Item - 2016.HL15.4

The Board of Health:

1.  Requested the Acting Medical Officer of Health to work with the General Manager, Transportation Services to explore opportunities to improve sidewalk safety during the winter months, including:

a.  changing the snowfall threshold for sidewalk clearing to 2 cm in all areas where mechanical sidewalk clearing is available;

b.  collaborating with the Director of Insurance and Risk Management to improve the data quality of claims against the City to track claims over time for the purposes of assessing whether increases in snow removal to high volume pedestrian areas result in reduced claims;

c.  producing and keeping up to date an online, publicly available map that clearly defines areas that receive sidewalk snow and ice clearing services in the City of Toronto;

d.  increasing awareness of existing programs to help older adults and those with disabilities who are unable to clear their own sidewalks, in areas where sidewalks are not cleared by the City of Toronto;

e.  increasing resident awareness of their responsibilities related to clearing snow from sidewalks adjacent to their properties;

f.  clearing all sidewalks in all parts of the city;

g.  strengthening "clear your sidewalks" and "good footwear" campaigns.

2.  Forwarded the report (October 14, 2016) from the Acting Medical Officer of Health to:

a.  the Public Works and Infrastructure Committee for their information;

b.  the iDAPT Centre for Rehabilitation Research, Walk Toronto, Sick Kids Hospital, the Ministry of Health and Long-Term Care (MOHLTC), Parachute, the Public Health Agency of Canada (PHAC), the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), the Toronto District School Board (TDSB), the Toronto Catholic District School Board (TCDSB), the French school boards, CARP (formerly the Canadian Association of Retired Persons), Women's College Hospital, the 5 Toronto LHINs, the Seniors Accountability Table, and the Toronto Seniors’ Forum.

Walking is a healthy, environmentally-friendly behaviour linked to a lower risk of heart disease, obesity, type II diabetes, certain types of cancer, and mortality. The presence of snow and ice on sidewalks may discourage residents from walking in the wintertime, lead to isolation in older adults, and reduce equity of access to opportunities for physical activity and transportation.  Between 2006 and 2015, there were almost 30,000 emergency department visits and 2,800 hospitalizations among Toronto residents from falls on snow or ice, and older adults were especially vulnerable.  These injuries cost the provincial healthcare system close to $4,000,000 per year.  Slips and falls on snow or ice also cost the city about $6,700,000 per year as a result of liability insurance claims. Indirect societal and direct and indirect personal costs add to the burden from wintertime slips and falls.

Annual rates of emergency department visits, hospitalizations, and liability insurance claims related to slips and falls on snow and ice all closely mirror annual snowfall amounts.  While keeping sidewalks clear of snow and ice is likely to reduce the risk of slips and falls, the type and level of sidewalk snowclearing varies across the City.  Ways to encourage walking as part of a safe, healthy wintertime lifestyle include enhancing efforts by Transportation Services to target and clear sidewalks in areas of the city with high pedestrian volumes and seek opportunities for improvement in areas that currently do not receive mechanical snowclearing through technology, enforcement, and resident education.  Tracking claims data over time and producing an accessible, online map of areas where sidewalks are currently mechanically cleared would further support efforts to reduce injuries related to slips and falls on snow and ice in the future.