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Abstract
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Background
Health impact assessment (HIA) is rapidly growing approach to decision-making that identifies potential health impacts of proposed projects, policies, plans, and programs. HIAs provide valuable recommendations about how to maximize health benefits and avoid or mitigate unintended negative consequences of decisions. Proposed transportation decisions that affect walking and bicycling often do not assess the unintended injury risks. This research examines the usefulness and characteristics of HIAs that have addressed injury risk as part of proposals promoting opportunities for active transportation in U.S. communities.
Methods
HIAs were identified using the searchable Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts, online database of self-reported HIAs. The database includes all HIAs conducted in the U.S. to date that have been reported to the Health Impact Project. A key word search identified HIAs as relevant to the "built environment" or "transportation" sectors. HIAs were excluded if active transportation was not central to the purpose of the proposal.
Results
Twenty-one HIAs, conducted in both urban and rural jurisdictions, were completed between 2004 and 2013. Six of these HIAs addressed projects exploring walking and biking paths, greenways, and bicycle lanes; six addressed policies exploring complete streets, safe routes to school, and walking and biking; and nine addressed pedestrian and bicycling plans. HIAs used local and state data on to illustrate the potential injury risks, and also illustrated the effects on inequities. Evidence-based recommendations to address injury risk as part of these HIAs incorporated Crime Prevention through Environmental Design principles, traffic calming, and improving sidewalks near schools.
Conclusions
Proposed active transportation decisions are generally favorable to health in their initial design, but they do not always consider injury risk. HIAs advance the field of injury prevention and control by illuminating the unintended injury and violence risks of proposals and proposing evidence-based injury strategies. Although the HIAs that were reviewed were conducted in the U.S. the findings provide important lessons for communities around the world.
Keywords: SR2S |