Archive for the ‘health’ Category
A free public lecture from SFU Continuing Studies and The City Program
How Transportation Affects the Essential Qualities of Life In Metro Vancouver
Thursday, 30 April 2015 7:30 PM at SFU Segal School of Business
Transportation connects us to our community, our place of work and our friends and family. The way transportation infrastructure is designed and the modes of transportation that we have access to impact our lifestyle and our health.
The lecture reviewed some of the evidence from other jurisdictions, but focused primarily on the findings from the My Health My Community project that surveyed 28,000 Metro Vancouver residents in 2013/14.
While there are clear dividends in health for active transportation users, current transit infrastructure does not equally benefit all communities in Metro Vancouver. Access to transportation widens opportunity and is a significant equity issue in Metro Vancouver.
This lecture was in collaboration with the 2015 ITE QUAD Conference, May 1-2 at the Pan Pacific Hotel, Vancouver.
It is fortunate that the text and illustrations that were used for this lecture are all available on line. I noticed that several people were trying to photograph the illustrations used, but that turns out to unnecessary too.
The talk was preceded by a presentation by Dale Bracewell, the Manager of Active Transportation at the City of Vancouver. He started by stating that Vancouver now designs its active transportation projects to meet the needs of all ages and abilities. The overarching goals are set by Transportation 2040 but that includes the interim goal of 50% of trips by walk, cycle and transit by 2020. The City has set itself objectives in the fields of Economy, People and Environment. The active transportation program fits within the People category and the Healthy City Strategy, which has a four year Action Plan. Walking and cycling are now the fastest growing transportation mode which reflects Vancouver’s high Walk Score. A panel survey is conducted annually with the City’s Health Partners.
Walking has increased by 19% while the collision rate has fallen by 20%. The collision data also needs to be seen within the context of the City’s Vision Zero. Cycling has increased by 41% while collisions have fallen by 17%. It is clear that the safety in numbers effect is working. Vancouver has installed a series of automated bike counters. He had a set of graphics which I have yet to find but the data is available as a large pdf spreadsheet.
This is the counter at Science World which now has the biggest count – even greater than the Burrard Bridge
The counters show cycle use growing between 7 and 15% over the last year. The Lion’s Gate Bridge now equals Hornby and Dunsmuir, even before the new safety measures for cyclists have been introduced.
Hornby Street still moves as many vehicle now as it did before, simply because the two way separated bike lane replaced on street parking. There are still 14,000 cars a day, but cycle traffic has increased 50% to 2,700 per day. At the same time there are 5,000 people on the sidewalk, with pedestrians showing a clear preference for the side with the cyclists rather than the parked cars. The street is now moving more people overall.
He also added a plug for an upcoming conference in Vancouver next year pro walk pro bike pro place September 12 – 15, 2016
Dr. Jat Sandhu is the regional director of the public health surveillance unit at the Vancouver Coastal Health Authority. He stressed that his remarks are his own personal views.
He started by contrasting the experience of driving a car in congested traffic on the Sea to Sky Highway with that of riding a bike on a path next to the North Arm of the Fraser River – the stress of the former versus the relaxation of the latter. He grew up in Hong Kong and described his boyhood commute to school from Stanley to Kowloon: and one and half hour combination of buses and ferry to cover the same distance as the Canada Line from Richmond Brighouse to Waterfront.
He cited the work of Larry Frank at UBC who has published the all embracing literature review on health and transportation, looking at physical activity, air quality, mental health, injuries and equity. “Urban Sprawl and Public Health”. He also pointed to USC study of the Los Angeles to Culver City Exposition LRT which reduced daily vehicle travel by households of between 10 to 12 miles a day which a 30% reduction of CO2 emissions.
It is known that daily physical activity helps maintain a healthy weight, reduces the risk of chronic disease and grants a 40% reduction in the risk of premature mortality. Yet only 40% of the population meet the recommended activity levels. Obesity is now overtaking smoking in the mortality race. Physical inactivity is a large part of the problem as shown by a study of commute time against obesity in Atlanta GA (Am J Prev Med 2004). He also pointed to the lack of transit equity citing the Next Stop Health study in Toronto.
