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This five-paper thesis explores office workers perceptions of green roofs and how this influences their health/well-being in Toronto and Chicago. Paper 1 examines the underlying paradigms and world-views of major research programs that look at the human relationship to nature and health/well-being, showing that despite some convergence between their methods and integration of different paradigms, continued differences and lack of clarity on the normative assumptions underlying each approach leads to confusion in the specification of ‘nature’ in health/well-being and place research. Paper 2 is a comparative analysis of the implementation of green roof policies in Toronto and Chicago. Paper 2 demonstrates the importance of ‘selling’ green roofs by linking them to larger environmental programs and of the municipal power structure that influences how and if environmental programs are implemented. Paper 3 examines the awareness, attitudes, and feelings towards green roofs by office workers with access to them (visual or physical) from their workplace in Toronto and Chicago. Using a phenomenological analysis of semi-structured interviews (n=55), Paper 3 shows that the hinterland, expectations of different kinds of ‘nature’ and aesthetics in the city, and access all influence perceptions of green roofs and sense of place. Paper 4 explores office workers awareness of and attitudes towards green roofs and the possible influence on their well-being in Toronto and Chicago from a large survey (n = 903). Participants showed a high literacy on the environmental benefits of green roofs. Chi-square analysis showed mixed results for health, but a significant association between visual access to a green roof and improved concentration. Paper 5 tests whether the relationship found in Paper 4, improved concentration with visual access, was still significant when other confounding variables were added to the model. Using a logistic regression on the same survey population (subset n =505), results found that concentration was no longer significant but that there was a trend towards improved concentration.

This five-paper thesis explores office workers perceptions of green roofs and how this influences their health/well-being in Toronto and Chicago. Paper 1 examines the underlying paradigms and world-views of major research programs that look at the human relationship to nature and health/well-being, showing that despite some convergence between their methods and integration of different paradigms, continued differences and lack of clarity on the normative assumptions underlying each approach leads to confusion in the specification of ‘nature’ in health/well-being and place research. Paper 2 is a comparative analysis of the implementation of green roof policies in Toronto and Chicago. Paper 2 demonstrates the importance of ‘selling’ green roofs by linking them to larger environmental programs and of the municipal power structure that influences how and if environmental programs are implemented. Paper 3 examines the awareness, attitudes, and feelings towards green roofs by office workers with access to them (visual or physical) from their workplace in Toronto and Chicago. Using a phenomenological analysis of semi-structured interviews (n=55), Paper 3 shows that the hinterland, expectations of different kinds of ‘nature’ and aesthetics in the city, and access all influence perceptions of green roofs and sense of place. Paper 4 explores office workers awareness of and attitudes towards green roofs and the possible influence on their well-being in Toronto and Chicago from a large survey (n = 903). Participants showed a high literacy on the environmental benefits of green roofs. Chi-square analysis showed mixed results for health, but a significant association between visual access to a green roof and improved concentration. Paper 5 tests whether the relationship found in Paper 4, improved concentration with visual access, was still significant when other confounding variables were added to the model. Using a logistic regression on the same survey population (subset n =505), results found that concentration was no longer significant but that there was a trend towards improved concentration.

Cardiovascular diseases (CVDs) are the leading cause of death and disability around the world. The purpose of this thesis is to investigate the impact of socio-environmental determinants of CVDs at the neighbourhood scale in order to inform actionable interventions, which may lead to large-scale reductions in preventable CVDs. Drawing on 2411 surveys carried out in Toronto, Canada, this thesis employs multilevel models to estimate the magnitude of socio-environmental influences on the risk of CVD while adjusting for individual-level risk factors. To advance current research methodology, strategies and innovations were developed to 1) improve the characterization of neighbourhoods by empirically testing a full range of socio-environmental influences; 2) account for non-residential exposures by including a combined analysis of work and home contexts; 3) account for variations in the duration of exposure through the use of time-weighted models; 4) deal with problem of spatial data aggregation by developing and testing a novel method of neighbourhood zone design, and 5) account for the spatial scales of different socio-environmental determinants by modeling at multiple scales. The thesis demonstrated that land use decisions are inextricably public health decisions. It found that living in neighbourhoods with inadequate access to food stores and areas for physical activity, burdened by violent crimes and fast food restaurants, and over-dependent on automobiles (leading to air pollution), with a high level of noise may significantly increase the risk of CVDs, over and above individual-level risks. The thesis also found that working in neighbourhoods that are socio-economically disadvantaged or have high-traffic may significantly increase CVD risk. The thesis developed and demonstrated novel methods to reduce the measurement error of neighbourhood exposures through 1) the use of “amoeba buffers” to improve neighbourhood zone design to better reflect participants’ local neighbourhoods and 2) the use of duration of exposure weights to adjust for individual differences in the time spent across different contexts. Finally, it found that the significance of socio-environmental factors depends on the scale of data aggregation; thus, investigation of multiple scales may be required to identify the relevant scale that matches the specific contextual factor in future research.

