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Moving Toward Physical Activity Targets by Walking to Transit: National Household Transportation Survey, 2001-2017

Le, Vi T.; Dannenberg, Andrew L. (2020). Moving Toward Physical Activity Targets by Walking to Transit: National Household Transportation Survey, 2001-2017. American Journal Of Preventive Medicine, 59(3), E115 – E123.

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Abstract

Introduction: Public transportation systems can help people engage in physical activity. This study assesses sociodemographic correlates and trends in the daily time spent walking to and from transit in the U.S. from 2001 to 2017. Methods: This cross-sectional study used data from the 2001, 2009, and 2017 National Household Transportation Survey. Data were analyzed in 2019 to assess the daily level of physical activity attained solely by walking to and from transit. Regression models were used to examine predictors of daily transit-associated walking. Results: Compared with the full National Household Transportation Survey sample, transit users who walked to and from transit tended to be younger, from households earning <$25,000 per year, in areas with rail infrastructure, and did not have a household-owned car. Transit walkers spent a median of 20 minutes per day (95% CI=18.5, 21.5) walking to and from transit in 2017, compared with a median of 19 minutes (95% CI=17.5, 20.5) in 2001. Among transit walkers, daily transitassociated physical activity was 27% higher for those residing in areas with rail infrastructure (adjusted coefficient=1.27, 95% CI=1.11, 1.46) and 34% higher for those from households earning $99,999 per year (adjusted coefficient=1.34, 95% CI=1.15, 1.56). Conclusions: As documented in a growing literature, most public transit trips include at least some walking; thus, efforts to encourage transit use are favorable to public health. Continued monitoring by transportation surveys is important as new forms of mobility and changing demographics may impact future transit use and associated physical activity. (C) 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Keywords

Physical Activity; Household Surveys; Public Transit; Cross-sectional Method; Public Health; Walking; Exercise; Research Funding; Transportation; Replacing Sedentary Time; Public-transit; Travel; Mortality; Adults; Health; Work

Paratransit Services For People With Disabilities In The Seattle Region During The Covid-19 Pandemic: Lessons For Recovery Planning

Abu Ashour, Lamis; Dannenberg, Andrew L.; Shen, Qing; Fang, Xun; Wang, Yiyuan. (2021). Paratransit Services For People With Disabilities In The Seattle Region During The Covid-19 Pandemic: Lessons For Recovery Planning. Journal Of Transport & Health, 22.

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Abstract

Introduction: Along with all public transit services, paratransit services for people with disabilities experienced substantially reduced demand and an increased need to provide equitable services while protecting their clients and staff's safety during the COVID-19 pandemic. Paratransit services provide a lifeline for their clients' essential mobility needs, including access to medical appointments and grocery stores. In the absence of pre-existing pandemic response plans, examining transit agencies' responses to provide paratransit services during the pandemic can help inform planning for post-pandemic recovery and future disruptive events. Methods: In September 2020, we conducted semi-structured interviews with 15 decision-makers, planners, and drivers working for the primary transit agency in the Seattle region - King County Metro - and its paratransit contractors. Interview questions were designed to identify current services, policy gaps, and critical challenges for recovery planning and post-pandemic paratransit services. Interview transcripts were analyzed using NVivo software to obtain essential themes. Results: The interviewees provided insights about (1) paratransit service changes in response to the pandemic, (2) anticipated impacts of a returning demand on paratransit service efficiency, equity, and quality during the recovery period, and (3) innovative approaches for maintaining post-pandemic equitable paratransit services while balancing safety measures with available resources. Conclusions: Study findings suggest that paratransit service providers should consider (1) developing guidelines for future disruptive events, (2) examining alternative methods for food delivery to clients, (3) planning scenarios for delivering equitable services in the post-pandemic recovery period, and (4) increasing resilience possibly by establishing partnerships with transportation network companies.

Keywords

Paratransit; Mobility; Equity; Covid19 Pandemic; Scenario Planning; Recovery

The 2019 Conference on Health and Active Transportation: Research Needs and Opportunities

Berrigan, David; Dannenberg, Andrew L.; Lee, Michelle; Rodgers, Kelly; Wojcik, Janet R.; Wali, Behram; Tribby, Calvin P.; Buehler, Ralph; Sallis, James F.; Roberts, Jennifer D.; Steedly, Ann; Peng, Binbin; Eisenberg, Yochai; Rodriguez, Daniel A. (2021). The 2019 Conference on Health and Active Transportation: Research Needs and Opportunities. International Journal Of Environmental Research And Public Health, 18(22).

