Sunday, April 28, 2013

Health Impact Assessments and their Influence on London’s Transportation Policy

Health Impact Assessments (HIAs) have been informing transportation policy in London since the early nineties, when several reports were published, establishing a direct link between health and transportation. These reports offered HIAs as a tool to mitigate the adverse health impacts and maximize the health benefits of transportation policies. HIAs have played a major role in aiding London’s recent cycling revolution and raising awareness for the need to reduce auto-dependency. They have also been used as a tool to address inequities existing in the current transportation system and public health programs that seem to ignore older population, children and depraved population.


In 1998, a committee headed by Sir Donald Acheson conducted and produced a report, “An Independent Inquiry in to Inequalities in Health”. In the section on Mobility, Transport and Pollution, the report introduces the health impacts of transportation policy in London – for example, how a bus fare increase can have a strong correlation with an increase in demand for statutory support service, especially home helps. This report is one of the early influencers of London’s proactive use of Health Impact Assessments as a valuable tool, guiding policy and decision makers in many major transportation projects.

At a World Health Organization (WHO) conference in June 1999, the UK government signed a Charter on Transportation, Environment and Health committing governments to promote health in transportation policies. Based on this, in 2000, London Health Strategy identified Transport as one of the four key priority areas, highlighting the importance of health impact considerations in transportation arising from air quality, noise, inequality, community severance, overall well being, physical activity and accidents. These relations are now used in developing HIAs all over UK.

Following this, several reports were published that established guidelines for developing HIAs. While some methods vary, the procedure largely entails identifying health impacts to be assessed (qualitative analysis), establishing how far these impacts are quantifiable and carrying out quantitative analysis of that, and lastly, recommending measures to minimize adverse effects and maximize benefits, based on qualitative and quantitative results.

One of the more prominent HIAs to be conducted in London was for the Olympics held in 2012. The HIA considered health impacts of transportation from the planning stage to the ‘legacy period’ up to 2021. The HIA was conducted in conjunction with the environment impact assessment the Transport Plan of the Olympics, using epidemiological criteria for assessment.

Based on the HIA, National and London transport policies recommended a shift towards active transportation and a reduction in motor vehicle usage in the Transport Plan, based on adverse effects of emissions from motor vehicles. However, due to the lack of empirical methods and availability of data, the HIA could not assess the extent of benefits from cycling, walking and other active transportation modes.

Health Impact Modeling for Active Transportation

More recent research in HIAs has been focused on assessing the impacts of active travel. This research, released earlier this year, suggests Health Impact Modeling tools to measure the benefits of active transportation for all age groups and recommends policy priorities to be focused on walking and cycling, while taking into account road safety. Other tools like Integrated Transport and HealthImpact Modeling Tools are being used to model scenarios to achieve policy shifts toward walking and cycling. Take a look at this website for an example this tool in action.

London recognized as early as 2003 that HIAs have a positive impact on influencing transport policy and changing the attitudes of policy makers when it comes to public health. From the Olympics to Mayor’s TransportStrategy, HIAs have played a key role in promoting active travel. Unlike the US, transport agencies no longer need to be convinced of the benefits of HIAs, however, recent research and modeling tools are helping HIA to generate more accurate results that only serve to underline their importance.


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