HEALTHY TRANSPORT HOBART

The following justification is provided from my own personal research to support this project.

TASMANIA’S HEALTH PROBLEM

“79% of Tasmanians have at least one chronic medical condition. Chronic diseases are responsible for two thirds of all health system expenditure.”

“34.1% of 18+ Tasmanians are classified as sedentary, 31.8 % 18+ Tasmanians Overweight, 17.1% 18+ Tasmanians are obese”

INTERNATIONAL OPINION

“WHO: Preventing Chronic Disease = A Vital Investment” (DHHS, 2008:20)

“US Healthy People 2010- No. 1 Health Indicator = Physical Activity (DHHS, 2008:21)

AUSTRALIAN OPINION

“No. 1 key action area for the National Chronic Disease Strategy is ‘prevention across the continuum’” (DHHS, 2008:11)

“Australian Better Health Initiative priority areas are: ‘promoting healthy lifestyles’ and ‘supporting lifestyle risk modification’ (DHHS, 2008:1,2)

TASMANIAN STRATEGIC SOLUTION

“Significant and sustainable health sector change is required to meet the chronic disease challenge, as well as leadership in advocating, engaging and partnering with other sectors to influence the social and environmental factors that determine the burden of chronic disease” (DHHS, 2008:11).

“Tasmania’s Health Plan:

• A focus on health and wellbeing, not just illness

• A population perspective on health – not only individuals

• A partnership approach in which a range of groups and organisations need to work together on improving health

• Fostering individuals control over their health and participating in health decision making.

PHYSICAL INACTIVITY IS THE KEY RISK FACTOR FOR CHRONIC DISEASE

“Lower levels of physical activity result in increased risk of developing the following:

• Overall Mortality

• Coronary Heart Disease (40% Reduction)

• Stroke and Cerebro-Vascular events

• Hypertension

• Increased cholesterol and lipid levels

• Colon and Breast Cancer

• Type 2 Diabetes

• Osteoporosis

• Osteoarthritis

• Falling

• Obesity

• Mental Health

• Health Related Quality of Life (WHO, 2006: 5; CPF, 2008: 2; US DHHS, 1996:8)

“Activity and exercise have many psychosocial benefits including:

• Reducing Anxiety

• Counteracting withdrawl, inactivity and feelings of hopelessness

• Positively affecting moods

• Improving self perceptions about physical abilities and body image” (Healthy Spaces and Places, 2008:20)

“Physical Activity is a critical public health issue because adequate physical activity is important for many aspects of health and few people participate in regular health enhancing physical activity” (WHO, 2006: 5).

COSTS OF PHYSICAL INACTIVITY

“Physical inactivity is estimated to cost the Australian community around $10 Billion annually in direct health care costs while obesity costs as high as $5 billion” (Healthy Spaces & Places, 2008: 2).

RECOMMENDATIONS

• Increase population physical activity levels as preventative measure

“Physical activity is a fundamental means of improving physical and mental health” (WHO, 2006: VIII)

“Participation in regular, moderate physical activity can reduce functional decline as well as delay the onset of chronic diseases among both healthy and chronically ill older people” (Davis et al, 2002: 11).

“Children (5-12 year olds) need at least 60 minutes (an up to several hours) of moderate to vigorous physical activity each day” (National Physical Activit Guidelines for Children, 2004).

“Young People (12-18 year olds) need to be doing at least 60 minutes of moderate to vigorous physical activity every day” (National Physical Activity Guidelines for Young People, 2004).

“Adults need at least 30 minutes of moderate physical activity, on most, preferably all, days”  (National Physical Activity Guidelines for Adults,  1999).

“Efforts to increase physical activity can almost be seen as ideal public health measures because:

• They influence several of the common problems

• There is evidence of effectiveness and little evidence of potential harm

• They are accessible and affordable by the majority of the population

• The overall benefit is so great that is justifies investment” (WHO, 2006: 24).

WHAT IS TO BE DONE

• Increase population physical activity through transport interventions

“National Audit Office Study in the UK, 2001, identified transport as a key area in which further action needs to be taken to encourage and assist people in being physically in their daily routines” (Davis et al, 2002:8).