The My Health My Community survey covers the entire area covered by Fraser Health and Vancouver Coastal Health. What makes Canadians sick? 50% of the time “your life”.
The study asked respondents 90 questions about their socio-economic status, health, lifestyle, healthcare access, built environment and community.
The transportation report on Metro Vancouver released last week is the first of a series of reports from this data, intended to inform the discussion of the transportation plebiscite in this region. It draws from the survey responses from residents of the region – which is a subset of the survey mostly conducted on line, but with supplementary paper surveys to ensure adequate coverage of ethnic minorities. It covers only those over 18 years of age. Its target was a 2% sample which may seem small but is much better than the 0.5% sample of the typical transportation survey. Census data to neighborhood level was used to ensure a representative sample. It was a one year process, and results have been weighted to correct for age, gender, education and geography. Of 34,000 respondents, 28,000 live in Metro Vancouver: 80% of those make daily trips for work or education.
55% car driver or passenger
Only Vancouver, New Westminster, Burnaby and the City of North Vancouver have over the Metro Vancouver average for active transportation modes.
I think the two maps are perhaps the most useful representations I have seen especially since they also map the Mayors’ Council’s proposals. What I think would be immensely more useful is a map of the non-active modes with the road projects that have been built in this region in the last ten years or so. While Dr Sandhu points to the goodness of fit of the proposals to correct some of the grosser transit inequities of this region, I think a map of “motordom” showing how the widening of Highway #1 (ongoing) the increase of traffic speeds on the Sea to SkyHighway, the impact of the South Fraser Perimeter road and the increase of capacity along Highway #10 through South Surrey, as well as all the various interchange improvements financed by development (200 St and Highway #1 for instance) as well as the Golden Ears Bridge and the new bridge over the CP yards in Port Coquitlam vastly overshadow anything that might happen as a result of the Mayor’s plan. I do not have the technical competence to produce such a map overlay myself, but I do hope one of you does.
By the way, the originals of these maps are huge: click on them to enlarge and see the details.
Among some of the other results he quoted:
The median commute time is 30 minutes: for car users it is 25 minutes and for transit 45 minutes. He said that reducing travel time for transit users should be a target, though absent the data on distance I am not sure that actually tells us much. To some extent, people choose how long they are willing to travel – and for some, such as West Coast Express users – the travel time will be viewed in a positive light. However, as a selling point for the Yes side in the plebiscite “Less time in your car, more time in your community” works well.
The determinants of transit use include age: the two biggest groups are 18 to 29 and those over 70. In both cases there is often a financial incentive for transit use (UPass, concession fares). 14% of transit users have a chronic health condition which he said points to the need for more HandyDART, which is included in the plan. There is a 50% higher transit usage by ethnic minorities – except for South Asians – with the highest usage among recent immigrants – who of course are not eligible to vote. Neither, come to that is Dr Sandhu. Only 75% of respondents are Canadian citizens. Transit use decreases with increases in income.
He also produced a graph showing municipalities by commute mode and the incidence of obesity. He said the correlation coefficient (r²) was 0.99 [which as far as I am concerned is unheard of].
He also showed the WalkScore map of the region – which I wish I could find on line. The web page I link to is not exactly what I was looking for!
The current transit infrastructure does not equitably benefit all communities. This is a social justice issue as it impacts access to education and employment. The proposed investments will be positive in this regard. The greatest health legacy of the Olympic Games was [not the creation of his position] the Canada Line. Metro Vancouver is 4th in transit use in North America, only behind the very much larger populations of New York, Montreal and Toronto. We have a relatively small population of 2.5 million and thus “do not have the same tax base”.
Q & A
1. A question about the aboriginal use of transit which seemed to be explained by lower income and the availability
2. Some people use different modes for the same trip on different days: walking or cycling in good weather for instance. Or more than one mode during one trip. The reply was that the choice of mode had been “collapsed down” and respondents were asked to pick their primary mode
3. A technical discussion of the sample compared to household survey which replaced the long form censu s
4. A question about income which produced the response that the City of Vancouver saw similar levels of active transportation across the city, but immigrants were more economically active than the population in general – a reflection of federal immigration policies.
