Transportation and Public Health

An Integrated Approach to Policy, Planning, and Implementation

M. D. Meyer, O. A. Elrahman

• Publisher: Elsevier
• Year: 2019
• Print ISBN: 9780128167748
• eBook ISBN: 9780128172964
• Topic: Technology & Engineering
• Subtopic: Transportation & Navigation
• Index: Technology & Engineering

Transportation and Public Health: An Integrated Approach to Policy, Planning, and Implementation helps current and future transportation professionals integrate public health considerations into their transportation planning, thus supporting sustainability and promoting societal health and well-being. The book defines key issues, describes potential solutions, and provides detailed examples of how solutions have been implemented worldwide. In addition, it demonstrates how to identify gaps in existing policy frameworks. Addressing a critical and emerging urgent need in transportation and public health research, the book creates a coherent, inclusive and interdisciplinary framework for understanding.By integrating principles from transportation planning and engineering, health management, economics, social and organizational psychology, the book deepens understanding of these multiple perspectives and tensions inherent in integrating public health and transportation planning and policy implementation.- Bridges the gap between transport and public health, two fields that have traditionally traveled on separate and parallel tracks- Synthesizes key research and practice literature- Includes teaching and learning aids, such as case studies, chapter objectives, summaries and discussion questions

Chapter 1

Transportation and public health

An introduction

Abstract

The chapter advances the argument that any meaningful public policy effort that seeks to improve health outcomes must be grounded in an in-depth understanding of the relationship between transportation systems/facilities and public health. The goal of the book is to explore the relationships between transportation system design/operations and public health and identify strategies that can be used to improve public health. The chapter identifies the different areas the book examines, including definition of the different dimensions of public health and the ways in which planning, design, and operations of transportation systems affect and/or influence public health outcomes; the medical and public health evidence of the public health outcomes of transportation system design and performance; transportation-related strategies that can be used to reduce negative public health outcomes; and incorporating public health concerns into the decision-making processes relating to investing in and operating the transportation system.

Keywords

Integration of public health concerns into transportation decisions; Relationship between public health and transportation; Strategies for improving public health

Introduction

Public health is a major focus of public policy, legislation, and regulations throughout the world. In some cases, this policy focuses on specific health-related behaviors such as regulating the use of tobacco and alcohol. In other cases, this focus targets sectoral activities that have been shown to lead to unhealthy consequences, such as reducing the concentration of motor vehicle–related emissions that are precursors to lung-related illnesses. In this latter example, legislation and regulations have focused on the motor vehicle manufacturing industry (to reduce engine-related emissions) and on public policies relating to investment in transportation systems (to reduce the amount of travel in pollutant-emitting vehicles). Thus, it is very common to see policy makers attempting to achieve public health goals by legislating and regulating those activities that might lead to unhealthy outcomes (T4 America, 2017; Richter et al, 2001).

As suggested above, the transportation sector is one such area. There are many examples of where the technology of transportation systems and vehicles has been the focus of health-related policies. This is most obvious in the many policies and regulations that have been adopted worldwide to reduce the motor vehicle–related emissions known to exacerbate human illness. Early efforts focused on reducing the lead content in fuels, which was followed quickly by regulations to reduce other types of emissions, such as nitrous oxides, sulfates, carbon monoxide, and most recently greenhouse gas (GHG) emissions.

Water quality is another area where transportation systems have been the focus of health-related policies, primarily in reducing the type and concentration of the elements that emanate from vehicles and vehicle parts (such as batteries). In addition, attention has been given to the procedures used to maintain transportation system operation, such as the level of salt used to remove ice from roadways (possibly polluting nearby water aquifers).

A broader view on public health and transportation, however, is becoming an ever more important perspective in transportation policy and decision-making. Since the 1960s, transportation officials have been concerned with the more physical and obvious health-related impacts of transportation decisions. Motor vehicle safety, emissions, noise, community disruption, and motor vehicle–related water pollution impacts have been the focus of many studies and plan components, often in response to national and state legislation requiring such attention. Over the past decade, however, the public health nexus with transportation has broadened to include many other issues, such as the role of transportation system design on physical activity (and thus on the incidence of obesity and chronic disease), access to healthy food (in particular for underrepresented population groups), the lack of mobility and its effect on mental health and sense of isolation, transportation facilities serving as conduits for the spread of disease (especially in concert with climate change), and vulnerabilities of transportation systems to extreme weather events, and the like.

Fig. 1.1 illustrates the concept that many different sectors and agencies in their own way contribute to public health outcomes. From an institutional perspective, the agencies and organizations constituting each sector utilize resources (e.g., funding and personnel) to produce organizational products or services (called outputs in the figure) that eventually produce policy or program outcomes. Many factors can influence what the ultimate outcomes will be, most of which are not controlled by the agencies or the respective officials. Fig. 1.2 provides more detail for both the transportation and public health sectors. For both sectors, the figure shows a pathway for how initial organizational actions lead to eventual health outcomes. As will be seen throughout the book, strategies for enhancing public health outcomes can intervene anywhere along this pathway. For example, such strategies could provide more resources to affect agency outputs, influence agency products and services through direct regulation, or try to position the products and services to take advantage of the exogenous factors that will affect the eventual impact on public health.

Figure 1.1 Sectoral contribution to public health outcomes.

These two figures greatly simplify very complex interactions of many different variables and factors that influence health outcomes. For example, Fig. 1.2 shows “social determinants of health” (discussed in more detail in Chapter 2) as possibly affecting organizational actions along this pathway. and ultimately public health. These determinants represent a wide range of socioeconomic, environmental, community, and personal factors that can lead to the health profile associated with any particular individual.

The motivation for this book is that there is a growing awareness that transportation systems and their impacts/consequences have an important role in the incidence and magnitude of health issues over and above simply being the source of unhealthy pollutants (Giles and Corti, 2016). The book discusses the relationships and linkages between the transportation and public health sectors....in other words, the interaction that would be represented in Fig.1.2 as two-headed vertical arrows between the two sectors. Concepts similar to those shown in Fig. 1.2 are discussed in more detail later in the book where an understanding of the role of transportation in the social determinants of health is presented.

Figure 1.2 Pathway from transport policy to health outcomes.

Why focus on transportation?

Subsequent chapters provide greater detail on the specific nature of the public health–transportation relationship. However, it is useful at the beginning of the book to make the case why transportation should even be of interest to those concerned with public health outcomes. Consider the following.

Transportation safety

Road safety by far represents the greatest transportation-related public health challenge...

Table of contents

• Cover image
• Title page
• Table of Contents
• Copyright
• About the authors
• Preface
• Acknowledgment
• Chapter 1. Transportation and public health: An introduction
• Chapter 2. Dimensions of public health affected and influenced by transportation
• Chapter 3. Institutional frameworks: Laying the groundwork for mainstreaming public health into transportation decision-making
• Chapter 4. Air and water pollution: An important nexus of transportation and health
• Chapter 5. Community development, active transportation and public health
• Chapter 6. Transportation design, operations, and public health
• Chapter 7. Transportation system safety and public health
• Chapter 8. Transportation and _______
• Chapter 9. Incorporating public health concerns into transportation decision making
• Index