Skip to content

Posts from the "Public Health" Category

Streetsblog DC 11 Comments

This Is Your Brain on Cars—Oh, and Your Lungs and Heart and Gut, Too

Gerontologists in a laboratory at the University of Southern California exposed a group of mice to the same atmospheric conditions that humans encounter when driving along the freeway. Horrifyingly, they discovered that the mice’s brains showed the kind of swelling and inflammation associated with diseases such as Alzheimer’s. The researchers didn’t super-dose to get these results: The mice were exposed to freeway air for the equivalent of 15 hours a week — less than the 18.5 hour average Americans spend in their cars. Jokes aside about getting those darn mice off the road, the study suggests that driving less may reduce our risk of brain damage.

Let’s make not strapping a child into a car seat a symbolic act of love. Photo: Lafayette County Health

For decades, Americans have been hearing about the dangers of air pollution, much of which derives from our fleet of vehicles. Yet as the body of research has grown, clarifying just how damaging automobiles are to human health and the environment, we’ve persisted in spending an astounding amount of time in cars. As a nation, we drove three trillion miles last year. We have developed responses designed to treat symptoms of the underlying ailment, like keeping children indoors when the local ozone level triggers “code red” or “code purple” alerts. But as a whole, we have not responded to the everyday contamination of our bodies by driving less.

Most of us feel powerless to affect air quality. Many feel trapped by the built environment and unable to cut down on driving. Plenty also see no point in changing their behavior when “everyone else” is going to drive as much as they wish to. It’s unsurprising then that news about pollution is brushed aside—as is news about other ills caused by driving, including crash fatalities and injuries, stress, and obesity.

The UCLA mouse study joined other recent reports that highlight the variety of ways in which remaining overly reliant on the private automobile is self-destructive. But these reports should also make clear that changes in individual behavior can alleviate some of the problems. Here’s just a sampling:

  • Sitting for long stretches greatly increases the risk of heart disease – even if you exercise afterwards – according to a study in the Journal of the American College of Cardiology. It may come as no surprise that sitting isn’t good for your health, but what’s shocking is that the raft of articles following the study tended to ignore active transportation while advocating improbable solutions such as standing treadmill desks. What’s more practical than replacing some of our long hours planted in the driver’s seat with walking, biking, or getting by foot to public transit stops?
  • While there was some good news in the American Lung Association’s 2011 State of the Air Report, as one commentator put it, it was “like getting a 53 on your math test after you got a 49 on your last one.” Half of Americans live in areas in which air quality is unhealthy. The ALA points out that the elderly, the young, and the sick are most vulnerable to the effects of pollution. And of course some of the sick—such as those suffering from asthma and heart disease—can trace the very causes of their conditions to air pollution.
  • Read more…

Streetsblog LA 5 Comments

The Federal Transportation Bill Is a Health Care Bill

Dr. Richard J. Jackson is Professor and Chair of Environmental Health Science in the UCLA School of Public Health.

On February 23, Senator Barbara Boxer and Representative John Mica held a congressional hearing here in Los Angeles to discuss the federal transportation bill. The dominant theme of the hearing was expanding and establishing federal financing programs to provide capital for major infrastructure projects such as Los Angeles’s 30/10 plan, an initiative to build 12 major transit projects in 10 years. The elected leaders and assembled experts lauded the proposed programs for their potential to rapidly stimulate job creation and economic growth. Very little was mentioned, however, about the need for transportation investments to also be guided by other objectives, such as reducing air pollution, investing in biking and walking networks, and improving safety – all critical elements for improving the economy and public health. Transportation has immense impacts on human health, both positive and negative. Current policies fail to consider and value these impacts, but they must.

Dr. Richard J. Jackson

Traditionally, federal transportation funds have been given to states according to formula and with little accountability for how they are used. In Los Angeles the results are staggering. The annual health impacts from air pollution in our region alone are conservatively estimated at $22 billion, or $1,250 per person per year. Also, while pedestrians or cyclists account for 12 percent of all trips, they suffer 25 percent of all traffic fatalities. And as we have become more dependent on cars as a way to get to our jobs, to the store, to our doctors’ offices, and to every place else, our physical activity has declined, and coronary heart disease has become the number one killer of LA County residents.

To the credit of many public health leaders, elected officials, local policymakers, and engaged citizens, cities throughout the region are investing in biking and walking infrastructure to address these issues, revitalize local economies, and increase the effectiveness of transit systems. Planners in numerous cities — including Pasadena, Long Beach, Culver City, Glendale, Santa Monica, and Los Angeles — are setting strategic long-term goals and formulating plans to expand biking and walking networks, make them safer, and integrate them into existing and future public transit networks.

