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Mobile and healthy cities: can Australian policy catch up with the evidence?

As Australia’s first ever Minister for Cities and the Built Environment, Jamie Briggs, steps up to the plate, this week has seen Sydney-siders cope (pretty well so far) with the first phase in an urban development project whose aim is to reduce traffic congestion in the inner city, and to encourage active transport.

City2 (1)Minister Briggs will not be working in a vacuum: public health experts have long been flagging the health costs of poor urban design and planning. Outlined below is a report from the Australian Council of Learned Academies, released today, which highlights the need to factor in transport needs early and often, when considering the health of Australians who live in cities.

****

Patrick Harris, Bruce Armstrong and Jennifer Kent write:

The recently adopted United Nations’ Sustainable Development Goals include “Good health and wellbeing” (Goal 10), “Reduced inequalities (Goal 4)” and, “Sustainable cities and communities” (Goal 11). A new Australian report, Delivering Sustainable Urban Mobility, prepared by the Australian Council of Learned Academies, brings these three goals together to position public health and public safety as central concerns for transport policy-making and planning.

Mobility and health

Mobility and health are entwined within an often under-appreciated complexity, which the report unpacks, using the most recent evidence to inform current and future policy considerations. The way we travel affects traditional public health concerns, such as exposure to air pollutants and noise, and risk of injury associated with traffic accidents.

It also profoundly shapes the way we manage time, fulfill responsibilities associated with work and family life, and access the opportunities inherent to living in cities, many of which influence health. Ideally good transport infrastructure, as part of good urban planning, provides easy and equitable access to family and friends, public space for wider socialisation, green space for relaxation and recreation, extensive active transport opportunities (walking and cycling), healthy food supplies, and access to health and social services.

The report’s findings

Delivering Sustainable Urban Mobility seeks to address and incorporate this complexity, highlighting that the relationship between transport and health extends to chronic disease, which is in turn influenced by unequal access to the benefits of well-functioning transport systems.

The report’s focus on three basic directions to improved urban transport – reduced demand, shortened journeys and increased efficiency – augments existing foundations for positioning public health within the balance of sustainable urban living.

These strategies provide the opportunities for healthy lifestyles and for protecting health. Crucially they engender capacity to reduce barriers for those on cities’ outer fringes, who are at great risk of transport poverty and social isolation. These three approaches together encourage sustainable urban living that will improve the lives of future generations.

Recent policy decisions in Australia are limiting the opportunities associated with cities, and putting their populations at risk. While providing a clear direction, the report also identifies key policy challenges. We are at a point where all levels of government in Australia are empowered to invest in transport infrastructure to provide societal goods in both the short and long term. Public health is one such good.

The perils of neglecting public health

Not prioritising public health, the report points out, can result in a reduction in the economic benefits usually advanced as justification for investment. For example, the recent emphasis on road building as the infrastructure answer to the transport problems cities face is narrowly based and flies in the face of international evidence and best practice. These developments are facing backlash in the community, not just from a fiscal position (Melbourne’s East West Link), but also through well-justified concerns that alternatives to private car use are not seriously considered in balanced planning decision making. They will deliver a net loss in public health.

A better way

Meanwhile, cities around the world are embracing evidence that successful urban spaces are connected by many more options than roads, and can deliver important gains in public health.

The report supports findings from recent research on environmental assessments of major transport projects, principally in Sydney, led by two of us (Patrick Harris and Jennifer Kent). Such assessments are the core regulatory process to consider the impacts of large-scale projects before they begin, and Australia is seen as a world leader in positioning health within this process. Researchers are investigating how health has been considered in planning four projects: Northconnex, Westconnex, the Sydney CBD and South East Sydney Light Rail, all in Sydney and the Darlington Upgrade in Adelaide.

Findings so far suggest that health has been considered, but in a superficial way and certainly not to the extent Delivering Sustainable Urban Mobility suggests ought to happen The researchers have also found that environmental assessments are highly constrained by earlier policy decisions, to the point that they are at risk of becoming tick box exercises to justify project approval. Their intended purpose – to mitigate the risk or enhance the benefits of a project before it is approved – is thwarted and the opportunity for better planning wasted.

Delivering Sustainable Urban Mobility supports the need for more comprehensive and earlier policy-making practices that include serious consideration of public health as a key concern for transport planning.

Patrick Harris is a Senior Research Fellow, Menzies Centre for Health Policy, University of Sydney

Bruce Armstrong is Senior Adviser, Sax Institute, Sydney and Emeritus Professor, School of Public Health, University of Sydney

Jennifer Kent is a Postdoctoral Research Fellow, Urban and Regional Planning Program, University of Sydney

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Australian Palliative Care Conference
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