Carolyn McAndrews

Revisiting exposure: Fatal and non-fatal traffic injury risk across different populations of travelers in Wisconsin, 2001-2009

Comparing the injury risk of different travel modes requires using a travel-based measure of exposure. In this study we quantify injury risk by travel mode, age, race/ethnicity, sex, and injury severity using three different travel-based exposure measures (person-trips, person-minutes of travel, and person-miles of travel) to learn how these metrics affect the characterization of risk across populations. We used a linked database of hospital and police records to identify non-fatal injuries (2001-2009), the Fatality Analysis Reporting System for fatalities (2001-2009), and the 2001 Wisconsin Add-On to the National Household Travel Survey for exposure measures. In Wisconsin, bicyclists and pedestrians have a moderately higher injury risk compared to motor vehicle occupants (adjusting for demographic factors), but the risk is much higher when exposure is measured in distance. Although the analysis did not control for socio-economic status (a likely confounder) it showed that American Indian and Black travelers in Wisconsin face higher transportation injury risk than White travelers (adjusting for sex and travel mode), across all three measures of exposure. Working with multiple metrics to form comprehensive injury risk profiles such as this one can inform decision making about how to prioritize investments in transportation injury prevention.

Community-Based Advocacy at the Intersection of Public Health and Transportation: The Challenges of Addressing Local Health Impacts within a Regional Policy Process

Integrating public health concerns into transportation policy agendas involves addressing the negative impacts of traffic on neighboring communities. Through interviews, focus groups, and participatory photo-mapping, we studied one community that advocated to improve community health through the design and reconstruction of an arterial road in their neighborhood. The transportation planning process provided an opportunity for neighbors’ participation, but it prioritized solving regional transportation problems instead of local impacts. The uneven adoption of public health concerns in this case was related to the constraints of regional planning and governance. Integrating health and transportation issues locally requires action at multiple scales.

Understanding livable streets in the context of the arterials that surround them

Not long after the advent of cars, a conflict between traffic and residential livability arose. The typical response pushed traffic off residential streets and onto nearby major roads. This line of thinking evolved into a hierarchical approach to the street networks and arterial roads designed to carry the majority of vehicle traffic. With many researchers identifying traffic on residential streets to be an underlying issue behind poor livability, this solution makes sense. However, is the relationship between residential livability and traffic moderated by the character of the nearby arterial road? By use of a residential study in Denver, Colorado, 10 arterials were partitioned along two dimensions: high and low traffic and high and low design quality. Comparable residential roads within the surrounding neighborhoods were selected to fit descriptions of heavy, moderate, and light traffic, and 723 residents were surveyed. The results suggest that the surrounding street network—in particular, the character of the nearby arterial road—influences the livability of residential areas on the adjacent streets according to a number of livability measures. When income was controlled for, both high levels of traffic and low levels of urban design on the arterial were found to detract from livability in the surrounding neighborhoods, sometimes more so than the residential street traffic itself. This finding should not be taken as a call to shift traffic onto residential streets. Rather, planners and engineers need to take a broader perspective and consider the whole network to understand livability. Livable residential streets can be only part of the solution; more livable arterials are also needed.

The Reach of Bicycling in Rural, Small, and Low-Density Places

Lessons derived from the urban experience of bicycling may not be broadly supportive of bicycling in rural, small, and low-density (RSLD) places because of differences in built environment, social, and political contexts. In this study, the hypothesis that bicycling was primarily an urban activity was investigated. Binary logistic regression was used to compare the frequency of bicycling and the population characteristics of bicyclists across urban and RSLD places. Multiple operational definitions of urban–rural continua were used to examine whether the results were sensitive to how RSLD places were defined. The data for bicycling were from the 2009 National Household Travel Survey, which was designed to represent the population of the United States. Bicycling was found to be primarily, but not exclusively, an urban activity. Moreover, women and youths were more likely to bicycle in RSLD places compared with urban places. These findings suggest that an urban perspective on bicycling could limit the success of initiatives aiming to increase the diversity of populations that bicycle. Developing a base of empirical knowledge of bicycling in RSLD places is a necessary step toward developing more inclusive and effective multimodal transportation strategies.

Understanding and Improving Arterial Roads to Support Public Health and Transportation Goals

Arterials are types of roads designed to carry high volumes of motorized traffic. They are an integral part of transportation systems worldwide and exposure to them is ubiquitous, especially in urban areas. Arterials provide access to diverse commercial and cultural resources, which can positively influence community health by supporting social cohesion as well as economic and cultural opportunities. They can negatively influence health via safety issues, noise, air pollution, and lack of economic development. The aims of public health and transportation partially overlap; efforts to improve arterials can meet goals of both professions. Two trends in arterial design show promise. First, transportation professionals increasingly define the performance of arterials via metrics accounting for pedestrians, cyclists, transit riders, and nearby residents in addition to motor vehicle users. Second, applying traffic engineering and design can generate safety, air quality, and livability benefits, but we need evidence to support these interventions. We describe the importance of arterials (including exposures, health behaviors, effects on equity, and resulting health outcomes) and make the case for public health collaborations with the transportation sector.