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Abstract

Active transportation (AT) is widely viewed as an important target for increasing participation in aerobic physical activity and improving health, while simultaneously addressing pollution and climate change through reductions in motor vehicular emissions. In recent years, progress in increasing AT has stalled in some countries and, furthermore, the coronavirus (COVID-19) pandemic has created new AT opportunities while also exposing the barriers and health inequities related to AT for some populations. This paper describes the results of the December 2019 Conference on Health and Active Transportation (CHAT) which brought together leaders from the transportation and health disciplines. Attendees charted a course for the future around three themes: Reflecting on Innovative Practices, Building Strategic Institutional Relationships, and Identifying Research Needs and Opportunities. This paper focuses on conclusions of the Research Needs and Opportunities theme. We present a conceptual model derived from the conference sessions that considers how economic and systems analysis, evaluation of emerging technologies and policies, efforts to address inclusivity, disparities and equity along with renewed attention to messaging and communication could contribute to overcoming barriers to development and use of AT infrastructure. Specific research gaps concerning these themes are presented. We further discuss the relevance of these themes considering the pandemic. Renewed efforts at research, dissemination and implementation are needed to achieve the potential health and environmental benefits of AT and to preserve positive changes associated with the pandemic while mitigating negative ones.

Keywords

Improving Arterial Roads; Physical-activity; Cost-effectiveness; Built Environment; Autonomous Vehicles; Walking; Behavior; Impact; Active Transportation; Covid-19; Climate Change; Physical Activity; Public Health; Pandemics; Public Transportation; Collaboration; Transportation; Economic Models; Environmental Impact; Outdoor Air Quality; Vehicle Emissions; Coronaviruses; Hispanic Americans; Fatalities; Systems Analysis; African Americans; Infrastructure; Medical Research; Committees; Land Use; Economic Analysis; New Technology; United States--us

Use of Health Impact Assessments in the Housing Sector to Promote Health in the United States, 2002-2016

Bever, Emily; Arnold, Kimberly T.; Lindberg, Ruth; Dannenberg, Andrew L.; Morley, Rebecca; Breysse, Jill; Pollack Porter, Keshia M. (2021). Use of Health Impact Assessments in the Housing Sector to Promote Health in the United States, 2002-2016. Journal Of Housing And The Built Environment, 36(3), 1277 – 1297.

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Abstract

Housing affects health, yet health is seldom considered in housing decisions. Health impact assessment (HIA) is a tool that can improve housing-related policies, plans, programs, and projects by bringing together scientific data, health expertise, and stakeholder engagement to identify the potential health effects of proposed decisions. We systematically identified and reviewed HIAs of housing decisions in the United States, yielding 54 HIAs between 2002 and 2016. Two examined federal proposals; the others explored decisions in 20 states. A variety of organizations led the HIAs, including non-profits, public health departments, and academic institutions. The primary decision-makers each HIA sought to inform were housing, planning, and/or elected officials. Eighteen HIAs focused on housing policies, codes, design elements, and utilities in residential structures. The remaining 36 HIAs included housing as one element of broader community development and transportation planning decisions. HIA recommendations changed decisions in some cases, and the assessment process helped strengthen connections between public health and housing decision-makers. To illustrate key characteristics of housing HIAs, we purposefully selected three HIAs and described the decisions they informed in detail: off-campus student housing in Flagstaff, Arizona; a rental housing inspections program in Portland, Oregon; and revitalization plans for a major thoroughfare in a suburb of St. Louis, Missouri. With a few exceptions, federal, state, and local agencies in the U.S. are not required to consider the health impacts of housing decisions, such as where housing is sited, how it is designed and constructed, and policies for ensuring that it is affordable and safe. HIA has emerged as a tool for advocates, health and housing practitioners, and policymakers to fill this gap. However, few studies have examined whether HIAs do in fact change housing decisions, shift the way that decision-makers think, or ultimately shift determinants of health (e.g., housing affordability and quality). This review demonstrates that HIAs can facilitate the consideration of health during housing decision-making. Housing HIAs can also help decision-makers address commonly overlooked effects, such as changes to social cohesion, and improve civic participation by engaging communities in the decisionmaking process.

Keywords

0; Community Development; Decision-making; Healthy Housing; Health Impact Assessment; Housing Policy; Stakeholder Engagement; Health Promotion; Public Health; Exceptions; Impact Analysis; Nonprofit Organizations; Affordability; Suburban Areas; Profits; Housing; Policy Making; Transportation Planning; Decision Making; Rental Housing; Public Officials; Policies; Regeneration; Utilities; Social Cohesion; Inspections; Community Involvement; Decision Makers; Community Participation; United States--us

Advancing Research in Transportation and Public Health: A Selection of Twenty Project Ideas from a US Research Roadmap

Dannenberg, Andrew L.; Rodriguez, Daniel A.; Sandt, Laura S. (2021). Advancing Research in Transportation and Public Health: A Selection of Twenty Project Ideas from a US Research Roadmap. Journal Of Transport & Health, 21.

