Using Health Impact Assessments to shape transportation policy

By Chris Spahr

Health Impact Assessments are increasingly being used to assess how transportation decisions will impact health outcomes. An HIA is an evidence-based research tool used to inform decision makers about the potential health risks and benefits of policies, programs, and projects outside the health sector.

On June 24, the County Health Rankings and Roadmaps, a project conducted by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation, presented a webinar on using HIAs to shape transit policy. This webinar highlighted the use of an HIA to study the expansion of the Columbia, Missouri transit system, which is stressed by increased student ridership, budget cuts, and rising fuel costs. The Columbia/Boone County Department of Public Health and Human Services, the PedNet Coalition, and Central Missouri Community Action performed the HIA, which found that those who use public transit accrue more physical activity throughout the day by walking or biking to and from bus stops. Also, the HIA found that expanding transit improves access to health care, employment, and healthy foods while increasing community cohesion and social capital.

COMO map

COMO Connect Network Routes
(click image to view a larger version)

Based on recommendations from the HIA, Columbia is re-launching its transit service. This includes renaming the system to COMO Connect and overhauling its existing routes. The current design of the system is a hub-and-spoke model with all routes beginning and ending in downtown Columbia and headways of 40 to 80 minutes. The new system, which will take effect on August 4, will be a network model with much shorter headways of 15 to 30 minutes. It will include four connector routes and seven neighborhood routes to improve access to activities such as shopping, medical care, recreation, schools, and government services. The system will also include a downtown orbiter route serving four college campuses, and a commuter route serving an unincorporated area just north of the city limits where there is a halfway house and a pocket of low-income families.  Jason Wilcox, a Senior Planner at Columbia/Boone County Public Health and Human Services, described HIA as a tool that allowed them to bring health into the conversation about transportation.

HIAs are also gaining traction within state DOTs. The Healthy Transportation Compact (HTC) in Massachusetts is a key requirement of the transportation reform legislation signed into law in June 2009. Among other health and transportation tasks, this legislation charges the HTC with implementing HIAs for use by planners, transportation administrators, public health administrators, and developers. Efforts such as those in Missouri and Massachusetts offer evidence that transportation officials are starting to recognize the impact of transportation decisions on health outcomes.

Chris Spahr is a Graduate Assistant with SSTI.