“The transport system can strongly influence opportunities to be physically active, both by facilitating walking and cycling and by enabling people to get to places to be active” (WHO, 2006: 20).

“Walking and Cycling for daily transport has greater potential than leisure activities for getting people physically active” (Davis et al, 2002:4).

“Several articles and editorials in the leading medical and public health journals have explicitly advocated more walking and cycling for daily travel as the most affordable, feasible and dependable way for people to get the additional exercise they need” (Pucher & Dijkstra, 2003: 1509).

THE ANSWER IS…..

• Walking and Cycling for Transport

“Walking is the dominant form of transport for journey’s under 1.6km. It is a rhythmic, dynamic, aerobic activity of large skeletal muscles that confers the multifarious benefits with minimal adverse effects. Walking is the nearest activity to the perfect exercise” (Davis et al, 2002: 8)

“The benefits of cycling are somewhat greater than walking because the intensity of effort is greater. Cycling users the large skeletal muscles of the body in a rhythmic pattern, with periods of active work alternating with rest periods. In addition, longer periods of rest occur in normal urban cycling, determined by such factors as traffic lights and other road users. The rest periods allow recovery from high levels of activity when in motion” (Davis et al, 2002: 9).

“Getting children out of cars, and using active transport instead, is believed to be the single most effective way to improve physical activity rates and reduce obesity in children” (CPF, 2007:1).

BARRIERS TO WALKING AND CYCLING FOR TRANSPORT

• Safety

• Environmental Barriers

“There are two problems with proposals to increase walking and cycling: Their current danger and their inconvenience” (Pucher & Dijkstra, 2003: 1509).

“No. 2 Barrier to physical activity has been identified as: environmental barriers, which are real world conditions that place restrictions on physical activity, such as a lack of bike lanes on roads, lack of road crossings for high traffic areas and poor footpath design” (Healthy Spaces and Places, 2008:22).

“Safety concerns, often arising from speed and volume of traffic and not having designated space for riding, and aggressive driving are the main deterrents (Rissel et al, 2006:53).

“Increased access to cars and deterioration in the conditions for physically active transport are the two reasons associated with more sedentary and inactive lifestyles” (WHO, 2006: 10).

HOW TO COMBAT THE BARRIERS TO WALKING AND CYCLING FOR TRANSPORT

• Improve Safety

• Traffic calming

• Provide infrastructure

“Behaviour Change approaches for physical activity rarely, explicitly include the role of the physical environment” (Healthy Spaces and Places, 2008:8).

“The improvement of safety for cyclists and pedestrians is one of the important means that is likely to encourage more people to become physically active in their daily life” (WHO, 2006: 4).

“Over the past decade, it has become clearer that environmental interventions may be the key to promoting physical activity. Improving local environments so that they are perceived as being attractive and safe and can meet everyday travel needs is important” (Davis et al, 2002: 8).

“A second condition for walking and cycling is widespread use of 30km/hr speed limits, slow speed limits (20km/hr) and pedestrianisation (Which gives priority to pedestrians in planning)” (Davis et al, 2002:15).

“Policies that increase walking and bicycling appear to be an effective route to improving the safety of people walking and bicycling” (Jacobsen, 2003: 209).

“A comprehensive review of traffic calming impacts in Denmark, Great Britain and Germany found that traffic injuries fell by an average of 53%” (Pucher & Dijkstra, 2003: 1509).

WHO AND WHAT SHOULD WE TARGET?

• Non Cyclists (most of the population 99%)

• Urban areas

• Health Development

• Collaboration between different sectors

Micro level

“Overwhelming trend is that well designed and connected bicycle infrastructure encourages participation, and a lack of it is a major barrier for non cyclists, infrequent cyclists and even regular riders” (CPF, 2008:4).

“Justification of targeting urban areas for physical activity change: by 2021 64.5% of Australians will be living within a capital city” (Healthy Spaces and Places, 2008:11).

“The strongest growth in cycling has occurred in the area with the highest level of bicycle infrastructure and investment. Melbourne has seen a 48% increase in trips to work by bicycle between 2001 and 2006 which coincides with a significant increase in bicycle investment” (HEAT, 2008: 1).

