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    • Issue #13 Health impact assessment: practice issues >
      • Introduction to health impact assessment: practice issues
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      • Assessing the health and social impacts of transport policies and projects
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Assessing the health and social impacts of transport policies and projects


Dr Angela Curl, Department of Population Health,
​
​University of Otago Christchurch

[email protected]

Introduction

The New Zealand Government’s ‘Wellbeing Budget’ in 2019 signalled a shift in focus of government policy from economic growth towards a greater consideration of social and wellbeing outcomes across all of government. In line with this approach, the Ministry of Transport has developed a Transport Outcomes Framework (Ministry of Transport, 2018), outlining five broad outcomes of the transport system: healthy and safe people; environmental sustainability; resilience and security economic prosperity; and inclusive access.

These outcomes recognise the breadth of impacts that the transport system has on social (including health), environmental and economic outcomes. Focussing on how transport can positively and negatively impact a range of outcomes marks a notable shift away from transport planning and policy that has focussed primarily on achieving economic growth and productivity, whilst mitigating negative externalities.

To ensure that transport policies, plans and projects are designed in a way to ensure that all the broad outcomes are met, new approaches to appraisal in transport planning are required.  Transport planners and policy makers can draw on existing health and social impact assessment frameworks to support decision making aligned with the Transport Outcomes Framework.
​
This short article starts with a brief overview of the multiple ways in which transport affects health outcomes. It then provides an overview of how health impacts have been considered in transport appraisal and the use of health and social impact assessments for transport policies and projects in New Zealand, before using the example of mode shift policies to demonstrate the importance of wider health and social impacts in transport assessment. 

Health impacts of transport

The way in which we get around has profound impacts on health of populations and individuals. In many ways mobility is good for our health and wellbeing. Being mobile facilitates access to places and people that are important for a good quality of life, such as healthcare, employment and social connections, and movement in and of itself is good for physical and mental wellbeing. However, there are limits – and excess mobility, or needing to travel long distances can be detrimental, in particular for mental wellbeing.

Importantly,  the mode of transport used has considerable impacts on health and wellbeing of populations and individuals. New Zealand’s rate of car ownerships is among the highest in the world, with 93.5% of households owning cars. This high level of car dependence has many negative impacts on health and wellbeing. 

Road traffic injuries and deaths, air and noise pollution are estimated to account for around 650 deaths per year in New Zealand (Briggs et al., 2015).  Transport related emissions constitute a considerable proportion of total emissions contributing to climate change. Increased car use for short local journeys is associated with sedentary lifestyles and inactivity, which are associated with rising levels of obesity and poor mental and physical wellbeing. Financial stress, associated with the cost of car ownership, constitutes a considerable proportion of household budgets for those on lower incomes. 

Historically, high levels of investment in road infrastructure have led to lower density cities, built around car ownership. As a result, car use is further perpetuated as it becomes difficult to travel by other modes of transport. This dependence on car as a means of accessing essential services can lead to forced car ownership, whereby a large proportion of household income is spent on car ownership and use, or social exclusion for those unable to afford a car and unable to access essential services as a result.

Addressing persistent heath inequities is a key challenge for public policy in New Zealand (Baker et al., 2019). Yet relatively little attention has been paid to understanding how transport inequalities, as a key social determinant of health, leads to inequities in health outcomes (Hosking et al., 2019). A large body of literature focusses on transport-related inequalities, mainly in the availability of transport resources, differences in travel patterns, and transport accessibility levels (Pereira et al., 2017). Inequities in the availability and use of transport affects the way in which people travel and the destinations they are able to reach, with clear implications for life outcomes. Consideration of the differential impacts of any proposed policy or plan is key to social impact assessment (Vanclay, 2003) but these impacts have rarely been considered in transport assessment.

Despite clear relationships between transport planning decisions and health outcomes, health has not featured explicitly in transport decision making. The following section outlines how health is incorporated into transport planning and the potential for broader health and social impact assessments. 

Health and social impact assessment of transport policies and project

There are several examples of health impact assessments (HIA) of transport strategies and policies. Haigh et al. (2013) reviewed 24 HIAs undertaken in New Zealand between 2005 and 2009. Three of them focussed on transport: the Auckland Regional Land and Transport Strategy HIA (2009); Wairau Road Widening HIA (2006), and the HIA of the Greater Wellington Regional Land Transport Strategy (2006). However, some of the other HIAs assessed also considered transport as part of their broader focus, for example the HIA of Greater Christchurch Urban Development Strategy options (2006). There are also more recent examples of HIA of transport strategies or projects, for example the Canterbury Regional Land Transport Strategy 2011-2041 and the Nelson Arterial Traffic Study (2010).

None of these HIAs were mandated but rather they were decision -support HIAs undertaken by or in conjunction with the organisation responsible for the proposed project or policy (Haigh et al., 2013), often led by or with considerable input from the area public health unit. In an international context, Christofa et al. (2020) suggest that health impact assessments have often been undertaken by public health agencies, and it is unclear to what extent they influenced transport decision making. 

