Transport and Its Effects on Health - Assignment Example

? Transportation: A Determinant of Health Transportation: A Determinant of Health Determinants of health are the internal and external factors that affect the health condition of a person or a population. According to the World Health Organization (WHO, 2012), the determinants of health include the social and economic environment like the income, social status and social support; the physical environment that includes the health services, transportation, urbanization, and working conditions; and the person’s individual behavior and characteristics taking account of genetics, gender and educational status. These determinants are interlinked in contributing to the good or bad health of an individual or a population and are evaluated using health impact assessment (HIA) tools. The broad link of the external and internal factors contributing to an individual’s well-being calls for an integrated effort that addresses individual and community behavioral changes as well as political will to create a sustainable and effective campaign to promote universal good health. Transport and its Effects on Health Transport in all forms is a crucial part of people’s daily lives. Walking, cycling, riding a car, buss, train or any other private and public transport vehicle has become an integral part because it aids people to reach their desired destination and execute daily tasks of equal importance for living. Transport as part of the physical environmental determinant of health is in itself a compound subject with multiple health impacts that needed more evaluative studies. Global Condition In its effort to promote healthy transport choice the World Health Organization has identified global positive and negative effects of transportation. Clearly transportation helps increase access to medical and social services as well as personal needs such as employment, shops and market. It has also improved health from active transport such as walking and cycling and has been contributing to “economic development and recreational uses of road spaces” (WHO, 2012). On the other hand, transportation is also known to have caused negative health impacts such as noise pollution, injuries and fatalities due to vehicular accidents, cardiovascular ailments and visual impairments, land loss when converted to highway, air pollution from using fossil fuels, ozone depletion and climate change due to carbon dioxide emissions, psychosocial effects like community severance, and limitation of children’s movement due to big highways, and spread of vector borne diseases like mosquitoes known to transit with luggage, parcels and crates. Australia is known to have the second highest car ownership in the world with transport placing as the second highest item in household expenditure (Catford, 2003). Accordingly, 10% of Australians are subjected to noise pollution caused by traffic and about 40-49% of their motor vehicles are responsible for pollutant emissions that cause cardiovascular diseases to the people most notably the children (Catford, 2003). In the last 30 years in the country, the pedestrians and the cyclists are the most common victims of road fatalities in urban areas while vehicular accidents with death of drivers and passengers mostly occur in the rural areas. In Asia, there is a high probability that air pollution will increase in the next three decades due to rapid urbanization and various levels of economic development. Burning of fossil fuels such as coal, oil and natural gas for power generation, industrial processes, domestic heating and motor vehicles is the main cause of urban air pollution (Haq et al., 2002). In Bangkok alone, studies have shown that its residents are harmfully affected by air pollution compared with citizens in Thailand. Bangkok residents are found to have varying degrees of respiratory diseases and throat irritation as high as 60% of its total population (Haq et al., 2003). National Condition According to the American Public Health Association (n.d.), obesity is one of the nation’s growing public health problems with 16% obese children and 66% overweight adults. Unfortunately, the transport system in the country has limited the connectivity of communities and services which also limits the opportunity for active transport that results in lower physical activity needed to prevent obesity. In the last 2 decades, traffic fatalities in the country have reached an approximate of 43,000 per year with 2.5 million people injured. The association further revealed that the United States spends $40 to $64 billion dollar per year on health issues associated with poor air quality due to transportation emissions which make up one third of the carbon dioxide emissions in the country. Transportation is said to be one of the main contributor to greenhouse gas emission in the U.S., accounting for about 10% of the energy-producing greenhouse emissions worldwide. In a study commissioned by the U.S. Department of Transportation, the physiological effects of noise pollution due to transportation include annoyance, speech interference, interference on recreational activities and disruption of performance at work while the known psychological effects are hearing impairment or loss, sleep disturbance, muscular effects, cardiovascular effects, and mental health effects such as anxiety, nervousness stress, argumentativeness and changes in mood among others (Lee and Fleming, 2002). Local Condition In the state of Florida, the Department of Transportation reported that 3,365 people died on roadways in 2006 alone (2012). The Department of Environmental Protection (2011) reported that transportation emissions in Southeast Florida contribute to 50% of the state’s air pollution and 40% generation of greenhouse gases. In a national report done by an independent organization Transportation for America, metro areas in Florida constitute the top four of the ten most dangerous metro in the U.S., namely Orlando-Kissimmee, Tampa-St. Petersburg-Clearwater, Jacksonville, and Miami-Fort Lauderdale-Pompano Beach respectively (2011). Health Promotion Strategies In 1986, the World Health Organization, Health Canada, and the Canadian Public Health Association gathered delegates from 50 countries around the world