Health and Well-Being Implications of Urban Transport Dick Ettema Faculty of Geosciences Utrecht University Summerschool The Application of Operations Research in Transport Beijing, September 9, 2015
Rationale Criteria for appraisal of transport investments (CBA) Practically: Mobility, congestion, travel speed, traffic safety Ideally also: Habitat, enjoyment, health, quality-of-life 2
Framework B. Van Wee and D. Ettema (2015), Travel behaviour and health: a conceptual model and research agenda, submitted to Journal of Transport and Health. 3
Exercise Related Health Effects Development overweight and obesity China (WU, 2006) People are expending less energy on traditional forms of transportation such as walking and cycling, and the popularity of cars, buses, and motorcycles is increasing.. Furthermore, the lack of consideration towards constructing environments in inner cities that promote physical activity has meant that it has become increasingly difficult to find safe places in residential areas to exercise or even walk 4
Exercise Related Health Effects Development overweight and obesity Netherlands (RIVM, 2014) overweight obesity 5
Exercise Related Health Effects Basset et al. (2008) 6
Exercise Related Health Effects Health benefits of walking and cycling a reduced risk of cardiovascular diseases, strokes and various cancers (WHO, 2010) lower risks of diabetes, arterial thrombosis, coronary heart disease and high blood pressure (Morris and Hardman, 1997) 7
Exercise Related Health Effects Health benefits of walking and cycling (Oja et al., 1998) 8
Exercise Related Health Effects Health benefits of walking and cycling (Tanasescu et al., 2002) 9
Exercise Related Health Effects So: how to increase the total share of walking and cycling Land use/transport planning? (connectivity, small blocks, mixed land use, close to retail, pedestrian/cycling infrastructure conditions, crossings, aesthetics, facilities at work) (Cervero and Duncan, 2002; Saelens and Handy, 2008; Heinen et al., 2010) But: land use infrastructure explain only minor part of walking/cycling behaviour (next to socio-demographics, weather, geographical circumstances, culture) 10
Faculty of Geosciences Pollution Related Health Effects Van Wee, 2007 Transport volume Technology Efficiency Driving behavior Infrastructure characteristics Emissions including locations Locations of activities Concentrations at locations of activities Concentrations due to other emissions Activities of people by location and time of day Exposure of people to pollutants Demographic and socio-economic characteristics, life styles Health effects 3 september 2015 11
Pollution Related Health and residential Effects sources Handy, 2014 Pollutant Description Sources Faculty Health of Geosciences Effects Carbon Colorless, odorless gas Monoxide (CO) Nitrogen Dioxide (NO2) Ozone (O3) Particulate Matter (PM) Sulfur Dioxide (SO2) Reddish brown, highly reactive gas. Gaseous pollutant when it is formed in the troposphere. Very small particles of soot, dust, or other matter, including tiny droplets of liquids. Colorless gas that dissolves in water vapor to form acid, and interact with other gases and particles in the air. Motor vehicle exhaust, indoor sources include kerosene or wood burning stoves. On-road sources = 52% Motor vehicles, electric utilities, and other industrial, commercial, that burn fuels. On-road sources = 44% Vehicle exhaust and certain other fumes. Formed from other air pollutants (NOx and volatile organic compounds (VOC)) in the presence of sunlight. On-road sources = 22% of VOCs Diesel engines, power plants, industries, windblown dust, wood stoves. On-road sources = 20% Coal-fired power plants, petroleum refineries, manufacture of sulfuric acid and smelting of ores containing sulfur. On-road sources = 1% Headaches, reduced mental alertness, heart attack, cardiovascular diseases, impaired fetal development, death. Susceptibility to respiratory infections, irritation of the lung and respiratory symptoms (e.g., cough, chest pain, difficulty breathing). Eye and throat irritation, coughing, respiratory tract problems, asthma, lung damage. Eye irritation, asthma, bronchitis, lung damage, cancer, heavy metal poisoning, cardiovascular effects. Eye irritation, wheezing, chest tightness, shortness of breath, lung damage. Lead (Pb) Metallic element Metal refineries, lead Anemia, high blood Workshop Integrated Land-use, Travel Demand, Air Quality, and Exposure smelters, battery 3 september pressure, 2015 brain 12 and Modeling, TRB 2015 manufacturers, iron and kidney damage, steel producers. neurological disorders,
Pollution Related Health Effects Gauderman et al., 2008PM 13
Pollution Related Health Effects Gan et al., 2011 14
