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1. How do the U.S. Department of Transportation (USDOT) and the Federal Highway Administration (FHWA) address health through transportation planning and decision-making?
A. The U.S. Department of Transportation and the Federal Highway Administration have a history of promoting health through our policies and funding programs. FHWA has made significant investments in transit infrastructure; bicycle and pedestrian plans, coordinators, and facilities; Safe Routes to School programs; road safety; air quality improvements and congestion reduction; and the management and operations of regional transportation systems. FHWA promotes sustainable and livable communities through involvement in the Partnership for Sustainable Communities, FHWA’s Livability Initiative, USDOT’s policy statement in support of “the development of fully integrated active transportation networks,” and FHWA’s support for context sensitive solutions (CSS), and environmental justice to ensure that transportation facilities fit appropriately into their surrounding environments. Our partners at metropolitan planning organizations (MPOs), State Departments of Transportation (DOTs), and tribal and other Federal, State, and local government agencies have developed transportation plans, programs, and projects that improve mode choice and access, thereby promoting health.
2. How does transportation affect public health?
A. Transportation can affect human health, either positively or negatively, in several ways. For example:
3. What are the opportunities to address health through transportation?
A. Early in the process, when a State DOT or MPO is developing a long-range transportation plan (LRTP), health can be included in the vision for the State or metropolitan area’s future. When a State DOT is developing a statewide transportation improvement program (STIP) or an MPO is developing a transportation improvement program (TIP), they can consider health when prioritizing transportation improvements. Health also may be considered during project design as well as during the National Environmental Policy Act (NEPA) review process. Several public health considerations, like air quality and safety, are routinely addressed through the planning and NEPA project development process, and these are important considerations that guide project design.
4. How can members of the community and other stakeholders influence transportation planning?
A. The public plays an important role in the transportation planning process. Public input can help State DOTs and MPOs develop a more complete understanding of the community’s needs and concerns as they develop transportation plans. Members of a community and other stakeholders can attend public meetings to learn about the planning process and provide input on draft transportation plans. Stakeholders can also serve on focus groups or advisory committees, and join mailing lists to receive periodic updates about the planning process and opportunities to be involved. By getting involved, members of the public have an opportunity to offer input about how the transportation system can be delivered in a way that promotes healthy and livable communities.
5. How can transportation planners work with public health professionals to leverage resources?
A. State DOTs and MPOs can also build partnerships with their colleagues in State and local health departments to tap their public health knowledge and expertise. Leveraging resources across the transportation and public health sectors has the potential to lead to better health and transportation outcomes.
6. How are State and metropolitan transportation planners addressing health through the transportation planning process?
A. The best opportunity to incorporate health into transportation decision-making is during the transportation planning process. State DOTs and MPOs across the country have used a range of strategies for addressing health through the transportation planning process. A 2012 FHWA report, Metropolitan Area Transportation Planning for Healthy Communities, reviewed the practices of 12 MPOs with demonstrated leadership in integrating health and transportation, and it included detailed case studies on four MPOs that have employed a “comprehensive, balanced, or holistic approach to health” that goes beyond well-established assessments of health impacts related to safety and air quality.iii Some of the MPOs highlighted in the report include the Nashville Area MPO, and the Puget Sound Regional Council. Additional examples of MPOs working to promote active transportation and transit to increase physical activity and access essential services are the Delaware Valley Regional Planning Commission, and the Denver Regional Council of Governments.
A 2014 FHWA report, Statewide Transportation for Healthy Communities, examines the experiences of five State DOTs that have demonstrated leadership in integrating health and transportation: California, Iowa, Massachusetts, Minnesota, and North Carolina. The report presents insights and a flexible framework for State DOTs that choose to integrate public health considerations into their transportation planning and decision-making.
7. How are health effects addressed in Federal actions?
A. FHWA routinely includes detailed assessments of health effects, such as safety, air and water quality, and noise, in environmental documents. The Council on Environmental Quality’s (CEQ) regulations implementing NEPAiv state that environmental documents should "include only brief discussion of other than significant issues," which gives Federal agencies flexibility to determine which topics to carry forward for detailed environmental analysis. While the CEQ regulations include provisions for considering health effects of Federal actions, the lead Federal agency decides how and when to analyze health through the NEPA process. For some plans and programs, it may be appropriate to establish baseline health and social conditions in a community when identifying the affected environment and to determine whether health-related issues other than those routinely analyzed warrant detailed study. Additionally, in accordance with CEQ regulations, Federal agencies should consider whether their action may violate State or local environmental laws.