California is moving forward with its SB 375 law to reduce emissions by focusing on the communities we build and the types of transportation we use. This landmark law has initiated a process where planners, regulators, and the public have come together to set long-term goals and plan to achieve them. One purpose of this law is to comprehensively evaluate how different projects — including public transit, bicycle and pedestrian infrastructure, car-pool lanes, and roads — contribute collectively to achieving these goals.

But federal transportation bills have not set these strategic goals. As a result, despite continuous increases in federal funding, public health has not been a major factor as transportation projects are selected. Los Angeles, for example, has seen its air quality improve significantly but not as a result of more public transportation or communities where people can bike and walk safely and efficiently, but rather because cars are cleaner. At the same time, sprawl has continued to increase to a point where, in Los Angeles alone, we spend 490 million hours annually stuck in traffic. The combined weight of the health impacts from air pollution, traffic accidents, and lack of physical activity along with the costs of wasted fuel and time is a collective drag on our health and economy. Read more…

Streetsblog DC 18 Comments

Food Deserts: Another Way the Deck Is Stacked Against Car-Free Americans

Slate has posted this map to illustrate the concentration of “food deserts,” where large numbers of people don’t have access to fresh food. The USDA considers households more than a mile from a supermarket and without access to a car to be in food deserts, often with only convenience-store junk food for nourishment. In 2009, the agency found 2.3 million of these households. Here, Slate shows the preponderance of those households in Appalachia and the Deep South, and on Indian reservations.

food deserts

Access to healthy food is just one reason to build walkable places with a mix of uses and diverse transportation options. The places on this map are where people have been stranded — how walkable can your neighborhood be if you can’t walk to buy fresh produce? Many of the people identified here are poor and can’t afford cars. Some are elderly or disabled and can’t drive.

The most vulnerable members of our communities are the ones most hurt by transportation policies that keep a singular focus on automobile transportation and ignore those who need other ways to get around. What Slate is calling a food desert, you could also call an unlivable neighborhood, where even residents’ most basic needs — like access to healthy food — are denied.

11 Comments

NYC MDs: Tackling Obesity Takes Systemic Change and Safer Streets

So it looks like the lasting media image from last week’s City Council hearing on bike policy will be Marty Markowitz’s string of non-sequiturs sung to the tune of “My Favorite Things.” The routine was allowed to proceed even though committee chair Jimmy Vacca began the hearings with a call for decorum at all times. (Maybe that’s what prompted NYC Greenmarket founder and car-free Central Park pioneer Barry Benepe to observe, “The entire process appeared to be staged for the benefits of the loudmouths.”)

Linda Prine

Linda Prine

After Markowitz had his moment, dozens of other people came to testify with less camera-ready but more substantive comments. One of them was Linda Prine, a primary care physician who works for a network of New York City-based health centers called the Institute for Family Health. She also heads up the Manhattan chapter of the New York State Academy of Family Physicians. Streetsblog had a short chat with Prine this week about what led her to testify.

Prine and a group of colleagues who cycle regularly (they call themselves “biker docs”) began meeting and strategizing early this fall about how to promote active transportation. “Those of us who are in primary care are struggling with what to do with obesity and the health problems that come with it,” she said. “One of the good pieces of data about exercise, is that people who incorporate exercise into their commute have a better likelihood of actually exercising regularly.”

The biker docs came to the conclusion that promoting physical activity was “a systems problem,” Prine said. One doctor at a time telling patients to exercise won’t change habits on a large scale, but “making systemic changes like putting in bike lanes gets more people to bike.”

The day of the City Council hearing, Prine presented a letter from her and more than 150 medical professionals to Mayor Bloomberg supporting the continued expansion of the city’s bike network.

The biker docs are also taking their message out to peers in the medical community. Prine will be giving a presentation this Friday to the Beth Israel family medicine department, making the case for policies that promote biking and walking. Other biker docs will make similar presentations at Mount Sinai, Bellevue, and Montefiore medical centers.

You can read the letter to Bloomberg as a PDF and follow the jump for Prine’s testimony to the Council.

Read more…

No Comments

Watch Health Commish Tom Farley Make the Case For Traffic Calming

For New Yorkers concerned about making our streets safer, Transportation Alternatives’ Stop Speeding Summit was the place to be on November 19. If you couldn’t make it to the all-day event, now there are some highlights available which you can browse on your own laptop. You can download every PowerPoint from summit at T.A.’s website (click on the presenters’ names to download). And Health Commissioner Thomas Farley’s keynote address is online, thanks to NYU’s Rudin Center.

