Considering Health in US Metropolitan Long-Range Transportation Plans: A Review of Guidance Statements and Performance Measures

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Journal/Book Title/Conference

International Conference on Transport & Health


San Jose, CA

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Background Transportation influences health primarily and most directly through the pathways of traffic safety, air quality, physical activity, and accessibility to destinations. Despite the importance of all four components, only safety and air quality are typically considered during institutionalized transportation planning processes. This research assesses how health impacts are considered in urban regional transportation planning by focusing on the long-range transportation plans (LRTPs) that US metropolitan planning organizations (MPOs) must develop. Methods We used content analysis to examine current MPO long-range transportation plans from twenty-five large US metropolitan regions. First, we identified plan guidance statements (policy language, including visions, goals, and objectives) and supporting performance measures (quantitative or qualitative metrics). Then, we analyzed statements and measures for their consideration of health in several areas: general health, traffic safety, air quality, physical activity, and accessibility. Finally, we summarized and synthesized the results of our analysis into several key findings regarding the state of the practice of health consideration in MPO LRTPs. Results Goals and objectives exhibited an incomplete perspective of transportation's effects on health; only ten plans referred to all four key pathways. Instead, plans focused on safety, air quality, and accessibility, neglecting physical activity; less than half of plans included guidance language noting the physical activity benefits of walking and bicycling. Overall, regional policies reflected national transportation goals and planning requirements, which are rarely framed from a health perspective. The prevalence of health-related performance measures generally followed policy guidance, with a focus on traffic safety and accessibility measures. Particularly, measures of health and physical activity were lacking; only five plans included health performance measures (beyond traffic injuries and deaths), and many measures of physical activity were simply US Census-based commute mode shares. MPOs with stronger walk/bicycle modeling capabilities did not appear to be more likely to include physical activity statements or measures. Conclusions Urban transportation planning would benefit from a broadening conceptualization of the health impacts of transportation, and from additional attention to the development of health-related performance measures and the data and analytical tools needed to support them. We also discuss best practices and study limitations. This research informs a stronger and more comprehensive consideration of health within the institutionalized structure of US metropolitan transportation planning.

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