Partners in Change for Healthy and Safe Transportation

Transcription

1 Partners in Change for Healthy and Safe Transportation Use of health evidence to make the case for Complete Streets Presented at: Complete Streets Forum Hart House, April 28, 2011 Monica Campbell, Director Healthy Public Policy Stephanie Gower, Research Consultant Toronto Public Health

2 Presentation Overview Photo Credit: Taxiarchos228 Partners with a common vision State of our health Active transportation: a prescription for health Street design for better health Toronto Public Health initiatives underway

3 One Vision, Many Partners The Vision Public Health Partners National organizations: eg. Public Health Agency of Canada, Health Canada, National Collaborating Centre for Environment and Health, Canadian Partnership Against Cancer. Provincial organizations: eg. Ontario Agency for Health Protection and Promotion, Ontario Ministry of Health. Local Public Health Units Photo Credit: Michael Kodransky IDTP

4 Obesity Rates are Soaring Obesity rates in Canadian adults Tjepkema M. Measured obesity. Adult obesity in Canada: measured height and weight. Nutrition: Findings from the Canadian Community Health Survey. Ottawa: Statistics Canada; Catalogue No: MWE

5 We have become a sedentary society Over 50% of adults living in Canada are not physically active enough to maintain or improve their health 78% of Canadian teenagers may not be active enough to meet international guidelines for optimal growth and development Canadian Fitness and Lifestyle Research Institute Physical Activity Monitor.

6 Diabetes Rates are Soaring Yearly Diabetes Prevalence Rates in Ontario 22 Diabetes Prevalence (%) Year Lipscombe & Hux Trends in diabetes prevalence, incidence, and mortality in Ontario, Canada : a population-based study. Lancet. 3;369(9563):750-6.

7 Health Burden is Also an Economic Burden Average Annual Cost of Obesity in Selected Canadian Provinces, in $Millions Annual economic burden of physical inactivity in Canada: $5.3 billion Annual economic burden of obesity in Canada: $4.3 billion The Obesity Epidemic in Canada, Ottawa: Parliamentary Information and Research Services. PRB 05-11E Peter T. Katzmarzyk and Ian Janssen, The Economic Costs Associated With Physical Inactivity and Obesity in Canada: An Update, Canadian Journal of Applied Physiology, Vol. 29, No. 1, 2004, p. 104.

8 Building Active Transportation into Everyday Living Active transportation is at least as easily sustained as other forms of physical activity or exercise programs Dunn AL, Marcus BH, Kampert JB, Garcia ME, Kohl HW, Blair SN. Comparison of lifestyle and structured interventions to increase physical activity and cardiorespiratory fitness. JAMA. 1999;281(4):327

9 Active Transportation: A Prescription for Health People who commute actively: Are fitter and less overweight or obese than those who use motorized modes Experience significant improvements in cardiovascular indicators of fitness over those who use motorized modes Experience an overall 11% reduction in cardiovascular risk Photo credit: Aviva Cohen Gordon-Larsen P, Nelson MC, Beam K. Associations among active transportation, physical activity, and weight status in young adults. Obes Res. 2005;13(5): Oja P, Manttari A, Heinonen A, Kukkonen-Harjula K, Laukkanen R, Pasanen M, Vuori I. Physiological effects of walking and cycling to work. Scand J Med Sci Sports 1991;1: Hamer M, Chida Y. Active commuting and cardiovascular risk: a meta-analytic review. Prev Med.

10 Good Street Design Reduces Injuries Pedestrians and cyclists face higher risks of fatality or injury per distance travelled than people who travel by car, bus, or rail Pedestrian and bicycling fatality rates and nonfatal injury rates in the US, Germany, and the Netherlands (2000) However, in countries with better walking and cycling infrastructure, these differences decline Pucher J, Dijkstra L. Promoting safe walking and cycling to improve public health: Lessons from The Netherlands

11 Safety in Numbers Injury and fatality rates decrease as active transportation mode shares increase Jacobsen PL. Safety in numbers: more walkers and bicyclists, safer walking and bicycling [corrected] [published erratum appears in INJ PREV 2004 Apr;10(2):127]. Inj Prev. 2003;9(3):205-9.

