Reflections on Health
in Transport Planning
and Policy
Haneen Khreis
Institute forTransport Studies, University of Leeds, UK
Barcelona Institute forGlobal Health, Barcelona, Spain
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!
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
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).
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
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
“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”.
Hk is global introduction presentation_web version
Hk is global introduction presentation_web version
Hk is global introduction presentation_web version
100 MAJOR
SCHEMES
FUNDED BY
£15.2 BILLION
OF PUBLIC
MONEY
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
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)
“ … supported
bus services
were cut by a
further 11%
compared to
2015/16, taking
the total
reduction to
33% since 2010
…”
Hk is global introduction presentation_web version
Hk is global introduction presentation_web version
Why is the discrepancy between
policy and practice?
… and what can we do about it?
The State of the
Practice of Transport
Appraisal
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”
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.”
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)
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’
“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”
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
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
Hk is global introduction presentation_web version
Hk is global introduction presentation_web version
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
Impacts are large
Hk is global introduction presentation_web version
Hk is global introduction presentation_web version
Hk is global introduction presentation_web version
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
Hk is global introduction presentation_web version
Health
More dialogue
across the sectors
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
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”
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
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

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Hk is global introduction presentation_web version

  • 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
  • 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
  • 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