1. Sustainable Development and Environmental Health Seminar Series towards Rio+20 March 28, 2012 – PAHO/WHO Rio+20 Road Safety and Public Transportation towards Sustainable Development Eloisa Tigre Raynault Transportation, Health and Equity Program Manager American Public Health Association Transportation at a Crossroads: Intersecting with Health

2. Health Leaders’ Concerns  Traffic injuries and fatalities: $180B  Obesity/overweight: $142B  Physical inactivity: $76B  Air pollution: $50-$80B  TOTAL: $478B Transportation Physical Activity Obesity Cardiovascular Health Air Quality Respiratory Health Cardiovascular Health Safety Access to Goods and Services APHA. 2010. The Hidden Health Costs of Transportation.

3. Key Areas: Physical (In)activity Safety Air Quality Equity and Access Public Transportation

4. Physical Inactivity  Opportunities to be physically active are missing in transportation networks  If every licensed driver reduced their travel by one mile per day, in six years the adult obesity rate would be 2.16 percent lower…so 5 million fewer adults would be classified as obese in the US alone  Physical inactivity connected to obesity, diabetes, heart disease, cancer… Jacobson, S.H., et al., A note on the relationship between obesity and driving. Transport Policy (2011), doi:10.1016 j.tranpol.2011.03.008.

5. Safety  Motor vehicle crashes = leading cause of death among persons 1-24 years old  32,885 deaths (2010) in US, declining but unacceptably high  SAFETY FOR OLDER ADULTS: 4,092 pedestrians were killed in traffic crashes (2009) in US; 16% of those were 65+ = 654 killed  SAFETY FOR KIDS: 490 children injured daily in crashes (2009) in US Photos by Dan Burden, PBIC USDOT, NHTSA: http://www-nrd.nhtsa.dot.gov/Pubs/811552.pdf, http://www-nrd.nhtsa.dot.gov/Pubs/811394.pdf, http://www-nrd.nhtsa.dot.gov/Pubs/811387.pdf

6. Air Quality  Increase in asthma and bronchitis symptoms in children attending schools near freeways, major roads  People living near heavily-trafficked roadways have double the risk of death from heart or lung disease  Exposure to traffic-related air pollutants is associated with a 30% greater risk of premature birth Kim et al. Traffic-related Air Pollution near Busy Roads: The East Bay Children's Respiratory Health Study. Am..J. Respir. Crit. Care Med. 2004 vol. 170 no. 5 520-526. Hoek et al. Association between mortality and indicators of traffic-related air pollution in the Netherlands: a cohort study. Lancet, 2002. 360 (9341): 1203-9. Wilhelm et al. Traffic-related air toxics and preterm birth: a population-based case-control study in Los Angeles County, California. Environmental Health, 2011; 10: 89.

7. Equity and Access  Fast-moving traffic on highways divides communities, especially those with older adults and people with disabilities, and this isolation is associated with higher mortality for older adults  Rural populations have disproportionately high injury rates, where much of this increase is related to motor vehicle crashes  Fatalities as percentages of all motor vehicle traffic fatalities have been highest for African American children in the 4–15 age group Greenwood et al. Coronary Heart Disease: A Review of the Role of Psychosocial Stress and Social Support. Journal of Public Health Medicine 1999, 18: 2. Peek-Asa et al. Acute traumatic injuries in rural populations. American Journal of Public Health. 2004 Oct; 94 (10):1689-93. NHTSA. Race and Ethnicity in Fatal Motor Vehicle Traffic Crashes 1999 - 2004. http://www-nrd.nhtsa.dot.gov/Pubs/809956.

8. Public Transportation  Produces 95% less carbon monoxide and 45% less carbon dioxide compared to automobiles  The fatality rate associated with transportation-related injuries in public transportation is approximately 1/25th that associated with automobiles  Studies have found that men who commute to work on public transportation are 44.6% less likely to be overweight or obese due to increased active commuting American Public Transportation Association. 2002. The benefits of public transportation: the route to better personal health. Washington, DC: APTA. American Public Transportation Association. 2007. Public transportation: benefits for the 21st century. Washington, DC: APTA. Zheng, Y. 2008. The benefit of public transportation: physical activity to reduce obesity and ecological footprint. Preventive Medicine; 46(1): 4-5.

9. Significant Volume of New Press

10. Emerging directions + next steps

11. New opportunity via TRB New TRB Health and Transportation Subcommittee: www.trbhealth.org

12. Eloisa Tigre Raynault eloisa.raynault@apha.org www.apha.org/transportation Protect, Prevent, Live Well