There are few that will disagree that non-motorized movement improves an individual's health. Active people are healthier and healthier environments positively impact health status.
It's also evident that communities are designed around the convenience of motorized movement above all else.
In recent years, public health planners and leaders have begun to focus on improving transit systems as a community health opportunity. Washtenaw County transit planners have incorporated non-motorized options for several years and recently have begun to collaborate with public health officials on programs like the Washtenaw Area Transportation Study Clean Streets program, and other less formal efforts.
Linking public health with transportation decisions, however, has been a pretty recent development.
In 2010, two University of Illinois civil engineering researchers established a correlation between urban transportation, land-use policies, and health improvement. They developed models for measuring health-related variables including general health, obesity, high blood pressure, high blood cholesterol, asthma, and heart attack in relation to transportation, land-use, and built environment variables, along with demographic and socioeconomic factors. The results, published in the
Journal of Urban Planning and Development, show that increasing transit use and decreasing auto use have a significant positive impact on all health variables except for asthma.
The GIT literature review bares this out: "Many public health professionals believe that lifestyle intervention programs, which aim to increase daily levels of walking and bicycling through changes in the environment in which people live and work, may be more effective in changing long-term activity patterns than interventions centered on structured activities such as aerobics classes."
While it might seem like health awareness and peer pressure to lead a more physically active life has fostered a more active society, the opposite seems to be the case. The Nationwide Personal Transportation Survey conducted by the
U.S. Department of Transportation has reported a trend toward increased use of automotive travel and reduced use of public transit and other forms of movement. Public health advocates have pushed for creating walking-and bicycling-supportive environments as a way of reducing or eliminating environmental barriers to physical activity.
Transportation systems are often major barriers to increased physical activity and tend to be designed without a priority given to the environmental impact to the individuals or communities. That may be changing. Natalie Sampson, a doctoral student at the University of Michigan, believes that there has been evidence of increased interaction between transportation and public health officials for planning healthier systems of motorized and non-motorized movement, but it's unreasonable to expect transportation planners, who are "tasked with getting people where they need to go in a way that reduces traffic and boosts the economy" to also assume responsibility for public health.
In interviews contributing to her dissertation on the role of public engagement with decisions involving freight transportation, Sampson learned that there is a desire for improved communication between transportation and public health officials. The upcoming American Public Health Association conference, Oct. 27-31, will have several presentations on transportation, including a
panel discussion specifically on the interplay between public health and transportation planners. The program was organized by the APHA's Transportation-Public Health Link.
Locally, the
Washtenaw Area Transportation Study (WATS), a transportation planning agency, recently completed a Complete Streets program that encourages non-motorized transportation in federal and state projects. The Washtenaw County Health Department, which helped underwrite Complete Streets the program, is also actively involved with it. The Complete Streets policy considers the needs of pedestrians, bicyclists, public transportation vehicles and riders, motorists, freight vehicles,and people of all ages and abilities. All modes of transportation are integral elements of the transportation system. The Centers for Disease Control has
recommended Complete Streets as a strategy to prevent obesity and also helps reduce asthma through improved air quality.
"The more you use an automobile the less healthy it is for you because you're not moving, except at the very end of the trip," says Terri Blackmore, WATS executive director. WATS, which helps plan transportation projects using federal or state funds, dedicates 10 percent of funds for non-motorized systems (walking or cycling), 10 percent for mass transit, and 80 percent for roads.
"Ever since this agency was formed there has been strong support for alternative transportation. ... In the last transportation plan and the Complete Streets plan we've begun to discuss how different ways of allocating money impacts health and what health factors may be impacted, whether it's obesity, asthma."
Planners are also beginning to use health impact assessments to link health and the built environment. The
CDC Healthy Community Design Initiative helps communities integrate health considerations into transportation and community planning decisions through health impact assessments. Currently, these assessments are usually voluntary, although several state and local laws include some for of health impact requirement.
Health impact assessments on road construction projects differ from existing environmental impact studies in that they focus on the population health outcomes of the transit development rather than how it may affect the environment. According to the CDC, these studies need to assess public health impact in "decision-making for plans, projects, and policies that fall outside the traditional public health arenas, such as transportation and land use."
Richard Deverman, an environmental planner in Chicago and 2012 APHA conference speaker this year, argues that "only through the auspices of health impact assessment have transportation and environmental planners taken a harder look at the linkages between public health and good transportation decisions." Sampson adds that there may be a need for multiple mechanisms -- health impact assessments, zoning laws, and other methods of protecting public health in the built environment.
Re-engineering existing communities and shaping emerging communities that promotes non-motorized movement has tremendous possibilities of improving health status, the GIT literature review concluded.
Washtenaw County is fairly rural, but is becoming increasingly urbanized. As decisions are made to establish or improve roads that connect growing communities such as Dexter, Chelsea, and Ann Arbor, transportation and public health officials will need to achieve consensus on how to best move people, while minimizing the impact on public health and promoting individual health. Blackmore is hopeful that this will occur.
Sampson, who peddles about a mile to her office in Ann Arbor, has been so focused on her dissertation that she has overlooked changes in the city and county that make cycling easier. "I spend so much time in Detroit that I seem to take for granted that things work here when I come home at night. I can get on my bike and someone has advocated for me to have that bike lane."
Dennis Archambault is both a reader and a writer. He is also afreelance journalist and regular contributor to Concentrate and Metromode.
All photos by Doug Coombe