Eric,
Your comments (pasted in below) to the TRB health and transportation
subcommittee are really interesting and useful.
David Ragland, here at SafeTREC, has done some preliminary work on
non-emergency health transportation systems, which he presented at a
separate workshop around the time of TRB. (He is cc'ed and might have
something to add, as I am not familiar with the specifics of his findings.)
In terms of health care facilities' "friendliness" to active transportation
access, as someone who thinks about bicycle-oriented design and has done 2
papers for TRB on the subject in the last two years, I am struck by the
lack of access--and not just for patients and visitors, but for employees.
Even our Oakland Kaiser campus, which has a longstanding shuttle service
connecting its buildings to BART, falls pretty short in this area. There is
bike parking in the garage, but it's for employees only and in a dark and
sort of scary place, with no signage or wayfinding. The patient parking
area, when I finally found it, is pretty enough, but very small. And this
from a company whose leadership enthusiastically embraces the 10,000 steps
program.
Part of the difficulty is that building owners and operators don't have a
"cookbook" for these designs and, unless they are bicycle riders
themselves, have problems understanding some of the unique needs and
opportunities. (Imagine a changing room, showers and safe and secure bike
parking for staff to avail themselves of lunchbreak bike rides.)
I'm attaching a paper I did with Karen Frick of the University of
California Transportation Center on 4 Berkeley building owners and their
decisions to invest in this "infrastructure that extends beyond the door."
A policy brief is also attached for quicker reading.
As part of my work developing the CATSIP website on active transportation
safety in California, I also am in contact with bike and ped planners
across the state. Some notable activity is taking place in SF and Silicon
Valley, the latter, I am hearing anecdotally, a hotbed of innovative ways
to incorporate bicycle riding and walking into their campuses (Google,
Facebook and Apple, to name a few). I can't help but think it would be of
value to collect their design solutions, along with costs, challenges and
opportunities, into a central toolkit.
Anyway, sorry for the long comments, but it seems like a potentially small
shift in design thinking that could alter the fabric of the built
environment to raise awareness of and participation in active
transportation modes (though we would have to evaluate the response to be
certain).
Best,
Phyllis
--
Communications Director
Safe Transportation Research and Education
Center<http://www.safetrec.berkeley.edu/>
(SafeTREC)
University of California Transportation Center <http://www.uctc.net/> (UCTC)
Institute for Urban and Regional Development <http://www.iurd.berkeley.edu/>
(IURD)
California Active Transportation Safety Information
Pages<http://catsip.berkeley.edu/>
(CATSIP)
2614 Dwight Way
UC Berkeley
Berkeley CA 94720-7374
510-643-1779
@transsafe <https://twitter.com/#!/transsafe>
@californiaUTC <https://twitter.com/#!/CaliforniaUTC>
@IURDBerkeley <https://twitter.com/#!/IURDBerkeley>
@trbhealth <https://twitter.com/#!/trbhealth>
>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
From: <erik.weber(a)dot.gov>
Subject: Re: [H+T--Friends] Help inform our Subcommittee's TRB 2013
Workshop Proposal!
In preparing a DOT presentation on Transportation and Health at a panel
about social determinants of health and health disparities at NIH for
Nation Minority Health Month, I sketched an outline that I think could be
informative to planning next year:
Transportation's impact on health
* Transportation availability & access to care
* Transportation options & livable communities
* Transportation planning & environmental justice
As I mentioned back at the annual meeting, there is nowhere near enough
research being done on bullet #1, while nos 2&3 get covered by a lot of
disciplines. This subcommittee can help fill that gap. There is a need to
look not only at "transportation decisions" which imply planning of
projects & future impacts, but transportation use and availability and
their impact on individual health outcomes. Arguably, transportation has a
much larger impact on health when considered in the immediate term and on
an individual scale.
To use two specific examples: certainly planning decisions can have large
future aggregate impacts on air quality and respiratory health as a result
- but how many people in the past year have ended up in emergency care, or,
sadly, died because they were unable to get to a preventive appointment
like dialysis or other chronic disease treatment? That's a much more
immediate and measurable impact, yet no one can really say for sure.
That's where, in my opinion, this committee has the biggest opportunity to
contribute.
I think TCRP made a good foray into this area with B-27 "Cost Benefit
Analysis of Providing Non-Emergency Medical Transportation,"<
http://www.trb.org/Main/Public/Blurbs/156625.aspx> but this was really only
a beginning, and happened 7 years ago now.
I would argue that the Public Health sector is pretty strongly engaged in
the transportation discussion and it's time now to engage more people in
the Health Care & Services sectors. In the long term, I think, that
engagement will have benefits for all of the other questions the
subcommittee considers. As hospitals, insurance companies, and other care
providers better understand the direct impact of transportation on their
missions and their bottom lines, the more they will support transportation
options and better transportation planning. I mean how many hospitals are
built today to enable, much less encourage, walking to and from? I sure
haven't seen one recently. To what extent to providers consider
transportation access (beyond driving & parking garages) when placing and
planning new facilities? These are all very important issues which are not
being researched.