Facilitation and Dialogue as Methods of Reflective Practice in Professional Education

Abstract Students may fear sharing their learning in public because classrooms are not traditional places where we teach skills needed for mutual understanding, such as facilitation and dialogue. This is a pedagogical challenge for planning, policy, and design fields because contemporary teaching requires collaboration among participants. We propose that learning to work collaboratively in the classroom has broader relevance for practice because it mirrors the learning that happens in organizations. To address this opportunity, we trained students in facilitation and dialogue. In this article, we discuss the design, implementation, and outcomes of this intervention.

Motivations and Strategies for Bicycle Planning in Rural, Suburban, and Low-Density Communities: The Need for New Best Practices

Problem, research strategy, and findings: Many planners view bicycles as a critical component of sustainable urban transportation, but assumptions about cycling derived from urban places may not translate to the social, political, and built environment contexts outside of cities. Our study focuses on the motivations and strategies that rural, small, and low-density (RSLD) communities have for investing in bicycle systems; our goal was to learn what kind of technical assistance such communities might need to realize their cycling goals. We conducted in-depth interviews in 10 communities that received grants from a Kaiser Permanente program in Colorado to increase cycling. Takeaway for practice: These 10 cases present a conflict between a recreational or quality-of-life approach to increasing cycling in RSLD communities and a transportation approach more common in urban areas, which stresses the use of cycling to supplement or replace auto travel for purposive trips. Most RSLD cities did not have the political or cultural support to plan for and begin constructing major cycling infrastructure for either recreational or transportation cycling. Most need best practices to educate local stakeholders on the value of cycling to support economic development, increase tourism, and improve property values without significantly reducing auto access. Planners in RSLD places also need special guidance for addressing the needs of riders with diverse environmental values and those from disadvantaged communities.

Linking transportation and population health to reduce racial and ethnic disparities in transportation injury: Implications for practice and policy

ABSTRACT In both developing and advanced economies, it is commonly believed that lower income and minority populations are disproportionately at risk of being injured or killed in a motor vehicle crash, especially as pedestrians. However, this risk is rarely quantified with information about exposure. We argue that a combined transportation–population health framework is one way to quantify, and therefore prioritize, equity considerations in transportation safety decision-making. We illustrate this approach with an analysis that compares age-adjusted fatal and nonfatal injury rates per 100 million person-trips by race/ethnicity and sex for motor vehicle occupants, bicyclists, and pedestrians. We found that, per trip, whites are equally safe as pedestrians and motor vehicle occupants, whereas other racial and ethnic groups for whom we have data are less safe when they walk. In addition, black/African-American female motor vehicle occupants and pedestrians have higher inpatient injury risk than female travelers of other races and ethnicities (for whom we had sufficient data). Such differences in transportation injury risk by race and ethnicity warrant deeper analysis to understand the underlying reasons, such as whether certain groups of travelers are exposed to qualitatively different hazards when they travel. We discuss frameworks for including information about injury disparities in decision-making.

Are rural places less safe for motorists? Definitions of urban and rural to understand road safety disparities

The objectives of the study are to understand road safety within the context of regional development processes and to assess how urban–rural categories represent differences in motor vehicle occupant fatality risk. We analysed 2015 motor vehicle occupant deaths in Wisconsin from 2010 to 2014, using three definitions of urban–rural continua and negative binomial regression to adjust for population density, travel exposure and the proportion of teen residents. Rural–Urban Commuting Area codes, Beale codes and the Census definition of urban and rural places do not explain differences in urban and rural transportation fatality rates when controlling for population density. Although it is widely believed that rural places are uniquely dangerous for motorised travel, this understanding may be an artefact of inaccurate constructs. Instead, population density is a more helpful way to represent transportation hazards across different types of settlement patterns, including commuter suburbs and exurbs.

Reducing the Negative Effects of Traffic on Communities: Public Engagement, Planners’ Engagement, and Policy Change

Abstract With improved participation requirements and feedback methods, the doors to discussion have opened significantly over the decades to invite participation by those most affected by planning decisions. But the effectiveness of our outreach—and ultimate incorporation of local concerns into our planning—can be limited by the ways in which we define a project or problem and by our own blind spots. In working with an exceptionally organized and engaged community, the authors have identified these missed opportunities and suggest an increased role for planners in ensuring policy makers and decision makers understand local ideas and concerns as not merely opposition, but opportunity.