Benefits of Multimodal Transportation on Public Health and Social Equity

1. Benefits of Multimodal Transportation on Public Health and Social Equity Department of Rail and Public Transportation Steering Committee on Multi-Modal and Public Space Design Guidelines Michael O. Royster, MD, MPH Director, Office of Minority Health and Health Equity Virginia Department of Health

2. Health The presence of complete physical, mental, and social well-being and not merely the absence of disease. -World Health Organization

3. Major Determinants of Public Health McGinnis M, et al. 2002. The case for more active policy attention to health promotion. Health Affairs; 21(2):78-93.

4. Social Determinants of Health (SDOH) “The complex, integrated, and overlapping social structures and economic systems that include the social environment, physical environment, and health services and structural and societal factors that are responsible for most health inequities. SDOH are shaped by the distribution of money, power and resources which are themselves influenced by policy choices.” -Centers for Disease Control and Prevention (CDC)

5. LIVE

6. WORK

7. LEARN

8. PLAY

9. Transportation

10. ↓ All-Cause Mortality ↓ Cancer Mortality ↓ Cardiovascular Mortality ↓ Colon and Breast Cancer ↓ Diabetes ↓ Stroke ↓ Heart Disease ↓ Stress Transportation Policies Affect Health Through… ↑ Physical Activity ↑ Active Transportation ↓ Risk Pedestrian/ Bicyclist Fatalities ↓ Air Pollution ↓ Asthma ↓ Lung Disease ↓ Lung Cancer ↓ Mortality ↓ Driving ↓ Car Injuries ↓ Car Fatalities ↓ Car Collisions

11. 20-Minute Neighborhoods & Health ↑ Physical Activity ↓ Mortality & Chronic Disease ↓ Stress ↑ Destinations and Good Land Use Mix ↑ Active Transportation ↓ Risk Pedestrian & Bicyclist Fatalities ↓ Air Pollution ↓ Mortality & Chronic Disease ↓ Driving ↑ Population and Residential Unit Density (↓ Sprawl) ↓ Car Collisions ↓ Car Injuries ↑ Minor Car Collisions ↓ Car Fatalities ↑ Car Injuries

12. Pedestrian/Bicycle Infrastructure &Health ↑ Sidewalks ↓ Mortality & Chronic Disease ↓ Stress ↑ Bicycle/ Pedestrian Paths ↑ Active Transportation & Physical Activity ↓ Risk Pedestrian and Bicyclist Injuries/Fatalities ↑ Quality Pedestrian Facilities ↑ Street Lighting ↕ Exposure to Air Pollutants ↑ Route Connectivity

13. Transit Access & Health ↑ Transit Access ↑ Physical Activity ↓ Mortality & Chronic Disease ↓ Stress ↑ Transit Use

14. Source: Hidden Health Costs of Transportation. American Public Health Association

15. Transportation Disadvantage and Health Equity

16. Transportation Disadvantage and Health Equity- Racial/Ethnic Minority Source:Steven Raphael and Alan Berube, “Socioeconomic Differences in Household Automobile Ownership Rates: Implications for Evacuation Policy,” paper prepared for the Berkeley Symposium on “Real Estate, Catastrophic Risk, and Public Policy,” March 23, 2006, http://urbanpolicy.berkeley.edu/pdf/raphael.pdf.

17. Transportation Disadvantage and Health Equity- Rural “Realizing the Potential: Expanding Housing Opportunities near Transit,” Reconnecting America’s Center for Transit Oriented Development, 2007, http://www.reconnectingamerica.org/public/ reports?page=2

18. Transportation Disadvantage and Health Equity- 65 Years and Older L. Bailey, “Aging Americans: Stranded Without Options,” Surface Transportation Policy Project, 2004, http://www.apta.com/research/info/online/documents/aging_stranded.pdf

19. Transportation Disadvantage and Health Equity- Disability

20. Source: At the Intersection of Public Health and Transportation: Promoting Healthy Transportation Policy, American Public Health Association.

21. http://www.apha.org/NR/rdonlyres/43F10382-FB68-4112-8C75-49DCB10F8ECF/0/TransportationBrief.pdfhttp://www.apha.org/NR/rdonlyres/43F10382-FB68-4112-8C75-49DCB10F8ECF/0/TransportationBrief.pdf

22. http://www.policylink.org/atf/cf/%7B97C6D565-BB43-406D-A6D5-ECA3BBF35AF0%7D/transportationRX_final.pdfhttp://www.policylink.org/atf/cf/%7B97C6D565-BB43-406D-A6D5-ECA3BBF35AF0%7D/transportationRX_final.pdf

23. http://www.upstreampublichealth.org/currentwork/transportation/THEprincpleshttp://www.upstreampublichealth.org/currentwork/transportation/THEprincples

27. Tools to Support Healthy Transportation Policy

28. Health Impact Assessment How does the proposed project, plan, policy affect Democratic process Housing Air quality Noise Safety Social networks Nutrition Parks and natural space Private goods and services Public services Transportation Social equity Livelihood Water quality Education and lead tohealth outcomes Health Impact Partners http://www.cdc.gov/healthyplaces/hia.htm

29. HIA can evaluate many types of projects, plans, policies HIA Topics Health Impact Partners

30. http://www.upstreampublichealth.org/sites/default/files/HIAEugene.pdfhttp://www.upstreampublichealth.org/sites/default/files/HIAEugene.pdf

31. http://www.policylink.org/site/c.lkIXLbMNJrE/b.7841971/k.7BB/The_Healthy_Corridor_for_All_Health_Impact_Assessment.htmhttp://www.policylink.org/site/c.lkIXLbMNJrE/b.7841971/k.7BB/The_Healthy_Corridor_for_All_Health_Impact_Assessment.htm

32. http://www.thehdmt.org/

34. http://www.kingcounty.gov/exec/equity/toolsandresources.aspx

35. Health Opportunity Index http://www.vdh.virginia.gov/healthpolicy/2012report.htm

36. Health Opportunity in Virginia

37. Source: SHCC

39. Michael O. Royster, MD, MPHOffice of Minority Health and Health EquityVirginia Department of Health(804) 864-7425michael.royster@vdh.virginia.govwww.vdh.virginia.gov/healthpolicy