Reducing vehicle miles travelled:

Impact on physical activity, air pollution, and car collisions

Cat Livingston, MD, MPH

Oregon Health & Science University

Oregon

Project Components

Community Engagement

State and Local Advocacy

Health Impact Assessment Research

Timeline2006-2007: 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

Community Forums in 17 cities and towns

Healthy Community Infrastructure

Economic Opportunities

Protection of Oregon’s Beauty

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

Climate Change Goals

Transportation,Climate Change and

Health

Governor’s Proposal for VMT Targets

Applies to Oregon’s six major cities

Targets set by state taskforces

Consistent with Climate Change Goals

Climate Change Policyand Health

ClimateChangePolicies

Direct Impactof Weatheron Health

Indirect Impact of Social and Economic Disruption onHealth

Co-benefits of Policies that Improve Health

Project Advisory Committee

Coordination: Upstream Public Health

Analysis: Oregon Health and Science University

Advisory Role: Human Impact Partners

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Metropolitan Planning Organization staff

Public Health Stakeholders

Land Use and Bicycle Advocates

Literature ReviewPolicies – 11 initially identified

Land use / built environmentAccess to public transportationIncreasing costs of driving

Health Impacts:Physical activityAir pollutionCollisions

Literature: Physical Activity

Physical activity levels are associated with

1.Community scale urban design

2.Land use regulation

Most consistent characteristics

A.Land use mix, population density, distance to non-residential destinations

Causal evidence - small community studies

A. Street level design improves ped/bicycle use

Urban Sprawl and Obesity

Literature: Physical Activity

Does physical activity make a difference?

Impressively so

Reduces incidence of diseaseColon and breast cancerDiabetesStrokeHeart disease

Reduces death ratesAll cause mortality in a dose-response fashionCardiovascular mortality Cancer mortality

Literature: Car CollisionsSuburban sprawl

Higher car collision fatality ratesHigher pedestrian collision fatality rates

Increased density (population and vehicles)Higher car collision rates

But less fatality…interesting

Literature: Air PollutionVehicle related emissions affected by

components of built environmentE.g. (Street connectivity, land use mix, household

and employment density)

Work, live and play location proximity to trafficRelates to exposure to air pollutantsAffects indoor airAffects outdoor air

Unequal Burden of Health Impacts

Literature: Air PollutionNitrogen dioxide (NO2) associated with:

Cardiovascular mortalityPulmonary mortalityLung cancerOverall (non-accidental) mortality

Particulate matter is associated with:Cardiovascular mortalityPulmonary mortalityAll cause mortalityLung cancer mortality

Literature: Air PollutionCausal relationship?

≈

Fine Particulate Matter

Life expectancy

Symptoms associated with asthma and chronic obstructive pulmonary disease (COPD)

Pathway between land use planning and health

↓ Broad chronic disease rates

↑ Employment Density↓ Work Distance

↓ Driving↓ Asthma↓ Lung Disease↓ Lung Cancer↓ Mortality

↑ Street Connectivity

↓ Car Collisions ↓ Car Injuries

↑ Active Transportation

↑ Employment/ Population/Residential Unit

Density

↓ Risk Pedestrian/ Bicyclist Fatalities

↑ Minor Car Collisions

↓ Car Fatalities↑ Car Injuries

↓ Air Pollution

Pathway between increasing costs of driving and health

↑ Congestion Prices

Time and Route Change

↑ Public Transit Use

↑ Physical Activity

No overall changes in air pollution

↑ Severe Collisions↑ Fatalities

↓ All-Cause Mortality↓ Chronic Disease Incidence

↑ Fuel Tax ↓ Driving

↓Collisions

↓Air Pollution

↓Injuries/Fatalities

↓Asthma↓ Lung Disease↓ Cancers↓ Mortality

↑ Parking Fees

↑ VMT Tax

VMT Policies5 VMT reduction policies with greatest health impact

1.Maximize urban neighborhood density

2.Require new developments to have mixed-use design, with good connectivity,

3.Develop good pedestrian infrastructure

4. Increase public transportation coverage area

5.Require businesses to charge a fee for employee parking

Health Trade-offs:Urban Density

Health Trade-offs:Pricing Mechanisms

Recommendations

Mix of policies have greatest effect

Increased focus on active transportation

Mitigation for vulnerable populations

Dissemination of HIA Research

Advocacy Agenda

Photo Credits

Contact

Cat Livingston, MD, MPH

livingsc@ohsu.edu

Oregon Health & Science University

Mel Rader, MS, MS

Upstream Public Health

mel@upstreampublichealth.org