Macro level

“Society is responsible for creating conditions that facilitate active living” (WHO, 2006:1)

“Health development means making health a central consideration of economic development strategies, or acting to minimise the negative and maximise the positive health effects of business activities across the city”

“Copenhagen (cycling share of city transport = approx 40%, pioneered one of the first city health plans between 1993 and 1997 (City Health Development Planning, 2001:4)

“A Healthy City is one that is continually creating and improving opportunities in the built environments and expanding community resources to enable all its citizens to be physically active in day to day life” (A healthy city is an active city, 2008: 3).

“Cities that invest in physical activity policies and programs (including active transport) can:

• Save money on health care

• Have more productive citizens and workers

• Be more liveable and attractive to residents, employers and visitors

• Have less air and noise pollution and better access to green spaces

• Enhance neighbourhood revitalisation, social cohesion and community identity

• Expand social networks (A Healthy City is an Active City, 2008:4).

“Collaboration between different sectors is essential to achieve positive change in transport patterns” (WHO, 2006:5).

“Ottawa Charter states: ‘health promotion goes beyond health care. It puts health on the agenda of policy makers in all sectors and at all levels, directing them to be aware of the health consequences of their decisions and to accept their responsibilities for health” (Davis et al, 2002: 17).

WHAT SHOULD THE FOCUS BE?

• Move beyond traditional health promotion

• Creating Supportive Environments for Walking and Cycling

• Health sector should play a role in improving urban environments

“Action must be stronger and go beyond the traditional approaches of health promotion, such as personal counselling, mass marketing or advice in primary care. At best, these can only address the needs of a small minority of the population” (WHO, 2006:2).

“The key to achieving high levels of cycling appear to be the provision of separate cycling facilities along heavily travelled roads and at intersections, combined with traffic calming of most residential neighbourhoods. Extensive cycling rights of way complemented by ample bike parking, full integration with public transport, comprehensive traffic education and training of both cyclists and motorists and a wide range of promotional events intended to generate enthusiasm and public support for cycling. It is the co-ordinated implementation of this multifaceted, mutually reinforcing set of principles that best explains the success of Germany, the Netherlands and Denmark in promoting cycling” (Pucher & Buehler, 2008: 495).

“On road facilities may not be sufficient to provide a foundation for behaviour change” (Rose, 2003:29).

“recreational riding can serve as an entry pathway to utilitarian (transport) cycling” (Rose, 2003:29).

“The quality of our environment has a direct influence upon levels of physical activity. The opportunity to explore safe, attractive and interesting parks and streetscapes can be a significant motivator for recreational walking and cycling. Equally, good urban design that takes into account the needs of cyclists and pedestrians, offering safety and convenience, helps tip the balance in favour of active travel for shorter distances” (Be Active, Be Healthy, 2009:15).

“The health sector should base action to improve physical activity levels on a number of key principles. No. 3 being ‘engaging multiple sectors’ and No. 4 being ‘improving the environment for physical activity’” (WHO, 2006: 15).

INTERNATIONAL SUPPORT FOR SUPPORTIVE ENVIRONMENTS

“a 1998 major review of community interventions in social marketing suggested that the next generation of interventions should aim to enhance quality of life and quality of environment” (McMurray, 2007:69)

“WHO’s ‘healthy settings’ approach acknowledged the importance of peoples environments in framing health promotion in terms of peoples daily lives, their schools, hospitals and workplaces. Part of the ‘Settings Approach’ encapsulated in the Jakarta Declaration” (McMurray, 2007:71).

“The second of the five required actions from the Bankok Charter for Health Promotion was to: Invest in sustainable policies, actions and infrastructure to address the determinants of health” (McMurray, 2007:400)

CURRENT SITUATION IN HOBART

• Local Cycling Conditions

• Cycling safety record (police statistics)

“Although the greater Hobart Region has a high quality and popular cycling facility in the form of the intercity cycleway, generally the region is poorly serviced with bicycle facilities. Major activity centres such as the Hobart CBD, large shopping areas in Kingston, Rosny Park, Brighton and Bridgewater are not easily accessible by bicycle. Access to educational facilities are often poorly provided with bicycle facilities” (Baird, McParland 2008:3.0)