Category Archives: Transportation policy
Earlier this month, following the heatstroke death of a Georgia toddler who was left in a sweltering car for hours, Tennessee became the first state in the nation to pass a law that specifically protects people from liability for forcibly breaking into cars and rescuing kids they think are at risk of heatstroke. The law requires those individuals to call 911 first and follow instructions.
Many states have Good Samaritan laws that may protect people in such instances, but the specifics vary from state to state, according to Cristina M. Meneses, JD, MS, a staff attorney with the Network for Public Health Law’s Eastern Region. A recent Today show poll found that 88 percent of the 44,000 people asked would break into a car to rescue a child they thought was in danger, but specific laws can increase the response—and potentially remove penalties—while raising awareness of the issue. More such laws could soon follow. Janette Fennell, founder and head of KidsAndCars, a nonprofit based in Kansas City, Mo., which advocates for laws that will protect kids from heat in vehicles, said she’s received inquiries from two states about those laws since Tennessee’s law was passed. Another set of laws that KidsAndCars tracks are those that penalize adults for leaving kids in cars. Nineteen states currently have such laws on the books.
“It’s a good deterrent for anyone who might think, ‘Oh, I’ll just leave them in the car for a minute,’” said Fennell, “because it’s often that minute that turns into much longer and results in injury or death.”
According to the National Highway Traffic Safety Administration (NHTSA), more than 40 kids—often under age 2—die each year of “vehicular heatstroke.” Seventeen U.S. kids have died after being left or trapped in car since the beginning of 2014. Fennell and other experts say many people just don’t realize how quickly temperatures can climb in a car, even if the window is cracked open a bit—when outside temperatures are in the low 80's, the temperature inside a vehicle can reach deadly levels in only 10 minutes, even with a window rolled down two inches. Children's bodies, in particular, overheat easily; and infants and children under four years old are at the greatest risk for heat-related illness.
NHTSA research shows that heatstroke deaths and injuries often occur after a child gets into an unlocked vehicle to play without a parent or caregiver's knowledge. Other incidents can occur when a parent or caregiver who is not used to transporting a child as part of their daily routine inadvertently forgets a child sleeping in the back.
Last week, KidsAndCars launched a petition drive to encourage NHTSA to require technology in all cars that would remind a driver that there is a child in the back. There are devices parents can install, but a 2012 study by NHTSA found that none that the agency studied were consistently effective.
“You get a warning if you don't buckle your seatbelt, leave a car door open, your gas is low or you leave your headlights on,” said Fennell. “If a child is left behind then you absolutely need a warning.”
Guidelines from NHTSA and other safety experts aimed at never leaving a child unattended in a car include:
- Make a habit of looking in the vehicle—front and back—before locking the door and walking away
- Ask childcare providers to call if a child doesn't show up for care as expected
- Put items in the back seat you’ll have to retrieve such as a purse or briefcase, or put a stuffed animal in sight of the driver to indicate there’s a child in the car.
A 2012 report from the U.S. Centers for Disease Control and Prevention (CDC) found that walking is hands-down the most common exercise activity in the United States—which only makes a new report showing the high rate of pedestrian fatalities and injuries that much more alarming.
The report, Dangerous by Design 2014, released by the National Complete Streets Coalition, a program of advocacy group Smart Growth America, finds that more than 47,000 people were killed and close to 700,000 injured while walking in the United States between 2003 and 2012. The report also found that the rates have been rising in the last few years, and that the majority of deaths and injuries could have been prevented with safer street designs such as crosswalks and traffic signs.
The report also ranks major U.S. metropolitan areas according to a Pedestrian Danger Index that assesses how safe pedestrians are while walking. The top four most dangerous cities—Orlando, Tampa, Jacksonville and Miami—are all in Florida and the other six are, in order, Memphis, Phoenix, Houston, Birmingham, Atlanta and Charlotte.
