Originally published in the January 2024 issue (v.44) of Streetsmart News
In this newsletter, we'll examine the indirect influence indicators have within a planning process, as compared to the direct and instrumental use and influence of indicators, as discussed in my previous newsletters. Drawing from my dissertation, The Use and Influence of Health Indicators in Municipal Transportation Plans, this article discusses the importance of how indicators are developed such that they influence the thinking of policy actors and can help set an agenda for policy change.
Let's begin with a couple key points about how policy learning and change happen. My research drew from Communicative Planning Theory as well as two policy process theories from political science, the Advocacy Coalition Framework (ACF) and the Multiple Streams Framework (MSF). Learning is defined as a change in beliefs about policy goals or solutions, with the assumption that beliefs are the "glue" of politics. (1) Communicative Planning Theory, and the ACF to a degree, assert that learning occurs through dialogue; that is, people learn when they are engaged in meaningful conversation in a lower-conflict, consensus-oriented discussion forum. Policy learning is a confirmed path to policy change. (2)
In all the cities under study, indicators had been developed in the context of community engagement processes, in which the public defined the key issues, goals, and objectives in the transportation plans. From there, city staff and consultants developed indicators to match the goals and objectives articulated by the public, typically with feedback from standing or plan-related advisory committees. As such, indicators were perceived as legitimate by policy actors. This differs from situations where the validity of the data is debated within contentious policy processes and/or processes where outside experts create the indicators.
My dissertation confirmed MSF research that demonstrates that indicators have the ability to draw attention to key issues and to frame them as problems. Policy actors frame issues as problems to justify public intervention. In my cases, the primary issue framed as a problem in many plans was about equity: equitable access to employment, transportation affordability, disparities in health outcomes, etc. Based on informant responses, this was the first time these problems had been so clearly defined within the city's transportation plans. Indicators helped people see disparities more clearly, such as this housing and transportation affordability indicator:
"A lot of the shock came from the expense of transportation in the Indianapolis region, because . . . there's a huge gap in regional job accessibility and it makes the combined housing and transportation costs the third highest in the country among our peer metros. And that usually takes people aback” (Informant 34).
Informants noted that indicator selection, being so clearly connected to community values and goals, helps frame problems that policy actors want to highlight:
“The data that you show pushes your agenda . . . . The fact that we are calling out and even researching how expensive it is to travel in Indianapolis and the disparity . . . I mean, that conveys a value” (Informant 31).
Dialogue helped not only to raise awareness of the issues but create a shared understanding and changes in policy beliefs (i.e., learning), such as the dialogue in this equity workshop:
“It was the dialogue, quite frankly . . . you're sitting in a small group around a table with people who live in this community going, ‘Whoa, wait a minute here,’ and it's like, . . . ‘Oh, I had not thought about that’ . . . . I think there are a lot of people, including many of the staff members, who are like, . . . ‘This is a lot bigger conversation than we intended’” (Informant 21).
Note that these awareness and learning opportunities only happened within the earliest parts of the transportation planning process. Once the planning processes move from setting goals to the later stages of analysis and project selection, the role of indicators changes from sparking "ideas" to providing "data" and ammunition for "argument." (3)
While indicators can help illuminate a problem, informants emphasized that it was the combination of data and dialogue that produces shared understanding. In fact, it was difficult to determine if the discussion about the indicator itself or policy goals more generally generated this shared understanding because the two were so intertwined. The combination of data and argument can also set the policy agenda and help advocate for policy change:
It's "not just the numbers . . . but the point, the narrative, the messaging around that, when you can use that with a broader audience, that includes not just the public, but civic leadership, community stakeholders, or . . . organizational type partners . . . I do think that can push leadership” (Informant 35, original emphasis).
In sum, make sure you develop indicators inclusively so that the users buy into them and they reflect community values. If indicators are developed by independent experts without community input, they run the risk of not being useful or perceived as illegitimate. Most importantly, the opportunity for learning and shared understanding is lost. The greatest opportunity for policy learning is within the earliest stages of a planning process: indicator development and the existing conditions analysis of a plan. Use these opportunities to raise awareness of problems and get them on the agenda for change.
1. Paul Sabatier (1987). Knowledge, policy-oriented learning and policy change: An advocacy coalition framework. Knowledge: Creation, Diffusion, Utilization, 8(4), 649-692.
2. Christopher Weibe (2018). Instrument constituencies and the advocacy coalition framework: An essay on the comparisons, opportunities, and intersections. Policy and Society, 37(1), 59-73.
