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Metropolitan Area Transportation Planning for Healthy Communities

Table of Contents

• Executive Summary
  • Purpose and Background
  • Case Studies
  • Conclusion
• Chapter 1: Introduction and Overview
  • Purpose
  • A Holistic Approach to Transportation and Public Health
  • Methodology
  • Structure
• Chapter 2: Context
  • Key Actors and Roles
  • Regulatory and Programmatic Framework
  • Federal Programs, Initiatives, and Funding Sources
  • NGO Advocacy, Research, and Programs
  • Data and Tools
• Chapter 3: Case Studies
  • Methodology
  • Synthesis and Framework
  • Case Study: Nashville Area MPO.
  • Case Study: Puget Sound Region Council
  • Case Study: Sacramento Area Council of Governments
  • Case Study: San Diego Association of Governments
• Chapter 4: Conclusion
  • Main Findings
  • Next Steps and Recommendations
• Appendices
  • Appendix A: Summary Guide to Relevant Resources
  • Appendix B: Sample MPO Discussion Questions
  • Appendix C: Scan and Case Study Tables
• References

Executive Summary

Purpose and Background

The purpose of this white paper is to identify an integrated and flexible approach to how metropolitan planning organizations (MPOs) and their partners can successfully consider aspects of health during the transportation planning process. Based on research including four best practice studies, the white paper proposes a framework for MPOs and partners to use to integrate health into metropolitan area transportation planning. The report develops a comprehensive approach both to how MPOs can approach health as a direct, broadly-based goal for their interdisciplinary planning, and how they can consider health during all stages of the metropolitan area transportation planning process. The report identifies a "holistic" approach to health, including consideration of:

1. Active transportation: Transportation systems that encourage walking or bicycling can help people to increase their levels of physical activity, resulting in significant potential health benefits and disease prevention. Transportation planners can increase opportunities for active transportation by planning regional and local transportation systems that are safe, convenient, affordable, and attractive for system users.
2. Safety: The critical step for MPOs to move from traditional measures of reduced injuries and fatalities to a more holistic approach is to include safety as part of an overall goal for transportation plans and projects that lead to a "healthier community."
3. Air pollution: This paper focuses on transportation-related air pollution emissions and their impacts on human health, such as asthma or bronchitis, and transportation planning processes that consider improved air quality as part of a holistic approach to health, in addition to meeting Federal air quality requirements.
4. Access to opportunities for healthy lifestyles: Community design and transportation systems can support or inhibit residents in their pursuit of health-related activities. These activities may include access from residences and workplaces to: stores selling healthy food, medical offices, social service centers, and active recreation facilities. Access to health-related activities is especially critical for vulnerable and disadvantaged populations, such as the elderly and children, as well as designated Environmental Justice communities (specifically low-income and minority populations) with limited transportation options.

The report also includes summaries of: Federal and State regulations, policies, and funding programs that provide the foundation or context for MPOs nationwide to engage in health-related transportation planning; available technical tools; and applicable research and reports.

The four MPOs featured in the best practice studies produce visible and significant results through connecting transportation planning activities to health considerations. However, they differ in their sources of motivation, their focus on different aspects or stages of the planning process, and the steps they are taking to consider health. The research team incorporated insights from the case studies and other research to develop a four-part, flexible framework for MPOs and partners nationwide to use to successfully incorporate health within metropolitan area transportation planning processes. The framework is summarized as follows:

1. Motivation: MPOs must identify an initial source of motivation for expanding traditional approaches to transportation planning to consider health. Motivations can include: political leadership, partner initiatives, community interest, local and State government initiatives, national priorities and programs, or research and analysis.
2. Transportation planning process: MPOs can formally integrate health at any stage in the transportation planning process -- regional vision and goals, development of twenty-year metropolitan transportation plans (MTP), development of a Transportation Improvement Program (TIP), and ongoing performance monitoring and reporting.
3. Early actions are outreach and communications activities that occur within the established MPO planning process. Over time, these actions can establish the relationships and support necessary for improved understanding of health-related activities that will allow MPO leadership to engage in more structural changes that can lead to the continuity essential to convert interest and ideas into decisions.
4. Structural changes in the on-going metropolitan area transportation planning process result in concrete, measurable, and institutionalized integration of health considerations into the core stages of the planning process. Examples include incorporating health into MTP goals, establishing standing committees for health topics, using health for TIP project screening or selection criteria, and developing and applying performance measures that capture and communicate the broad impacts of transportation plans, strategies, and investments on community health.

