Additional Information on Public Health Objective

There was discussion at the August 21^st MPO meeting about adding a public health objective specifically regarding regional obesity rates. The MPO did not take action on the issue at that meeting; however MAPC has since raised the issue again and has suggested adding an objective on chronic disease rates for tracking over the long-term without setting a specific target. They feel that public health should be included as a tracked objective, particularly given the Healthy Transportation Compact.

In addition, Federal Highway Administration released a report “Metropolitan Area Transportation Planning for Healthy Communities,” which evaluates how several MPOs and their partners are collaborating to bring broad consideration of public health into their planning. The report identifies a “holistic” approach to health, including consideration of:

1.B Active transportation: B Transportation systems that encourage walking or bicycling can help people to increase their levels of physical activity, resulting in significant potential health benefits and disease prevention. Transportation planners can increase opportunities for active transportation by planning regional and local transportation systems that are safe, convenient, affordable, and attractive for system users.

2.B Safety: B The critical step for MPOs to move from traditional measures of reduced injuries and fatalities to a more holistic approach is to include safety as part of an overall goal for transportation plans and projects that lead to a “healthier community.”

3.B Air pollution: B This paper focuses on transportation-related air pollution emissions and their impacts on human health, such as asthma or bronchitis, and transportation planning processes that consider improved air quality as part of a holistic approach to health, in addition to meeting Federal air quality requirements.

4.B Access to opportunities for healthy lifestyles: B Community design and transportation systems can support or inhibit residents in their pursuit of health-related activities. These activities may include access from residences and workplaces to: stores selling healthy food, medical offices, social service centers, and active recreation facilities. Access to health-related activities is especially critical for vulnerable and disadvantaged populations, such as the elderly and children, as well as designated Environmental Justice communities (specifically low-income and minority populations) with limited transportation options.

The Boston Region MPO actively promotes active transportation by prioritizing projects that provide bicycle and pedestrian facilities, improves safety by addressing high crash locations, and reduces air pollution through investments that encourage mode shift and reduce automobile delay. The MPO does not yet capture how projects provide access to opportunities for healthy lifestyles, including access to healthy food, medical services, social services, and recreational areas, but the FHWA report references two MPOs that have worked to incorporate these factors in decision-making process. Their results are listed below.B B B B

• Sacramento Area Council of Governments b SACOG was not able to specify measures for physical activity or obesity because of data and modeling limitations, but the plan adds several new measures to Environmental Justice area impacts, including transit access to parks, cited as important for physical activity, health, and recreation.
• Nashville Area MPO in Tennessee b Due to limited availability of health data at a fine scale, the MPO uses census data with high concentrations of low-income, minority, and elderly populations as a proxy measure for the locations of populations with higher rates of chronic disease and health disparities. The MPO favorably evaluates projects that improve physical activity, such as through including nonmotorized options or access in these “high health impact areas.”

These case studies indicate that there are limitations in the availability and scale of health data. However, MAPC has indicated that data sets from Massachusetts and federal public health agencies are more robust now than they have been in the past, which has improved the ability to monitor and track improvements in chronic disease rates in the region. MAPC suggested the following tracked objective, performance measure, and data source for reconsideration under the Transportation Options/Healthy Modes Goal.

• Objective: Rates of chronic disease will decrease over time
• Performance measure: The percentage decrease in chronic disease rates
• Data Source: Department of Public Health and the Center for Disease Control