in Ottawa to discuss, develop and affirm guiding principles and strategies that would aid in the execution of health promotion. Health promotion is a process that enables the people to have control on the determinants of their health and according to WHO health promotion strategies are not limited to a specific health issue or determinants as it is applicable to the entire living system with the common goal to improve the health condition of individuals in a community (WHO, 2012). The Ottawa Charter for Health Promotion resulted in the five core strategies that became the framework of nations in addressing multiple determinants of health. These strategies are building public health policy, creating supportive environments, strengthening community action, developing personal skills and reorienting health services (Jackson et al., 2006). Building health public policy pertains to implementation of regulations and legislations that would ensure “a high level of protection from harm and enable equal opportunity for health and well-being for all people” (WHO, 2007). Creating supportive environments would require multi-sectoral “partnership and alliances with the public, private, nongovernmental and international organizations and civil society to create sustainable actions” (WHO, 2007). To strengthen community action people should be the leader in executing health promotion. The government, though, should provide opportunities to develop their personal skills in determining what is beneficial to their health in terms of leadership, policy development, transfer of knowledge, researches and health literacy. This way there is ownership to both the problem and solution prompting people to be personally accountable and aware of the consequences on their health related choices. In order to assure continuous progress, health services should be reoriented to meet the current challenges on health as community population changes over time. The Hierarchy of Needs One theory that could be used to promote behavioral changes sought after by the health promotions strategies is the humanistic theory of motivation that believes in the strong cognitive reasoning of humans to execute actions and changes that could fulfill their needs. This theory is elucidated in Abraham Maslow’s hierarchy of needs which states that humans must satisfy the needs in the bottom pyramid in order to achieve satisfaction with other needs in ascending order. The primary needs in the bottom pyramid are the physiological or basic needs of a person that includes water, air, food and shelter which are essential for survival. The second level are the safety needs concerned with the security of resources, employment, health and body, family, property and values which are essential aids for survival. The third level in the hierarchy of needs focuses on social needs like love, belongingness, friendship, sex and intimacy which can be found in family relationships, community or social networks and religious groups. The fourth level in the hierarchy is on self-esteem that concerns self-confidence, personal worth, social recognition and respect for self and others. The fifth level is on self-actualization that focuses on a person’s potential like creativity, morality, problem solving, acceptance of facts and being devoid of prejudice. In this stage, a person is less concerned with what others will say but more with personal growth to enable oneself to fulfill larger roles in the society. This theory was chosen because it values the capacity of a person to improve oneself using logic and shows the most strategic manner in addressing human issues that could hamper personal and social development. As Maslow explained, only when the lower needs in the hierarchy are met can we expect a person to pursue higher needs on influence and development as such that when a person lacks food and shelter we cannot expect him/her to actively participate in community actions promoted by the government. Furthermore, this theory can aid in understanding human behavior and what influences a person to actively participate in a communal objective like the promotion and adherence to safety transport regulations. The health promotion strategies specially on creating supportive environments that requires multi-sectoral partnership can be better implemented using the hierarchy of needs as a tool in evaluating what type of partnership and assistance is required in a particular community to produce better results and cost efficient government programs. Promising Examples of Health Promotion Strategies in Transport In 2009, the New Zealand Transport Agency has developed a pedestrian guide with the goal of promoting the country’s walking environment which outlines the processes, designs and standards that would aid the government, private and public partners in deciding and undertaking projects on walking infrastructures. The guide was crafted by professionals commissioned by the NZ Transport Agency with the community involvement in scheme development. The guide has four focus action areas and ten action priorities that include collaboration of efforts for walking and cycling, providing supportive environments and systems, influencing individual choices to use often walking and cycling as modes of transport, and address community concerns on crimes related to walking and cycling (NZ Transport Agency, 2009). The U.S. Department of Transportation (2011) announced that 2010 marked the lowest level of highway deaths in the country since 1949. The result was attributed to the government projects that involved the general public and various sectors in crafting and executing the outcomes. In its effort to reorient and improve health services, the National Highway Traffic Safety Administration (NHTSA) unveiled a new measure designed to gauged fatalities related to distractive driving behavior such as texting and answering calls in order to provide concrete actions. The agency called the community participation through a survey that provided insights on the behavior of drivers when behind the wheel and their perceptions on road safety. As reported by the American Public Health Association (n.d.), since 2002, Marin County in California has successfully increased the number of children who walk by 64%, use bike by 