or INFPQ is a publicly available data set based on small area units from Canadian census data. This data has already been used extensively in public health research and includes metrics that describe geographic variations in material and social deprivation. The 2011 deprivation indices were linked to the CLSA baseline data and are provided as raw scores and quintails based on region, province, and for all of Canada. The maps here on the slide shows material deprivation scores as quintiles for Victoria, British Columbia. Green shows areas of low material deprivation and red shows areas of high material deprivation. Each dot on this map and on subsequent maps represent one postal code. And the light pink lines that you see on the map are the dissemination area boundaries for reference. The Canadian active living environments index or TAN AL was recently developed by Nancy Ross and colleagues at McGill University. This data sets includes postal code level measures that represent active living friendliness or walkability of Canadian communities for the years 2006 and 2016. This slide shows a favorability of active living or walkability with red showing low active living friendliness and light green showing areas of high active living friendliness. Another neighborhood factors dataset distributed by canoe and linked to the CLSA is nighttime lights. So to build this data set canoe staff extracted values of annual mean nighttime brightness for all postal codes in Canada using satellite imagery from the Google Earth Engine. Now let's look at air quality data. Can you hold a large set of historical and current ambient air pollution exposure data at the national level for fine particulate matter nitrogen dioxide, sulfur dioxide, and ozone. The fine particulate matter or PM 2.5 dataset distributed by canoe are publicly available data that were developed out of Dalhousie University from NASA satellite data. Annual average concentrations at a one kilometer resolution are now available through the CLSA. Green here shows lower annual average PM 2.5 concentrations and orange is higher annual average concentrations of PM 2.5. Annual average nitrogen dioxide estimates for all Canadian postal codes were developed by Perry Heistad using a land use regression model for 2006 and these modeled concentrations were then adjusted for subsequent years using air quality monitoring data. On this map green is lower and red is higher annual average concentrations and since NO2 typically indicates traffic related air pollution we can see higher exposures along traffic corridors in Victoria. Modeled annual average concentrations of sulfur dioxide are also available to researchers through the CLSA. These databases were developed by Environment and Climate Change Canada using 30 kilometer satellite data. On this map pale orange is low and darker orange is high SO2 and note that this data has a lower spatial resolution than the previous datasets which explains the blockiness of SO2 exposure on this map. Finally researchers interested in the effects of air pollutants on health may request the national scale model dataset of monthly and annual concentrations of ozone which is also provided by Environment and Climate Change Canada at a spatial resolution of 10 kilometers. Pale pink is lower concentrations of ozone and darker pink is higher concentrations of ozone on this map of Victoria. The next data theme I'll cover is greenness so normalize difference vegetation index or NDVI is a greenness metric derived from satellite images. The lowest range of NDVI in pale color on this map indicates low or no vegetation and the highest range shown here in dark green indicates dense vegetation. This data is derived at a spatial resolution of 30 meters and provided within set buffer distances of postal codes. Greenness variables linked to CLSA baseline data and available to researchers include annual average, grown season average and maximum annual greenness values. Finally weather and climate metrics so pre-linked data on annual total precipitation is rain and annual total precipitation is snow from gridded surfaces based on weather station observations at postal co-locations can also be accessed through the CLSA. This slide shows total annual precipitation as rain for Victoria with green is showing lower precipitation and dark blue is showing higher annual rainfall. We've used very narrow class breaks here to show local differences since the values range from about 1,000 to 1,100 millimeters in Victoria. Of course wider ranges will be seen over larger regions. Now I'll just mention here that full metadata documentation on each of the data sets I just presented are available on the canoe website at canoe.ca slash data. I'll finish my section of the webinar with some preliminary descriptive statistics of pre-linked data sets I just presented to give you an idea of the variation of environmental exposures within the CLSA cohort. So first of all we see some geographic variation in exposures across urban and rural areas so when comparing participants living in urban core to those in urban fringe and rural areas we see higher active living friendliness or walkability in central urban areas but we also generally see higher mean air pollution concentrations within the urban core relative to peripheral areas. This slide shows the distribution of pre-linked canoe exposure data as quintiles. Thresholds for these quintiles are based on exposure data covering the entire country so in other words quintiles are defined using exposure data for all Canadian postal codes. In terms of deprivation we