Environmental specialists should use all available information to make informed decisions about what health topics may be appropriate to analyze for a given plan, program, or project. For example, MPOs and State DOTs often conduct a great deal of study on issues with health implications during the planning process. On a case-by-case basis, environmental specialists may coordinate with planners on these studies and/or consider whether previously prepared planning efforts may meet statutory and regulatory environmental requirements related to health in the NEPA review process. Environmental specialists should consider regulations on transportation planning and environmental linkages at 23 CFR 450.212 and 450.318 and should determine whether they can apply the provisions of 40 CFR 1502.21, “Incorporation by Reference,” to use health-related planning studies when developing a NEPA document.
8. How does transportation project design address health?
A. Transportation projects can be designed to promote health by: using geometric design that promotes safety for all road users; including adequate, accessible pedestrian and bicycle facilities, and safe connections to transit; incorporating signs, signals, and safe crossings for pedestrians; providing appropriate lighting, wayfinding, street furniture, bus shelters, and trees; and mitigating traffic noise. Public involvement can help provide transportation engineers with input and feedback to ensure that planned designs adequately meet the community’s needs.
9. What tools are USDOT/FHWA developing to help transportation planners consider public health in the transportation planning process?
A. USDOT and the Centers for Disease Control and Prevention (CDC) have developed an easy-to-use online Transportation and Health Tool to help transportation planners and decisionmakers assess how their transportation system influences the health of their State or metropolitan area population and how their jurisdiction compares to other jurisdictions. The tool uses health and transportation indicators to help inform health-supportive State and regional transportation policies and project decisions. The indicators are:
These indicators help State DOTs and MPOs assess how the jurisdiction's transportation system is performing related to health. The Tool provides recommendations for making improvements by further incorporating health considerations into the transportation planning and decision-making processes.
FHWA also developed the Framework for Health in Corridor Transportation Planning (Framework) to help State DOTs, MPOs, and local transportation agencies incorporate health considerations into their corridor planning processes. Anchored in traditional corridor planning technical steps that are familiar to practitioners, the Framework highlights specific activities that can inform transportation decisions at each step - making it intuitive to support healthy outcomes while improving the transportation system.
10. How can health impact assessment (HIA) be used in transportation planning and decision-making?
A. Health Impact Assessment (HIA) is a tool some have used to assess the health effects - both positive and negative - of proposed policies, plans, programs, and projects in a variety of contexts. In the transportation context, it has been used to evaluate certain programs, plans, and proposed projects. Although HIA is not required, it can inform transportation planning and decision-making when transportation officials and stakeholders agree to use it. HIA can be most effective when it is used in the transportation planning process. When a jurisdiction decides to complete an HIA during the project development process, it is most likely to influence the project if it is conducted early - during the scoping or development of purpose and need phases.
In 2009, Massachusetts enacted transportation legislation that established a Healthy Transportation Compact requiring State transportation and health officials to develop "methods to implement the use of health impact assessments to determine the effect of transportation projects on public health and vulnerable populations" and "institute a health impact assessment for use by planners, transportation administrators, public health administrators, and developers" v The State’s first transportation-related HIA completed under the compact was the McGrath Highway Corridor HIA. Several other examples of transportation-related HIAs are the Atlanta BeltLine HIA, Clark County Bicycle and Pedestrian Master Plan HIA, and South 24th Street Road Diet HIA. The Health Impact Project is a good resource for more information about HIA.
i 2008 Physical Activity Guidelines for Americans, U.S. Department of Health and Human Services, pp. 9-11 http://health.gov/paguidelines/guidelines/default.aspx.
ii 2008 Physical Activity Guidelines for Americans, U.S. Department of Health and Human Services, pp. 9, 12-14, http://health.gov/paguidelines/guidelines/default.aspx.
iii Metropolitan Area Transportation Planning for Healthy Communities, Federal Highway Administration and John A. Volpe National Transportation Systems Center, December 2012, http://www.fhwa.dot.gov/planning/health_in_transportation/resources/healthy_communities/index.cfm.
iv 40 CFR 1500-1508
v An Act Modernizing the Transportation Systems of the Commonwealth, Chapter 25, Section 33, 2009 https://malegislature.gov/Laws/SessionLaws/Acts/2009/Chapter25