Prevention Matters

This week – October 17-23 – has been designated as National Teen Driver Safety Week. And, we have a good reason to celebrate – today’s edition of the Morbidity and Mortality Weekly Report states that in 2009 there were approximately 500 fewer teen deaths in motor vehicle crashes. During 2004-2008, the percentage of drivers aged 16-17 years involved in fatal crashes decreased by 36%.

However, we can’t be too joyful. In 2009, about 3,000 teens died in motor vehicle crashes – still the leading cause of death for teens.

The numbers do illustrate the value of teen driver safety programs, graduated driver licensing and more involved parents. Evaluations of the graduated driver license programs show a 20-40 percent reduction in crash risk for the youngest drivers.

The watch word – keep it up! The programs and policies in place are working. Communities need to continue to proactively enforce minimum drinking age laws, blood alcohol levels, and safety belt laws. Ongoing evaluation of value of anti-texting laws needs to occur as well to assess impact of distracting driving on teen motor vehicle crashes.


Diane Canova
VP, Policy & Programs
Partnership for Prevention

A new study in the American Journal of Preventive Medicine showing that the construction of a light-rail system (LRT) resulted in increased physical activity and subsequent weight loss was named the “Best Prevention Idea of the Week,” while the recent report from Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) that 28 US states saw obesity rates increase last year was named the “Worst Prevention Idea of the Week."

The “Best/Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. Nominees are submitted by Partnership staff as well as the general public, and are voted on by the staff. Partnership for Prevention is a nonpartisan organization of business, nonprofit and government leaders who are working to make evidence-based disease prevention and health promotion a national priority. More information is available at http://www.prevent.org/.

BEST

New Study Finds Public Transit Systems Contribute To Weight Loss and Improved Health

Increasing the availability of public transit systems is one among a number of modifications to the built environment that offers opportunities for increasing physical activity and reducing the prevalence of obesity and its associated problems. In a study published in the August issue of the American Journal of Preventive Medicine, researchers from the University of Pennsylvania, Drexel University and the RAND Corporation found that construction of a light-rail system (LRT) resulted in increased physical activity (walking) and subsequent weight loss by people served by the LRT. These findings suggest that improving neighborhood environments and increasing the public's use of LRT systems could improve health outcomes and potentially impact millions of individuals.

WORST

Adult Obesity Rates Rose in 28 States and Fell in Just One


28 US states saw obesity rates still rising last year, while the only place to experience a decline was the District of Columbia (D.C.), F as in Fat: How Obesity Threatens America's Future 2010, according to a report from the Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF). In 38 US states more than 25% of the adult population is obese. 19 years ago the number of US states with an obesity rate of over 20% was zero.

The USA has had the highest adult obesity rate in the world for several years.

The Environmental and Energy Study Institute, (EESI) held a Congressional briefing on May 24, 2010 that highlighted the important health choice Congress will need to consider as it debates a pending, multiyear reauthorization of Federal transportation spending. The briefing featured a presentation by Jonathan Patz, MD, MPH, professor and director of Global Environmental Health, University of Wisconsin, who spoke of the direct impact on public health that results from climate change; specifically the role that transportation policy plays in healthy/unhealthy air and lifestyles. While its well known that air pollution can cause respiratory diseases such as chronic obstructive pulmonary disease and asthma, Patz told congressional staffers that poorly planned transportation policies have a morbidity and mortality rate significantly higher than the conventional associations with automobile and pedestrian accidents.

In addition to extensive health consequences resulting from air pollution, Patz argued that transportation decisions are significant factors contributing to the nation’s obesity epidemic due to community designs that foster inactivity and chronic disease. Chronic diseases, such as diabetes, obesity, heart disease and cancer, are an inevitable result of a unhealthy lifestyle. Patz noted that nearly half of all car trips are less than two miles long, and a significant number could be reduced through investments and incentives in alternative transportation methods; especially investments such as mass transit, community design and other policies that reduce reliance on private automobiles and increase walking and other forms of physical activity. Whats the bottom line? While organizations like the American Public Health Association have persuasively argued that “climate change is a public health issue” Dr. Patz's presentation included a powerful image (see below) illustrating how simple policies can hinder or enhance a physically active lifestyle.

Dr. Jonathan Patz's complete presentation is available on the Environmental and Energy Study Institute website.