5. Do people realize how walkable their neighborhood really is? Don’t we need more education?
The study helps the Health Authorities feed information into the OCP and community partners, as well as their interactions with nonprofits and school boards
6. “I have not heard the word Translink used. Is there going to be more bus service?”
7. Eric Doherty pointed out that just increasing bus service shows diminishing returns without a greater commitment to bus priority. He also mentioned feelings of superiority when he rode on a bus to the ferry and passed all those car users stuck in congestion.
I responded that bus priority measures are one of the most cost effective ways of improving the attractiveness of transit, but requires a level of enforcement not so far seen here.
Gordon Price was really impressed by the cycling data. There’s nothing like a few good figures to destroy some long held misbeliefs.
The health study simply confirms what we have long known, but seem reluctant to act on. My own views on this were set out in a post in published earlier this year. I want to acknowledge the recent promotion of that post on Twitter by Brent Toderian which has had a very significant impact on my WordPress statistics.
The talk was in a larger room than usual, and was linked to the ITE Quad conference, but was poorly attended. The discussion was really rather muted.
A Media Release from UBC with a link to the whole research paper – actually hosted by Translink – and dated August 20 last year
No surprises here – but useful back up to the argument that we ought to spend more on transit. Not that I expect that to influence people like Jon Ferry, [The Province, paywalled] who is pretending to be open minded!
A new report from the University of British Columbia shows that transportation and health are closely linked and recommends that health outcome be considered in transportation planning.
The report, funded by TransLink and Vancouver Coastal Health Authority as part of updates to Transport 2040, the regional transportation strategy, presents a range of opportunities for Translink to incorporate health into its planning.
“This report documents how prioritizing transit, bike and pedestrian infrastructure will positively impact health,” says the study’s lead author Lawrence Frank, Professor and Director of the Health and Community Design Lab, part of UBC’s School of Population and Public Health. “It looks at encouraging active transportation, such as walking, cycling and transit, and reducing air pollution and traffic collision risk.”
Dr. Lawrence Frank. Photo: Amanda Skuse
Previous research by Frank has shown that every hour a person spends in a car each day makes them six per cent more likely to be obese, while each additional kilometre a person walks makes them five per cent less likely to be obese.
Sedentary lifestyle is a major cause of many chronic diseases such as obesity, heart disease and some cancers. Many chronic diseases are preventable and active transportation and other sustainable transportation choices offer the possibility of prevention and even treatment through increased physical activity. The costs of these diseases are projected to increse by more than $1.5 billion in B.C. over the next 2 to 3 years.
“TransLink’s consideration of the health impacts of transportation systems could help offset the rising costs of health care in the Vancouver area and promote an active lifestyle that will benefit all Canadians,” Frank adds.
The full report is available at here.
Thanks to Spacing Vancouver‘s mis-transcription of a headline I have come across some very important, Canadian, research. This shows that spending billions of dollars widening a freeway, including the widest bridge in the world, is going to be costing us huge amounts of public funds long into the future.
This is a screen shot of the day’s headlines – and it was that first story I noticed. Actually the story is titled
and I have left that as a headline and made it a clickable link. A new study out of Toronto just published online in the journal Diabetes Care shows that if you live in a place where walking is difficult – like most new subdivisions – you have a much higher risk of developing diabetes.
The study looked at just about everyone in Toronto aged 30-64 – the population experiencing the most rapid rise of diabetes incidence – and singled out those who did not have diabetes as of March 31, 2005. The study followed these people over the next five years: in all, 1,239,262 of them, including 214,882 who appeared to be recent immigrants based on registration in the province’s healthcare plan.
By March of 2010, 58,544 of these people had developed diabetes. And the walkability of the communities in which they lived turned out to be closely linked to that outcome (given the complex factors that affect health, the researchers acknowledge that they can’t definitively say this relationship is directly causal).
