Tag Archives: air quality

Public Health and Land Use Planning: Two Reports Revisited

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CHASE is re-posting two reports on Public Health and Land Use Planning, which were released in April 2011. They were produced by CHASE’s Executive Director for the Clean Air Partnership (CAP), in partnership with the Ontario Public Health Association (OPHA) with funding from the Ontario’s Healthy Communities Fund.

Based on interviews with over 70 public health staff in 10 public health units in Ontario, the background report examines the ways in which ten public health units are trying to influence land use and transportation planning processes in their communities in order to make their communities healthier and more sustainable.  The ten case studies examine the interventions these public health units are seeking, the strategies they are employing, and the organizational structures they are utilizing to encourage collaboration across disciplines within their health units. They focus on the work of public health professionals who are involved in chronic disease, injury prevention and environmental health programs.

The background report considers the built environment’s impact on human health as mediated through six health-related factors; physical activity, access to healthy foods, vehicle-related injuries, air quality, climate change and water quality. This report, which is 230-pages long, is intended as a capacity-building tool for public health professionals, and possibly for professionals in the fields of land use planning, transportation planning and sustainability planning.  A hard copy of this report was sent to every Medical Officer of Health in Ontario in May 2011.

The summary report, which is 30 pages long, includes a high level overview of the built environment’s impact on human health as mediated through the six factors listed above. It also includes a high level discussion of the findings from all ten public health units. It is hoped that this report will build awareness among public health professionals, other professionals in the municipal sector, community activists and decision-makers about the many ways in which the built environment can impact human health, and about the ways in which public health professionals can inform, influence and/or support land use and transportation planning processes.

The background report has been broken down into four smaller pieces for those who do not feel they need to review the entire report; one on the one northern public health unit and the three rural public health units interviewed (68 pages); one on the two urban/rural mix public health units interviewed (39 pages); one on the four Greater Toronto Area public health units interviewed (82 pages); and one with the executive summary, health background, discussion and recommendations (60 pages). 

The full background report, the four sections of the background report, and the highlights report can be downloaded on the “What’s New?” page of this website at: http://chase-canada.org/whats-new/

WHO Finds Significant Health & Climate Benefits associated with Transit & Active Transportation

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The World Health Organization (WHO) has concluded that the climate change mitigation strategies that significantly increase the accessibility, affordability and quality of public transit and active transportation (e.g. cycling), and the land use measures that support these modes of transportation, will generate much greater health co-benefits than those which focus solely on vehicle and fuel technologies.

The WHO has released a new report, “Health co-benefits of climate change mitigation – Transport Sector”.  Based on a review of 300 peer reviewed and health-related articles and reports, this report concludes that the transportation systems around the world are responsible for approximately 5.8 million deaths per year:

  • 3.2 million deaths from physical inactivity;
  • 1.3 million deaths from road traffic injuries;
  • 1.3 million deaths from outdoor air pollution.

The WHO report begins by noting that, on a global basis, the transportation sector is responsible for 23 per cent of the greenhouse gases that are emitted, with land transport responsible for 80 per cent of those emissions. The report estimates that 40 to 50 per cent of Canada’s urban emissions of greenhouse gases could be avoided, for less than US$200 per tonne, if aggressive land use policies were used to: reduce travel demand; shift people from motorized vehicles to walking, cycling and transit; and emphasize more densely built and energy-efficient housing. 

The WHO report concludes that a significant shift from private motorized vehicles to walking, cycling and public transit could also:

  • Reduce cardiovascular and respiratory disease from air pollution;
  • Reduce traffic-related injuries;
  • Reduce noise and noise-related stress; and
  • Reduce chronic diseases such as type 2 diabetes, heart disease and cancers that are associated with physical inactivity.

The report found that climate mitigation strategies that are directed at increasing walking, cycling and public transit, can improve health equity as well.  The researchers found that socially disadvantaged groups tends to experience more transportation-related health risks due to air pollution, noise and vehicle-related collisions, because they tend to live in closer proximity to high volume traffic corridors.  These groups also tend to have less income for travel and less access to public transit and active transportation facilities. 