Amy Himmelstein
Policy and Program Intern
Partnership for Prevention

There is growing awareness that transportation systems and policies can impact our health and indeed the quality of life in communities across America. Congress is currently hard at work developing a multi-year transportation authorization that will have a profound impact on air quality, traffic safety, the availability of walkable communities and affordable mass transit…the challenge is for this impact to be a positive one.

In a thoughtfully written 11 page report (“CDC Recommendations for Improving Health through Transportation Policy”) the Atlanta-based Centers for Disease Control and Prevention (CDC) offers federal, state and local policymakers a valuable framework to consider that will foster consideration of transportation policies and investments that have the greatest “positive impact on health.” The CDC recommendations have been under development since 2007 and have been informed by the work of the US Department of Transportation and key public health organizations like the American Public Health Association and the Convergence Partnership. CDC calls for adoption of “a balanced portfolio of transportation choices that supports health and reduces health care costs.” The goals of a balanced portfolio are straightforward and should enjoy broad support inside and outside of government.

• Reduce injuries associated with motor vehicle crashes
• Encourage healthy community design
• Promote safe and convenient opportunities for physical activity by supporting active transportation infrastructure
• Reduce human exposure to air pollution and adverse health impacts associated with these pollutants
• Ensure that all people have access to safe, healthy, convenient, and affordable transportation

The challenge for those of us committed to prevention is convincing transportation advocates that healthy transportation is in everyone’s interest. We need adoption of complete streets policies, expanded support for safe routes to school, greater attention to community design that promotes health and safety, support of public transportation that improves access for all people and a commitment to reduce human exposure to transportation-related air pollution.

Partnership for Prevention is working to support these efforts by partnering with the Transportation for America, APHA and other public health and prevention leaders to educate policymakers about the extensive body of research that supports the CDC recommendations.

Ripley Forbes
Director, Government Affairs
Partnership for Prevention

The proposed ban on text messaging at the wheel by interstate truck and bus drivers was named the “Best Prevention Idea of the Week,” while the possibility of gonorrhea becoming a drug-resistant superbug was named the “Worst Prevention Idea of the Week."

The “Best/Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. Nominees are submitted by Partnership staff as well as the general public, and are voted on by the staff. Partnership for Prevention is a nonpartisan organization of business, nonprofit and government leaders who are working to make evidence-based disease prevention and health promotion a national priority. More information is available at http://www.prevent.org/.

BEST

Government Set to Ban Texting by Truck, Bus Drivers

The Transportation Department last Wednesday proposed a ban on text messaging at the wheel by interstate truck and bus drivers, following up on its call to reduce distractions that lead to crashes. The proposal would make permanent an interim ban announced in January by Transportation Secretary Ray LaHood, applying to drivers of buses and commercial trucks over 10,000 pounds. The drivers could face civil or criminal penalties. The proposal "keeps our commitment to making our roads safer by reducing the threat of distracted driving," LaHood said.

WORST

Gonorrhea Close to Gaining Superbug Status

Unless medical experts devise a new way to treat it, gonorrhea -- the world's second most common sexually transmitted infection, after chlamydia -- will soon become a drug-resistant superbug. "This is a very clever bacteria. If this problem isn't addressed, there is a real possibility that gonorrhea will become a very difficult infection to treat," Catherine Ison, a British gonorrhea specialist, told Reuters. Right now, gonorrhea is treated with a single antibiotic dose, of either cefixime or ceftriaxone. But some strains of the illness are becoming resistant to both drugs, meaning treatment could become increasingly difficult without innovations.

An influential East Tennessee doctor suggests that, while his state is successful in getting federal transportation funds, it fails to address transportation challenges in a comprehensive way that address health-related concerns.

"The right kind of streets allow kids to burn those calories by bicycle, foot or skateboard to school, recreation, social engagements and the like," Dr. Anthony DeLucia, a member of the faculty at East Tennessee State University and former chairman of the American Lung Association, wrote in an op-ed published in the Johnson City Herald. "For our growing senior population, some of whom cannot drive, a complete street and sidewalk system with amenities like crosswalks, raised medians, trees, fountains and benches is a thing of beauty and utility."

"Instead, we have provided an illusory and one-dimensional economic stimulus," he writes. "In transportation policy, 'my way or the highway' literally means 'my way is the highway.' We need a fresh look at policy, funding and accountability that addresses the challenges of local metropolitan planning organizations, state departments of transportation and the Federal Highway Administration."

