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Metropolitan Area Transportation Planning for Healthy Communities


Appendix A: Summary Guide to Relevant Resources






Annotated Bibliography on Health and Physical Activity in Transportation Planning (2004)

Transportation Planning Capacity Building (TPCB) Program (FHWA and FTA Offices of Planning, USDOT Volpe Center)

Annotated bibliography that examines studies and programs that evaluate or demonstrate how health and physical activity concerns can be incorporated into transportation planning processes

Bibliography from American Journal of Public Health and the Nation's Health (2011)

American Public Health Association (APHA)

Research from the American Journal of Public Health and the Nation's Health.


Urban Health (2000)

World Health Organization (WHO)

Webpage devoted to urban health, contains case studies, background document on the link between health and urban planning, and a guide to planning.

Planning and Designing the Physically Active Community (2003-6)

American Planning Association (APA) (funded by the Robert Wood Johnson foundation)

Initiative to encourage changes to the built environment that would promote physical activity. Project resulted in a report, survey, and resource list.

Integrating Health and Physical Activity Goals Into Transportation Planning: Building the Capacity of Planners and Practitioners Proceedings of the Portland Roundtable (2004)

TPCB Program (FHWA and FTA Offices of Planning, USDOT Volpe Center)

Proceedings of a national roundtable of transportation and public health professionals that discussed opportunities and strategies to include health and activity goals within the transportation planning process.


Cities and Towns Toolkit (2012)

Let's Move! Initiative (First Lady Michelle Obama, White House)

Strategies and resources to help communities address childhood obesity. Includes the Department of Transportation as a relevant agency and specifically highlights the Safe Routes to School, Transportation Enhancement, and Recreational Trails programs.

Online Transportation Toolkit (2012)


Health, equity, and transportation resources related to public health, including fact sheets and resources specific to transportation and public health.

Fact Sheets

Public Health in Land Use Planning and Community Design (2003)

National Association of County and City Health Officials (NACCHO)

Fact sheet on Public Health in Land Use Planning and Community Design, considering traffic safety, physical activity, and air and water quality, and mental health.

Development checklist (2003)


Development checklist created in partnership with the Tri-County Health Department of Colorado; aim is to ensure long term protection of public health and can be used to identify potential health impacts and provide a screening process for improving the quality of decision-making.

Public Health Terms for Planners & Planning Terms for Public Health Professionals (2003)


Fact sheet with definition of terms in public health and planning.

Working with Elected Officials to Promote Healthy Land Use Planning and Community Design (2003)


Fact sheet to help create relationships between public health professionals and planners and develop strategies.

General Resources

Transportation Recommendations (2010)


Provides recommendations to include public health within transportation issues.

Active Living by Design Resource Guides (2012)

Active Living by Design (North Carolina Institute for Public Health/UNC Chapel Hill) (funded by the Robert Wood Johnson foundation)

Resource guides about a variety of subjects, including active living, provides a list of relevant programs, organizations, tools and presentations.

Active Living Research Resources (2012)

Active Living (University of California, San Diego) (funded by the Robert Wood Johnson foundation)

Database of research and other documents that can be sorted by transportation and other topics

APHA Resource Page (2012)


APHA developed this resource page to highlight new and useful health and transportation resources from partner organizations, whether national, State, local, private or otherwise

Designing and Building Healthy Places (2012)

Centers for Disease Control and Prevention (CDC)

Resources with recommendations to improve public health

Design for Health (2004-2012)

Collaboration between University of Minnesota, Cornell University, University of Colorado

The resource library contains event presentations, fact sheets, journal articles, and reports, organized by information types and topic area.

ChangeLab Solutions Healthy Planning Tools (2012)

Collaboration between California Department of Health Services, California Endowment, Kaiser Permanente

List of resources and tools regarding collaboration between public health and planning.

Health Impact Assessment (HIA) Resources

"Planning for Healthy Places with Health Impact Assessments" Online Course (2006)

APA (funded by CDC and in partnership with NACCHO)

Online course that explains the value of conducting an HIA and provides a how-guide to the steps involved in conducting an HIA.