see that most CLSA participants fall within the first two quintiles of material deprivation meaning low deprivation or the most privileged quintiles. We also see that social deprivation which is a measure of the fragility of an individual's social networks is more equally distributed across quintiles for Canada. Of note few CLSA participants live in active living friendly neighbourhoods so quintiles four and five of the walkability metric shown in the table and lastly many CLSA subjects live in areas of relatively high fine particulate matter concentrations and relatively low NO2 and Ozone concentrations. The last slide shows correlations between the different to new area level environmental exposures that are now linked to CLSA participants. As we can see some exposures are highly correlated for example we see high positive correlations between fine particulate matter nitrogen dioxide walkability and social deprivation and negative correlations between greenness metrics and NO2 walkability and nighttime light. Disentangling the individual effects of interacting exposures has been a major challenge of research in environmental health and environmental epidemiology as Jeff alluded to earlier. So with the data sets I just presented as well as new exposure data canoe is currently developing researchers will be able to look at the role of many environmental exposures together within a large sample of Canadians using cohorts such as the CLSA. To conclude we hope that partnerships between canoe and the CLSA will stimulate new research including new grant applications on the role that environmental factors play in healthy aging. So I'll now pass it over to Eleanor who will touch on some of the new data sets canoe is working on and which will also be available to researchers. Thanks Denny. Let's just take further slides. There we go. Hi I'm Eleanor as introduced earlier I'm here in Victoria BC this morning. So again thanks everyone for attending the webinar. We're really happy to be able to showcase some of the hard work we've been doing. I just want to emphasize at this point that what we're doing is just a one-time linkage to the CLSA. Denny's worked hard with the CLSA folks to get that great range of data in and pre-linked and ready to go now but we do see this as an ongoing probably annual kind of event where we add updated data and add new data as time goes on as well so that we can support the CLSA and researchers through all the follow-up period. So far we've been working on bringing together a lot of existing data that you've seen already. Some have been widely used in publication and some of them have just been harder to access or need a whole lot of work reformatting and summarizing before researchers can use them. A good example of that are some of the air quality data that come out of Environment and Climate Change Canada. They're hourly, they're in an odd format and it takes a lot of work to shape them up so we've taken on that heavy lifting for the researchers. At the same time those six data teams that you've seen are also filling some of the gaps that we know exist as well as developing new data that push things forward. In a lot of cases people tend to use data because it's there and we know that we can do better so a big part of Canoes mandate is to try and push that forward as well. So I'm going to go through a few of the data sets that we're working on now. Some of these are going to be available very shortly. Some are further along in our next two and a half year mandate. Within the next few weeks available we'll have available a new monthly and annual water balance metrics. So not just temperature related information but rain and snow, snowpack days, moisture surplus and deficits, soil moisture and moisture indices. These have been really of interest to people working on allergies, thinking about fungus, mold, loads in the air as well as people thinking about just general safety. You know, is it icy days? Is it rainy days? What areas potentially are having a drier season and so less vegetation out? There's quite a lot of links around the climate data here. Again these are at the postal code level. What you see here is actually a screenshot of something else we're working on, our data browser. So right now for the Canoes data you essentially go to our website and get a description of it but within the next few months we'll be launching our data browser. So you'll be able to go and work with a map, zoom in, zoom out and look at all the different variables and see all the variation that's there across Canada or in the city of interest. So that's an exciting development for us. I think Danny mentioned monthly metrics for some of the air pollutants. Those are just coming out now again so monthly ozone and monthly nitrogen dioxide. These are potentially important for shorter term health outcomes that people may be interested in studying. We have some new neighborhood factor variables coming up. Access to employment is a fairly recent one. It's been developed by researchers using census data and this speaks to how people choose transportation modes where they're going throughout the day. We have the Canadian marginalization index so this is similar to the material and social deprivation index that we already carry but this is a different view, different factors going into it. It has also been widely used for research so there's a lot of good information on what it seems to be associated with in terms of people's social determinants of health. Another thing we're about to deliver is something called local climate zone. So we're