Cardiovascular diseases (CVDs) are the leading cause of death and disability around the world. The purpose of this thesis is to investigate the impact of socio-environmental determinants of CVDs at the neighbourhood scale in order to inform actionable interventions, which may lead to large-scale reductions in preventable CVDs. Drawing on 2411 surveys carried out in Toronto, Canada, this thesis employs multilevel models to estimate the magnitude of socio-environmental influences on the risk of CVD while adjusting for individual-level risk factors. To advance current research methodology, strategies and innovations were developed to 1) improve the characterization of neighbourhoods by empirically testing a full range of socio-environmental influences; 2) account for non-residential exposures by including a combined analysis of work and home contexts; 3) account for variations in the duration of exposure through the use of time-weighted models; 4) deal with problem of spatial data aggregation by developing and testing a novel method of neighbourhood zone design, and 5) account for the spatial scales of different socio-environmental determinants by modeling at multiple scales. The thesis demonstrated that land use decisions are inextricably public health decisions. It found that living in neighbourhoods with inadequate access to food stores and areas for physical activity, burdened by violent crimes and fast food restaurants, and over-dependent on automobiles (leading to air pollution), with a high level of noise may significantly increase the risk of CVDs, over and above individual-level risks. The thesis also found that working in neighbourhoods that are socio-economically disadvantaged or have high-traffic may significantly increase CVD risk. The thesis developed and demonstrated novel methods to reduce the measurement error of neighbourhood exposures through 1) the use of “amoeba buffers” to improve neighbourhood zone design to better reflect participants’ local neighbourhoods and 2) the use of duration of exposure weights to adjust for individual differences in the time spent across different contexts. Finally, it found that the significance of socio-environmental factors depends on the scale of data aggregation; thus, investigation of multiple scales may be required to identify the relevant scale that matches the specific contextual factor in future research.

Ce mémoire présente l’étude de cas de la ville de St George, ancienne capitale du protectorat britannique des Bermudes. Sa situation géographique particulière et la présence d’un ensemble architectural colonial britannique et d’ouvrages militaires lui ont récemment valu le titre de Site du patrimoine mondial de l’UNESCO, ce qui constitue une reconnaissance de la valeur exceptionnelle universelle de cet ensemble urbain. Cette inscription survient au moment où les autorités locales souhaitaient diversifier l’économie de l’archipel en misant davantage sur le tourisme culturel et patrimonial. L’hypothèse centrale de ce mémoire est que la ville St George se révèle, au sens où l’entendent G.J. Ashworth et J.E. Tunbridge dans leur ouvrage The tourist-historic city, un « joyau du patrimoine », ce dernier étant défini comme une petite collectivité territoriale recelant des ressources historiques exceptionnelles qui en définissent de manière notable la morphologie urbaine et l’identité paysagère et orientent les politiques municipales. La recherche, suite à la présentation d’un cadre théorique sur le patrimoine mondial et le tourisme patrimonial, a par ailleurs permis de montrer que le concept de « cité historico-touristique » développé par les mêmes auteurs s’applique aux Bermudes à la condition qu’un transfert d’échelle soit opéré. En effet, nous ne sommes pas en présence d’un espace touristique constitué de deux secteurs d’une même ville qui contribuent, chacun à sa façon, à la définition de l’attractivité touristique, mais plutôt de deux petites villes voisines – St-George et Hamilton, la capitale – qui constituent le substrat d’une cité historico-touristique éclatée. / This dissertation presents the case study of the town of St. George, historic capital of Bermuda. Its unique geography, the presence of British colonial architecture and of many military forts allowed its inclusion on the UNESCO world heritage List. This nomination in itself constitutes a recognition of the exceptional universal value of this urban entity. This inscription happens at the exact moment where the local authorities wish to diversify the archipelago’s economy by exploiting cultural and heritage tourism. The hypothesis of this dissertation is that the town of St. George is, according to the proposition of G.J Ashworth and J.E Tunbridge in their book The tourist-historic city, a «heritage gem », that is, a small community containing a great number of exceptional historic resources shaping the urban morphology, the landscape identity and local policies. The research, following the introduction of the relevant theoretical framework on world heritage and heritage tourism, demonstrated that the concept of the “tourist-historic city” developed by the same authors can be easily applied to the case of Bermuda if a scale reduction is made. Indeed, we are not presented with a touristic space created by two different sectors of the same city, but by two small neighbouring cities – St. George and Hamilton, the capital – which are the basis of a fragmented tourist-historic city.