Reducing vehicle miles travelled: Impact on physical activity, air pollution, and car collisions

1. Reducing vehicle miles travelled: Impact on physical activity, air pollution, and car collisions Cat Livingston, MD, MPH Oregon Health & Science University

2. Oregon

3. Project Components • Community Engagement • State and Local Advocacy • Health Impact Assessment Research

4. Timeline • 2006-2007: Community Forums across Oregon • 2008: “Blueprint for Oregon’s Future” published • 2008: Governor proposes targets for car use in Oregon cities • 2009, May: Health Impact Assessment completed • 2010: Legislation passes

5. Community Forums in 17 cities and towns

6. Healthy Community Infrastructure

7. Economic Opportunities

8. Protection of Oregon’s Beauty

9. Policies Coming Out of Forums Priorities • Protection of farmland • Healthy / “green” jobs • Public transit, walking and biking Investments • Land use planning to promote vibrant city centers

10. Climate Change Goals

11. Transportation,Climate Change and Health

13. Governor’s Proposal for VMT Targets • Applies to Oregon’s six major cities • Targets set by state taskforces • Consistent with Climate Change Goals

14. Climate Change Policyand Health Indirect Impact of Social and Economic Disruption on Health Climate Change Policies Direct Impact of Weather on Health Co-benefits of Policies that Improve Health

15. Project Advisory Committee • Coordination: Upstream Public Health • Analysis: Oregon Health and Science University • Advisory Role: Human Impact Partners -------------- • Metropolitan Planning Organization staff • Public Health Stakeholders • Land Use and Bicycle Advocates

16. Literature Review Policies – 11 initially identified • Land use / built environment • Access to public transportation • Increasing costs of driving Health Impacts: • Physical activity • Air pollution • Collisions

17. Literature: Physical Activity Physical activity levels are associated with • Community scale urban design • Land use regulation Most consistent characteristics • Land use mix, population density, distance to non-residential destinations Causal evidence - small community studies A. Street level design improves ped/bicycle use

18. Urban Sprawl and Obesity

19. Literature: Physical Activity Does physical activity make a difference? • Impressively so • Reduces incidence of disease • Colon and breast cancer • Diabetes • Stroke • Heart disease • Reduces death rates • All cause mortality in a dose-response fashion • Cardiovascular mortality • Cancer mortality

20. Literature: Car Collisions • Suburban sprawl • Higher car collision fatality rates • Higher pedestrian collision fatality rates • Increased density (population and vehicles) • Higher car collision rates • But less fatality…interesting

21. Literature: Air Pollution • Vehicle related emissions affected by components of built environment • E.g. (Street connectivity, land use mix, household and employment density) • Work, live and play location proximity to traffic • Relates to exposure to air pollutants • Affects indoor air • Affects outdoor air

22. Unequal Burden of Health Impacts

23. Literature: Air Pollution • Nitrogen dioxide (NO2) associated with: • Cardiovascular mortality • Pulmonary mortality • Lung cancer • Overall (non-accidental) mortality • Particulate matter is associated with: • Cardiovascular mortality • Pulmonary mortality • All cause mortality • Lung cancer mortality

24. Literature: Air Pollution Causal relationship? Life expectancy Fine Particulate Matter ≈ Symptoms associated with asthma and chronic obstructive pulmonary disease (COPD)

25. Pathway between land use planning and health ↓ Broad chronic disease rates ↑ Street Connectivity ↑ Active Transportation ↓ Risk Pedestrian/ Bicyclist Fatalities ↑ Employment/ Population/Residential Unit Density ↑ Minor Car Collisions ↓ Car Fatalities ↑ Car Injuries ↓ Asthma ↓ Lung Disease ↓ Lung Cancer ↓ Mortality ↓ Air Pollution ↓ Driving ↑ Employment Density ↓ Work Distance ↓ Car Collisions ↓ Car Injuries

26. Pathway between increasing costs of driving and health ↓Injuries/Fatalities ↑ VMT Tax ↓Asthma ↓ Lung Disease ↓ Cancers ↓ Mortality ↓Collisions ↑ Fuel Tax ↓ Driving ↓Air Pollution ↑ Parking Fees ↑ Severe Collisions ↑ Fatalities Time and Route Change ↑ Congestion Prices No overall changes in air pollution ↑ Public Transit Use ↓ All-Cause Mortality ↓ Chronic Disease Incidence ↑ Physical Activity

27. VMT Policies 5 VMT reduction policies with greatest health impact • Maximize urban neighborhood density • Require new developments to have mixed-use design, with good connectivity, • Develop good pedestrian infrastructure • Increase public transportation coverage area • Require businesses to charge a fee for employee parking

28. Health Trade-offs:Urban Density

29. Health Trade-offs:Pricing Mechanisms

30. Recommendations • Mix of policies have greatest effect • Increased focus on active transportation • Mitigation for vulnerable populations

31. Dissemination of HIA Research

32. Advocacy Agenda

33. Photo Credits • 1000 Friends of Oregon • Ian Britten • Sherri • Millicent_bystander • Vivek Shandas • Amarette • gmeador

34. Contact Cat Livingston, MD, MPH livingsc@ohsu.edu Oregon Health & Science University Mel Rader, MS, MS Upstream Public Health mel@upstreampublichealth.org