Article

Public health benefits of strategies to reduce greenhouse-gas emissions: urban land transport.

Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
The Lancet (Impact Factor: 39.21). 11/2009; 374(9705):1930-43. DOI: 10.1016/S0140-6736(09)61714-1
Source: PubMed

ABSTRACT We used Comparative Risk Assessment methods to estimate the health effects of alternative urban land transport scenarios for two settings-London, UK, and Delhi, India. For each setting, we compared a business-as-usual 2030 projection (without policies for reduction of greenhouse gases) with alternative scenarios-lower-carbon-emission motor vehicles, increased active travel, and a combination of the two. We developed separate models that linked transport scenarios with physical activity, air pollution, and risk of road traffic injury. In both cities, we noted that reduction in carbon dioxide emissions through an increase in active travel and less use of motor vehicles had larger health benefits per million population (7332 disability-adjusted life-years [DALYs] in London, and 12 516 in Delhi in 1 year) than from the increased use of lower-emission motor vehicles (160 DALYs in London, and 1696 in Delhi). However, combination of active travel and lower-emission motor vehicles would give the largest benefits (7439 DALYs in London, 12 995 in Delhi), notably from a reduction in the number of years of life lost from ischaemic heart disease (10-19% in London, 11-25% in Delhi). Although uncertainties remain, climate change mitigation in transport should benefit public health substantially. Policies to increase the acceptability, appeal, and safety of active urban travel, and discourage travel in private motor vehicles would provide larger health benefits than would policies that focus solely on lower-emission motor vehicles.

2 Bookmarks
 · 
788 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Anthropogenic climate change is likely to add significant pressure to the determinants of public health, and to current health and social protection measures in high, middle and low income countries. Adaptation strategies within the health sector are being developed to address the multi-dimensional nature of the costs and impacts. We further develop and apply a new generic conceptual framework for development-compatible climate policy planning to evaluate policy options for middle and low income countries that reduce the adverse health effects of climate change. The criteria used for comparative evaluation included economic, environment, social and institutional factors. The proposed framework, incorporating system dynamics, provides a foundation for a decision-analytical approach to support the formulation of robust climate change adaptation policies to protect human health.
    Mitigation and Adaptation Strategies for Global Change 03/2014; 19(3):309-330. DOI:10.1007/s11027-014-9544-9 · 2.02 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study examined perceived environmental and personal factors associated with walking and cycling as means of transportation for Taiwanese adults. A random-digit-dialing telephone-based cross-sectional survey was conducted with Taiwanese adults aged 20 to 64 years. Data on time spent walking and cycling for transportation and perceptions of neighborhood environment and personal characteristics were obtained from 1065 adults by using the International Physical Activity Questionnaire-long version and its environmental module. Adjusted binary logistic regression was performed. The results showed that, after adjusting potential confounders, common and different personal and perceived environmental factors were associated with walking and cycling for transportation. For common personal factors, adults who had employment were less likely to engage in 150 min of walking per week (odds ratio [OR] = 0.41; 95% confidence interval (CI): 0.27-0.62) and to use cycling as a means of transportation (OR = 0.51; 95% CI: 0.32-0.79). For common perceived environmental factors, adults who perceived good connectivity of streets were more likely to walk (OR = 1.95; 95% CI: 1.20-3.16) and cycle (OR = 2.02; 95% CI: 1.16-3.54) for transportation. Targeting employed adults and improving the connectivity of streets should be a priority for developing transport policies and intervention strategies to promote active transportation.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Population dependence on car use has adverse health consequences including road traffic injury, physical inactivity, air pollution and social severance. Widespread car dependence also entrenches lifestyles that require unsustainable levels of energy use. Most transport policies explicitly include goals for public health and sustainability. Transport interventions can therefore be seen as complex public health programmes, and assessing their outcomes against health and sustainability goals is vital. Using organisational travel plans (OTPs) as an example, we demonstrate how best practice epidemiological systematic reviews can be used to assess the existing evidence to inform transport policy. Such a synthesis of the evidence for OTPs has not been undertaken previously.Methods We undertook a rigorous systematic review in accordance with a peer reviewed protocol to assess the effects of OTPs on individual and population health. We defined OTPs as travel behaviour change programmes conducted in a workplace or education setting. We included published and unpublished randomised controlled trials and controlled before and after studies, where the measured outcomes included change in travel mode or health.Results17 studies were included. One study directly measured health outcomes, and all studies measured change in travel mode. The overall methodological validity of studies was poor. The highest quality studies reported mixed effects on travel mode in the school setting. An isolated randomised controlled trial in a workplace suggests that reductions in car use are possible by people already contemplating or preparing for change to active travel.Conclusions Despite widespread implementation, there is insufficient evidence to determine the effectiveness of organisational travel plans for improving health or changing travel mode. Given the current lack of evidence, new OTP programmes should be implemented in the context of robustly-designed research studies, accounting for potential adverse effects such as child pedestrian injury. Cochrane systematic review methods used in partnerships between public health and transport planners can help achieve transport policy goals.
    Transport Policy 09/2013; 29:249-256. DOI:10.1016/j.tranpol.2012.06.019 · 1.72 Impact Factor

Full-text (2 Sources)

Download
2,345 Downloads
Available from
May 31, 2014