As part of his effort to fight obesity statewide, Delaware Governor Jack Markell has issued an executive order that requires state transportation officials to consider all modes of getting around when planning road improvements. The state also is circulating a handbook that gives municipal officials hands-on advice to create more walkable communities.

The governor is incorporating the state's new five-year strategic plan to make environmental changes that make it easier for people to make healthy choices. At the state Department of Transportation, new road projects won't include just engineering for road design. State officials also look to see if the project can be modified to be more bike- and pedestrian-friendly.

"It sounds so easy," said Jennifer Baldwin, the state pedestrian coordinator-planner. "But historically, departments of transportation ... have focused on motor vehicles."

In Delaware, 36 percent of adults overweight and 28 percent were obese in 2007, while the obesity rate among high school students has climbed from 10.1 percent to 13.2 percent in eight years and 20 percent of those students say they get no physical activity.

That report, entitled "Dangerous by Design." was prepared by a coalition called Transportation for America. In this podcast, we're talking with David Goldberg, Director of Communications for that coalition.
 

The following guest post was written by Sean Barry with Transportation for America - a national coalition seeking to align our national, state, and local transportation policies with an array of issues like economic opportunity, climate change, energy security, health, housing and community development.


In the last few years, health advocates have increasingly urged Americans to walk, bike and exercise more often, noting regular physical activity is paramount to good health. Unfortunately, a new report released this week by Transportation for America and the Surface Transportation Policy Partnership reveals that walking in many of our communities is far more dangerous than it should be.

Dangerous by Design: Solving the Epidemic of Preventable Pedestrian Deaths (and Making Great Neighborhoods) shows that the level of pedestrian fatalities in the U.S. is roughly equivalent to a jumbo jet going down every month. But there is no national sense of urgency about pedestrian safety.

Under current federal transportation law, projects that benefit pedestrians and bicyclists are labeled “enhancements” and attacked by some as luxuries that detract from core road and highway building.

Current transportation policies vastly shortchange people who walk or bike. Less than 1.5 percent of total federal funds are ultimately spent on pedestrian safety, despite walkers comprising 11.8 percent of all traffic deaths and a comparable percentage of all trips. In this decade alone, 43,000 Americans have died preventable deaths while walking or crossing a street in their community. Although members of every demographic group are affected, ethnic minorities are suffering disproportionately, with African-American fatalities 70 percent higher than whites, and Hispanics 62 percent higher.

It should not come as a surprise that our inadequate investment in roads safe for all users adversely affects safety and health. For many Americans, daily physical activity is no longer a part of their daily existence. Seniors, the disabled and low-income Americans who cannot or chose not to drive face limited alternatives. Lower rates of physical activity are linked to rising obesity and pollution from automobiles increases the risks of asthma.

Dangerous by Design ranks America’s major metropolitan areas according to a Pedestrian Danger Index that measures how safe they are for walking. The report also profiles communities across the country that have successfully stepped up and reversed current trends.

In St. Petersburg, FL, for example, a “Vision 2020” planning process resulted in 13 additional miles of sidewalks and 32 rapid-flashing signals at crosswalks, improving driver-yielding compliance by 83 percent. In Charleston, SC, two-thirds of area residents say they are getting more exercise after the launch of a three-mile pedestrian and bike path. And, the installation of 1,600 speed humps in residential Oakland, CA led to a 50 to 60 percent reduction in the odds of injury or death among children walking.

There is growing movement for action in Congress as well. Last year, Sen. Tom Harkin (D-Iowa) and Rep. Doris Matsui (D-CA) introduced the Complete Streets Act. This legislation would ensure that new road projects emphasize safety and accessibility for all users, including pedestrians, bicyclists and transit riders.

Transportation for America is working to arrange a meeting with U.S. Transportation Secretary Ray LaHood, perhaps as soon as next week. At this meeting, we plan to deliver the message from our hundreds of partner organizations and thousands of supporters across the country that safer streets must be a priority.

Sign our petition today and help us send a strong message to the USDOT!

We hope the release of this report will fuel a greater sense of urgency about pedestrian safety and the need for a more balanced transportation policy. With health care remaining in the headlines, let’s convey to our representatives that making our streets safer is no longer just an “enhancement,” but an essential.