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Jan 24 2012
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Transportation and Health By the Numbers

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Yesterday’s “Intersection of Transportation and Health” workshop, a day for the health-o-philes at the Transportation Research Board Annual Meeting, underscored the concept that transportation plays a critical role in determining health outcomes. Brian Raymond, MPH, Senior Policy Consultant, Kaiser Permanente Institute for Health Policy, outlined several important ways transportation affects health:

  • injuries and accidents from motor vehicle crashes;
  • poor air quality its effects on asthma and a myriad of other health conditions;
  • impact on physical activity, for better or worse (depending on whether automobiles or public transit are the focus); and
  • “access to the necessities of life,” providing a way to get to jobs and economic opportunities, to access health care options and to readily and regularly access fresh, health foods.

Air pollution and motor vehicle crashes get a lot of attention, and thus have a lot of research behind them, said Andrew Dannenberg, MD, MPH, Affiliate Professor at the University of Washington and consultant on the Centers for Disease Control and Prevention (CDC) Healthy Community Design Initiative, who presented on research priorities for transportation and health. Though more research is needed on access and physical activity, some interesting trends are beginning to emerge. Some of the statistics revealed at the workshop include:

  • Three trillion vehicle miles are traveled in the U.S. each year, according to the Federal Highway Research Administration.
  • Between 1990 and 2009 the vehicle miles traveled for passenger cars and trucks has increased by 39 percent, said David Ragland, PhD, MPH, Director of the Safe Transportation Research and Education Center at the University of California at Berkeley.
  • Every additional hour spent in a car is associated with a 6% increase in the risk of obesity, and every kilometer walked is associated with a 5% decrease in obesity risk, said Raymond.
  • Thirty-six percent of adults don’t report any leisure time physical activity; 88% don’t meet federal guidelines for the recommended amount of activity.
  • The estimated medical costs of inactivity top $75 billion per year.
  • Walking and biking are the top leisure physical activities of choice in the U.S., and are also the top utilitarian physical activities.
  • Public transit users walk a median of 19 minutes daily getting to and from transit stops. Nearly 30 percent of transit users exceed the 30 minutes of recommended physical activity per day.

Some resources shared at the workshop included:

>>Follow continued coverage of the Transportation Research Board Annual Meeting from NewPublicHealth.org here.

Jan 23 2012
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Transportation Research Board Annual Meeting: Intersection of Health and Transportation

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Most of us get in our cars, subways, buses, trains and walking shoes without thinking much about the network of decisions and research that went into making that commute a little bit easier – and, more and more, healthier. This week, more than 11,000 transportation and transportation research professionals convene in Washington, DC for the Transportation Research Board Annual Meeting to discuss exactly those issues. Yesterday’s full-day workshop, “Intersection of Health and Transportation: What We Know, What We Don’t Know, and How We Can Better Integrate Health Considerations Into Transportation Decisions,” organized by the TRB Health and Transportation Subcommittee is a chance to look at how we drive, metro, walk and bike and how it affects our health.

One theme that emerged today included the critical role of cross-sector partnerships. Innovative new collaborative planning teams are springing up from local to national levels, including North Carolina’s Healthy Environments Collaborative, launched in 2006, with partners from the North Carolina Departments of Commerce, the Department of Environment and Natural Resources, the Department of Health and Human Services and the Department of Transportation, with the purpose of shaping policies that influence physical activity-friendly environments. On a national level, the Partnership for Sustainable Communities is an interagency collaboration between the U.S. Department of Transportation, the Department of Housing and Urban Development and the Environmental Protection Agency.

Presenters also spoke about the need to emphasize that strategies that support public health have co-benefits across a variety of issues, including a cleaner environment and safer roaders and motor vehicle injury prevention. Arthur Wendel, MD, MPH, Team Lead of the Healthy Community Design Initiative at the Centers for Disease Control and Prevention (CDC), discussed the alignment of physical activity and safety and motor vehicle injury prevention goals – common solutions include better medians and pedestrian refuge areas, more sidewalks and shared use lanes, and a more robust public transportation infrastructure.

Why is public transportation so critical to public health? Public transports’ links to physical activity and obesity have been well-explored. Nearly 30 percent of public transit users exceed the 30 minutes of daily recommended physical activity, simply as part of their everyday commute, said Dr. Wendel – compare that to the fact that 36 percent of the general population of U.S. adults get no physical activity at all.

Dr. Wendel also mentioned that health impact assessments are one important tool to help weave health considerations into transportation decisions. “Coming from a clinical background, I view it as similar to a pre-op physical to make sure your heart, lungs and kidneys will be able to survive the operation,” said Dr. Wendel. “Health impact assessments make sure the public’s health will come out better after a transportation decision.”

Leslie Meehan, Director of the Healthy Communities program of the Nashville Area Metropolitan Planning Organization, noted that unlike the proactive health impact assessment approach, most transportation decisions are made in a reactive planning mode, in response to the need to mitigate land use problems like roadway congestion. In fact, most of the measurement tools around transportation “focus on mobility – not quality of life or accessibility,” said Meehan. She described some of the challenges in shifting the thinking around transportation. The Healthy Communities program reached out to policymakers and decision-makers with the following messages, bringing to light the underlying health, social and economic implications of transportation:

  • A CEOs for Cities report ranked Nashville among the worst cities in the country for residents’ time spent in traffic due to sprawl.
  • Ninety percent of Nashville residents spent over 20 percent of their income on transportation.
  • Nashville’s aging populations is leading to more people losing access to personal transportation.
  • The steep upward trend in daily vehicle miles traveled closely mirrors the steep upward trend in the obesity rate over the past 40 years.
  • There are economic implications of transportation-related health effects in that an unhealthy child cannot learn and an unhealthy worker cannot work.

In response, the Healthy Communities group championed a restructured funding mechanism that prioritizes health and safety concerns. As a result, 70 adopted roadway projects include sidewalks, bike lanes or shared-use provisions, compared to 2 percent in prior plans.

>>Check out TRBHealth.org to view emerging research in this area.

>>Follow NewPublicHealth coverage of the Transportation Research Board Annual Meeting here.