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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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What Are the Public Health
Benefits Associatedwith Mode Shifts to
Non-Motorized Travel?Andrew L. Dannenberg, MD, MPH
National Center for Environmental Health
Centers for Disease Control and Prevention
acd7@cdc.gov
Transportation Research Board Workshop #139
Non-Motorized Transportation Pilot Program
Washington, DC, January 11, 2009
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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What is Health?
Physical health
Mental health
Well-being
Livability
a state of complete physical,mental and social well-being
and not merely the absence of
disease or infirmity World Health Organization
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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Physical Activity
A sedentary lifestyle increases the risk of
overall mortality (2 to 3-fold)
cardiovascular disease (3 to 5-fold)
some types of cancer, including colonand breast cancer
The effect of low physical fitness is
comparable to that of hypertension, highcholesterol, diabetes, and even smoking.
Sources: Wei et al., JAMA 1999;
Blair et al., JAMA 1996
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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Increasing weight is associated with:
o risk of overall mortality
o risk of cardiovascular mortality o risk of diabetes
o risk ofhypertension
o risk ofgall bladder disease
Obesity
Sources: Willett et al, NEJM, 1999; JAMA, Vol. 282, 1523.
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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Determinants of Physical Activity
More likely to exercise if: Walking trails, parks and gyms accessible
Sidewalks present and scenery enjoyable
Many people exercising
Friends available with whom to exercise
Less likely to exercise if:
Too little time
Too tired
Unmotivated
Perceived traffic, crime or danger
Long distance to exercise location
Source: Brownson RC et al, AJPH 91:1995, 2001
HealthStyles Survey, 1999
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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Walkable Community Designs:
Connectivity and Physical Activity
Suburban
Development
TraditionalNeighborhood
Drawing by Duany Plater Zyberk,
in ITE Journal 1989;59:17-18
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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SHOPPINGCENTERS
HOMES
IMPREGNABLEBORDER
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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Access to Parks
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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Durham, NC
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006Year:
0
2,500
5,000
7,500
10,000
12,500
0
50
100
150
200
250
300
350
Bridge Bicycle Traffic
Bikeway Miles
Bridge Bicycle Traffic 2,850 3,555 3,885 3,830 3,207 4,520 5,225 5,690 5,910 6,015 7,686 8,250 8,562 8,875 10,192 11,956Bikeway Miles 78 83 86 103 113 144 166 183 213 222 235 252 254 260 262 263
Increasing Bicycle Use, Portland, ORCyclists Per Day Bikeway Miles
1991:
78 miles of bikeways2,850 daily trips
2006:
263 miles of bikeways
11,956 daily trips
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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Children Walking to School
Parental reported barriers to walking/biking toschool: 55% distance, 40% traffic danger
Source: MMWR 2002;51(32):701-704
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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Hubbard Lake Elementary SchoolHubbard Lake Elementary School
Hubbard Lake, MichiganHubbard Lake, Michigan
"Outstanding in Its Field""Outstanding in Its Field"
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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Safe Routes to School:
Benefits for the Larger Community
Watson M and Dannenberg AL, submitted for publication
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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Friedman et al. JAMA 2001;285:897
Asthma and Air Pollution
Asthma-related emergency room visits bychildren decreased 42%
Childrens emergency visits for non-asthmacauses did not change during same period
Natural experiment during1996 Summer Olympicgames in Atlanta
Peak morning trafficdecreased 23% and peakozone levels decreased 28%
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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Deaths and Injuries to Motor Vehicle
Occupants and Pedestrians
Leading cause of deaths among persons 1-34 years old
Annual U.S. toll from motor vehicle crashes:
42,000 deaths
3 million nonfatal injuries $230 billion in costs CDC 2000; NHTSA 2002
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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Walking and Bicycling:
International Comparisons
7
34
46
0
10
20
30
40
50
USA
Germ
any
Netherland
s
Percent
Percent of trips by walking and biking,1995
17
5.2
1.1
0
10
20
USA
Germ
any
Netherland
s
Fatalities
Pedestrian fatalities per 100 milliontrips, 2000
Pucher, AJPH 93:1509,2003
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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Complete Streets
Definition: a safe, comfortable and
convenient route designed for travel
via automobile, foot, bicycle, and
transit.
Oregon state law: Footpaths and
bicycle trails shall be provided
wherever a highway, road or street is
being constructed, reconstructed, or
relocated.
Source: www.AmericaBikes.org
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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Development Patterns
http://www.smartgrowthamerica.org/smartgrowthintro.htm
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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Minutes of Walking To and From
Public Transit Per Day
10
19
31
0
10
20
30
40
25%ile
MED
IAN
75%ile
Minutespe
rday
Besser LM, Dannenberg AL
Amer J Prev Med 29:273, 2005
Data from National HouseholdTravel Survey, 2001, USDOT
N= 3312 transit users
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8/6/2019 Session 6- "What are the public health benefits associated with mode shifts to nonmotorized travel?" by Andy Dannenberg
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Transportation and
land use choices can
either promote or harm
human health
www.cdc.gov/healthyplaces
www.epa.gov/smartgrowth
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