Growing the Field of Health Impact Assessment in the United States: An Agenda for Research and Practice (2006)

Dannenberg et al., American Journal of Public Health

Documentation of 2004 workshop on advancing use of HIAs.

Health Economic Analysis Tool for Walking and Bicycling in the United States: Summary of prospective U.S. users' interest and recommendations. (2010)

Fenton, Mark and Brigid Junot. Active Living by Design. (funded by the Robert Wood Johnson foundation)

Study that explores the development and dissemination of HEAT tools in the United States through a short survey and interviews with potential users (professionals and advocates).

Transportation Health Impact Assessment Toolkit (2011)


Resources on HIAs, including strategies, publications, background information, tools, and case studies

HIA tools, including Health Economic Analysis Tool (HEAT) for Walking and Bicycling (2011)

World Health Organization (WHO)

Resources for HIA as well as a specific online tool to estimate the economic savings resulting from reductions in mortality as a consequence of regular bicycling and/or walking.

HIA resources (2012)

Human Impact Partners

Capacity building HIA resources, including fact sheets and case studies.

Appendix B: Sample MPO Discussion Questions

  1. How would you define "health issues" as it relates to MPO transportation planning, and what topics does it include?
  2. Please describe your activities and initiatives that link transportation planning and public health.
    1. How long have you been working on these activities?
    2. How do you incorporate these activities into your transportation planning process (vision, LRTPs, project selection, etc.)?
    3. How do you consider the health impacts across modes of transportation?
  3. What characteristics of your region or community have been particularly relevant to transportation and health planning (i.e. a growing elderly population, active Environmental Justice communities, and air quality nonattainment area)?
  4. Who are the key partners for your health and transportation activities? Do you currently work with health professionals? Please describe your relationship, shared roles and responsibilities, and benefits for each partner.
  5. How do you fund your activities? Do you share funding responsibilities with partners?
  6. How do you track the results of your transportation and health activities?
    1. Do you have specific performance measures in your LRTP that relate to health impacts?
    2. Have you used technical tools or Health Impact Assessments to measure health impacts of projects or programs?
  7. Have you received health related requests, including requests for health impact assessments? If so, from whom and how did you respond?
  8. What are they biggest accomplishments or milestones from your transportation and health activities? What are your near-term next steps?
  9. What are gaps that still exist for incorporating health into your activities? Where do you see targeting improvement for the future?
  10. What do you see as the greatest opportunities for other MPOs to engage in transportation planning for healthy communities?

Appendix C: Scan and Case Study Tables

Appendix C Table 1 Survey of Potential Case Study MPOs

MPO (Municipality)



Health Area(s)

Specific activities of interest

Sacramento Area Council of Governments


  • Planning
  • Food access
  • Active transportation

San Francisco Metropolitan Transportation Commission


  • Health impact assessment

San Diego Association of Governments


  • Planning
  • Active transportation
  • Health impact assessment

Shasta County Regional Transportation Planning Agency


  • Active transportation
  • Health impact assessment

Southern California Association of Governments


  • Planning
  • Active transportation

Denver Regional Council of Governments


  • Safety
  • Active transportation
  • Access to food
  • Aging in place

Pikes Peak Area Council of Governments (Colorado Springs)


  • Planning
  • Active Transportation
  • Access to food
  • Aging in place
  • 2012 Update to RTP includes chapter on integrating public health, drawing upon the El Paso County Public Health's Community Health Assessment

Chicago Metropolitan Agency for Planning


  • Access to food
  • GO TO 2040 mentions health for livability and quality of life
  • Health Strategy Paper (2009) in support of GO TO 2040: CMAP, Chicago Community Trust, and University of Illinois at Chicago School of Public Health
  • MetroPulse Chicago, the Regional Indicators Project, includes health indicators (obesity, walkability, food access, etc.)

