Transportation and Health: A Conversation With Seattle/King County Health Director
NewPublicHealth continues a series of conversations with local public health directors on the issues that impact their work and the health of their communities. Recently, we spoke with David Fleming, MD, MPH, public health director of Seattle and King County in Washington State. Dr. Fleming talked with us about how transportation innovation can impact the health and prosperity of a community.
>>Check out an INFOGRAPHIC on the connection between transportation and health.
>>Hear from Secretary of Transportation Ray LaHood on how transportation impacts public health.
NewPublicHealth: How is transportation innovation making a difference in the health of communities in Seattle/King County?
Dr. Fleming: We’ve started with transit-oriented development such as increasing bike and walking paths, which provides opportunities for physical exercise for many folks that want to do it, but haven’t been able to. It draws a larger number of people into activities and helps them exercise routinely. And in addition to increasing physical activity, you’re also increasing safety, reducing injuries, increasing the social capital in the community, getting better connections between community residents and from an economic development standpoint, you’re creating jobs and increasing property values, and therefore, improving one of the underlying social determinants of health.
NPH: What other examples of transit-oriented housing and community development can you tell us about in Seattle/ King County and what have you learned from them?
Dr. Fleming: We’ve worked especially hard on our poorer communities, along with local government, to create master plans for bike paths, for pedestrians, for safe routes to school. And we’ve been working on a couple of really cutting-edge housing developments. High Point is a good example in West Seattle that is really trying to integrate transit-oriented communities with safe and sustainable housing.
And we’re working on a prosperity partnership with the Department of Housing and Urban Development, looking at starting from the ground up in creating true corridors of transit-oriented communities.
NPH: What lessons have you learned that communities looking at transportation changes and innovations in their communities can make use of?
Dr. Fleming: There are a lot of lessons to be learned here. Number one, is that when you begin to engage with the multiple stakeholders that are involved, not surprisingly everyone is speaking a different language. So it takes time to learn the jargon, to learn how different people are saying what sounds like different things, but actually when you get down to it, we’re pretty much all saying the same thing.
Second, it’s important to engage the community in this work, and in some communities that’s easy. But particularly as you begin to work in poor communities and communities that may have disaffiliated populations, it takes a lot of time and energy to actively engage the community voices. First is getting people in the community involved early on thinking about these issues and planning for them; in essence, give the community skin in the game.
And, finally, this is not something that you can parachute in to do the job and then leave. To make a difference in community health, you really need to be prepared to be in it for the long haul. Moving from community engagement to design to construction is a multi-year process.
NPH: How do you get people to use the bike and walking paths and other innovations you’ve created?
Dr. Fleming: It is true that if you build it some people will come—but not everybody. There are a number of additional enhancements to maximize the effectiveness of these innovations and make sure they are used. First, as I mentioned, is community engagement. Next, think about how to integrate whatever is new into existing systems so that people will naturally come across this new bike path or this new walking path. Have clear signage. That’s a very basic thing so that people are educated about new opportunities.
And then finally, and in some ways most importantly, is to recognize that not all bike paths are the same, not all walking trails are the same—really think as you’re designing these enhancements in a community what elements are critical to make them as accessible as possible, as enticing as possible and as safe as possible.
NPH: What do we need to teach pedestrians to help make them safer?
Dr. Fleming: I think technology like portable music devices and cell phones have created new hazards and new distractions when it comes to cars, bikes and pedestrians. We need to accommodate these distractions in how we think about and train and enforce our laws. At least in Seattle, probably the biggest environmental change in all of this is the number of bikers on our roads, particularly as commuters. There are more bikes on the road now, but most of us have grown up as drivers in a setting where there were very few bikes on the road. And so, it is retraining, but it is retraining in the context of recognizing that the road conditions that we’re facing are changing rather dramatically as people begin to commute to work on their bikes.
NPH: You’ve said that a focus on transportation can also impact other critical issues in a community. How?
Dr. Fleming: One important aspect to share is that so many communities are increasingly concerned about strategies to not only improve health but to reduce health disparities. I think that focus on communities, particularly our poorest communities in the region, and thinking about transit-oriented development is a really powerful tool to engage policymakers around health and health disparities as a way of affecting not only health, but economic development and environmental sustainability within the community.
We’re talking about strategies to improve the fundamental vitality and wellbeing in the community, particularly our poorest communities. There’s a huge overlap in strategies and there are a large number of willing partners with independent financing sources that coming together under an integrated concept like transportation can really create synergies that were not there before.