This white paper, the second in a series from the Federal Highway Administration (FHWA), presents insights and a flexible framework for State Departments of Transportation (DOTs) that choose to integrate public health considerations into their transportation planning and decision-making. It draws from five case studies of DOTs and their partners, and builds on the project team's previous white paper in this series, which focused on metropolitan planning organizations (MPOs) and the metropolitan area transportation planning process: Metropolitan Area Transportation Planning for Healthy Communities ("MPO white paper"). The audience for this white paper is DOTs that are interested in considering health in their planning and related activities; this paper is also a resource for the health and transportation partners of these DOTs.
This white paper uses the five case studies to test and adapt the project team's flexible framework, developed for MPOs seeking to consider health, to the context of statewide transportation planning. Both the MPO and DOT frameworks incorporate the federally defined transportation planning process.
In analyzing and drawing conclusions from the case studies for DOTs, the project team refined two aspects of that framework in particular:
Summary Figure A: Holistic Approach to Health
1. A holistic approach to health:
DOTs successfully considering health in planning, including the case studies in this white paper, are explicit in their recognition of health as a goal and comprehensive in the health topics included. DOTs across the country are already leaders in the well-established topics of safety and air quality, but this white paper focuses in particular on two emerging topics: active transportation and access to healthy destinations (see Summary Figure A).
2. Framework for considering health in transportation planning: This white paper expands the project team's framework for considering health in metropolitan area transportation planning to better respond to DOTs and statewide planning (Summary Figure B). While statewide planning shares many similarities with its metropolitan area counterpart, DOTs are integrating health into many programs that are related to transportation planning but not part of the federally defined planning process. The framework presented in this paper identifies key decision points for considering health--including motivations, early actions, and structural changes--both within the formal planning process itself and in related State programs.
Summary Figure B: DOT Health and Transportation Planning Framework. See Chapter 3 for icon credits
This white paper describes how DOTs and their partners in five States are considering health in their transportation planning and activities. It synthesizes trends, lessons, and opportunities based on these cases and translates them into insights for peer DOTs and partners. The DOTs featured are:
The project team selected these DOTs based on a broader scan of DOTs that are considering public health in a variety of ways. The scan and case studies reveal that DOTs can approach health in a variety of ways, focusing in particular on different topics, programs, or aspects of the planning process. However, the featured DOTs stand out for their comprehensive and explicit consideration of health, consistent with the holistic approach described above. The project team held discussions with staff from these DOTs and their partners in late 2012 or early 2013. The information presented in this chapter reflects the state of activities at that time, unless otherwise noted.
This white paper summarizes key themes from the case studies and their implications for considering health in statewide planning. Building from the geographically and topically broad responsibilities of DOTs, all case study agencies are considering health in statewide planning through related programs and initiatives in addition to the federally defined planning process. These programs include Safe Routes to School (SRTS), Complete Streets, and human service transportation, among others. In addition, these DOTs are collaborating extensively both with traditional transportation partners such as MPOs, local governments, and the U.S. Department of Transportation (USDOT), but also health organizations such as State health agencies, non-governmental organizations (NGOs), and the Centers for Disease Control and Prevention (CDC).
The case studies themselves describe each DOT's definition of health, relationships with partners, health-related programs, and the evolving role of health in the transportation planning process. Each concludes with perspective on the evolution of the DOT's health activities and a timeline of key events.
The case studies and analysis highlight common characteristics of DOTs pursuing health considerations in their planning activities. These include:
The project team concluded that there are several opportunities to support the evolving approach that DOTs are using to consider health. In particular, MPOs and DOTs may benefit from adapting techniques from each other's approaches, and USDOT and its Federal partners can study the potential role of health data in a performance-based transportation planning process.