interested in urban form and how it impacts people and we've been talking about how it's many things working together and the idea of a local climate zone sort of integrates those things so we're mapping every postal code in terms of is it in an urban canyon downtown with lots of high buildings and no greenery around it. Is it mostly an agricultural area so it's very laggy oriented but it does integrate building height, building density, vegetation height, vegetation density all into one metric so we're interested in seeing how that relates to health in general. One thing that we haven't done yet is look at proximity metrics although there's some good evidence for that so for example here's a study that's shown that living within 50 meters of a busy road is associated with increased dementia even when they're controlling for different kinds of individual characteristics. We see lots of these kinds of studies in air pollution as well. Very recently one of our canoe members was published a paper here looking at how living near water affects the risk of mortality and so these are really interesting but as researchers we know that these metrics are quite crude just proximity so our transportation team is working hard at very detailed characterizations of transportation networks in selected cities so that we can improve the kind of proximity metrics that we make for these and similarly on our work plan is to do something similar for water. This study was done using a very basic exposure proxy so we're working on getting a more detailed characterization of exactly what type of water it is so we can tease out some more of the association that's been seen there. We talked about greenness and the satellite measure in DVI. This has again been widely used partly because it's available and somewhat convenient but most of the exposure researchers and people working in this field recognize that again it's a relatively coarse proxy for exposure to greenness and we're all working hard on trying to push this forward into more comprehensive metrics. One of the things we're working on is using Google Street View so we can look down from the satellite and say this area shows green and then we can also look at the Google Street View at that location and understand exactly what we're seeing there so this is taking us into the realm of machine learning, artificial intelligence, you know sort of big image scraping and big data so we're excited about that and you can see that this paper is recently published by Canoe Team including some of our Canoe staff. You think that using the Google Street View in combination with satellite is going to give a lot of insight on more micro-scale urban features so hopefully we'll have lots to share with people and certainly interested in hearing people's ideas about what they might want to pull from these images in terms of different metrics of interest. One of our teams is the noise team. Interestingly Canada doesn't really have a very good comprehensive data set of noise in cities. It's apparently we're well behind Europe in this endeavor where they're very carefully mapped almost all of Europe at a very high resolution so some of our research teams are working diligently on this. We have postdoc now working on field monitoring where they'll be going out and putting monitors out in major cities and developing a very high resolution what we call a land use regression model for noise for all of Canada so that'll give us these postal code estimates of noise in various different metrics for it to add to the data set. We're probably about a year and a half possibly two away from having that ready to go at this point. Another thing that we're working on that should bear some fruit within the next year and a half are incorporating higher resolution satellite data than we've had easy access to before. Certainly over the last five years I would say there's been an absolute explosion of access to and tools and to use and data repositories for these big satellite data sets. One of the things I think Danny mentioned was Google Earth Engine where we can just go online write scripts process huge data sets that we wouldn't be able to do locally on our own computers. One of these other data sets is called the PlanetScope data where it's daily three meter images of all of Canada so we're really interested in pushing these forward and trying to find new ways to pull information out of this around urban form and how it changes over time so going forward can we see where new developments are happening can we go backwards in time with some of them and understand where urban form has changed and look at how that's affected people's health you know before and after so the idea of looking at intervention studies in urban form is really a big interest to new researches and hopefully to others as well. Along the same lines very shortly we'll be able to have access to new air quality data from satellites. This is a new effort one of three satellites going global and what this is is a satellite that stays over Canada and the US in the same position and gives us hourly air quality data at a resolution of around five kilometers so this is a huge data stream and some of the canoe team members are are working with NASA on this they're part of the science scheme and again there's a postdoc getting ready to start setting up the protocols for running this data through and processing it so you can see we've got a lot of really exciting data still to come so we see this as a long-term partnership with all of the big health data cohorts and especially the