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Abstract

Background: Transportation policies and projects have multiple impacts on health. Research on these impacts can help promote positive and reduce adverse health consequences of decisions made by transportation agencies. Methods: In 2019 the U.S. National Cooperative Highway Research Program published a research roadmap for transportation and public health based on an extensive literature search and key informant interviews. The roadmap identified 44 research gaps and 122 research needs on a wide range of relevant topics. From this list, using pre-established criteria including specificity, equity, potential impact, and long-term usefulness, we selected 20 topics suitable for further research especially in academic settings. Results: We present the questions, context, and possible research approach for each of the 20 topics. These topics cover issues ranging from integrating equity into performance measures and developing forecasting models for active travel to incorporating health questions into routine household travel surveys and examining health impacts of autonomous vehicles. We added questions on the impacts of the COVID-19 pandemic on transportation. Discussion: This list will be useful to faculty, researchers, and students as they consider topics for research in transportation and public health. Results of research on these topics could influence transportation decisions in policy making, planning and community participation, capital programming, project design, and implementation. Future leaders of transportation agencies, transportation providers, and advocacy organizations may be more likely to consider transportation policies that incorporate a health perspective if their training includes research findings that increase their awareness of the health impacts of these policies.

Keywords

Public Health; Equity; Research; Public Transit; Metrics; Transportation Planning

Ensuring Equitable Transportation For The Disadvantaged: Paratransit Usage By Persons With Disabilities During The Covid-19 Pandemic.

Wang, Yiyuan; Shen, Qing; Abu Ashour, Lamis; Dannenberg, Andrew L. (2022). Ensuring Equitable Transportation For The Disadvantaged: Paratransit Usage By Persons With Disabilities During The Covid-19 Pandemic. Transportation Research Part A: Policy & Practice, 159, 84 – 95.

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Abstract

Paratransit services developed under the Americans with Disabilities Act are a critical transportation means for persons with disabilities to meet their basic needs, but the COVID-19 pandemic posed an unprecedented challenge to service providers. To safeguard transportation equity, this study used complete records of service trips and riders obtained from the Access Transportation Program in the Seattle region for an empirical analysis aimed at answering two research questions. First, how did the ridership and trip purposes of paratransit change after the outbreak of COVID-19? Second, what factors explained the users' changing levels of service usage in response to the pandemic? Statistical methods, including a Hurdle model, were employed as the analytical tools. The results show that paratransit ridership dramatically decreased during 2020 with the most substantial reductions of working and non-essential personal trips, and that most of the remaining trips were for medical purposes. The results also indicate that riders' service usage during the pandemic was associated with their sociodemographic characteristics, disability conditions, and pre-pandemic travel demand. When controlling for other factors, riders who lived in neighborhoods with lower income and lower access to personal vehicles were more dependent on the service. Based on the empirical findings, we recommend that when developing plans for future disruptive events, public transit agencies should promptly implement safety measures, identify and prioritize neighborhoods that are most in need of mobility services, and actively pursue collaboration with other organizations for innovative service delivery options.

Keywords

Covid-19 Pandemic; Public Transit; People With Disabilities; Americans With Disabilities Act Of 1990; Public Transit Ridership; Paratransit Services; Seattle (wash.); Americans With Disabilities Act (ada); Hurdle Model; Paratransit; Transportation Equity; Mobility; Justice

Use of Health Impact Assessment for Transportation Planning Importance of Transportation Agency Involvement in the Process

Dannenberg, Andrew L.; Ricklin, Anna; Ross, Catherine L.; Schwartz, Michael; West, Julie; White, Steve; Wier, Megan L. (2014). Use of Health Impact Assessment for Transportation Planning Importance of Transportation Agency Involvement in the Process. Transportation Research Record, 2452, 71 – 80.

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Abstract

A health impact assessment (HIA) is a tool that can be used to inform transportation planners of the potential health consequences of their decisions. Although dozens of transportation-related HIAs have been completed in the United States, the characteristics of these HIAs and the interactions between public health professionals and transportation decision makers in these HIM have not been documented. A master list of completed HIAs was used to identify transportation-related HIAs. Seventy-three transportation-related HIAs conducted in 22 states between 2004 and 2013 were identified. The HIAs were conducted for projects such as road redevelopments, bridge replacements, and development of trails and public transit. Policies such as road pricing, transit service levels, speed limits, complete streets, and safe routes to schools were also assessed. Five HIAs in which substantial interactions between public health and transportation professionals took place during and after the HIA were examined in detail and included HIAs of the road pricing policy in San Francisco, California; a bridge replacement in Seattle, Washington; new transit lines in Baltimore, Maryland, and Portland, Oregon; and the BeltLine transit, trails, and parks project in Atlanta, Georgia. Recommendations from the HIAs led to changes in decisions in some cases and helped to raise awareness of health issues by transportation decision makers in all cases. HIAs are now used for many topics in transportation. The range of involvement of transportation decision makers in the conduct of HIAs varies. These case studies may serve as models for the conduct of future transportation-related HIAs, because the involvement of transportation agencies may increase the likelihood that an HIA will influence subsequent decisions.

