Public Health and Transportation       Planning in Massachusetts         Institutionalizing HIAThe Social Determinants of ...
OutlineI. IntroductionII. Healthy Transportation CompactIII. Interagency Working GroupIV. Health Impact Assessment Pilot P...
I. IntroductionTransportation Reform Law     In June 2009 Governor Deval Patrick signed the     Transportation Reform Law ...
I. Introduction• Under M.G.L. Chapter 6C, Section 33 the Healthy  Transportation Compact is directed to:   – (v) establish...
II. Healthy Transportation Compact• M.G.L Chapter 6C also called for the establishment  of a Healthy Transportation Compac...
III. Interagency HTC Working Group• Established Interagency Working  Group• Members include:   – Senior staff from the Mas...
III. Interagency Working Group • Monthly meetings beginning in late 2009 • Discussions about:     – What is an HIA – do we...
IV. Health Impact Assessment PilotProject• The goal of the proposed transportation-related HIA project  is to work togethe...
IV. Health Impact Assessment PilotProject: • Project underway by the MassDOT that the HIA will inform   is the “Grounding ...
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Factors Responsible for Population HealthHealth status is determined by:       genetics 20 – 30%;       health care 10%;  ...
HIA Addresses Determinants of HealthHow does the proposed   affectproject, plan, policy                                   ...
Steps of an HIAScreening         Identify and prioritize topics for HIAsScoping           Identify health issues to be stu...
Proposed Pathways for the Grounding           McGrath HIA  • Mobility and Connectivity    – Vehicle use    – Pedestrian/Bi...
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No-Build Research                    Alternative ResearchEvaluation Criteria                                              ...
Examples of Baseline Health Data for Considerationin HIAHealth Determinants                 Health Outcomes               ...
MA Environmental Justice Policy• Environmental Justice (EJ) populations are  determined by identifying all Census block gr...
EJ Populations in Boston Region                              21
Summary• HIAs are a useful tool to comprehensively  address public health and social  determinants of health• Mitigating r...
Margaret Round: Public Health & Transportation Planning: Institutionalizing HIA
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Margaret Round: Public Health & Transportation Planning: Institutionalizing HIA

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Presented at "The Social Determinants of Urban Mental Health: Paving the Way Forward," hosted by the Adler School of Professional Psychology Institute on Social Exclusion, Sept. 19-20, 2012, Chicago.

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  • 5 pathways with a focus on mobility and connectivity as it relates to land use and economic development and air quality
  • Margaret Round: Public Health & Transportation Planning: Institutionalizing HIA