CLSA. So I want to sort of sum up a little bit with just the idea that I think it's hard to really overstate how important the canoe initiative is. You can see sort of the current state of data you know if you're trying to put together a study with multiple factors you know maybe you're looking through boxes of papers in an old storage cabinet maybe it's on some you know something's on a portable drive somewhere who knows where it went anymore maybe you're reading through a journal paper and hand transcribing into a spreadsheet from a table that you find and you know we all know that our research associates and students graduate and go away and sometimes the files that they worked on are not found again and this is a real problem in research data so by creating this platform and we've had enormous support from the research community in terms of them wanting to put their data into canoes just for these reasons it gets documented we can manage the sharing it gets archived properly most researchers want their data to be used again and this is the way that canoe is really helping to move the field forward I think. It also supports reproducibility in a big way if you have done a study using one metric and five years later you want to go back or you want to look at another cohort canoe will have that original data available so that you're directly comparing things and as I mentioned there's a lot of new metrics coming all the time how do we know which one is better or if it's not better how is it different you know what are we picking up with the new things so again we need a way to be able to keep the data sets alive and use them for future information and I think that's what canoe is doing you can see we're providing sort of a one-stop portal where people can bring their data in in our closet and researchers can access it and it's all managed through data sharing agreements and being properly referenced and people are getting acknowledged appropriately. So that's what canoe is I'm going to turn it over back to Jeff now who's going to conclude with a few thoughts before that I would just encourage you to go to the canoe website you can subscribe to our newsletter it comes out every few months sort of the big news of what's happening in terms of webinars or new data sets you can also formally join canoe by going to the connect menu and down to join there's a lot of information there on what each of our research teams are working on and the data sets themselves so with that I'll conclude and I'll hand it over to Jeff. Okay great thanks very much Eleanor and thanks again for everybody's attention so far I hope that you've been really excited with what you've heard and seen that we're doing and how it can be used for CLSA and other environmental health research and you know just to summarize sort of a key aspect of what you know we feel we've done is that we really feel that we we are increasing the capacity of the CLSA to advance research on how where an individual lives impacts their age and experience and health so it's really about place as a very important factor and how we can sort of measure various features of place a quick look through the approved projects on going to CLSA you know bring up key words like sleep and physical activity sedentary behavior built environments mobility exercise environment permanence physical activity these are all influenced by place as we know and they're you know part of canoe and our canoe data holdings and canoe data improvements for trying to make and our important questions to continue to work on so there are really good links between our interests and what we can do and some of the researchers around CLSA but I think that you know with the platform that we've established and Eleanor just made a really compelling argument for because those boxes almost look like my office I'm vacating in environment Canada but that we really are now have established a platform that you know houses these data that allows it to be brought in and standardized documented and we have the opportunity now to really build the capacity to explore place face questions over the long run so not you know one snapshot of let's get the best exposures we can now for this outcome over this follow-up period but over the long run which is you know something that CLSA is geared towards doing is is a long-term follow-up other cohorts same thing over time and that can be done you know I think best with this sort of concerted effort and platform as opposed to one study at a time and also in talking about you know standardizing and and understanding our data I think it allows us to better reach out internationally and look at how we are consistent with other similar efforts around the world how we can harmonize exposures and information or understand differences better to then begin to think about how we can exploit contrasts between countries or you know do various pooling exercises whatever it might be but having a common environmental data from like canoe I think can help there as well so we are considering you know as we look at this opportunity in front of us for continued canoe CLSA efforts and I hope that we will investigate ways that we can all bring in new funding new grants to to maintain this relationship so that we can have these regular updates of metrics and new metrics and I think that you know Eleanor talked about sort of data that you can collect that's available from other sources we're also really and I think canoe is embracing this we're on the on the cusp of all sorts of new technologies that can allow people to who