As we reported at the time, Dr. Farley gave a concise, 20-minute explanation for why traffic calming is essential for the city’s health. If you want the highlight reel, here’s our cheat sheet:

  • Check in at the 3:29 mark to hear Farley say that after quitting smoking, physical activity is the best thing you can do for your health.
  • At 9:38, he explains why health professionals are looking to the built environment to promote activity, and at 12:25 he lays down some evidence for the impressive health benefits of infrastructure like sidewalks or a transit system.
  • And at 14:35, Farley make the argument for re-engineering streets, recommending traffic calming treatments, including bike lanes.
  • Farley also makes the case that reducing the number of traffic crashes is a key public health issue. “Pretty much the entire reduction in child mortality in New York City is due to better transportation infrastructure,” he says at the 16:33 mark.
  • Finally, Farley explains why slowing down traffic will save lives. Check out minute 19:00.

2 Comments

Slow Down Traffic: It’s Doctor’s Orders

*May 19 - 00:05*

Health Commissioner Tom Farley, a sometimes-bike commuter, offered strong support for slower traffic speeds last Friday. Photo: Daily News

Last Friday, Transportation Alternatives kicked off a new phase of its campaign for safer streets with the Stop Speeding Summit, bringing together doctors, elected officials, transportation advocates and engineers to outline the high costs of high vehicle speeds and plot a course toward slower traffic.

We’ll be bringing you a series of posts from Friday’s event and wanted to let Thomas Farley, the city’s health commissioner, start things off. Farley laid out the public health argument for 20 mph traffic at the summit and offered to send Health Department staff to community boards and other public meetings to lend some lab coat gravitas to livable streets arguments.

Farley made clear that building safer streets is a top priority for him as a health professional. “We are living in the era of chronic diseases and injuries as the top killers,” he explained. Nearly all the top killers in New York are chronic diseases, with heart disease topping the list. “Accidents,” a category which includes traffic crashes, come in at number four.

That means promoting physical activity is a public health necessity. “Even just taking transit as opposed to driving could make a substantial reduction in heart disease deaths,” Farley said, adding that walking or biking for longer distances would improve health even more.

Because obesity, diabetes, high blood pressure, and other conditions correlated to the lack of physical activity are so widespread, Farley said that New York needs to address them by redesigning the city, not through individual conversations with doctors. “The way that we have an impact on the entire population is change the environment in which they live,” he said.

Read more…

9 Comments

APTA Report Prescribes Public Transport to Improve Public Health

FatalitiesTransit.pngTransit use is correlated with decreases in the number of traffic crashes. Image: "Evaluating Public Transportation Health Benefits"

A new report written by the Victoria Transport Policy Institute's Todd Litman for the American Public Transit Association [PDF], the trade organization for the nation's transit agencies, reminds us that one of the most valuable benefits of transit is to our health. Summarizing the state of research in the field, "Evaluating Public Transportation Health Benefits" lays out the basic fact that increasing transit use is an easy way of preventing thousands of unnecessary deaths each year. 

The damage that our current transportation system does to our health is staggering. Each year, 40,000 Americans die in traffic crashes, according to the report, the equivalent of 1,186,070 years of life lost. Estimates attribute an equal number of deaths to motor vehicle air pollution, which tends to affect an older population. The number of deaths attributable to a third category of health impact, the sedentary lifestyle driving promotes, wasn't estimated.

Importantly, the report points out that these tens of thousands of deaths, along with a number of injuries and illnesses an order of magnitude larger, aren't the result of how we drive but of how much we drive. For example, the United States has by far the highest traffic fatality rate among its peer countries per capita, but not per mile driven (that title goes to Ireland). Americans die more because we drive more, not because we drive worse.

Read more...
Streetsblog DC 40 Comments

Our Waistlines Are Expanding In Sync With Our Car-Dependence

cdc_map.jpgStates with the highest obesity rates also tend to be where the fewest people bike or walk to work. Image: CDC
Two reports released last week underscored the increasing severity of America's obesity epidemic. And the eye-opening findings add to the mounting evidence that stopping the spread of obesity and its attendant health risks will require changes to the nation’s transportation system as surely as it demands altering our diets.

A report from the Centers for Disease Control and Prevention released Tuesday showed the number of obese Americans has increased by 2.4 million since 2007. There are now nine states where more than 30 percent of the population qualifies as obese -- up from three states in 2007. (Just ten years ago, no state had obesity levels above 30 percent). 