Maybe not definitively, but it is well known that the lack of physical activity is directly related to a range of conditions – heart disease, obesity and type 2 diabetes. Moreover, while you can live in a new suburb without sidewalks, drive everywhere and also exercise a lot (join a gym, run with your dog …) most people don’t. Although I do have to say that when you go to places like Buntzen Lake at the weekend and just see the numbers of people who do take exercise seriously, my hopes increase.
The point I am trying to make here is neatly captured at the end of the Atlantic article
The Toronto study highlights that within urbanized areas, the impact of neighborhoods on public health can vary significantly. And so there’s hope for applying this lesson in the parts of the world that have yet to urbanize, as well as within cities like Toronto as they continue to grow. It’s no coincidence that the least walkable neighborhoods identified in this research were often the most recently developed. Unlike their older counterparts, they had large blocks instead of smaller ones, sprawling development instead of density, separated land uses instead of mixed ones.
The doctors and public health researchers behind this paper noted all of these differences, sounding remarkably like urban planners themselves. Reaching across disciplines, they conclude: “the way we structure and build our cities will play an increasingly greater role in shaping the health of the world’s population.”
Now we know that among the challenges facing the current government is the ever increasing rise in public health care costs. They are always looking to find ways of passing that along – BC being one of the very few Canadian provinces that levy a Medical Services Premium. “Slashing costs” through privatizing jobs like cleaning and looking after people who don’t need hospitals but do need long term care has also been a favourite. Perhaps less well publicized has been a recent shift in the way the government treats its own pensioners. The Public Service Pension Plan used to pay members MSP and Blue Cross premiums. So did the Teachers. Both of those are now borne by members. So much nicer than having a story about pension cuts, don’t you think?
We know for a certainty that widening Highway #1 will both induce more traffic – and encourage the sort of development described in that last block quote – “large blocks instead of smaller ones, sprawling development instead of density, separated land uses instead of mixed ones.” The people who live in such places will in future be less healthy than those who can walk, cycle or ride transit on a daily basis. I include transit quite deliberately – since every transit ride has some walking at each end (transit takes you from where you are not to not quite where you need to be). Indeed, Weight Watchers has long advocated a simple way to burn more calories – get off the bus a couple of stops too soon. Walk to the next station not the closest one.
I really doubt that Christy Clark or Kevin Falcon actually care very much at all about anyone’s health but their own. But their policies do depend on them being able to rattle on about lower taxes. That’s why they love stories about spending cuts – and why they much prefer that Translink be audited multiple times, rather than deal with the real issue – lack of funding for transit expansion. But what the Toronto health study shows is that their preference for the sort of suburbs that we have been building and occupying since 1945, the sort of places that their paymasters have been selling us and which have been so profitable, are actually one of the causes that public health care costs continue to rise. We have got very good at treating conditions, but we are not very good at all in creating a healthier society. Prevention is always much more efficient than cure – or treatment for the incurable. The greatest health care problem is that caused by a sedentary populace. One that sits all day – in front of a computer screen or in a car to travel any distance at all. We do not have a health system: we have a sickness system. And there is a huge lobby of corporate interests that wishes that system to continue, unchanged. Doing the same thing repeatedly and expecting a different outcome is a good definition of madness – but it is also an accurate description of conservatism. The obsession with resisting change, with refusing to admit that what we did was wrong and that we need to do things differently.
Transit is not a local problem. It is not something that municipalities can or should fund on their own. It is part of a much broader picture. The province cannot continue to pretend that it does not have an immediate and direct concern. Its highway policies – the construction of the wider Sea to Sky Highway, the South Fraser Perimeter Road, the Highway #1 expansion were all driven by property developers. All of them were directly contrary to the precepts of the Livable Region. The people of this region have repeatedly told the political leadership that they valued compact urban development, complete communities, with protection for the green zone and increased transportation choice. Oddly enough it was Gordon Campbell himself who came up with that formulation – when he was Mayor of Vancouver and Chair of the GVRD. And it was his government that chose – carefully and deliberately – to wreck that strategy, for short term political gain. There is no doubt that the widening of the Port Mann Bridge was – and is – very popular. But not only will it not solve the congestion problem (building roads has never cured congestion anywhere) it is also going to create a series of problems long into the future. Increasing public health care cost ought to be one that catches their attention – since all of the others they seem happy to ignore.