    1. 1. Public Health and Transportation Planning in Massachusetts Institutionalizing HIAThe Social Determinants of UrbanMental Health: Paving the WayForwardSeptember 20, 2012Suzanne K. Condon, Associate Commissioner Margaret Round, Senior Environmental AnalystDirector, Bureau of Environmental Health, MDPH MDPH/ Bureau of Environmental Health
    2. 2. OutlineI. IntroductionII. Healthy Transportation CompactIII. Interagency Working GroupIV. Health Impact Assessment Pilot ProjectV. Summary 2
    3. 3. I. IntroductionTransportation Reform Law In June 2009 Governor Deval Patrick signed the Transportation Reform Law – M.G.L. Chapter 6C The primary goal was to consolidate all transportation agencies in MA to reduce duplicate efforts and enhance transportation planning 3
    4. 4. I. Introduction• Under M.G.L. Chapter 6C, Section 33 the Healthy Transportation Compact is directed to: – (v) establish methods to implement the use of health impact assessments (HIAs) to determine the effect of transportation projects on public health and vulnerable populations; and – (x) institute a health impact assessment for use by planners, transportation administrators, public health administrators and developers.• Transportation planning projects often have a range of health implications that are not uniformly considered• MDPH was awarded funds from the Robert Wood Johnson/Pew Charitable Trusts Health Impact Project to conduct a transportation-related HIA and develop an approach to institute a health impact assessment 4
    5. 5. II. Healthy Transportation Compact• M.G.L Chapter 6C also called for the establishment of a Healthy Transportation Compact (HTC)• The HTC shall be composed of: – Secretary of Transportation (co-chair) – Secretary of Health and Human Services (co- chair) – Secretary of Energy and Environmental Affairs – Administrator of Transportation for Highways – Administrator of Transportation for Mass Transit – Commissioner of Public Health 5
    6. 6. III. Interagency HTC Working Group• Established Interagency Working Group• Members include: – Senior staff from the Massachusetts Department of Public Health Bureau of Environmental Health and Bureau of Community Health Access and Promotion – Senior planning staff from MassDOT – Senior Staff from the Executive Office of Energy and Environmental Affairs 6
    7. 7. III. Interagency Working Group • Monthly meetings beginning in late 2009 • Discussions about: – What is an HIA – do we need a MA definition? – Need for cross agency framing to develop common understanding and language • Inventory by agencies related to transportation work – What worked best? – What hurdles were met? • Greater clarity on what is involved in existing transportation planning process • Identification of a transportation project that could benefit from early incorporation of HIA into decision making process 7
    8. 8. IV. Health Impact Assessment PilotProject• The goal of the proposed transportation-related HIA project is to work together with MassDOT, EEA and other community representatives to: Pilot an HIA of a Serve as a vehicle Provide the proposed for training staff framework for transportation- responsible for developing methods related project implementing the to determine which HIA directives types of transportation projects might benefit from an HIA and the process to make such determinations 8
    9. 9. IV. Health Impact Assessment PilotProject: • Project underway by the MassDOT that the HIA will inform is the “Grounding McGrath” Study in Somerville, MA – Overall this transportation project aims to determine the future of the Route 28 corridor – MassDOT indicated that the size of the investment necessary to restore the highway provided an opportunity to evaluate the feasibility, benefits, impacts, and costs of removing at least a portion of the elevated structure on Route 28/McGrath Highway – MassDOT’s existing study protocol lends uniquely to the HIA process by establishing criteria to assess impacts and benefits of alternative designs and establishing an advisory group composed of community representatives to provide recommendations throughout study 9
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    13. 13. Factors Responsible for Population HealthHealth status is determined by: genetics 20 – 30%; health care 10%; social, environmental conditions, and behavior 60 – 70% J Health Affairs, 2002 13
    14. 14. HIA Addresses Determinants of HealthHow does the proposed affectproject, plan, policy and lead to health outcomes 14
    15. 15. Steps of an HIAScreening Identify and prioritize topics for HIAsScoping Identify health issues to be studied Prioritize research questionsAssessment Conduct literature reviews Research existing conditions data Conduct surveys, interviews, focus groups Conduct data analysis Interpret and ground truth dataRecommendations Identify and prioritize recommendationsReporting Write, review and edit final report Develop a communication, media and advocacy plan to report findings to decision-makersMonitoring Collect data on impacts Hold decision-makers accountable for decision agreements and mitigations 15
    16. 16. Proposed Pathways for the Grounding McGrath HIA • Mobility and Connectivity – Vehicle use – Pedestrian/Bicycling Network • Land Use and Economic Development – Access to goods & services (e.g., prediction of walk/bike to goods and services) • Air Quality – Air pollution from vehicles – Proximity (200 meters) to roadways • Public Safety – Injuries and fatalities – Crime and fear of crime • Noise – Noise from motor vehicle – Impact from de-elevation 16
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    18. 18. No-Build Research Alternative ResearchEvaluation Criteria Possible Indicators Questions Questions Proximate Effects Will changes to the corridor improveImpacts of congestion What is the level of congestion? congestion? - Travel delay by car; Will changes to intersections/ What is the access to corridorAccess around corridor via intersections/crosswalks? crosswalks increase access by traffic, - Crossing speed bus, walking, biking ? How will changes to the corridor What is the current pedestrian - Number of pedestrians andChange in use bicycle infrastructure? affect pedestrian/bicycle bicyclists along corridor infrastructure/? Health Outcomes What are the current rates of How will rates of disease changeCVD/Respiratory - Baseline respiratory and CVD rates respiratory and cardiovascular from improving mobility/connectivity in communities around the corridor disease? of the corridor?Mental Health How would changes in - Outpatient MH clinic visits; What are the mental health mobility/connectivity affect mental - Stress levels (due to traffic, noise, outcomes? health? congestion, lack of social support);Physical Activity - Rates of physical activity; What are the current rates of How will physical activity change due - Percent of population physical activity? to various factors related to changes biking/walking for commute and in the corridor structure? non-commute Vulnerable Pop -Access within ¼ mile to goods andEnvironmental Justice What is the accessibility and services by ethnicity and income traffic safety associated with the What changes to the corridor will Areas, level; corridor for specific vulnerable assist in the access of vulnerableElderly, Disabled - Fatalities and injuries from traffic populations (e.g., elderly, populations? collisions by ethnicity and income disabled) level
    19. 19. Examples of Baseline Health Data for Considerationin HIAHealth Determinants Health Outcomes Data SourcesAir pollution – high gradient Respiratory disease/illness MDPH Bureau ofnear roadways and scientific (e.g., asthma), cardiovascular Environmental Healthevidence that continues to disease (e.g., heart attack), all- Environmental Public Healthemerge regarding health cause mortality, certain cancers Tracking (EPHT) Portalimpacts http://matracking.ehs.state.ma. us/Access to active transportation Benefits for reducing obesity, MDPH Bureau of Communityand increasing physical activity diabetes, cardiovascular Health and Prevention(e.g., access to sidewalks, disease, premature mortality,bicycle paths) improved mental and physical healthAccess to public transit mobility Access to goods/services that MassDOTfor vulnerable populations support health, such as(people with disabilities, groceries, clinicselderly)Traffic Safety Injury to pedestrians, vehicle MassDOT drivers, and cyclistsEconomic: vitality of small Multiple indirect impacts on Economist to be hiredbusinesses; property values healthand health care costs thatcould be reduced based on HIAoutcomesEnvironmental Justice Multiple indirect impacts on EEA/MDPH EPHT/MassDOT 19 health
    20. 20. MA Environmental Justice Policy• Environmental Justice (EJ) populations are determined by identifying all Census block groups that meet any of the following criteria: - Households earn 65% or less of statewide median household income - 25% or more of residents include people of color - 25% or more of residents are foreign-born - 25% or more of residents lack English language proficiency
    21. 21. EJ Populations in Boston Region 21
    22. 22. Summary• HIAs are a useful tool to comprehensively address public health and social determinants of health• Mitigating risks combined with health promotion optimizes health benefits• Need additional method(s) to assess mental health impacts/benefits in HIA’s• Important to build upon established EJ indicators (e.g., education) 23

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