APA National Planning Conference Session Brings Light to Common Health Challenges


The way we move around—in terms of transportation choices as well as physical activity—has a direct impact on health and well-being.

Studies show that inadequate physical activity is linked to a significant array of health problems, including heart problems, diabetes, even premature mortality rates. Considering that on average, Americans spend 300 hours per year driving in their cars, there is significant opportunity for us as transportation planners to work with MPOs to affect change.

For example, the Center for Disease Prevention and Control recommends that adults average at least 22 minutes of moderate physical activity per day. Although fewer than half of American adults achieve this target, most public transportation passengers meet the recommended minimum by walking to and from public transit stops.

In another study, according to the 2017 United States Report Card on Walking and Walkable Communities, 43 percent of people who live in walkable areas (meaning they have safe places to walk within ten minutes of home) achieve physical activity targets. Only 27 percent of people who live in less walkable areas achieve physical activity targets.

43 percent of people who live in walkable areas (meaning they have safe places to walk within ten minutes of home) achieve physical activity targets. Only 27 percent of people who live in less walkable areas achieve physical activity targets.

The intersection of transportation and health is significant, and active transportation can play a leading role in improving health outcomes. This was a topic of interest at the 2019 APA National Planning Conference in San Francisco, where a panel on the health of Florida residents served as a springboard into a larger conversation about common health challenges across auto-centric states, and what MPOs and transportation planners can do.

Building a Healthier Florida

Older American cities like Boston, New York City, and Chicago were designed at human scale. New York and Boston’s first settlers arrived in the mid-1600s and Chicago was incorporated in the late 1830s, writes Miami’s The New Tropic. They were pre-automobile boom and had only the human form to guide the layout of blocks, buildings, streets, and parks.

In contrast, growth and development in Florida first boomed in the late 1800’s at the height of train and trolley travel, and then with even a bigger boom post-WWII coinciding with a robust and more affordable automobile industry. Throughout the “long and lean” state of Florida, transportation networks were built through cities and between them with automobiles as a primary mode of transportation. In fact, the first Florida Interstate (Interstate 4) not associated with a previous highway opened just three years after President Eisenhower signed the Federal Highway Act of 1956. It was the second “interstate” that did not connect to another state, opening only months after I-87 which connects New York City to Canada.

Today, the health of Floridians is suffering, and there is a direct connection to transportation networks. Unsafe streets mean pedestrian fatalities and traffic crashes, and long commutes by car are correlated with upticks in obesity, heart disease, and diabetes.

Health and Transportation in Florida According to the State’s Health Assessment in 2017, nearly 7 out of 10 deaths in Florida were attributed to chronic diseases such as heart disease, hypertension, type-2 diabetes, and obesity. It is important to note that many of these diseases are the easiest to avoid or successfully treat with exercise and physical activity.

Transportation infrastructure investments are needed to build a healthier Florida. Kittelson’s John Paul (JP) Weesner moderated a session at the APA National Planning Conference about how MPOs across the state are responding to these realities.

  • In Central Florida, MetroPlan Orlando is promoting health in all transportation policies, an initiative that includes an innovative corridor study focused on health and community engagement. The unprecedented effort is reaching people who have never participated in a transportation planning study.
  • Along the East Coast, the Palm Beach TPA is using health impact assessments to inform not only Complete Streets initiatives and regional agency cooperation, but also premium transit planning, the location of transit-oriented developments, and locating specific transit stations in areas that will benefit the most people.
  • In the Tampa Bay area, Forward Pinellas is focusing on the 20-Minute Neighborhoods initiative: an effort to overcome gaps and barriers in the transportation network to support active transportation that connects low- and moderate-income residents with everyday destinations and transit service.

Although the conversation started with this panel of Floridians, animated dialogue with attendees revealed that other states face similar challenges when it comes to transportation and health – especially with getting buy-in from local leadership and implementing projects through their various agencies.

“Attendees from California, Arizona, and other states were asking great questions and sharing experiences. A big takeaway for me was how common some of these challenges are across vastly different states,” says JP. “It was powerful to swap ideas and strategies and discuss how we fit into this conversation as transportation planners.”

The Role of Transportation Planners

Metropolitan planning organizations (MPOs) are required to regularly revisit long-range transportation plans to set investment priorities. As transportation consultants support MPOs to uncover their community’s biggest transportation needs and set clear goals for the future, we must look for direct ways to integrate public health in the transportation planning process.

Collaboration is paramount to accurately consider today’s health concerns in future transportation infrastructure investments. “Initiating public-private partnerships that support healthy transportation with private and nonprofit institutions is a critical step in improving public health,” states TransFormCA in a report on public health and transportation planning. This report urges transportation agencies to coordinate their efforts with land use and economic development agencies, public health departments, and social service providers. Better planning and coordination across all state agencies means everyone is working together to improve health outcomes.

Education is another critical component. Whether elected officials, MPOs, transportation planners, or the general public, we all need to better understand the intersection between transportation and health. Improved and ongoing education on the health impacts of transportation has implications for every step of the planning process, from data collection to community engagement.

Improved and ongoing education on the health impacts of transportation has implications for every step of the planning process, from data collection to community engagement.

Setting SMART goals is a third way that health considerations find lasting integration into a long-range transportation plan. At a high level, SMART goals are:

S: Strategic; pointing you toward the real challenge you’re trying to solve.

M: Measurable; defining what success will look like, for both planning and operations.

A: Agreed to among all parties; representing a diversity of perspectives.

R: Realistic; reasonably achievable.

T: Time-bound; set within a determined deadline for accountability.

Building health-oriented goals into your decision-making criteria means you will naturally revisit these principles as you move through the scope of your project.

Keep the Conversation Going

MetroPlan Orlando, Palm Beach TPA, and Forward Pinellas are leading by example in Florida to show how agencies can integrate health priorities in transportation planning, but much ground remains to be covered.

Is your MPO also prioritizing this integration? If you’re reading this as a transportation professional, you can help your organization be a part of the solution. By collaborating thoughtfully with the agencies around you and considering what additional health experts and resources you can bring to the table, you will play a role in bringing health outcomes to the forefront of transportation investment decisions.

We encourage you to reach out to discuss this topic further!