It is available at your friendly local book store: there was a discussion and book signing at The People’s Co-op Boosktore on Commercial Drive last night, and I know that they had some copies left. Or you can buy it on Amazon. When I have done here, I will be posting a review there too. Amy Walker is, as I am sure many of you know the cofounder of Momentum magazine and she also has a blog at onbicycles.com.
I was asked originally to contribute a piece on the environmental impact of cycling: I responded – “That will be the shortest chapter in the book. There isn’t any.” Well, ok that is an exaggeration, but a pardonable one I think. So my piece now carries the unwieldy title “The Environmental Good of Switching from Car to Bike” and it takes 8 pages. Out of 372 – none of which I have had an opportunity to read until I got my copy last night. Readers of this blog can happily skip over my pages, of course, and now I have read a few of my other favourite contributors, I can only say that I wish I had done a much better job. Todd Littman and Amy herself (she wrote 8 chapters out of 50) set a very high standard indeed.
If you do not have a bicycle and wonder what benefits you might enjoy I would like to present to you what I think will be some of the most compelling reasons: Youth, Sex and Cake. In the spirit of “you learn something every day” I have to acknowledge that Kristen Steele surprised me when she wrote that cycling makes you better in bed – and she has all the correctly cited academic articles to support that. Of course cycling makes you fitter, and you do burn more calories when you substitute a bike for a ride in a car (or even transit), which is why more people really ought to consider commuting by bicycle. And, as Todd Litman demonstrates, that has economic benefits too. But more and better orgasms ….
Does reading a book actually persuade people to switch mode of travel? Obviously the publisher thinks there is a market for this book for they commissioned it, and not only do I hope that they are right, but that there is a follow up volume. For the common thought that occurred to the contributors in last night’s discussion was “that ought to go in to the next book”.
Or is this really a handbook for cycling enthusiasts to use in their on-going cycle advocacy? Certainly on the basis of last night’s event, we were preaching to the converted. But it is definitely the book that I had wished had been written when I started looking at cycling as a transportation policy issue. We have come a long way since my boss said “We mustn’t encourage people to cycle, we will only be killing more of them”.
Of course I hope you will buy this book – or at the very least get your local library to get a copy. Richmond has two.
UPDATED November 1, 2010
The Health & Community Design Collaborative held a workshop at the Richmond Cultural Centre today. It was supposed to start at 9am. I got there on time. But it started late – of course – and, as seems to be typical of the City of Richmond, only one microphone could be made to work and no-one could make out anything that was being projected. My guess would be that they simply did not have the right projector for the size of room. Given that everyone seemed to be dependent on powerpoint, this did not make for good presentations. There was no break in a three hour meeting. And despite being called a “workshop” and sitting around tables – so most people had to crane to see or hear – there were no participatory activities. We sat and listened. Mostly. I sat at a table with City of Richmond parks department staff and they spent most of the time on their Blackberries.
Perhaps this was because there really wasn’t much that was new to listen to – for them or me. Now I must start by praising the existence of an ad hoc committee with such a broad range of representation. Once upon a time I tried to organize meetings between the health authority planners and Translink. That was because the way we ran HandyDART had effectively turned it into a delivery service of their patients to increasingly centralized program delivery points. I just wanted to know where they intended to put the next ones, so we could do some planning for the necessary service changes. I failed to meet a single regional health authority planner, but I did meet many health authority service providers who wanted to bitch about HandyDART service delivery – or lack of it.
Things seemed to have changed in part due to a federal initiative – though no-one from the federal government was present. They did have handouts at the side of the room and from them I now know that there is a Canadian Partnership Against Cancer’s Coalitions Linking Action and Science for prevention (CLASP). And I have solemnly copied their spelling and punctuation. They have developed tools for free download. And you can get a quarterly update on their work and resources by email from amiro (at) hsf.ca.