3. Carol H. Weiss (1991). Policy research: Data, ideas, or arguments? In P. Wagner (Ed.) Social sciences and modern states: National experiences and theoretical crossroads (pp. 307-332). Cambridge University Press.
Originally published in the November 2023 issue (v.43) of Streetsmart News
This newsletter focuses on another component of my dissertation, The Use and Influence of Health Indicators in Municipal Transportation Plans. In my last newsletter, I discussed the key indicator characteristics that made them for useful for transportation decision-making. I'll continue in this newsletter discussing the instrumental use of indicators--the presumption that indicators inform decisions--but focus on the organizational aspects of developing and using indicators.
First of all, none of the people I interviewed (city and transportation planners, advocates, public health practitioners, etc.) felt that data was the problem, despite whatever challenges they may have had with spatial scale, measurability, or the like. One informant was clear:
“I don't think it's because the data isn't usable or available. It's because of the systems. We do not have the systems in place to use the data in the way they're intended to be used” (Informant 35).
In some cases, different departments, such as public health and city planning, collaborated to develop indicators. The development process helped "force different departments to talk to each other" (Informant 12) or otherwise generate some policy alignment through indicator alignment. While helpful, this was not a critical factor in terms of having an influence on administrative decision-making. The three things that mattered most were:
The data-driven paradigm, as compared to one based on territoriality or a "cash grab" (Informant 36), was one that valued transparency, accountability, and fairness in decision-making. In two cases, elected leadership drove this approach, which in turn became infused within the culture of the departments. Non-profit organizations helped municipalities be accountable for the goals set in their plans--sometimes they even created their own progress reports.
Having sufficient funding may seem obvious, but some municipalities did not fully appreciate the degree of infrastructure required to monitor indicators over time. Indicator development was no problem--many cities had funding to develop the indicators as part of transportation plan development--but tracking indicators over time required new structures and funding.
Finally, having a clear procedural connection for the indicators was important. In one case, the city had data-driven leadership, sufficient funding, and was tracking indicators over time but they had not created a clear enough link from indicator reporting to decision-making. Specifically, they were reporting on systems monitoring indicators during budgeting decisions. As one informant reported:
It was “a good half-hour of city council just free-associating on their fears and anxieties. It had nothing to do with, like, ‘Are we getting where [we want to be] going?’” (Informant 25)
When reporting on indicators, you need an action proposal. Otherwise, you use indicators as an analytical input to a decision. The most successful cases used evaluation criteria as part of capital improvement programming; that is, a clear nexus between the data and the decision.
In short, to influence administrative decision-making: Ensure the organization has sufficient financial and technical capacity to create data infrastructure. Create accountability mechanisms such as required internally-produced progress reports; if the city doesn't, then advocates can step in. Make sure that indicators are used for a specific routine or analysis in order for them to be influential.
Originally published in the September 2023 issue (v. 42) of Streetsmart News
Municipal transportation plans can play a vital role in shaping the health and well-being of the public. By incorporating health indicators into these plans, municipalities can promote active transportation, reduce air pollution, and improve access to healthy food options. But are these indicators used and do they influence municipal transportation decision-making? Through a case study of five cities my dissertation, The Use and Influence of Health Indicators in Municipal Transportation Plans, explored which factors contributed to use and influence. By indicators, I mean constructs measuring a condition; in the transportation world these are typically called performance measures.
Let's start with the instrumental use of indicators and their usefulness. The instrumental use of indicators is likely the way most people conceptualize their use: technical information as an input to a decision. In the transportation plans I examined, there were two primary instrumental use cases. The first was systems monitoring, in which municipalities constructed baseline conditions using indicators with the intention to monitor them over time, ostensibly to assess progress and course correct. All the plans examined had this use case. The second use case was prioritization. Indicators were either used to prioritize projects within the plan itself or they were developed to be used as evaluation criteria at a later date--primarily within capital improvement programming.
I explored both indicator usability factors and organizational factors to determine how indicators were used in administrative decision-making. I'll focus on the indicator usability factors in this newsletter. By indicator usability, I'm referring to indicator credibility (e.g., accuracy, reliability), salience (e.g., policy-relevance, timeliness), and legitimacy (i.e., are they trusted by users and stakeholders?). Overall, the legitimacy of indicators was not a concern of any of the people I interviewed. This may be because they were developed in the context of community engagement processes (more on that in another newsletter).