Metro (Portland)


  • Health impact assessments

Nashville Area Metropolitan Planning Organization


  • Planning
  • Active transportation
  • Access to food

Puget Sound Regional Council


  • Planning
  • Active transportation
  • Access to food

Madison Area Transportation Board


  • Planning (transit-housing-jobs)
  • Health impact assessment

Appendix C Table 2 Types of Motivation/Input for Integrating Health into Transportation Planning

Source of Motivation/Input





Public health departments, non-governmental organizations (NGOs), schools, and community groups

  • Participate in an MPO initiative or committee, thereby bringing health considerations to a transportation project
  • Invite an MPO to participate in a health-related initiative, thereby initiating early thinking about linking transportation projects to health impacts

The San Diego County Health and Human Services Agency invited SANDAG to assist in scoping out, and then working on, two Federal grants to promote physical activity.


Members of the public, advocacy groups

  • Provide specific feedback to the MPO through public meetings or comments, or proactively approach the MPO to place the issue on the MPO's agenda
  • Give input to local governments and the elected officials that serve on MPO policy boards
  • Publicize issue or event in local media

SACOG's MPO membership has indicated that air quality, quality of life and rural issues are important to the region's populations.

Local government

Local, regional, and State government elected officials and agencies

  • Bring health issues directly to the MPO or introduce them more indirectly through championing initiatives or campaigns that attract MPO interest
  • Pass legislation that mandates MPOs to include programs or projects in their plans that address health

Nashville Area MPO became interested and involved in the statewide obesity initiative, which resulted in transportation-related actions such as Complete Streets policy adoption.


Federal government officials, agencies, and programs; national NGOs

  • Promote a national initiative such as the White House's Let's Move Initiative, aimed to reduce childhood obesity
  • Provide grant funding, such as the CDC Putting Prevention to Work grant or Partnership for Sustainable Communities grants to support livable communities, which can incorporate health considerations

PSRC received a HUD grant in which public health stakeholders are participating, and one of the county public health departments received a CDC grant that has helped fund PSRC to develop a bicycle and pedestrian toolkit and to integrate health into the LRTP.

Research and analysis

MPO staff, academics, local technical staff

  • Develop tools by which health-related transportation infrastructure and other investments can be tracked and measured
  • Assess and quantify connection between land use and transportation strategies and healthy behavior outcomes

SACOG has a strong data and technical mapping capacity and currently manages I-PLACE3S, a scenario planning tool. In 2009, SACOG partnered with a group at the University of British Columbia, to develop health and climate change / air pollution modules for I-PLACE3S.

Appendix C Table 3 Incorporation of Health into the Transportation Planning Process by Case Study MPOs

MPO Name

Regional Vision and Goals

Development of Transportation Plan

Development of S/TIP

Monitor System Performance

Nashville Area MPO

  • Connection with Eat Well Play More Tennessee
  • Data and research to identify long-term health needs and connections
  • Designation of 15% of funding for active transportation
  • Project selection criteria includes food access, health disparities, and physical activity
  • Systems-level performance measurement but interested in shifting to performance-based project management


  • Studies connecting health and transportation
  • Inclusion of health goals in Vision 2040
  • Inclusion of health in definition of LRTP priority measures
  • LRTP health priority measures may be applied to project selection in future
  • LRTP priority measures are being used to monitor plan and communicate with the State legislature


  • Blueprint Project to study linkages between transportation, land use, and air quality
  • Inclusion of health narrative and access measures in MTP
  • Air quality focus in Sustainable Communities Strategy
  • Project selection criteria indirectly address health
  • Requirement for bicycle / pedestrian component in STP road rehabilitation funding
  • Performance measures and metrics are being pursued and developed for assessing the MTP and funding trends


  • Draft Health and Wellness Policy Framework
  • Developing health-related indicators for the regional comprehensive plan
  • Inclusion of the connections between land use, physical activity, and AG to assist in scoping out, and then working on, a federal grant to adhealth benefits of physical activity
  • Voter-approved list of projects funded by sales tax provides limited support to smart growth and bicycle, pedestrian, and safety projects and requires bicycle/pedestrian accommodation where possible
  • Developing health-related indicators for LRTP

Darker colors signify greater progression in activity

Updated: 12/16/2014
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