Regional Land Transport Strategy________________

Health Impact Assessment

3 August 2009

Outline

• Public health and impacts of transport on health/wellbeing

• Health impact assessment

• NZ Research: health impact assessment and land transport planning

• Application of health impact assessment to Waikato RLTS

Public health as a shared responsibility

• The planning and funding decisions of all organisations whose activities are subject to the LTMA are obliged to ensure they:

“contribute to each of the following:-assisting economic development-assisting safety and personal security-improving access and mobility-protecting and promoting public health-ensuring environmental sustainability”

(LTMA 2008)

What is public health?

• Social model of health – includes overall wellbeing

• Enhance wellbeing of whole population, minimise sickness and prevent people becoming unwell in the first place

• Wellbeing not absence of disease.

“The science and art of preventing disease, prolonging life and promoting health through the organised efforts of society”

Determinants of health and wellbeing

Barton and Grant after Dahlgren and Whitehead, WHO Healthy Cities Collaborating Centre, 2006

Impacts of transport on health

• Transport planning and funding decisions have major impacts on the wellbeing of current and future generations – both positive and negative

• Substantive evidence base for transport’s influence on health has developed in past 20 years

Examples impacts of transport

Impact on health inequalities

• Those who are socio-economically well off tend to enjoy better health and live longer than those who are worse off

• Potential of transport decisions to narrow or widen health and social inequalities

• Transport contributes to health inequalities when the negative impacts of transport fall disproportionately on low socioeconomic groups and/or when transport’s benefits accrue primarily to those at socio-economic advantage

Transport's responsibility to consider health

• Social and environmental consequences of NZ’s transport development

• Public health, wellbeing and sustainability

• Increasingly on transport’s agenda both in NZ and internationally

• Land Transport Management Act, amended 2008 -five objectives

Health impact assessment –the concept

A combination of tools and approaches

that systematically judges (+ve and -ve)

potential, and sometime unintended effects

of a policy or project on the health and wellbeing

of a population and the distribution of those

effects within the population. Identifies appropriate actions to manage those effects.

(Public Health Advisory Committee, 2005)

What is health impact assessment?

• Systematic exploration of potential health effects (both +ve and –ve) of a policy, plan, programme or project and distribution of those within a population

• ‘Early warning system’ of unintended consequences –focus is on health as opposed to other effects

• Identifies ways of managing those impacts

• Key output a set of evidence-based recommendations

Why do a health impact assessment?

• Use of local and published evidence

• Consideration of broad scope of

determinants of health

–social and economic environment

–physical environment

–individual characteristics and behaviours

• Has been widely used overseas in transport planning and is increasingly being used in NZ

Use of health impact assessment in NZ

• Avondale Liveable Communities Plan

• Greater Christchurch Urban Development Strategy

• Greater Wellington Regional Land Transport Strategy

• Auckland Regional Land Transport Strategy

• Central Plains Water Irrigation Scheme (Canterbury)

• Research on HIA in transport decision-making

NZ research background

• Funded by NZTA and Ministry of Health

• Conducted by Quigley and Watts Ltd and Martin Ward in 2008, available at http://www.landtransport.govt.nz/research/reports/375.pdf

• Peer reviewed by Ministry of Transport and Auckland University

• Drew on international and NZ learning to produce recommendations on the best application of HIA in NZ land transport planning

NZ research findings

• This research highlighted international evidence of HIA’s effectiveness in transport planning

• Further application of transport HIA in NZ is needed to be able to draw firm conclusions for our local context

• Application of HIA at an early stage in transport planning is recommended

• Good potential for transport and public health sectors to work together toward improving both accessibility and quality of life - and for HIA activities to assist this process

Application of HIA to Waikato RLTS

• Early stage of RLTS development means that health and wellbeing issues can be considered at an early stage, not ‘added on’

• Consider strategic options for health and wellbeing impacts -Relatively few constraints on potential focus

• Potential health and wellbeing impacts will cut across outcome areas (e.g. economic development)

• Outcome: Identification of key areas where positive health outcomes can be optimised and negative health outcomes minimised

Strategic options: potential key focus areas

• Safety: opportunities to ensure optimal safety for all users of the different modes of transport.

• Access: opportunities to increase access and mobility, particularly for disadvantaged groups, to be able reach services, amenities and facilities that support healthy living.

• Active modes: opportunities for embedding active modes of transport across the region (physical activity as an intervention to help to reduce obesity rates).

• Harmful emissions: opportunities to reduce air and noise pollution and to enhance the positive health impacts of improving environmental sustainability in this area.