The following day, Gallup released a ranking of the nation’s most and least obese states as part of a broader index of well-being. By its accounting, a cluster of states in the southeast -- West Virginia, Kentucky, Mississippi, Arkansas, and South Carolina -- have the highest rates of obesity, while the thinnest states, mainly in the west and New England, tend to have obesity rates about ten percentage points lower.

In the CDC ranking of states (which varies slightly from the Gallup ranking), Colorado and the District of Columbia are the only states with obesity rates under 20 percent, making their rate nearly 15 points lower than the most obese states. Their secret? During a press briefing, the CDC's Bill Dietz speculated that Colorado’s investment in biking and walking trails, as well as District residents' frequent use of public transportation, which goes hand in hand with walking and thus burns more calories than driving, are possible factors.

Indeed, if you look at rates of active commuting (walking and biking) in the most and least obese states, a revealing correlation emerges. Three of the five most obese states in the Gallup ranking are also among the five states with the smallest percentage of people who bike to work. At the other end of the spectrum, four of the ten thinnest states are among those where people bike to work most frequently. (The commuting rates come from Census data detailed in this League of American Bicyclists report.)

Read more...
Streetsblog DC 5 Comments

The Problems With Ports, or Why We Need a National Freight Act

Maybe you commute by train, or maybe you’ve switched from driving to biking. But your stuff is still traveling the country by diesel truck.

port_of_oakland_noaa.jpgContainers at the Port of Oakland. Photo: NOAA

Nearly a quarter of transportation-related greenhouse gas emissions come from freight. The movement of goods from port of entry to a store near you throws enough particulate pollution into the air to shorten the lives of 21,000 people each year, according to the Clean Air Task Force.

The freight sector is lumbering under inefficient and outdated systems that cause pollution, public health problems, safety hazards, and delivery delays. There’s never been a coordinated national approach to solving these problems. And with no deliberate strategy, the default approach is often to build more highways.

As Stephen Davis of Transportation for America writes:

If a port is congested or wants to expand, there’s little available
federal money to spend directly on rail or any other mode. Your choices
are highways or highways. When a state or port does spend to improve
operations, there is no accountability to make sure they’re actually
reducing port/freight congestion, moving freight faster, or reducing
air pollution in surrounding communities.

Enter the FREIGHT Act. (That’s the Focusing Resources, Economic Investment and Guidance to Help Transportation Act of 2010, with true Capitol Hill acronym panache.) The FREIGHT Act was introduced in the Senate toward the end of July and in the House a week later.

The bill focuses on areas known as "connectors," said Kathryn Phillips of the Environmental Defense Fund. “All the literature and studies say it’s the connector areas, the hubs, where you have the most congestion and environmental impacts.” The bill calls for troubleshooting at these bottlenecks, where products are transferred “from boat to truck to another truck to rail” and everything gets bogged down. Trucks get stuck in traffic; trains sit on the tracks; ships idle at port.

Communities near international ports pay the price. In Riverside, California, traffic gets tied up at 26 at-grade rail crossings 128 times a day when trains pass. Add to that the noise and pollution nearby neighborhoods must contend with.

Read more…

Streetsblog DC 8 Comments

Car-Dependent States Hit Hardest by Obesity Epidemic

driving_obesity.pngStates where more people drive to work face an even worse obesity crisis. Graphic: Noah Kazis and Carly Clark

Transportation is a public health issue. As profiled in the recently released report from the Trust for America’s Health, "F as in Fat," obesity rates continue to rise across the nation, increasing the risk of serious health problems like diabetes and hypertension. To solve the obesity epidemic, the data suggest, we need to rethink our dependence on the automobile. 

"F as in Fat" breaks out obesity numbers state by state. After glancing at their map, it seemed like transit and pedestrian-friendly states were doing better than the national average. To get more precise, we decided to compare adult obesity rates, as gathered in the report, to commuting statistics in the U.S. Census. You can download our spreadsheet here

The result is the scatterplot shown above, which clearly shows that states where more people drive to work have higher obesity rates. Caveats abound — correlation isn’t causation and state-level data can obscure important patterns visible only through a closer microscope — but the result is provocative. The two outliers are D.C. and New York State; they imply that while a large shift away from driving can make a big difference, it can’t solve the obesity crisis on its own.

Although "F as in Fat" doesn’t analyze transportation behavior itself, the authors agree that moving away from a reliance on the automobile is a critical component in curbing obesity. Their recommendations include: passing legislation supporting non-motorized transportation, such as an expansion of the Safe Routes to School program or a national complete streets bill; building more safe pedestrian space and bike paths to encourage active transport; and supporting mixed-use, walkable, and transit-oriented development.