Transportation and Health Resource Hub - Journal Article

The Safe Systems Pyramid: A New Framework for Traffic Safety. (2023) Transportation Research Interdisciplinary Perspectives.

This article challenges the way that engineers and health practitioners have traditionally considered addressing safety concerns that produce health evaluators. It challenges the three E’s being Education, Enforcement, and Engineering and suggests that an improved way to evaluate the relationship between engineering and health is the “Safe Systems Pyramid” approach which consists of Education, Active Measures, Latent Safety Measures, Built Environment, and Socioeconomic Factors in descending order. This article continues to describe each of these factors and provides examples of how they can be applied in a real-world context. In conclusion, this “Safe Systems Pyramid” approach links transportation practice to public health for the purpose of evaluating Vision Zero and other traffic safety programs. Practitioners can 1. Prioritize countermeasures; 2. Assess the population level impact; 3. Determine whether individual effort is needed; and 4. Support efforts that address the social determinants of health, all using the same framework.

Systematic literature review of built environment effects on physical activity and active transport - an update and new findings on health equity

This systematic review—a review of the body of evidence on a subject—identified which environmental interventions increase physical activity for residents while also considering intervention costs. Furthermore, this study examined how the effects of these interventions differ by ethnicity and socioeconomic status. Interventions such as parks and playgrounds and active transportation facilities showed an increase in active transportation, visits to parks, and physical activity. There was some evidence that these kinds of interventions benefit socioeconomically advantaged groups more than other groups.

Considering health in US metropolitan long-range transportation plans: a review of guidance statements and performance measures

Transportation influences health primarily and most directly through traffic safety, air quality, physical activity, and accessibility. Despite the importance of all four components, only safety and air quality are typically considered during institutionalized transportation planning processes. This paper assesses how health impacts are considered in transportation planning by focusing on the long-range transportation plans that US metropolitan planning organizations develop. By assessing the state of the practice and discussing potential approaches, this review informs a stronger and more comprehensive consideration of health within the institutionalized structure of US metropolitan transportation planning.

Children’s transport built environments: a mixed methods study of associations between perceived and objective measures and relationship with parent license for independent mobility in Auckland, New Zealand

This mixed methods study investigates whether parent perceptions of the neighborhood environment align with objective measures of the neighborhood built environment, and how perceived and objective measures relate to parental preferences for children's independent mobility (supporting active travel and physical activity). Parental preferences for independent mobility was only associated with a need for safer places to cycle (positive) and objectively assessed cycling infrastructure (negative) in adjusted models. Overall, the study findings indicate the importance of safer traffic environments for children's independent mobility.

Associations of children’s active school travel with perceptions of the physical environment and characteristics of social environment: a systematic review

This study documents a systematic review of 37, English-only, published studies related to school-aged (5-13) and travel mode choice. The study extracted data, assess quality and evaluated the evidence presented using a vote-counting technique to document associations between school travel modes as well as social and sociodemographic characteristics. The authors found that active school travel was associated positively with safety, walkability and neighbourhood social interactions, and negatively with travel distance and car ownership. They did not find sufficient evidence for social characteristics.

Associations between the neighbourhood built environment and out of school physical activity and active travel: an examination from the Kids in the City Study 

This study examined selected objectively-measured and child-specific built environment attributes in relation to proportion of out-of-school time spent in moderate-to-vigorous physical activity (%MVPA) and active travel in a group of ethnically and socio-economically diverse school-aged children in Auckland, New Zealand. The researchers found that the ratio of high speed to low speed roads and improved streetscape for active travel were related to %MVPA on weekdays only. Local destinations (particularly schools) along a safe street network may be important for encouraging children's activity.

An integrated conceptual model of environmental needs for New Zealand children’s active travel to school 

This study correlated data from New Zealand children, their parents, school representatives, and objectively-assessed environmental features to generate a model enabling how these variables interrelate with each other and active travel to school. It demonstrates the complexity of active travel to school and reinforces that increasing active travel modes needs multi-faceted approaches to be successful.

Integrating health and transportation in Nashville, TN, USA: from policy to projects

This journal article describes the integration of health into regional transportation planning, scoring criteria, policy, project prioritization, data collection, modeling and funding. This transformed $7 billion worth of transportation spending in the greater Nashville area, prioritizing health and equity over volume and speed of cars on roadways. It is possible to positively address health in transportation policy and funding. Transportation agencies can think creatively to include health in data collection and modeling.

The integrated transportation and health impact tool in Nashville, TN, USA: implementation steps and lessons learned

This article describes the implementation of Integrated Transportation and Health Impact Tool (ITHIM) in greater Nashville, TN, and the important lessons learned. ITHIM is a scenario planning tool that sets active transportation targets and calculates the resulting positive or negative impacts on population health. ITHIM also has the capability of monetizing healthcare savings from averted injury and disease. This resource provides a methodology for MPOs and state DOTs to calculate the potential health impacts and healthcare savings from increased walk, bike and transit trips.