The WHO report notes that: “improved active transportation and rapid transit/public transportation is not only healthy; it is cost-effective”.   For example, the International Panel on Climate Change found that greenhouse gas emissions in Latin America could be reduced by 25 per cent at relatively little cost (i.e. about $30 per tonne of CO2) if funds were directed at providing bus rapid transit, pedestrian upgrades and cycleways.  

The WHO reports identifies four key strategies that should be used to maximize the health, climate and cost benefits associated with this approach to the transportation sector:

  • More compact land use that integrates residential and commercial areas to support active transportation and public transit;
  • The inclusion of health and equity costs into cost-benefit assessments that are directed at transportation projects and planning;
  • The use of health assessment tools in transportation and land use policies; and
  • Investments in active transportation and rapid transit/public transit.

World Health Organization (WHO).  Health in the Green Economy.  Health co-benefits of climate change mitigation – Transport Sector.  2011 (156  pages). Prepared by Jamie Hosking, Pierpaol Mudu, and Carlos Dora. http://www.who.int/hia/examples/trspt_comms/hge_transport_lowresdurban_30_11_2011.pdf30_11_2011.pdf

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Fine Particulate Matter, Lung Cancer & Cardiovascular Disease

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When researchers re-examined the data for 1.2 million adults from the Cancer Prevention Study, they found that fine particulate matter found in tobacco smoke and air pollution, has a very different relationhip with cardiovascular disease and lung cancer. 
 
They found that lung cancer has a linear exposure-response curve with fine particulate matter so the risk of lung cancer continues to increase as the exposure increases.

With cardiovascular disease however, the researchers found a non-linear exposure response curve.  They found a steep increase in the number of cardiovascular deaths at low levels of exposure to fine particulate matter with the risk increasing less as the exposure increases.  
 
This means that cardiovascular deaths would account for most of the deaths associated with low levels of exposure to fine particulate matter, while lung cancer would become proportionately more important at higher levels of exposure.  
 
These relationships are important when estimating the burden of
illness associated with exposures to air pollution, second-hand smoke and cigarettes. They suggest that lung cancer would be the dominant health concern with smokers while cardiovascular disease would be the dominant concern with air pollution and exposure to second-hand smoke.
 
Pope III, Arden, Richard T. Bennett, Michelle C. Turner, Aaron Cohen, Daniel Krewski, Michael Jerrett, Susan M. Gapstur, Michael J. Thun.  “Lung Cancer and Cardiovascular Disease Mortality Associated with Ambient Air Pollution and Cigarette Smoke: Shape of the Exposure-Response Relationships”, Environmental Health Perspectives.  July 2011.  http://dx.doi.org/10.1289/ehp.1103639
 
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Weaving Health into the Land Use Planning Process: One Story

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In 2006, I was hired by a health department in a regional municipality in southern Ontario to integrate public health’s priorities, particularly those associated with air quality and physical activity, into the land use planning process.  Early on in my new position, health department staff met with the Manager of Long-Range Planning from the planning department.  We asked him to tell us where in the planning process we needed to get involved in order to address our priorities.  The Manager responded by telling us: ”You need to be involved in every step in the process.  It is the only way that you will understand what needs to be done and how to influence the process.” 

From that point forward, health department staff were invited, along with staff from other regional departments, to participate in two planning exercises: one to conform with the Province’s Places to Grow plan; and one to review the Regional Official Plan. 

At the first stage in the process, we learned that background papers were prepared by external consultants and/or staff on issues such as agriculture, transportation, housing, and population and employment density. The two departments agreed that the health department would prepare four  background papers: one on air quality and the built environment; one on physical activity and the built environment; one on community food security; and one on healthy communities principles.  These background papers were taken out for public and agency consultation by the planning department along with all of the other background papers.

In the second stage of the process, the health department offered detailed comments on the language in the existing Regional Official Plan on issues such as climate change adaptation, land use compatibility and air quality, walkability, access to transit, the energy efficiency of buildings, and the accessibility of greenspace, recreational facilities, and services including stores that sell fresh foods.    