“We are allowing an epidemic of pedestrian fatalities, brought on by streets designed for speed and not safety, to take nearly 5,000 lives a year; a number that increased six percent between 2011 and 2012,” said Roger Millar, director of the National Complete Streets Coalition. “Not only is that number simply too high, but these deaths are easily prevented through policy, design and practice. State and local transportation leaders need to prioritize the implementation of Complete Streets policies that keep everyone safe.”
Complete Streets refer to “streets for everyone,” according to the Coalition, and are designed and operated to enable safe access for all users. People of all ages and abilities are able to safely move along and across streets in a community, regardless of how they are traveling. Complete Streets also make it easy to cross the street, walk to shops and bicycle to work, while allowing buses to run on time and making it safe for people to walk to and from train stations.
Rates of walking deaths and injuries are far higher for more vulnerable populations such as older adults, children and people of color, according to the report. For example, while just 12.6 percent of the total population is over age 65, that group accounts for nearly 21 percent of pedestrian fatalities nationwide.
This year, the County Health Rankings and Roadmaps, an annual report of the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, added some new measures, including transportation, to help track what communities can do to help improve population health. Researchers have found that more than three-quarters of workers drive to work alone and among them 33 percent drive longer than a half hour each way. Driving contributes to physical inactivity, obesity and air pollution.
One idea that has sprouted as an alternative to cars is actually a throwback: Streetcars. First introduced in the 1820s and drawn by horses on rails that let wagons move faster than they could on unpaved roads, many cities later added electricity by the 1920s to create early transit systems. They then added buses—and often faster underground rail lines—to transportation options as the 20th century continued, and then usually discontinuing the streetcar lines.
Planners say resurgence has come with plans to revitalize downtown areas as well as attract tourists, who often fly into town but then look for inexpensive and accessible ways to go from site to site. But funding, including grants from the U.S. Department of Transportation, is sometimes awarded for streetcars on the promise of using the lines as an inexpensive transit mode to get to and from work. An opinion piece in The New York Times last month proposed that idea for people who live in lower-income neighborhoods a mile or more from subway stations, which can be a deterrent to looking for higher-paying jobs outside of home neighborhoods.
But some researchers remain skeptical that streetcars will meet that and other promises made by some developers, including reducing car emissions and the need for parking spaces in cities. A study published last year in the Journal of Public Transportation by Jeffrey Brown, an associate professor in the Department of Urban and Regional Planning at Florida State University, said there is “a lack of information about how these investments [in streetcar lines] function as transportation modes as opposed to urban development tools.”
Brown said few streetcar rider surveys have been done, but where they have been ridership so far does not indicate they’re being used as a transportation option for work. A Memphis survey found that only 9 percent of streetcar rides transport workers between home and job, while 58 percent of bus rides are for transportation to work and back. And surveys of the Portland system, the heaviest used streetcar system in the United States, show that streetcar users tend to have higher incomes than users of the city’s other mass transit modes.
Although the overall traffic death rate is dropping, the number of pedestrians and bicyclists killed by distracted drivers in the United States is climbing, according to a new study in Public Health Reports.
Researchers utilized the Fatality Analysis Reporting System to find crashes on public roads from 2005 to 2010 that led to at least one death, finding that pedestrian deaths jumped to 500 from 347. The number of bicyclist deaths rose to 73 from 56, with a peak of 77 in 2008. They also found that distracted drivers were three times more likely to hit pedestrians on road shoulders and 1.6 times more likely to hit them in marked crosswalks.
“The problem is that pedestrians and cyclists have little protection on the roadways,” said study author Fernando Wilson, PhD, associate professor in the College of Public Health at the University of Nebraska Medical Center, adding, “Evidence suggests that separating non-motorized travel from motorized travel, through bike lanes or other redevelopment efforts, could greatly reduce deaths.”
The study’s authors concluded that new and better policies are needed to stop this growing public health problem. They hope that the findings—particularly the demographic findings—can help advocates and policymakers determine exactly what these policies should be.
For example, the pedestrian victims are more likely to be:
- Older than 65
- Physically impaired
- On the road shoulder
- Hit during the day
Bicyclist victims are more likely to be:
- Riding in the morning
- On the road shoulder
- In a rural area
The study was funded by the Robert Wood Johnson Foundation’s Public Health Law Research program.
