A presentation on the linkages between #transport #planning and #policy and #public #health

1. Reflections on Health
in Transport Planning
and Policy
Haneen Khreis
Institute forTransport Studies, University of Leeds, UK
Barcelona Institute forGlobal Health, Barcelona, Spain

2. Health in
transport
planning
and policy
and what
we’re doing
about it
• Health and other objectives in the transport
agenda
• Including health in other high priority policy
agenda e.g. climate change
• Synergies between transport and health
(pathways/ linkages, impacts, scale, specific
policies)
• Including health in transport planning tools
• Promoting cross-disciplinary dialogue,
collaboration and knowledge transfer
• Other initiatives: ICTH,WCTRS SIG onTransport
and Health, book on Urban development,
Environment Exposures, and Health
• Thinking solutions – over to you!

3. Sustainability
• 1962 – Silent Spring
• 1987 – Brundtland Report
• The concept of SustainableTransport has
from the broader notion of sustainable
development
• The roots of the SustainableTransport can be
traced to the 1972 Stockholm and 1992 and
2012 Rio conferences

4. Sustainable
Transport
• Sustainable transportation
satisfies “current transport
and mobility needs without
compromising the ability of
future generations to meet
these needs” (Black 1996, p.
151).

5. Sustainable Urban
Mobility Planning
• The European Commission’s Action Plan on Urban
Mobility (EC, 2009) recommends and encourages
SUMP
• White Paper on transport (EC, 2011) proposed SUMP
to become mandatory (GHG focus)
• The allocation of regional and cohesion funds might
be made conditional on the submission and auditing
of a SUMP
• Placed environmental issues firmly on the political
agenda

6. SUMP’s Key Objectives
Ensure all citizens are offered transport options that enable access to key
destinations and services
Improve safety and security
Reduce air and noise pollution, greenhouse gas emissions and energy
consumption
Improve the efficiency and cost-effectiveness of the transportation of
persons and goods
Contribute to enhancing the attractiveness and quality of the urban
environment and urban design for the benefits of citizens, the economy
and society as a whole

7. “At the same time, the scandal
should bring to light the limitations
in the current narrow framing of
issues in transport planning and
policy: despite the elaborate
discourse around the
sustainability agenda since the
1970s (Hall et al., 2014), the focus
was effectively reduced to CO2
reduction and engine design,
without concretely considering
and addressing the larger impacts
of transport planning choices”.

11. 100 MAJOR
SCHEMES
FUNDED BY
£15.2 BILLION
OF PUBLIC
MONEY

12. Economic Growth
TravelTime Savings
Cost Effectiveness
Land-use
Accessibility
Noise Reductions
Equality
Providing for Cars
Efficiency
Safety Policy Integration
Connectivity
Economic Growth
TravelTime Savings
Cost Effectiveness
Land-use
Accessibility
Carbon ReductionsNoise Reductions
Equality
Providing for Cars
Efficiency
Safety Policy Integration
Connectivity
Sustainability

13. Public
policy
favouring
car mobility
“For national and local policy makers, I suggest the
following ranking of priorities in transport policy: (1)
stimulate the economy by facilitating the smooth flow
of goods and people, (2) ensure social equity by
facilitating access to mobility for disadvantaged groups
(especially via public transport), and (3) addressing
negative externalities in the following order of
importance: (a) congestion, because it has negative
social and economic implications, (b) local ‘quality of
life’ problems such as air pollution, parking and spatial
problems, (c) safety (traffic deaths and injuries), and (d)
environmental sustainability such as climate change.
This externality ranking explains why most transport
policy programs address congestion (via congestion
charging, dynamic traffic management, and demand
management)” (Geels 2012)

14. “ … supported
bus services
were cut by a
further 11%
compared to
2015/16, taking
the total
reduction to
33% since 2010
…”

17. Why is the discrepancy between
policy and practice?
… and what can we do about it?

18. The State of the
Practice of Transport
Appraisal

19. The State of the
Practice of Transport
Appraisal
“Would it be the solution to conduct
an overall appraisal/evaluation of a
plan/intervention. Not just health or
economic benefits, but as wide as
possible? I guess that is the main
problem at the moment that
evaluations/appraisals are mostly done
by domain”

20. The State of the
Practice of Transport
Appraisal
“The notion of sustainability is never really
translated into proper policy indicators (do
we need to focus on kilometres per
vehicle, car-share in modal split, levels of
pollution?) and no alternative to cost
benefit analysis has been developed, so
we always have valued/appraised
transport projects as usual.”