are parts of health studies to actually provide even more specialized data if you were able to have them participate whether it be in small studies small sub studies of course we know about providing biospecimens which can be used for various purposes but now in the era of care of everybody carrying a smartphone there are there are much more modern ways to gather information about their environmental experiences and that's the tea and the technology there that is something that's I think exciting to explore to really bring our cohort research to the modern age so another area that is important is is the exposome and asking the question about whether or not canoe with various cohorts can really subtly advance this exposome concept in Canada hasn't really had a I think a home here in in Canada that's a station time but you know we know that a person's life course exposure leads to their their unique phenotype which is expressed as their exposure which is interacting of course the life course with their genome to lead to you know what we ultimately observe and you know we have difficult questions still to grapple with respect to their lifetime environmental conditions and then how that might influence susceptibility say for example those who are in the clsa you know all came with a history of of an environmental exposure that places them in some sort of unique you know condition right now in terms of the current morbidities they may have or susceptibilities and unfortunately we know you know very little about you know those people and what happened prior canoe was able to do some of this going back in time with the residential history to 1980 and it's an opportunity that we hope to continue to explore to be able to do that for clsa so it's not only from recruitment forward but a little look back in time at least in 1980 really you know we come from wanting to look at solutions to environmental risks and a really challenging question that I hope we can all work on together is just how we can really learn quickly from the research and what we learn about how the urban area and urban areas and our influence our health and we're not really only urban as the states we are something about all of Canada but really need to turn towards solution oriented research going forward and thinking about how changes in environment can lead to improvements in health changes in outcome we can look back and think about past interventions that have taken place that might be differentually affecting different populations and possibly exploit those then that's an area of interest in canoe is to try to start to document where there's been urban form changes that we can track and do that or also the interest might be really areas of urban disasters like a large flood and how the populations in those areas have been getting on since that time but in the long run we really want to be able to optimize our urban and transportation planning for healthy aging or a healthy you know not childhoods as well at any stage in the life course and a big elephant in the room that is a real driver for our cities and our our plans going forward courses addressing and preparing for climate change of which I hope you've seen through some of the data we're collecting and the way we're thinking is an area where canoe and canoe data can also help address some various questions so I really see where we're at now is a really exciting point we have lots of data together we have good partnerships we have pre-linked data and I really entertain any questions people might have and and ideas to move forward so that we can really collectively go to the whole real next level of environmental health research in Canada with some some big visions that are solution oriented so I'll leave it there and hopefully we've sparked some thoughts and ideas and questions from those online and now we're happy to take those in the time remaining thanks very much for your attention well thank you very much I was really a fabulous introduction and overview of canoe data really enjoyed your presentation thank you so I'll go ahead and open it up to questions just a reminder we mute muting remains on but you can enter your question into the chat window in the bottom right corner of the Webex window and I will go ahead and read it out and moderate the questions to our guests so we're waiting for a couple questions to come in I'll go ahead and ask a couple so as I was listening to the presentation I was thinking how much of this environmental data do you think might just associate with socioeconomic measures do you think that the interactions between just socioeconomic measures of where you live and how your environment interacts with that is an important concept to think through yeah I don't know for all unmuted but absolutely there's no question that socioeconomic factors play a big role directly but they also interact with place and where people live sometimes you know there's there's areas where people can exercise more that people will selectively move to who have higher socioeconomic needs and really if we don't have the best measure of these all together we can't start to tease apart you know what's really along the causal pathway or how to intervene how to fix some of those place problems yeah you're right yeah very interesting so um oh we have a question from from Martin do you consider the political geographic environment as an important determinant of health worth mapping and studying I yeah I would say yeah certainly why not it's uh it's it's certainly is something that has some spatial coherence to it in