Equity, Opportunity and Good Health: How Transportation affects the Essential Qualities of Life in Metro Vancouver SFU City Program Public Lecture 30

Transcription

1 Equity, Opportunity and Good Health: How Transportation affects the Essential Qualities of Life in Metro Vancouver SFU City Program Public Lecture 30 th April 2015 Jat Sandhu MPH MSc PhD Principal Investigator, My Health My Community Regional Director, Public Health Surveillance Unit, Vancouver Coastal Health Clinical Associate Professor, School of Population and Public Health, UBC

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7 Transportation and Health 1. Physical activity 2. Air quality 3. Mental health 4. Injuries 5. Equity American Public Health Association

8 Los Angeles to Culver City Exposition Light Rail Before and After Study of Households in 2013 Compared those living near (< ½ mile) the Expo Line stations to those living farther away (> ½ mile) Before opening - no differences between experimental and control households in travel patterns After opening found: reduced their daily vehicle travel by miles reduced CO 2 emissions by 30% experienced an 8-10 minute increase daily in physical activity after station opening (for those least physically active) Social and economic impact anticipated

9 Physical Activity Maintains healthy weight Reduces risk of chronic diseases 40% reduction in dying prematurely.. yet few Canadians meet recommended guidelines

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11 Physical Inactivity Lawrence Frank et al, Am J Prev Med 2004

12 Active Transportation Walking/biking: 70 more minutes physical activity per week Saelins AJPH 2003 Transit 8 more minutes physical activity per day Lachapelle JPAH 2011

13 Source: Saskatoon Health Region CommunityView Collaboration

14 Equity Public transit enables all residents to access the determinants of health, maximize health related opportunities, and fully participate in urban life. Access: Employment, educational, health services, social and recreational opportunities, healthy food Vulnerable populations: Low income families, new immigrants, children and youth, seniors

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16 Source: Canadian Medical Association - healthcaretransformation.ca

17 1. Socio-demographic 2. Health status 3. Lifestyle 4. Health care access 5. Built environment 6. Community belonging SURVEY Questions

18 Data collection Online survey 18 years + Media and social media promotions Community partnerships Outreach Incentives

19 Ensuring a representative sample 2% population target overall Purposeful sampling Monitoring of progress Outreach Post-collection weighting Age, gender, education and geography (municipality)

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28 Sense of community belonging decreases with increasing commute time

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31 Transit use decreases with increasing household income

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35 Car as primary mode of transport (%) 90.0 Relationship between primary mode of transportation and obesity (BMI >30.0). My Health My Community Survey, Metro Vancouver, Obesity 80.0 Langley Township South Surrey/White Rock Better than MV Same as MV 70.0 Port Moody Maple Ridge Delta Pitt Meadows Port Coquitlam Bowen Island West Vancouver/Lions Bay Coquitlam Langley City North Vancouver DM Surrey Richmond Worse than MV 60.0 Metro Vancouver 50.0 North Vancouver CY Burnaby New Westminster 40.0 R 2 = 0.99, p<0.001 R = Vancouver *Includes walk, cycle and public transit. Source: My Health My Community Survey, Prepared by: Vancouver Coastal Health, Public Health Surveillance Unit, April Active transporation* as primary mode of transport (%)

36 WalkScore data from Redfin Real Estate (redfin.com)

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38 Walk Score and Obesity in Metro Vancouver Compared to car dependent area MHMC residents Walker s paradise residents had 31% lower odds of being obese/overweight Very walkable area residents had 11% lower odds of being obese/overweight - controlling for sociodemographics, health status, lifestyle behaviours and built environment factors

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40 Summary Clear dividends in health for active transportation users, however current transit infrastructure does not equally benefit all communities in Metro Vancouver Access to transportation widens opportunity and is a social justice issue (promote equal opportunity in society) Access to education and employment opportunities impacts economic opportunities Proposed investments can support creating a more equitable environment These investments have the potential to be the biggest investment for population health improvement in our generation

41 2010 Olympic Games Greatest Public Health Legacy Opened Aug Cost: $2 billion 130,000 passengers per day Metro Vancouver 4 th in per capita ridership behind only New York, Montreal and Toronto (APTA 2012)

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43 Project Team (since 2013) Andi Cuddington*, VCH Belinda Boyd, VCH Chae-Lyn Dopke, VCH/UBC Chris Richardson, UBC Christina Fung, FHA Claire Gram, VCH Eleni Kefalas, VCH Elizabeth Stacy, UBC Emily Laflamme*, VCH Evelyn Derus*, UBC Geoff Ramler, FHA Helen Novak Lauscher (CI), UBC Helena Swinkels, FHA James Lu*, VCH Jami Brown, FHA Justyna Berzowska*, UBC Katherine Tweedie, FHA Kendall Ho (CI), UBC Lisa Mu, FHA Lisa Thibault, FHA Maritia Gully*, VCH Michael Lim*, UBC Peter Chow, UBC Paul Gustafson, UBC Paul Martiquet, VCH Peter Vlahos, VCH Rahul Chokar, FHA Salman Klar, FHA Sha Xiao, UBC Stephanie Bale, FHA Sophie Pasche, UBC Tanya Lo, VCH Tiffany Akins*, VCH Victoria Lee (CI), FHA Yumian Hu, VCH CI - Co-Investigator * - Working Group Lead