1. www.capitalhealth.ca 1 Moving Right Along: Transportation, Public Health and Social Equity Sherrill Johnson, PhD Population Health Consultant CPHA, June 2008 Halifax, Nova Scotia

2. www.capitalhealth.ca 2 Population Health, Capital Health Goal Reduce chronic disease and injury in Capital Health region Approach Foster health-promoting environments Built environments Social environments

3. www.capitalhealth.ca 3 Two Perspectives On Prevention Focus on the people and undertake interventions to support and/or change their behavior Focus on the environments in which people live and undertake to modify those environments

4. www.capitalhealth.ca 4 Planning Healthy Places In light of growing concerns about the sustainability of the health care system, interest has been growing in exploring how different types of municipal design can promote health and prevent chronic disease and injury.

5. www.capitalhealth.ca 5 Auto Dependence Edmonton77% Calgary75% Quebec74% Winnipeg72% Ottawa- Gatineau 71% Vancouver69% Toronto66% Montreal65% % of population aged 18 and over making all trips by car (as a driver or passenger) on the reference day by census metropolitan area (Statistics Canada 2008). Dependence on cars in urban neighbourhoods: Life in metropolitan areas Statistics Canada, Canadian Social Trends, January 2008 Edmonton region leads country in auto dependence

6. www.capitalhealth.ca 6 Auto Dependence And Neighbourhood Features High58% Medium77% Low80% Housing density Less than 5 km64% 5 to 9 km78% 10 to 15 km80% 15 km or more82% Distance from city centre % of population aged 18 and over making all trips by car (as a driver or passenger) on the reference day in the Edmonton census metropolitan area (Statistics Canada 2008). Dependence on cars in urban neighbourhoods: Life in metropolitan areas Statistics Canada, Canadian Social Trends, January 2008

7. www.capitalhealth.ca 7 Auto Dependence and Health Impacts Physical inactivity Poor air quality Driver and pedestrian injuries

8. www.capitalhealth.ca 8 Auto Dependence & Physical Inactivity How healthy are we 2006: Annual report of the Medical Officer of Health, Capital Health Edmonton Journal, January 23, 2008 Residents (12+) in the region who are physically inactive 46.6% Adults in the region who are overweight or obese 48.8%

9. www.capitalhealth.ca 9 Physical Inactivity Obesity Hypertension Heart Disease Diabetes Some Cancers Automobile Dependence Other Contributing Factors Auto Dependence, Inactivity and Chronic Disease

10. www.capitalhealth.ca 10 Auto Dependence and Air Quality Motor Vehicle Emissions Some Constituents: Carbon monoxide Nitrogen oxides Ozone precursor (O3) Volatile Organic Compounds Ozone precursor (O3) Fine particulate matter (PM)

11. www.capitalhealth.ca 11 Health Effects of Motor Vehicle Emissions Health Effects of Emissions Cardiopulmonary death Myocardial infarction Lung cancer long-term exposure Increased risk of respiratory ailments eye, nose and throat irritation reduced lung function and capacity Increased risk of asthma for children within 75m of major roads reduced to median rates at >200m Reduced asthma attacks and medication use in children where emissions have been reduced

12. www.capitalhealth.ca 12 A “natural experiment” … 1996 Olympic Games, Atlanta, GA Downtown closed to automobiles, public transit increase Morning traffic reductions of 23% Reduced peak daily ozone levels by 28% Reduced emergency asthma visits by 42%

13. www.capitalhealth.ca 13 Automobile Transportation and Injuries Auto-dependent suburb design results in higher levels of motor and pedestrian injuries and deaths (Ewing et al., 2003) Incidence of fatal and non-fatal injuries (resulting from traffic collisions) is closely related vehicle miles travelled, automobile speed, and traffic volumes – all factors linked to distribution of land uses (Ewing et al., 2006)

14. www.capitalhealth.ca 14 Injury prevention In general, compact cities with extensive public transit systems have lower automobile fatality rates (drivers and passengers) (Frumkin, 2002).

15. www.capitalhealth.ca 15 Sprawl and injury prevention Figure 1 Annual Traffic Death Rate (Ewing, Schieber and Zegeer, 2003)

16. www.capitalhealth.ca 16 Auto Dependence and Social Equity Who is marginalized in an auto-dependent transportation system? Children Some seniors

17. www.capitalhealth.ca 17 Auto Dependence and Social Equity Persons with physical or cognitive impairments that limit or prohibit driving Those who can’t afford to drive Some new immigrants

18. www.capitalhealth.ca 18 Smart Streets? Bringing A Population Health Perspective Potential benefits of a health perspective on transportation: Reduced chronic disease (via increased physical activity and decreased air pollution) Reduced injury (via less miles travelled…)

19. www.capitalhealth.ca 19 Smart Streets? Potential Benefits: Increased social equity….? Increased social cohesion….?

20. www.capitalhealth.ca 20 Contact Information Sherrill Johnson, PhD Population Health Consultant Sherrill.Johnson@capitalhealth.ca Tel: (780) 413-7733