Case Studies

The white paper assesses how four MPOs are integrating consideration of public health benefits and impacts into on-going metropolitan area transportation planning and decision-making. The MPOs are the Nashville Area MPO in Tennessee, the Puget Sound Regional Council (PSRC) in the Seattle metropolitan area, the Sacramento Area Council of Governments (SACOG), and the San Diego Association of Governments (SANDAG). The project team selected the case study areas as part of a scan of MPOs considering different aspects of public health. The scan revealed that the MPOs are engaged in: establishing active transportation as part of the regional transportation system; the application of health impact assessments, or similar assessment; analysis of options for access to food; and programs to support aging in place. The identified MPOs frequently include health-related goals in their MTPs; receive Federal grants to study health; or analyze health impacts of transportation projects.

The four best practice MPOs are leaders in: institution of health considerations in transportation plans and programs; supporting active staff roles in health activities; and participation in health-related partnerships and grants. Each of the case studies outlines the background and structure of the MPO, motivations for its transportation and health activities, and the health-related focus areas for the MPO, including how the MPO defines the relationship between transportation and health. The case studies summarize and provide links to plans, studies, and programs that have resulted from planning activities and describe the roles of partner organizations in these initiatives. Finally, each case study summarizes the MPO's evolution in integrating health within transportation, with a timeline of health-related activities, and identifies observations, challenges, and a focus on future evolution.

Conclusion

The four case studies and the broad scan of additional MPO examples demonstrate that although each MPO may have a unique experience, approach, and set of actors involved in incorporating health in their planning activities, the planning processes, strategies, and challenges are very similar. The case studies identify cross-cutting themes including:

• MPOs form partnerships with local or State organizations with health-related missions, in some cases leading to later establishment of formal roles and responsibilities such as membership in MPO committees.
• All of the case study MPOs are developing internal capacity to conduct quantitative assessment of health benefits of transportation plans and projects, and are providing training and tools to community members, including those with responsibility for land use decisions.
• The MPOs emphasize the importance of building support from their boards and the community for the incorporation of health into MPO planning and activities.
• All of the case study participants have made substantial progress through an incremental approach. This helps build interest and support within the MPO staff and Board as well as with metropolitan stakeholders for health to be added as a priority without adversely affecting pursuit of core transportation goals.

Acknowledgements

The John A. Volpe National Transportation Systems Center of the U.S. Department of Transportation, Research and Innovative Technology Administration, prepared this report for the Federal Highway Administration, Office of Planning. William M. Lyons of the Transportation Planning Division manages the best practices in transportation planning research project for the FHWA Office of Planning and managed development of this report. Other members of the Volpe Center project team for this report were Lindsey Morse and Haley Peckett, the lead analysts, Monisha Khurana, and Logan Nash of the Transportation Planning Division.

This study and others in the series are posted on the FHWA-FTA Transportation Planning Capacity Building web-site (http://www.planning.dot.gov/).

The Volpe Center team thanks Fred Bowers, the FHWA project lead, for guidance and support in developing the report; the FHWA Division Offices for coordination with the case studies; and the following Metropolitan Planning Organization and partner organization staff who graciously provided their time, knowledge, guidance, and comments in developing this report:

• Puget Sound Regional Council and Partners
  • Robin Mayhew, Program Manager, Transportation Planning, rmayhew@psrc.org
  • Dr. Anthony Chen, Director, Tacoma-Pierce County Health Department
  • Marianne Seifert, Community Liaison, Environment Health Division, Tacoma-Pierce County Health Department
  • Amy Shumann, Built Environment Planner, Environmental Health Services Division, Public Health - Seattle & King County
• Nashville Metropolitan Planning Organization
  • Leslie Meehan, Director of Healthy Communities, Meehan@nashvillempo.org
• Sacramento Area Council of Governments
  • Matt Carpenter, Director of Transportation Services, mcarpenter@sacog.org
  • Gordon Garry, Director of Research and Analysis
  • Sharon Sprowls, Sustainable Communities Project Coordinator
• San Diego Association of Governments
  • Vikrant Sood, Public Health Planning Specialist / Senior Planner, vikrant.sood@sandag.org
  • Coleen Clementson, Principal Regional Planner
  • Stephan Vance, Senior Regional Planner

Sources for images on cover (clockwise from top left): Nashville MPO, Puget Sound Regional Council, and Sacramento Area Council of Governments.