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Guest opinion: Transportation planning should consider health

By Op-Ed Dr. Bob Lutz
Spokesmen Review
An Op-Ed in the Spokesmen Review on health and transportation.

Active living has been engineered out of our daily lives. Can you remember the last time you walked or rode your bike to do some errands? What about getting to work? Americans drive almost 35 miles getting around town every day, and the average commute to work is 16 miles one way. This “autocentricity” has led to us driving more than 3 trillion miles in 2010, the equivalent of traveling around the world more than 120 million times.

Not surprisingly, when it comes to health, transportation legislation has historically focused on safety. And it’s been successful, with fewer injuries and deaths as a function of safer vehicle design and changing driving patterns.

Unfortunately, these statistics are those for motorists, not pedestrians and cyclists. Pedestrian fatalities have fallen at only half the rate of those for motorists, dropping by just over 14 percent during the period, compared to 27 percent for motor vehicle fatalities. Almost 48,000 pedestrians were killed from 2000 to 2009, and almost 690,000 were injured, the equivalent of a pedestrian being hit by a car every seven minutes.

Bicyclists fare better, but only because their numbers are less – 630 cyclists were killed in 2009, and more than 51,000 were injured. And Spokane saw a spike in fatalities last year, in spite of more dedicated bicycle facilities and signage.

Disproportionately, the young, the old and those of lower socioeconomic status are adversely affected by these statistics. While in many situations someone was at fault, the reality is that road design has historically favored one mode of transportation. It’s therefore not surprising the Spokane City Council passed an ordinance supporting Complete Streets and the Washington Legislature passed HB 1071, which created a Complete Streets Grant Program to provide funding for communities with such an ordinance.

Similarly, the Spokane Regional Board of Health passed Resolution 10-01 in support of Complete Streets based on the connection between transportation and health. Recently, the U.S. Senate Committee on Commerce, Science and Transportation passed a federal transportation authorization bill that includes a measure for the safe accommodation of all users in federally funded street projects.

While addressing the prevention of collisions, importantly, these efforts are attempting to change the paradigm by recognizing the possibilities of promoting health through affecting transportation and urban planning. We’re well aware of the reality that how we live makes us unhealthy, with dietary indiscretions, sedentary lifestyles and smoking leading the list of preventable causes of illness.

As this burden of chronic disease has increased, the message has been to exercise more, eat better and stop smoking. And while data suggest these messages are starting to register, with, for example, recent findings to suggest a leveling of obesity rates after decades of increase, it’s hardly a time for celebration. American adults and kids are still heavier than their counterparts around the world, with an estimated 36 percent of adults and 17 percent of youth obese (Washington rates are a little better at 26 percent and 11 percent, respectively).

Increasingly, research is demonstrating the relationship between the built environment and health. For example, recent international comparison data have demonstrated the health benefits of regular biking, walking and/or taking public transportation to work, school or shopping. Industrialized countries with high rates of “active transportation” were often found to have the lowest obesity rates, while, not surprisingly, Americans, with the highest rate of obesity, were the least likely to walk, cycle or take mass transit, with only 12 percent actively commuting.

In comparison, our northern neighbor’s rate of 23 percent obesity is coupled with 19 percent use of active transportation. And Europeans walk an average of 237 miles and bicycle 116 miles per year, as contrasted with our 87 miles and 24 miles, respectively. This equates to a difference of eliminating 9 pounds of fat versus 2. These findings, and others, suggest opportunities to address Americans’ health without dependence on the health care system. State and federal legislatures should consider how their decisions can not only prevent diseases but also promote health.

Legislation has been forwarded to committee by Rep. Andy Billig, of Spokane, that would do just that. The CDC and the World Health Organization have recommended giving consideration to the health impact of land-use planning and transportation policies. HB 2370 adds health to Washington’s six transportation goals to integrate health implications when designing, building and maintaining our transportation system.

I encourage you to support this important legislation that would make the health of our citizens a priority.

Bob Lutz, M.D.,serves as an appointed memberof the Spokane Regional Board of Health.

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