In the third stage, we learned that policy papers were prepared on specific issues identified from the first round of papers and consultation.  It was agreed that the health department would prepare two policy papers: one on land use compatibility and air quality, which addressed, among other things, concerns that the health department had about high levels of air pollution along high traffic corridors; and one which examined the criteria that could be enshrined in official plans, secondary plans and/or implementation guidelines to help create walkable and transit-supportive communities. These papers were also taken out for consultation by the planning department along with the others papers.

The Regional Official Plan Amendment, which was adopted in December 2009, included a number of new or revised policies that are important to the creation of healthy and sustainable communities.  Among these were policies that required the development of three implementation guidelines that would be applied to all development across the Region: one on healthy communities; one on compatible land uses; and one on air quality impact assessments.  These guidelines are currently under development and the health department remains actively engaged in that process.

During this period, staff in the health department also began providing comments on secondary plans, subdivision plans, site plans, transportation master plans and cycling plans from an air quality and physical activity perspective.  All of this on-going review and policy work has built upon the research that went into the health department’s background papers, demonstrating for me the wisdom of the advice offered by that Manager of Long-Range Planning.   

Relationships between public health units and municipalities vary across the province, as do health priorities and resources.  We would like to hear from you.  Are public health and planning staff collaborating in your communities, and if so, how and where is that working for the creation of healthy and sustainable communities?

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Bike Lanes are a Public Health Priority!!

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Last week, the local paper in my community ran an article about the candidates in my riding who are running in the provincial election.  Apparently, one of them is saying that all roads should provide three feet of space between bikes and cars, while another is calling that position impractical.  I found myself thinking, whether I agreed with the specific policy or not, it was about time that bike lanes became an election issue!

In 2010, I had the opportunity to interview over 60 public health professionals working in ten public health units across this province about the ways in which they were working to change the built environment in order to improve human health. There was one position that staff from all ten public health units agreed upon. Whether they were working to improve air quality, increase physical activity, address climate change, reduce the rates of chronic disease, improve mental health, or foster a sense of community, public health professionals from all ten public health units agreed that our communities must be created, or re-designed, to support active forms of transportation such as walking and cycling.  From Sudbury to Niagara Falls and Haliburton to Owen Sound, the public health professionals all agreed that we need to get people out of their cars!  They all agreed that we need to ensure that our communities allow people to get around safety, efficiently and conveniently without needing to use their cars!

The health and environmental arguments for active transportation abound, but here are two of them:

Active transportation can improve air quality.   In 2008, the Ontario  Medical Association estimated that poor air quality in Ontario contributes to approximately 9,500 premature deaths each year.  Most of those deaths are from chronic heart and lung diseases that result from long-term exposures to unhealthy levels of air pollution.  The transportation sector in Ontario is well-recognized as a signficant source of air pollution.  Many studies directed at high volume traffic corridors have demonstrated that highways can have a significant impact on local air quality and on the health of those who live near them.  One study, conducted by Toronto Public Health and Health Canada, demonstrated that, each year, 190 premature deaths from traffic-related air pollution in Toronto, could be avoided if vehicle-related emissions were reduced by 30% by shifting people to alternate modes of transportation.

Active transportation increases the levels of physical activity among residents.   Agencies such as the Public Health Agency of Canada have concluded that a moderate increase in physical activity can reduce the risk of chronic diseases such as Type 2 diabetes, colon cancer and breast cancer by as much as 50 per cent.  They estimate that billions of dollars in health-related costs could be saved if levels of physical activity were increased among the overall population.  A variety of studies have demonstrated that people who live in communities that support walking and cycling can get the physical activity needed to stay healthy by doing errands and walking to local services.

There are a number of factors that determine whether people will walk or cycle as a means of transportation; the provision and design of walking and cycling facilities such as sidewalks and bike lanes are among those factors.  Studies have demonstrated that many people will not cycle if it does not feel safe.  One study of bicycle-friendly environments in the Netherlands, Denmark and Germany found that the safety of the cycling facilities in these countries was the most important factor contributing to the higher levels of cycling in those countries, particularly among women, children and the elderly.

While there is considerable debate how best to design cycling facilities, and there is a recognition that the facilities needed will vary depending upon the speed and volume of traffic along a particular roadway, the debate about whether cycling facilities are needed should really be over.  We should let candidates across the province know that active transportation is a public health priority.

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