In the prioritization use case, the primary concern was in the geographic spatial scale of the indicators; this was especially true for health outcome data, which tends to be aggregated into large geographies. The systems monitoring use case, on the other hand, faced additional challenges. The geographic scale of the data was sometimes a concern, but concerns about data availability, measurability, accuracy, timeliness, and ease of communication (i.e., interpretable) were more often raised. For those who wanted indicators to serve as an accountability mechanism, measurability was important. Timeliness was essential to make adjustments in programs and projects:
“There's a real understandable lean towards using data that's going to be available anyway . . . Census-type data . . . but it's very slow, it's very delayed, it's very infrequent . . . . If there's a course correction needed, will you know it before it's too late?” (Informant 25)
Another key aspect of indicators is whether indicators were output or outcome focused; both have their own advantages and shortcomings. Output indicators measure an activity (e.g., miles of bike lanes) and outcome indicators measure the desired result or condition (e.g., bicycle mode shift). Outcome indicators faced timeliness and attribution challenges because the desired condition may taken many years to achieve and several different factors may contribute to that outcome:
"You're not actually going to see change on obesity . . . over one year, three years, or maybe even five years . . . let alone attribute any change to the ped[estrian] plan . . . . It's fine, but . . . what is it really telling us and does it really matter?" (Informant 35)
Output indicators, on the other hand, run the risk of measuring an activity that may not ultimately contribute to the desired outcome:
“[The city's accountability structure] is very focused on: ‘Are you doing the things you promised?' which are about outputs, not outcomes. Not, ‘Are you doing the most important things?'” (Informant 56)
In short: Know which indicator usability characteristics are important for your use case and use a mix of output and outcome measures.
Originally published in the June 2023 edition (v. 41) of Streetsmart News
A diverse group of built environment practitioners ame together after the emergence of COVID-19 and the death of George Floyd to develop principles for centering health equity into built environment work. The result was the PHEAL principles. PHEAL has inspired the two initiatives below:
Originally published in the February 2022 edition of Streetsmart News (v. 40)
As discussed in the APHA policy statement, the effects of segregation have had lasting effects on people of color. This includes reduced economic opportunity and more severe impacts on health from the urban heat island effect (discussed in a previous newsletter). The results from a joint project by FiveThirtyEight and ABC news, The Lasting Legacy Of Redlining, show that historically redlined areas are still primarily populated by people of color: "In total, we analyzed the demographics of 138 metropolitan areas where HOLC (Home Owners’ Loan Corporation) drew maps, using data provided by the University of Richmond’s Mapping Inequality project and by the 2020 census. And we found that nearly all formerly redlined zones in the country are still disproportionately Black, Latino or Asian compared with their surrounding metropolitan area, while two-thirds of greenlined zones — neighborhoods that HOLC deemed 'best' for mortgage lending — are still overwhelmingly white." However, it should be noted that a different problem is happening in some cities, where gentrification has pushed people of color out of historically redlined areas and white people have moved in.
Originally published in the February 2022 edition of Streetsmart News (V. 40)
ITE's Health and Transportation Committee has been busy this past year producing webinars and "Quick Bites" (something like a cross between a white paper and fact sheet) to help transportation professionals better integrate health into transportation. If you are looking for a quick, easy, and accessible way to learn about and communicate transportation and health, take a look at the these three Quick Bites finished in December 2021: Transportation as a Determinant of Health, Health and Co-Benefits of Active Transportation, and Transportation for Mental Health and Happiness.
The American Public Health Association Policy Statement has updated its policy statement, Improving Health through Transportation and Land Use Policies, to better address equity. The new policy statement, Ensuring Equity in Transportation and Land Use Decisions to Promote Health and Well-Being in Metropolitan Areas, using a social determinants of health framework to identify the pathways by which land use and transportation decisions impact health equity. Key issues include authentic community engagement, the legacy of redlining on economic opportunity and health, and transportation investments that have severed communities. Strategies and policies at federal, state, and local levels are recommended to address these inequities and improve health outcomes.
Vehicle electrification often gets promoted as the best strategy for reducing greenhouse gas emissions (GHG) in the transportation sector. However, new research shows that active travel can not only better reduce GHG but also reduce traffic-related deaths as well as improve other health outcomes. In the journal article Health Benefits of Strategies for Carbon Mitigation in US Transportation, 2017-2050 (paywall), the health benefits of active transportation are compared to the electrification of cars as ways to decarbonize the transportation sector. Results showed that the active travel scenario avoided 167,000 deaths and gained 2.5 million disability-adjusted life years by 2050, monetized at $1.6 trillion using the value of a statistical life. Carbon emissions were reduced by 24% from baseline. Electric cars avoided 1,400 deaths and gained 16,400 disability-adjusted life years, monetized at $13 billion. These take-aways can be used to improve public health and urgently reduce carbon emissions in transportation by centering active travel in public policy.