21. Health not explicit
in the transport
agenda
• Not in the transport curriculum
• Increasing focus by local (transport)
authorities
• That’s all very well if they have
any control over public transport
and the budget to put it right
• National policy still focus on
functionality of system, road safety
and GHG (problematic  bigger
pots of investment money)

22. Rapid and car-
centred
urbanization
• Advanced a car-centred planning
approach dominated urban and transport
planning since post-SecondWorldWar
• Increased spatial separation of activities
lowers urbanised population densities,
and results in lower commuter numbers
needed to support a meaningful public
transport system and a gradual
abandonment of these urbanised areas
• Reinforces policy focus on ‘economic
centres of agglomeration’

23. “The transport sector is susceptible to
long term effect on design decisions.
Urban form does not change as rapidly
(or even at all) as building or roads are
built or demolished, for example many
roman road still exist in the landscape
or still serve as roads”
In regard to transport policy measures :
“Why land use policy measures seem to
receive the least attention whilst they
could be most effective?” – “I agree with
you! Is true, there are the most effective
because there are the cause of the cause.
But at the same time is the harder to be
changed from a politician perspective, is
a change of model. But is the most
important and effective intervention”

24. Mass
Motorization
and Ethical
Positions
Towards
Human Life
• Manifested most clearly in the substantial deaths due
to MVC, and less clearly in the rise of chronic diseases
related to traffic exposure and practices over the same
periods that car traffic undergone large changes
• Systems approach; such as theVision Zero initiated by
Sweden and Sustainable Safety in the Netherlands
based on an ethical position in which it is unacceptable
to have people seriously injured or killed on the
network
• Transport infrastructure design is inherently conceived
to drastically reduce crash risk
• This clarity in policy and guidance may have led to a
substantive influence for human life in the transport
design agenda

25. The Car
Lobby
• Acknowledge car industry as a
powerful and diffuse force in
advocating for mass motorization
through marketing strategies to
increase uptake and maintenance
of driving
• Opposing measures that may
reduce car use, e.g. fuel duty
increases, reduction in parking
supply, proposals for car-free zones,
improvements in traffic safety and
delayed EU emissions regulations
• Little public support for measures
to rectify the impact

28. Public
perceptions
and awareness
Lack of public awareness of these
impacts, even those which have
been receiving increasing media
coverage such as air pollution;
reinforce the lack of political
commitment and initiative to
address these problems

29. Impacts are large

33. 64 transport
policy measures
• Many, but not all urban
transport policy measures, can
have a positive impact on health
• Health professional and health
impact assessors can benefit
from this summary to identify
and get acquainted with
feasible policy measures at the
urban scale
• Transport planners can have a
better idea of the potential
health impacts of their policy
measures

35. Health

36. More dialogue
across the sectors

37. More dialogue across
the sectors
The SIG will serve as a forum to facilitate discussion,
communication, dissemination of evidence, co-production of
future directions and various other activities related to
Transport and Health research and practice, within the
society and beyond – part of the UPEH initiative

38. Gaining more (academic) attention…
but how to REALLY impact policy?
“The one major lesson learnt is
that although health has made
significant advances in
demonstrating effects from car-
oriented planning (which I was
not aware of), such work has yet
to contribute to a more evidence-
based approach to urban policy
and practice”

39. Over to you!
• Strong leaders
• Strong statements (e.g. tobacco messages)
• Focus on risk rather than uncertainty
• Work with practioners
• Give them health impacts and cost
assessment tools
• Develop indicators
• Collaborate across sectors and share
knowledge and practice
• Educate, empower and engage communities
• Impact public opinion enough, stir social
movement

40. Compliance,
effectiveness
Atmospheric transport,
chemical transformation,
and deposition
Human time-activity in relation
to indoor and outdoor air quality;
Uptake, deposition, clearance, retention
Susceptibility factors;
mechanisms of damage
and repair, health outcomes
Transport
policy
Emissions
Ambient air
quality
Exposure/
dose
Human
healthHealth Effects Institute, 2003
21st April 2017 – 9:30 AM
Full-Chain Quantitative Health Impact Assessment ofTraffic-Related Air Pollution and
Childhood Asthma in Bradford, UK