'Health is everything'

Growing up in the Netherlands, Evelyne de Leeuw wanted to be a doctor. Her interest was personal: from the ages of six to 16 she suffered from a chronic inflammation of the large intestine, something rare in children, and took laudanum drops daily for the pain.

But today, as she begins an eight-year, $4-million project as a Canada Excellence Research Chair (CERC) at Université de Montréal, the 63-year-old professor recalls how public health, not medicine, became her career of choice.

You wouldn't know it, listening to this gregarious, engaging and straight-shooting academic now, but in her youth she wasn't exactly a people person.

"When I was 17 I went to an open house at a medical school, and all of a sudden I realized: I'm not the caring type," she says. "It wasn't the sight of blood that bothered me. I just knew I  didn't have the patience, the compassion, the love of people that's required to be a good doctor."

After a brief sidestep – an aborted attempt at studying landscape architecture at the Dutch agricultural university in Wageningen – the teenage de Leeuw took a career aptitude test, discovered she had a high IQ, and learned about an innovative area of study that had just opened up in a new and innovative university in Maastricht.

A lightbulb went on

It was called ‘social health science’. And a lightbulb went on in de Leeuw's mind: here was something larger than the medical field she'd imagined, and, bonus, it was grounded in a new concept called "problem-based learning," where students didn't have to learn by rote.

"I thought: 'This is fantastic,'" she recalls. "Why? Because health is everything, from the planetary down to the microscopic. And this was really cool, because I could work in this new field, in this new learning environment, and make it my own."

De Leeuw went on to do her master's and Ph.D. at Maastricht, got a second master's at the University of California, Berkeley, and in a career now spanning nearly 40 years has chaired a health policy foundation in Denmark, advised the World Health Organization, written or edited several scholarly journals and books, founded a consultancy, advised governments and schools of public health in Estonia, El Salvador, Finland and Kazakhstan, and held professorships at three Australian universities, most recently the University of New South Wales.

Along the way, she also found time to self-publish a rollicking, fictionalized biography of Rikste van Witzenburg-Meijer, whom she describes on the book jacket as "my great-aunt; black sheep; adventuress; sartorial icon; party animal; truck driver; firewoman during the London Blitz; among the crew of a crashing Catalina; passenger on the SS Rimutaka, core of the most heavily armed and longest-distance convoy of World War II."

In 2013, while on sabbatical in Montreal, she co-edited Health Promotion and the Policy Process, with Carole Clavier, an assistant professor of political science at Université du Québec à Montréal. In 2017, she followed that up with what she calls her magnum opus: Healthy Cities: The Theory, Policy, and Practice of Value-Based Urban Planning, a 515-page book co-edited with her University of Geneva colleague Jean Simos.

Very familiar with Montreal

Over the years, de Leeuw had come to know Montreal well as a frequent guest lecturer at UdeM. Now on the faculty of its School of Public Health (ESPUM), she'll be continuing her association with UdeM on a more formal basis, through what she calls "my very lavishly funded and quite prestigious position" researching and promoting "everyone’s and everything’s" health in cities.

"Why move all the way to the other side of the world to do it? Well, one thing you have to know about Australia is that while it may have an image as being a laid-back, easygoing, surfer's paradise kind of place, it's actually very, very hierarchical, and the bureaucracy in universities is simply terrifying. And when I went to see my superiors at the UNSW medical faculty with the idea of developing a program in One Urban Health, they turned me down flat.

"'Inconsequential esotericism' – that's what they called it. And there was no way they were going to entertain any proposals of mine in that area."

With typical pluck, de Leeuw reacted by having "Inconsequential esotericism" T-shirts printed up, distributed them to colleagues, and went about finding somewhere else to call home. Temporarily leaving behind not only the woman she finally married after 18 years, occupational therapist Lynne Adamson of Deakin University, who can't abide Canadian winters, but also their bitch golden retriever, Tekahionwake (Mohawk for "double life"), she moved to Montreal.

Her CERC, she explains in her prospectus, "will allow UdeM and its international partners to explore new opportunities and break some boundaries at the interface between health interactions between nature, animals, people and cities, from the extremely local to the super-global." In other words, carving out her niche, de Leeuw is adapting the concept of One Health – usually applied to animals, by the veterinary sciences – to humans living in cities.