A story on the urbanwonk blog of The Atlantic Cities website finds that in Vienna, Austria, pilot projects are taking women’s home, work and elder care responsibilities into account in design planning. For example, surveys found that women—often with strollers in in tow—were more likely than men to use public transportation and needed some accommodating. They also found that after age nine boys were more likely than girls to use park space, perhaps because the girls felt fearful or outnumbered. A reengineering soon followed that brought girls into the parks. Austrian city planners have worked a lot of that data into other city construction, including a pilot apartment complex that includes onsite parks, doctor’s office, a pharmacy and a preschool.
A key concept? Assess needs first…and then plan the design.
>>Read the full article at The Atlantic Cities
>>Bonus Link: Read a NewPublicHealth post on creating safer urban biking opportunities for women
Kids and their parents aren’t the only ones who need to do some back-to-school prep as the fall term starts. A new survey of U.S. school bus drivers released by the National Association of Directors of Pupil Transportation Services (NADPTS) last week found that more than 80,000 vehicles illegally passed a stopped school bus on a single day this past year. That translates to nearly 15 million violations during the 180-day school year, according to the association.
Laws and regulations can vary somewhat by state, but generally drivers must come to a full stop when they are behind or across the street from a school bus when it has its stop sign out and its lights are flashing. The NADPTS maintains a list of state laws regarding what cars must do when they see a stopped school bus.
No one organization keeps tabs on all children injured and killed by drivers who didn’t stop for a school bus, but three children were killed in such accidents in North Carolina alone last year, bringing that state’s total of children killed in such accidents to a dozen since 1998.
“There are nearly a half million school buses on the road each day in the United States,” said Max Christensen, NADPTS president, and, “any driver who passes a stopped school bus illegally is gambling with a child’s life.” According to the association, some states are adopting more stringent safety measures, such as improved motorist education, increased fines, and more law enforcement, including the use of photo evidence in court cases from cameras mounted on the sides of school buses.
>>Recommended Reading: To help reduce the number of injuries and fatalities related to school bus accidents, the National Highway Traffic Safety Administration has a school bus safety website stocked with information.
The following post originally appeared on the Harvard Law School blog, Bill of Health, launched in September 2012 by Harvard's Petrie-Flom Center. The blog explores news, commentary, and scholarship in the fields of health law policy, biotechnology, and bioethics. This post examines the policies that impact proper use of child car seats and booster seats.
Author Kathleen West is an intern with the Public Health Law Research program. Her summer work has included researching and creating a comprehensive dataset on child restraint systems across the United States using LawAtlas, a gateway database to key laws aimed at improving our health or access to health care. Read more on LawAtlas.
As the world watched Prince William place the new royal baby, reluctantly snug in his car seat, into a vehicle a few weeks ago, my thoughts were not limited to, “Oh, how cute!” After two months researching and collecting a dataset to capture the U.S. laws and regulations for child passenger restraint systems, I also thought, “I wonder if he took a class and knows how to do that correctly?” Perhaps an odd thought, but misuse and faulty installation of child restraint systems is actually a major concern.
According to the CDC, proper restraint use can reduce the risk of death or injury by more than 50 percent. Yet, ongoing studies by the National Highway Traffic Safety Administration (NHTSA) are finding that as many as 20 percent of drivers with child passengers are not reading any of the instructions regarding proper installation, while 90 percent of drivers of child passengers are reporting that they are confident that they are properly installing and using child restraint systems.
Almost everything touches public health. From understanding care options to access to nutritious food to being able to breathe clean air—it all works together to prevent disease and promote healthy living. That includes the types of available transportation.
>>View NewPublicHealth’s infographic exploring the role of transportation in the health of our communities, “Better Transportation Options = Healthier Lives.”
The Transportation Research Board Subcommittee on Health and Transportation (H+T) was formed in the Summer of 2011 to provide a variety of disciplines the opportunity to share and compare transportation-related health research in an academic environment. It’s a place where engineers, public health professionals, planners, epidemiologists, advocates and others can identify, advance and publish research that advances our understanding of transportation infrastructure and policies affect public health. [Editor’s Note: Read NewPublicHealth’s coverage of last year’s Transportation Research Board conference.]