some sense and influences within their community you know could influence behaviors lifestyles you know it gets even right into your gene expression through various mechanisms we have to think of whether we could map that I know they've done it through google street view south of the border with with looking at a pickup truck index as an example or civic involvement or yeah I think that there are you could certainly map out different policy arenas I know that's something that people have tried to do and in some cases it's just incredibly complex when you're down to the you know uh municipal jurisdictions there are thousands of them in Canada and trying to develop really good policy inventories um it's a real challenge so I mean if people online have ideas about that you know we'd love to love to take that in because clearly the kinds of policies the urban planners are putting in place do shape the environment and the social environment as well you know what kinds of food stores are available you know what kinds of parts are available so it in that terms of politics I think um city politics and and policies are are certainly a key thing that we're not really capturing yet it'd be a more colorful map than the red state would be sure would be certainly as a um a political you know in terms of you know planning planning the cities that we want is very very political topic um you know going through the elections here in Ontario Lee was high in the agenda and lots of lots of an interest to to provide some real knowledge I have a comment from Susan Kirkland uh to everybody and all the speakers can do as an example of a highly beneficial partnership your leadership in environmental health and language cohorts is greatly appreciated so I think that can be echoed by us all here at CLSA and across across Canada yes thank you Susan um so uh online we also have some people from our statistical analysis center we have our data access officer ish fun molnar soft patch available to answer questions if we have any specific issues about data access through the CLSA I'll go and ask ask you a question about that um so throughout the webinar you discussed the postal code as being a six six uh digit postal code so with CLSA data would we need the six digit postal code to be able to uh utilize the the data or could you roll that up to a higher amount and still have meaningful associations at the dissemination level or even the city or provincial area but um uh I'll start with that one it's Eleanor um some of the data for sure are already at a fairly coarse resolution so you know in that regard you could aggregate but I do think uh there's real value in using the appropriate resolution data for what you're trying to study so yes we could aggregate some of our lower resolution data up to dissemination areas um and you know that might be useful if you think there's a regional component to what you're interested in as opposed to a very local one so if you think that you know the greenness on my street is important to your health outcome you might want to use the better resolution data but if you think well it's actually the greenness in my neighborhood I'm interested in more around walkability so I think you know greenness within a kilometer or two is more important than you could aggregate up um but you would still need to have some connection to your person's health data so how you connect it to individual x would still be through that postal code you would just use a aggregated exposure metric for the area around the postal code I hope that's helpful yeah and maybe just to add on that so we did since the six digit postal code had some privacy implications the CLA can't distribute six digit postal code with any health data to researchers so what we did is canoe had sent data sets with the six digit postal code as the first column and exposure is at subsequent columns to the CLA data curator who then linked the data sets within the secure environment and and these are the data sets a strip of six digit postal codes that have been distributed to researchers thank you that's a that's a good good discussion of the point so we have a comment from Marielle Van Acker from Europe and hopefully we have addressed that issue about the privacy making link to more challenging so thank you Danny for that well we'll wait for a couple of more questions to come through but I'll go ahead and thank you again for being here and being a part of our webinar series I'd like to remind everyone that CLA data access request applications are ongoing the next deadline for applications since February 25th 2019 please visit our website under data access to review available data for their information details about the application process that's I'd like to remind everyone to complete their survey located under the polling option if you have any questions or concerns that we can help you with you can write it in the chat box right now and we can help continue to ask questions in the chat box and we at the CLA we'll try to answer them as we can and the CLA promotes this webinar series using the hashtag CLA webinar we invite you to follow us on Twitter but thank you again to our canoe team and our presenters for being here today thank you finally we'll have our next monthly webinar in November on moving more to breathe better associations between physical activity sitting time and lung function in the CLA presented by Dr. Shiplet. So go to our CLA website to register for the webinar series soon and join us for all of our monthly webinars and thank you again for attending today's presentation