Pollution Related Health Effects Determinants of exposure Base level of pollution (due to other emissions) Stationary location (home, work, school) Travelling Travel mode Traffic composition (volume, density, fuel type) > route choice Building density/hight Level of physical activity In-vehicle: ventilation/filtration Active: distance to motorised traffic Temperature, wind speed (esp. slow modes) (-) 15
Pollution Related Health Effects Effects of travel mode (Knibbs et al., 2007) 16
Pollution Related Health Effects Effects of speed using active modes (McNabola et al., 2007) 17
Well-Being Effects of Travel Utility Well being Subjective Well-Being (or happiness) Includes affective and cognitive component (Diener et al., 1985; Ettema et al., 2010) Based on EXPERIENCED well-being, not decision utility Applicable to a wide variety of contexts (also travel) 18
Well-Being Effects of Travel Subjective well-being: Affective well-being (emotional responses) (e.g. PANAS) Positive: interested, alert, proud, Negative: distressed, nervous irritable, Cognitive well-being (rational assesment) (e.g. Satisfaction with life scales (SWLS)): In most ways my life is close to ideal The conditions of my life are excellent I am satisfied with my life So far I have gotten the important things I want in life If I could live my life over, I would change almost nothing 19
Well-Being Effects of Travel Satisfaction with Travel Scale (STS) (Ettema et al., 2011) Cognitive and affective 20
Well-Being Effects of Travel Ettema et al., 2010 21
Well-Being Effects of Travel Mode effects Sweden (Olsson et al., 2011) Primary travel mode Car Public transit Walking/biking n M (SD) n M (SD) n M (SD) Commute to work 269 0.9 (1.0) 251 0.5 (0.8) 165 1.2 (0.9) Commute from work 259 0.9 (1.0) 254 0.5 (0.8) 164 1.2 (0.9) Beijing (Mao et al., 2015) 22
Well-Being Effects of Travel Effects of trip characteristics (Ettema et al., 2015) Car +: independence, freedom, mastery, prestige, scenery, speed, privacy, security - : stress, long commutes, unsafety, congestion Public Transport +: seat availability, cleanliness, conversation, information, attractive stations, vehicle design, rail - : crowding, waiting time, critical incidents, duration, unsafety Walking/cycling +: physical activity, arousal, autonomy, social interaction, sidewalks, cycle paths, aesthetics - : motorized traffic, crossings, rain, wind, cold, 23 duration, unsafety
Well-Being Effects of Travel Effects travel on Life Satisfaction and Affect Balance (% explained variance) is rather small. (Ollson et al., 2011) Commute to Work Commute from Work Affect balance SWLS Affect balance SWLS Model 1 Model 2 Model 1 Model 2 Model 1 Model 2 Model 1 Model 2 Affect balance - - - 28 - - 28 SWLS - 28 - - - 28 - - Sociodemographic 9 3 14 7 9 3 14 7 variables STS to work 12 5 8 2 24 STS from work 11 5 7 2
Well-Being Effects of Travel But relevant in specific cases E.g. Stutzer and Frey (2008) > commuting paradox 25
Well-Being Effects of Travel But relevant in specific cases E.g. Delbosc and Currie (2010) > transport disadvantage 26
Well-Being Effects of Travel But relevant in specific cases E.g. Martin et al. (2014) > mode switching and PWI 27
Well-Being Effects of Travel But relevant in specific cases E.g. Martin et al. (2014) > mode switching and PWI 28
Indirect effects: socio-economic factors Moderate the impact of exercise, intake and accidents: Traffic safety and age Intake and gender, age, health, social status, smoking behaviour (relative risks are not straightforward!) Effects for groups may be contradictory (e.g. cycling for elderly) 29
Travel related PA vs Other PA E.g.: does cycling substitute for, or stimulate other PA? Jansen et al. (2015): travel related PA accounts for 11.7% of all PA Troped et al (2010), Forsyth et al. (2008) > walkable neighbourhoods increase walking and PA close to home, but not overall PA Miller et al. (2015) > light-rail opening leads to more Pa in access/egress travel but also total PA 30
Self Selection Effects Residential self-selection: people choose residential location (partly) based on travel preferences, but also health related (pollution, PA)? Health-based self selection towards active travel Health attitude-based self-selection towards active travel 31
Causalities of Well-being PA > well-being and mental health (Wood et al., 2013; Paluska & Schwenk, 2000) Well-being > PA (Baruth et al., 2010) Well-being <> PA (Standage et al., 2012) 32
Conclusions Travel has health and well-being implications not necessarily captured by conventional appraisal methods Health effects complex and subject to spatiotemporal dynamics How to value health and well-being? Unresolved issues Combined effects (exercise, accidents, intake, Wellbeing) for specific groups Travel related PA vs other PA Self-selection effects Causalities Transport innovations 33