Even though they started late and had a long program we were required to sit through three sets of introductory remarks which I transcribed but said nothing of value prior to Larry Frank’s talk. Now again though I made notes it did seem to me to be very much the same stuff that I heard at the recent streetcar seminar. I did this time get my hands on an Executive Summary of “Neighbourhood Design, Travel and Health in Metro Vancouver: Using a Walkability Index” .
UPDATE Vancouver Walkability and Health Exec Summary Oct 2010 (pdf file)
Ellen Dunham-Jones is visiting Vancouver this week and is speaking at a number of venues but apparently they are all booked out. She did say: “I will learn more from this visit than you can learn from me” – which may be false modesty, or perhaps simply reflects the fact that not only have we done a bit better at walkable communities here than most US cities, but we also have not had the collapse of commercial real estate that they have experienced. She talked about dead malls and dead big box stores and how suburban office parks and similar places are being retrofitted to be more like real places. Some of the examples were taken from here – including Surrey City Centre and Big Tom’s SFU campus on top of the Surrey Centre mall. Apparently SFU are also going to do something of the sort in suburban Vancouver where they are turning a former strip mall into an art school.
I did pick up a key phrase that I am sure I am going to be able to use in future: “underperforming asphalt”. Suburban shopping centres overbuilt their parking lots to be ready for the rush on Black Friday (the day after their Thanksgiving when Christmas shopping starts and all the shops finally get into the black.) And while she gave a lot of evidence on what has been working in the US, and why the demographics of suburbia have changed and point to the need for a very different future. (She did not mention peak oil, but did talk about the need to reduce dependance on “foreign oil – I did not get the chance to ask her if that included Canadian oil.) I really did not hear very much about walkability or health – or indeed what is going to have to happen to large swathes of single family homes on the cul de sacs across Canada where to get to anything within a 1km crow fly radius you have to walk at least 2 kms. It’s all very well to say that the next generation doesn’t want to live there, but there was not one suggestion that I heard about how it could be changed.
If there is demand, I could transcribe my notes – when I have more time – and look up links to dead malls but for now if you are interested I suggest you start at deadmalls.com/
Suzanne Carter Huffman gave an express tour of the City of Richmond’s City Centre Plan. I learned that each of the four Canada Line stations are now seen as the centre of an “urban village” – plus of course the one yet to come at Sexsmith. Another urban village is also going to pop up next to the Oval where there is no transit at all. There was much about waterfront – and the apparent problem of the dyke. Not that it is too low and will offer no protection against the inevitable sea level rise associated with global warming but rather that it does not allow for a river view from ground level. She also managed to talk about the city centre without once referring to the private ownership of all the parking lots – which generates an inordinate number of short driving trips. I have dealt with that here more than once. Dave Semple talked extempore about Richmond’s parks and dykes. About the only relevant point was his observation that the one metre wide tarmac paths which Richmond has built around all its neighbourhood parks are too narrow and should be two meters wide. He did not say when they thought they might achieve that. And he also hopes that kids exploring Richmond will have plenty of opportunities to get dirty.
When I get invited to a “workshop” I expect to be involved in some activity – not just listening. I also expect to hear – and hopefully discuss – practical things that are going to be tried out to improve our current situation. I heard a lot about why we need to act, but not what needs to be done here. I did hear about some design features, but none in any context that I felt applicable here. It may have been that other participants got more from it than I did – after all I do not pretend to be an urban designer. But I will never know since there was no opportunity for any discussion. There was not even a coffee break. When you go to a thing like this and there is a long line up for the men’s washroom, then you know that there is somehting wrong with the arrangements.
I am pleased that Translink is talking to the Health Authorities – and that Metro is involved. I suspect that it is as yet early days and that they have not very much developed they can talk about. I hope that, as they get their act together, subsequent workshops will be more practical. Maybe the odd design charrette might be a better idea. But for now I regret that I can only report that we are not very far along the road to doubling the market share of transit, walking and biking from 25% (where they say we are today) to the 50% they think they will have by 2040.