114%, and carpooled by 41,000 to school though the Safe Routes to School program initiated by the federal transportation act SAFETEA-LU (the Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users). In the west, the U.S. Department of Transportation (DOT) forged partnership with West Harlem community environmentalist group called WE ACT and the northern Manhattan residents in a private-public campaign for clean air. The partnership has forced the Metropolitan Transit Authority (MTA) to locate their depots and to use natural gas and clean fuel busses after MTA was charged of emitting harmful air pollutants by their diesel operated transport. The Florida Department of Transportation Safety Office (2012) recently released the Florida School Crossing Guard Training Guidelines to assist guards in helping children “cross streets safely at key locations on their ways to school.” Moreover, the Florida Department of Environmental Protection forged partnership with the Florida Department of Transportation, Federal Highway Administration, Metropolitan Planning Organizations, and local air quality agencies to create strategies that would help address the environmental consequences of air pollution. Conclusion and Recommendations The chronic and dangerous effects of transport on health exacerbate the economic crisis that the nation is facing today because of the loss of productivity and investments. The WHO along with other multilateral and bilateral agencies has already established the health promotion framework that could assist countries in addressing the damaging effects of transport. The challenge on the health promotion strategies on transport adopted by the nations worldwide is not on the framework itself but on the action areas. In America, the federal government has to continue its fund allocation on road safety programs in order to ensure sustainment of public support which is the main objective of the strategy on strengthening community action. It must be noted that the five strategies are interrelated thus its effects are also integrated. Going back to Maslow’s theory on the hierarchy of needs, the actualization or attainment of the basic needs are dependent on the external and internal factors with the former consisting of availability of opportunities thru private and government support in economic and social services. Another challenge is on the dissemination of public-private programs on transport based on segmented market that would address the strategies on developing personal skills and strengthening community action. The proliferation of new technologies like the internet and cable TV can be used as tools to reach the public more effectively on top of sending mailers to the target market. In addition, more effort is needed to establish a cross-sectional partnership between government agencies involved in transport, health and environment to be cost effective. The nation’s financial crisis should not be used as a reason for cutting back on integral programs that could address the adverse effects of transport. Instead, it is an opportunity to forge stronger partnerships between private and public sectors in working towards achievement of realistic goals. Lastly, since transport, health and environment is a concern for all, there is need for a unified evaluation of current initiatives and more health impact assessment that should start from the federal government down to each state. Clearly, only a few states are making progress in addressing health and environmental issues on transport and to remain in the same situation for another decade would only result to more loss for the country and its people. The proactive fight for healthy living and safe transport is the duty of every citizen; after all we share and breathe the same air every day. References American Public Health Association. (n.d.). At the Intersection of Public Health and Transportation: Promoting Healthy Transportation Policy. Supported by Convergence Partnership Fund. Catford, Robert (2003). Transport as a Determinant of Health: What Role for the Health Sector? Retrieved from http://camwest.pps.com.au/docs/Transport_and_Health.PDF Florida Department of Transportation. (2012). Strategic Hi-way Safety Plan. Retrieved from http://www.dot.state.fl.us/safety/SHSP/StrategicHwySafetyPlan.shtm Florida Department of Transportation Safety Office. (2012). Florida School Crossing Guard Training Guidelines. Retrieved from www.dot.state.fl.us/safety/SRTS_files/FSCGT%20Guidelines_March%202012_FINAL.pdf Florida Department of Environmental Protection (2011). “Southeast District Air Resource Management Program – Mobile Sources and Outreach.” Retrieved from http://www.dep.state.fl.us/southeast/air/mobile.htm Haq, G. et al. (2002). Benchmarking Urban Air Quality Management and Practice in Major and Mega Cities of Asia. Korea Environmental Institute. Retrieved from http://www.unep.org/PDF/APMA_Benchmarking_report.pdf Jackson S.F. et al. (2006). Integrated Health Promotion Strategies: a Contribution to tackling Current and Future Health Challenges. Health Promotion International Vol. 21 S1, 75-83 doi:10.1093/heapro/dal054 Lee, C. S.Y, & Fleming, G. G. (2002). General Health Effects of Transportation Noise. U.S. Department of Transportation (DTS-34-RR297-LR2 FRA/RDV-03/01). Washington, DC: U.S. Government Printing Office. New Zealand Transport Agency. (2009). Pedestrian Planning and Design Guide. ISBN 978-0- 478-35228-3. Retrieved from http://www.nzta.govt.nz/resources/pedestrian-planning-guide/docs/pedestrian-planning-guide.pdf Transportation for America. (2011). Dangerous by Design. Solving the epidemic of Preventable Pedestrian Deaths. Retrieved from http://t4america.org/resources/dangerousbydesign2011/ United States Department of Transportation. (2011). “U.S. Transportation Secretary LaHood Announces Lowest Level Of Annual Traffic Fatalities In More Than Six Decades.” Retrieved from http://www.dot.gov/affairs/2011/nhtsa2111.html World Health Organization. (2007). The Bangkok Charter for Health Promotion in a Globalized World. Health Promotion International, Vol. 21 No.S1, 10-14.doi:10.1093/heapro/dal046 World Health Organization. (2012). Health Impact Assessment. The Determinants of Health. Retrieved from http://www.who.int/hia/evidence/doh/en/index.html Read More