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Baseline Health Assessment for HIA Associated with Transportation Planning

Baseline health and environmental conditions are described in the Assessment step of an HIA. The following section provides examples of different health outcomes explored in transportation and land use HIAs.

Transportation and Land Use

Our nation faces some critical and often preventable health problems, including a decline in physical activity and associated rise in obesity and chronic illnesses (e.g., diabetes and heart disease); increased rates of respiratory illnesses and asthma in adults and children; reduced access to goods and services that exacerbate health inequities; increased stress and related mental health issues; and physical injuries and fatalities.

Properly designed transportation systems can promote healthy, sustainable, safe, accessible and affordable modes of travel. The CDC has identified a number of key transportation policies that can have positive impacts on heath, including:

  • Promoting safe and convenient opportunities for physical activity. Physical activity has the power to reduce obesity and improve cardiovascular, respiratory, and mental health.
  • Reducing exposure to air pollution, especially fine particles and ozone. Major transportation corridors often create high pollution levels.
  • Reducing exposure to noise.
  • Improving accessibility to services. Easy access to places of employment, groceries and medical services is a hallmark of a healthy community.
  • Encouraging healthy community design.

Table 1: Examples of Health Effects That Have Been Addressed in Transportation-related HIAs

Influence on Health Health Consideration Recommendations
Influence on Health Air pollution Health Consideration Asthma, cardiovascular disease, all-cause mortality, certain cancers Recommendations Reduce congestion, limit speed, increase public transportation; Building modifications: intake filtration, relocating intakes away from road sources
Influence on Health Physical activity - sidewalks, active transportation options, mixed use Health Consideration Obesity, diabetes, cardiovascular disease, mortality Recommendations Active transportation options, such as walkable design, bike lanes, light rail and bus
Influence on Health Mobility for disabled, elderly, and other vulnerable populations (public transit, pedestrian amenities) Health Consideration Access to good/services that support health, such as groceries, clinics Recommendations Increasing level of service for public transportation/decreasing fares; Pedestrian amenities
Influence on Health Traffic Safety Health Consideration Injury Recommendations Alternative transportation; Wider sidewalks, separated bike lanes, traffic calming measures
Influence on Health Safety - neighborhood cohesion/social capital, lighting Health Consideration Violent injury Recommendations Better lighting, Safe pedestrian corridors; Mixed use, promoting walking to stores
Influence on Health Noise Health Consideration High blood pressure, annoyance, and developmental/cognitive problems Recommendations Noise-buffered courtyards for new buildings near roadway; sound walls
Influence on Health Access to services - grocery stores, clinics, pharmacies, etc. Health Consideration Obesity linked to "food deserts"; many other health issues can be affected, depending on specific services Recommendations Zoning, code-based changes to encourage optimal mix
Influence on Health Economic and employment effects: property values and displacement; revenues to support services Health Consideration Multiple Recommendations Affordable housing requirements; Local hire provisions; Allocation of revenue to public health services
From: Human Impact Partners
Table 2: Ways Transit-Oriented Development (TOD) Can Affect Health
12 Ways transit-oriented development can affect health. click the link to view on website. From: Healthy Neighborhood Equity Fund HIA

Land use decisions can be a critical part of transportation studies and can help promote community health and wellness throughout the planning process. “Land use” refers to a broad set of community design and built environment topics, including zoning, access to parks, walkability, and transportation.

Land use design affects how people live. For example, communities that are designed to encourage physical activity, such as walking and biking, help promote healthy behaviors. These healthy behaviors reduce obesity and chronic diseases like diabetes and heart disease. Similarly, communities that are designed to reduce exposures to harmful pollutants or reduce displacement due to housing affordability improve health across a wide range of outcomes. The Healthy Neighborhood Equity Fund HIA provides an example of the breadth of issues related to one broad category of land-use decisions, specifically mixed-use development. Table 2 illustrates the many ways that transit-oriented development (TOD) can affect health.

Pathway Diagrams and Tracking Data

Pathway diagrams are an important component of HIAs because they illustrate potential connections between planning decisions and health outcomes. The pathway diagram below illustrates links between determinants of health with some health and environmental data on the portal. Visit the health and environmental pages for a complete list of health and environmental data currently available on this portal.

Diagram showing the pathways for possibly HIA's and the related health outcomes
Diagram that shows the pathways for possibly HIA's and the related health outcomes.

For transportation and land use HIAs, this website has data available for:

  • Asthma hospitalization and emergency department visits
  • Heart attack hospitalizations
  • Heat stress hospitalizations and emergency department visits
  • Pediatric asthma (Grades K-8)
  • Childhood blood lead levels
  • Outdoor air pollution for ozone and fine particulate matter
  • Cancer
  • Reproductive outcomes
  • Birth defects