Complete Streets are one of many tools for creating streets that are safe and accessible to all users. Scores of states and cities have developed Complete Streets policies, resolutions, and design guidance. A good example of Complete Streets guidance is the new Complete Streets Manual from the City of Baltimore.
Now the Complete Streets Coalition and Smart Growth America have produced a tool, The Benefits of Complete Streets, to quantify the economic, environmental, health, safety, and equity benefits of proposed projects. This tool helps makes the case for Complete Streets by demonstrating their manifold benefits.
Implementing Complete Streets can be incredibly fraught if private vehicle owners feel threatened about the loss of space dedicated to the automobile. A Complete Street process in Stevens Point, WI, offers some insightful lessons for how advocates can overcome these political obstacles. For the full story, read this case study featured on America Walks’ website.
The greatest threat to public health is climate change. Over 200 medical journals have signed a joint statement to that effect, demanding urgent action on climate change.
As discussed in a previous newsletter, extreme heat is one of the many health effects of climate change with potentially deadly consequences. Transportation contributes to the urban heat island (UHI) effect not only as the leading contributor of greenhouse gas emissions, but also locally through excess pavement, surface parking, and a lack of street trees.
Planners and designers need to reckon with UHI in a variety of contexts: Have you ever considered UHI in a transit-oriented development or at COVID-19 vaccination sites? Perhaps you should.
As the urgency of climate change and UHI are becoming clearer, cities are beginning to develop tools to meet the challenge. For example, New York City has developed a strategy called Cool Neighborhoods NYC and Miami-Dade County has developed an Extreme Heat Toolkit. In fact, Miami-Dade County now has a chief heat officer. For transportation-specific ideas, check out Cooling Long Beach: Urban Heat Island Reduction Strategies. Specific tools listed in the report include street trees, green infrastructure, shade structures, cool pavement and hardscape, and cooling amenities. Also, the ITE Transportation and Health Standing Committee will be producing fact sheets and other materials regarding transportation strategies for UHI in the coming year. Watch for them in a future newsletter and on the website listed above.
with Huijun Tan
For some time, researchers and professionals have advocated for a paradigm shift in transportation that focuses on access rather than mobility, as expressed here by Todd Litman or explained in this video by Dr. Susan Handy. This recognizes that the purpose of transportation is to provide access; it is not just travel for travel’s sake. In technical jargon, transportation is a derived demand, which is a term that emphasizes that transportation responds to household and land use characteristics.
The benefit of this approach is that it de-centers the mobility strategies that have not produced healthy or sustainable outcomes—or even effectively solved mobility goals (looking at you, induced demand). Prioritizing mobility and speed, for example, has serious safety consequences. In a recent analysis of pedestrian traffic fatality hotspots, nearly all fatalities occurred on multi-lane arterials (which are designed for automobility), with 70% requiring pedestrians to cross five or more lanes.
After decades of conceptualizing and measuring accessibility*(aka access to destinations) in academia, there is growing acceptance of the idea in practice. Some version of this concept has been described as creating complete neighborhoods or as 20-minute neighborhoods. However, Paris Mayor Anne Hidalgo’s plan for the 15-minute city (also called a city of proximities) has captured international attention and generated conversation about accessibility.
Part of this conversation also includes some skepticism about the feasibility and fairness of this model, particularly for American cities with land use and transportation patterns that make it difficult to get to any destinations by walking or bicycling. Another critique is that the 15-minute city excludes people with disabilities owing in part to the economic inaccessibility of existing complete neighborhoods. Edward Glaeser argues that a 15-minute city does not provide enough economic opportunity for residents; residents need access to the entire metropolis within an hour's time.
Another factor to consider is perceived accessibility. Measuring access to destinations through objective means has been computationally difficult until relatively recently. Today, practitioners have a number of tools at their disposal. These tools typically define access as the destinations closest to residents, but do people travel to the closest grocery store, as a gravity model would suggest? Or do they choose the store with lower prices or the store with more options? What if the route to the closest destination feels unsafe because of traffic or personal security concerns?