Keywords

Policy; Inequalities; Benefits; Justice; Oregon

Health Impact Assessment: Considering Health in Transportation Decision Making in the United States

Wier, Megan L.; Schwartz, Michael; Dannenberg, Andrew L. (2015). Health Impact Assessment: Considering Health in Transportation Decision Making in the United States. TR News (0738-6826), 299, 11 – 16.

Abstract

The article talks about Health Impact Assessment (HIA) when it comes to transportation decision making in the U.S. and discusses the Collaboration between public health professionals and transportation in order to execute HIA.

Keywords

Health Impact Assessment; Public Health -- United States

Review of Health Impact Assessments Informing Agriculture, Food, and Nutrition Policies, Programs, and Projects in the United States

Cowling, Krycia; Lindberg, Ruth; Dannenberg, Andrew L.; Neff, Roni A.; Pollack, Keshia M. (2017). Review of Health Impact Assessments Informing Agriculture, Food, and Nutrition Policies, Programs, and Projects in the United States. Journal Of Agriculture Food Systems And Community Development, 7(3), 139 – 157.

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Abstract

Policies, programs, and projects related to agriculture, food, and nutrition can significantly affect public health. Health impact assessment (HIA) is one tool that can be used to improve awareness of the health effects of decisions outside the health sector, and increasing the use of HIA for agriculture, food, and nutrition decisions presents an opportunity to improve public health. This study identifies and reviews all HIAs completed in the United States on agriculture, food, and nutrition topics. Studies were identified from HIA databases, an Internet search, and expert consultation. Key characteristics were extracted from each study: type of decision assessed, location, level of jurisdiction, lead organization, methods of analysis, and recommendations. Twenty-five eligible HIAs that were conducted between 2007 and 2016 address topics such as regulations on land use for agriculture; food and beverage taxes; and developing grocery stores in food deserts. These HIAs have predominantly supported policy, as opposed to program or project, decisions. Four case studies are presented to illustrate in detail the HIA process and the mechanisms through which HIA findings affected policy decisions. Among other influences, these four HIAs affected the language of legislation and provided guidance for federal regulations. These examples demonstrate several findings: appropriate timing is critical for findings to have an influence; diverse stakeholder involvement generates support for recommendations; and the clear communication of feasible recommendations is highly important. There is substantial scope to increase the use of HIA in the agriculture, food, and nutrition sectors. Challenges include the paucity of monitoring and evaluation of HIAs' effects on health outcomes, and the limited funding available to conduct HIAs. Opportunities include integrating HIAs and community food assessments, and more widely sharing HIA findings to inform related decisions in different jurisdictions and to increase support for additional HIAs that address the food system.

Keywords

Environments; Obesity; Health Impact Assessment; Policy; Food; Nutrition; Agriculture

Review of Education-Focused Health Impact Assessments Conducted in the United States

Gase, Lauren N.; Defosset, Amelia R.; Gakh, Maxim; Harris, Celia; Weisman, Susan R.; Dannenberg, Andrew L. (2017). Review of Education-Focused Health Impact Assessments Conducted in the United States. Journal Of School Health, 87(12), 911 – 922.

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Abstract

BACKGROUNDHealth impact assessment (HIA) provides a structured process for examining the potential health impacts of proposed policies, plans, programs, and projects. This study systematically reviewed HIAs conducted in the United States on prekindergarten, primary, and secondary education-focused decisions. METHODSRelevant HIA reports were identified from web sources in late 2015. Key data elements were abstracted from each report. Four case studies were selected to highlight diversity of topics, methods, and impacts of the assessment process. RESULTSTwenty HIAs completed in 2003-2015 from 8 states on issues related to prekindergarten through secondary education were identified. The types of decisions examined included school structure and funding, transportation to and from school, physical modifications to school facilities, in-school physical activity and nutrition, and school discipline and climate. Assessments employed a range of methods to characterize the nature, magnitude, and severity of potential health impacts. Assessments fostered stakeholder engagement and provided health-promoting recommendations, some of which were subsequently incorporated into school policies. CONCLUSIONSHealth impact assessment is a promising tool that education, health, and other stakeholders can use to maximize the health and well-being of students, families, and communities.

Keywords

Decision Making; Elementary Schools; High Schools; Medical Policy; Medline; Nutrition; Online Information Services; Research Funding; Student Health; Systematic Reviews (medical Research); Search Engines; Physical Activity; Health Impact Assessment; United States; Collaboration; Policy; Public Health; Academic-achievement; Programs