The H+T Subcommittee’s areas of interest and study include sustainable and active transportation modes (e.g., walking, biking, transit); mobility and accessibility; safety; transportation-related air pollution and noise impacts; and social cohesion and other social, physical and mental health impacts.
State and local government across the country are already utilizing engineering and design solutions to improve public health in their communities, according to The Network for Public Health Law, which provides information and technical assistance on issues related to public health and is funded by the Robert Wood Johnson Foundation.
“In Massachusetts and Minnesota, transportation officials are exploring infrastructures that allow for ‘active transportation’—like walking and bicycling—which can help prevent weight gain and lower the risks of obesity, diabetes and heart disease. In Washington and California, programs are incorporating transit-oriented development strategies to improve environmental health and access to healthy foods.”
>>Read more on how transportation can impact health.
International Making Cities Livable Conference: A NewPublicHealth Q&A with Conference Co-Founder Suzanne Lennard
NewPublicHealth is on the road this week at the AcademyHealth Annual Research Meeting in Baltimore, Maryland and the International Making Cities Livable Conference meeting in Portland, Oregon. Watch out for session coverage, Q&As with presenters and other updates from both conferences this week.
The International Making Cities Livable Council is an interdisciplinary, international network of individuals and cities dedicated to making our cities and communities more livable, with a focus on how the built environment impacts the wellbeing of the people who live in a community. This year’s conference focuses on creating healthy suburbs. And though health is an inextricable component of a livable city or suburb, this concept also includes enabling healthy social interaction; fostering a healthy local economy; creating safe spaces where children can grow up successfully; and more. NewPublicHealth coverage will focus on the critical connection between health and livability.
Prior to the conference, we connected with Suzanne Lennard, co-founder of the International Making Cities Livable Conference, who provided critical context on just what makes a city livable, and some of the contextual history on how our nation’s cities and suburbs strayed from livability—and what we can learn from other counties in getting back to healthy, livable places to live, learn and play.
NewPublicHealth: How did you come to found the International Making Cities Livable Conference?
Suzanne Lennard: My husband, who died several years ago, was a medical sociologist and social psychologist and his field was the study of social interaction in different settings and under different circumstances. When I met him, I was studying for a PhD at UC Berkeley in Human Aspects of Architecture and Urban Design and I was interested in how the built environment enhanced well-being. We started working together and since we were both from Europe—he was Viennese and I was from England—we began to look at how some European cities were enhancing well-being.
The Transportation Research Board, a division of the National Research Council, is holding its annual meeting this week including a critical session later today that will bring together several subcommittees to talk about the intersection of transportation and health.
>>Read our coverage from last year’s Transportation Research Board meeting.
Ed Christopher, who is with the Federal Highway Administration Resource Center Planning Team and co-chair of the health subcommittee, says that over the last ten years people in the transportation sector have become more aware of the connections between health and transportation including physical activity, safety, air quality, equity, and access, but that collaboration is still in its early stages. “Health and transportation professionals often come from different scientific backgrounds and have separate institutional structures,” says Christopher. Today’s session bring together the health subcommittee along with several others including committees on policy, legal resources, safety and public transportation.
Christopher says the session will help “demystify” the connections between health and transportation, and identify promising opportunities for research and collaboration.
The keynote speaker at today’s session is Andrew Dannenberg, MD, MPH, an Affiliate Professor at the University of Washington’s School of Public Health Department of Environmental and Occupational Health Sciences and the Department of Urban Design and Planning in the College of Built Environments.
Dr. Dannenberg is also a consultant to and former team lead of the Healthy Community Design Initiative at the Center for Disease Control and Prevention, where he works on activities related to the health aspects of community design including land use, transportation, urban planning, and the built environment. In advance of today’s meeting, NewPublicHealth spoke with Dr. Dannenberg about synergies between transportation and health.
NewPublicHealth: What is the intersection of health and transportation and why does it matter?