The conceptual issue, which some of the 15-minute city critiques approach, is that measures of accessibility represent potential access to destinations. They don’t represent actual travel behavior or whether resident needs have been met. For example, planners could use typical approaches to measuring accessibility to determine whether there are any food deserts in the city. However, objectively measured accessibility doesn’t capture whether stores are affordable to residents or sell culturally relevant foods. Perhaps the problem is not a food desert, but a food mirage.
Here are some recommendations for analyzing complete neighborhoods:
The climate and health benefits of complete neighborhoods are clear—they increase opportunities for physical activity as part of daily life and reduce the need for driving, which is likely to reduce greenhouse gas emissions and air pollutants. There’s also a good chance that they will create more attractive and safer neighborhoods. Many low-income communities and communities of color have reduced access to resources owing to inequitable planning and policy decisions. Improving access to destinations should be prioritized for these communities. Planners must ensure that these existing residents benefit from improvements. Methods for analyzing the risk of displacement and case studies for preventing displacement can be found on Streetsmart’s Equity and Inclusion page.
We mustn't treat the 15-minute neighborhood (local accessibility) and access to the larger metropolis (regional accessibility) as mutually exclusive paths—we need both for climate, health, and equity.
* Unfortunately, the transportation field uses the term accessibility in two different ways: one is access to destinations, the subject here, and the other is accessibility for people with disabilities. Any efforts to improve local access to destinations should ensure that it meets the needs of people with disabilities.
Climate Change, Health, and Structural Racism
Recent record-breaking heat waves have drawn attention to the impacts of climate change on health and well being. These heat waves have proven especially dangerous in parts of the country that have not historically relied on air conditioning, resulting in emergency actions that ranged from the creation of temporary cooling shelters to school cancellations. Heat is already the leading cause of weather-related deaths and climate change is increasing the severity of the urban heat island (UHI) effect.
These heat waves also elevated the scholarship that illustrates how racist land use practices, such as redlining, have created differential health effects (see also this EPA Environmental Justice webinar on Redlining and Climate Crisis). Historically redlined neighborhoods, deemed unsafe for investment by banks because they were inhabited by people of color, have been found to have significantly higher temperatures than non-redlined neighborhoods. The higher temperatures are a function of high amounts of impervious surfaces, fewer street trees, and inadequate park access. Park-deficient neighborhoods do not benefit from the cooling effects that park vegetation brings. It also means there are fewer places to retreat from the heat, which is particularly poignant when residents do not have air conditioning. Greenspace access is also important for healthy birth outcomes. Less tree canopy coverage has been found to be associated with preterm births among Black women.
While the UHI has recently captured the public’s attention, the particular hazards resulting from the interaction of climate change and racist planning policy may differ depending on the region of the country and the location of formerly redlined neighborhoods (explore the climate change hazards of your region here and here). For example, Sacramento’s formerly redlined (“hazard”) and yellowlined (“declining”) neighborhoods face high flood risk.
Air quality is another area with differential exposure and health effects. We now know that fossil fuel air pollution is more deadly than previously realized. The Fourth National Climate Assessment outlines the climate-induced risks of increased ground-level ozone and particulate matter, with respiratory and cardiovascular effects including premature deaths, hospital and emergency room visits, aggravated asthma, and shortness of breath.
Tools and Solutions
For resources on climate change mitigation and adaption, look at the C40 Cities site for suggestions. Streetsmart’s page on Greenhouse Gas Emissions (GHG) also has transportation-specific resources, including a list of proven strategies for reducing GHG.
Trees are a critical strategy for improving urban health (increased shade, UHI reduction, reduced housing energy costs, air filtration, stormwater absorption, reduced mental stress, etc.) To help identify where trees should be planted to achieve greater heat equity, use the Tree Equity Score tool created by American Forests. A simple but elegant solution for increasing street tree canopy builds on the oft-lauded 10-minute walk to essential destinations (aka 15-minute city):
“All Charlotte households will have access to essential amenities, goods, and services within a comfortable, tree-shaded 10-minute walk, bike, or transit trip by 2040” (Charlotte’s newly adopted comprehensive plan, Streetsmart emphasis).
One possible solution for reducing air pollution and increasing public space is the Barcelona superblock. In addition to journal articles on this model, the Barcelona Institute for Global Health created a mini-graphic novel to tell the fictional story of how the Barcelona Superblock came to be, inserting air pollution’s health effects (“one third of childhood asthma cases are caused by air pollution”) into the story.