'You must find the glue'

"Superficially, the two don't share too much," de Leeuw acknowledges. "You must find the glue, the gel to bring them together, and that will be governance: simply put, how we do stuff around here? What are the rules, explicit or implicit? Who needs to be involved in making or breaking those rules? They range from the highest level – human rights, planetary stability – to basic operational governance. We need to think about the rules that drive what we do."

Inspired by mentors like Ilona Kickbusch, Trevor Hancock and the late Leonard Duhl, de Leeuw wants to answer some pressing questions.

For instance, how can cities better prepare for respiratory pandemics like Covid-19, how can they be designed to limit transmission of the virus? How can air quality be improved? How, again by design and planning, can local outbreaks involving animals and humans be nipped in the bud and not spread, as Covid-19 did, out of cities like Wuhan in China and out to the world in general?

In another area, will health-care facilities be built that are not only carbon-neutral but that actually absorb more carbon than they produce? Or how about healthy airports – are they an oxymoron, or can aviation be made environmentally friendly, via electric airplanes someday, perhaps? ("That's a rather pertinent question for Montreal, the little-known aviation capital of the world, home of ICAO," says de Leeuw.) And what about dementia-friendly towns: can urban planners design cities where the cognitively challenged can always find their way home?

"They're novel, these questions, but not so novel that people are being put off by the 'esotericism,'" de Leeuw says. "They won't be answered by me creating an Institute of One Urban Health, either – that's not my ambition. Far more important will be to integrate the ideas we will generate not just here at ESPUM but also at the faculties of medicine, veterinary science, urban-planning and law, mostly through listening, then engaging the many people I know here already."

'I add value'

How will she get busy professors to care about her initiative? "Because I add value to what they're doing," de Leeuw replies. Among other initiatives, she is helping to set up a structuring plan around the themes of urban health, communities and territories at the Centre de recherche en santé publique, within which her CERC is integrated.

"There are professors I know here, like Yan Kestens, who are already thinking about urban health, via modelling, and that coincides with what I'm doing. I'm not in competition; I'm creating a new level of synergy with people where we collaborate toward unknown ends – it's really, really fascinating. With Katherine Frohlich, too, I'm on the same wavelength, thinking about play and streets and how they should be safe for kids. We're already a community."

Post-pandemic, the challenge is ever greater, she adds.

"We need to restore the value of public health in society. Public health has come out of Covid-19 damaged. Everybody thinks they're their own epidemiologist, they can interpret the data, they say 'All those experts, they're only so-called experts, and their scientific facts are only opinions' – we need to fix that. As a political scientist, I see that there are big chunks of the population that don't believe in what we do, that it's not a good investment."

'Queering' initiatives in four countries

One last thing she'd like to promote, and this, like her initial dream of going into medicine, gets back to the personal: de Leeuw wants to develop a new project called "queering public places." She began it in Australia, spoke about it last year at a Montreal-based conference of a global health NGO she's active in, and credits her inspiration as coming from a report commissioned by the global engineering firm Arup, the British multinational that also advised on the construction of Montreal's new Samuel-de-Champlain bridge.

"I thought, 'That's interesting stuff,' not only because I'm gay myself and have a vested interest, but in general, good public places are something everybody wants," de Leeuw says. "So I found people in Australia to replicate the pilot project that Arup had funded in London, and they went one step further, and actually tested local public policy, going to local governments in Sydney, Brisbane and Melbourne and asking them, 'How 'queer-friendly’ are your public places?"

The process amounted to "a bit of naming and shaming," de Leeuw admits, but that suited her fine as an activist for the cause. When local council members had a grudging response to the initiative, she'd say: "You put a rainbow bench in a park – hello! does that make me feel safe?" At the conference in Montreal, she approached an Arup representative and made her case. Result? The process is now under study here, just as it has been in Switzerland, in England and, backed by $400,000 in funding, in Australia.

Typically, "this is something that I never planned," de Leeuw says proudly of the "queering" initiatives.

"I just saw something that was of interest and it ballooned, it rolled. I love that sort of stuff. Story of my life!"