12 Physical activity is good for mental health Meta-analyses from peer reviewed journals report exercise as treatment for depression is: more effective than no treatment as effective as traditional interventions in some instances possibly a promising approach to postnatal depression has equivalent adherence rates to medication Photo credit: Natalia Rivera Daley A. Exercise and depression: A review of reviews. J Clinical Psych. 2008;15(2):140-7.

13 Benefits of active transportation outweigh risks In a Dutch study of switching from cars to bikes, health benefits of physical activity from cycling were greater than risks from injury or air pollution In London, active transport interventions could avoid 541 premature deaths and 5,295 years of life lost each year from increased physical activity and decreased vehicle emissions De Hartog et. al.. Do the Health Benefits of Cycling Outweigh the Risks? EHP (8) doi: /ehp Woodcock J, Edwards P, Tonne C, Armstrong BG, Ashiru O, Banister D, et al. Public health benefits

14 Lower speed limits are safer for pedestrians If collisions occur between vehicles and pedestrians, severity of injury for pedestrians increases dramatically above vehicle speeds of 40km/h Probability of pedestrian fatality by impact speed IWGAM, 1986, as cited in Anderson RWG, McLean AJ, Farmer MJB, Lee BH, and Brooks CG. (1997). Vehicle traffic

15 Child Friendly Street Design A CDC survey found that after distance, traffic-related danger is the most common reason children did not walk to school A recent poll found that while 71% of adults walked or bicycled to school when they were young, only 18 % of their children do so S Martin, S Carlson, Barriers to Children Walking to or From School United States, 2004M MMWR. 2005;54:

16 Traffic-Related Injuries Rates per 100,00 population Toronto Montreal Vancouver Data Source: Transportation Services Traffic Management and Safety Unit (2009) Of all traffic-related injuries in Toronto, 18% involve cyclists or pedestrians In 2008, about 2000 injuries were reported by pedestrians and close to 1000 were reported by cyclists Little improvement in pedestrian and cyclist injuries in Toronto in last decade

17 Equitable Street Design Must Protect Everyone % of Total Pedestrian Injuries in Toronto by SES, % 30% 25% 20% 15% 10% 5% Lowest SES group had 3 times the rate of pedestrian injuries as highest SES group Injury prevention must account for inequities 0% SES group (1 = highest; 5 = lowest) Data Source: The Canadian Institute for Health Information

18 Bike Lanes Increase Ridership Street 1 2 Motor Vehicle Traffic % Change Bicycle Traffic % Change 0% 42% 0% 13% Toronto Case Study: Several 4 lane roads were converted to 2 lane roads Included parking, new trees, and incorporation of bicyclefriendly design 3-6% 4% 4 7% 36% 5 0% 10% 6 0% 31% Findings over 2 years: Average annual bicycle traffic increased by 23% Average annual motor vehicle traffic did not change Average 0% 23% Macbeth,A. (1999). Bicycle lanes in Toronto. ITE Journal, 69(4),

19 Availability of transit and physical activity Odds of doing Physical Activity % 14-18% 19-24% 25-53% Percent of nearby street segments with a bus stop (quartiles) More public transit stops in a neighbourhood increases likelihood residents will be physically active Canadians living in areas where people rely on biking or taking public transit to work more likely to report BMI <25 than those living in neighbourhoods where fewer people do so C. M. Hoehner et al., Perceived and Objective Environmental Measures and Physical Activity Among Urban Adults, American Journal of Preventive Medicine 28, 2 Supplement 2 (2005): pp

20 Complete Streets within Complete Communities Complete Streets support health best when they are destinations, or link nearby destinations Higher population density is associated with more walking and lower BMI, obesity rates, and vehicle ownership Being close to mix of services is associated with more walking, especially for grocery stores, schools, workplaces, and parks People who live in walkable neighbourhoods, with more land use mix, are more likely to be physically active and less likely to be obese or overweight Smaller block size is one factor associated with lower BMI, lower obesity rates, lower blood pressure, and higher walking frequency. Dunn et al Final Report. Peel Healthy Development Evaluation Tool. Prepared for Peel Public Health by

21 Current Initiatives by Toronto Public Health Initiatives beneficial to our partners: Policy document on health benefits of walking and cycling, and how to make them even healthier in an urban setting Creation of a walkability index and geospatial mapping of walkability in Toronto Residential preferences survey Software tool to assess health impacts of development scenarios Results expected in 2012!