In addition to being undertaken on a voluntary basis, it is notable that all of the HIAs identified by Haigh et al. (2013) were undertaken at a regional or local level. Despite research undertaken in 2009 on how to integrate HIA into land transport planning (Ball et al., 2009) there is no requirement to undertake in-depth health or social impact assessments of transport policies, strategies or projects at the national level. Recently, however, the Ministry of Transport has undertaken a Social Impact Assessment (SIA) of the proposed (now approved) Clean Car discount scheme (Ministry of Transport., 2019).

Consideration of how national level policy might impact the population differentially is an important part of a social impact assessment and it is encouraging to see progress in this direction, especially given the focus on ‘inclusive access’ as a transport outcome. However, the approach taken in the SIA of the Clean Car discount scheme was a data intensive disaggregation of costs and benefits, without any community engagement or consideration of impact pathways that should also form part of a full SIA.  So called “full chain” impact assessments can be challenging because of data and labour intensiveness, the multi-disciplinary expertise required, and inherent uncertainties and inaccuracies when considering complex causal pathways (Nieuwenhuijsen et al., 2020).  A disaggregation of costs and benefits can be seen as one part of a health or social impact assessment but is not sufficient for understanding wider impacts. Community engagement and social science expertise are  important to ensure that assessments do not become a tick box exercises (Hickman, 2019; Walker & Curl, 2021).

So while there are examples of health and social impact assessments applied to transport policies, plans, and projects in New Zealand, these are not mainstream approaches to the appraisal of transport investment.  Assessment of proposed investment in transport often follows a business case approach, using multi-criteria assessment heavily dominated by quantifiable cost-benefit analysis. The monetisation of benefits has historically been dominated by journey time savings, leading to the prioritisation of vehicle mobility over accessibility and the prioritisation of investment in faster modes of travel, often the private car, leading to many of the health problems noted.  

More recently a wider range of impacts, including health impacts, has been incorporated into the cost-benefit approach (Waka Kotahi NZ Transport Agency, 2021). Those impacts that explicitly relate to the transport outcome “healthy and safe people” include: crash cost savings; walking and cycling health benefits; vehicle emission reduction benefits; and impact of noise and vibration on health. However, impacts on health and wellbeing cut across all of the transport outcomes, not just those included in “healthy and safe people”. Vehicle emission reduction benefits are quantified under “environmental sustainability”; cost savings are monetised under “economic prosperity” and driver frustration reduction benefits, and user benefits from new public transport or cycling facilities, are monetised under “inclusive access”. 

Beyond the monetisable impacts, Waka Kotahi’s social impact guide (Waka Kotahi NZ Transport Agency, 2016) outlines a range of social impacts that are likely to occur as a result of highway interventions. These include: air quality, noise, vibration, water quality, changes to transport modes, social connectedness, community severance, changes to facilities, changes to local movement patterns, safety, economy or public health. However, these impacts are considered largely as negative social impacts that should be mitigated. Instead social and health impact approaches could help to identify transport as having positive health outcomes across the whole of the transport outcomes framework.

Although the inclusion of aspects such as health benefits and valuation of noise and environmental impact demonstrate a broadening of impacts considered in cost-benefit analyses, there is still an emphasis on journey time savings. Furthermore, the impacts noted above are limited: for example, walking and cycling health benefits are often the health impacts associated with physical activity from active modes, but health impacts are much broader and not limited to active modes. There is no consideration of the negative health or physical activity impacts of investment in other modes.

The impacts considered are also usually the direct impacts arising from a particular project or policy, but there is limited consideration of the longer term pathways to impact or system level changes that occur as a result of investment decisions.
​
The nature of cost benefit analysis means that it focusses on aggregate costs and benefits at the population level and does not consider the gains and losses of different groups (Thomopoulos et al., 2009). Better consideration of health and social impacts can also help draw attention to issues of equity and fairness, which are important both in ensuring a fair and inclusive transport system and addressing persistent health inequities that can arise from an unfair transport system. 

The example of mode shift policies 

The example of mode shift policy demonstrates the importance of considering health and social impacts at the national policy level. Transport mode shift is a key priority in shifting towards a healthier, fairer and more sustainable transport system. Mode shift policy that leads to reduced car use, better public transport, and walking and cycling for short journeys can be health promoting and has the potential to help reduce health inequities. However, policy approaches that seek to limit car use and promote shared or active modes of transport can be perceived as unfair, especially where car ownership is seen as necessary (Mattioli & Colleoni, 2016; Smith et al., 2012) as is the case in many parts of New Zealand. In particular concerns are often raised around the fairness of mode shift policies that involve pricing (Levinson, 2010; Rajé, 2003) and increases in fuel tax (Farrington & Farrington, 2005). Public acceptability can be threatened when policies are seen to be unfair (Schuitema et al., 2011).

Concerns around fairness and public acceptability, as well as consideration of the ‘inclusive access’ transport outcome, have underpinned recent Waka Kotahi research to understand the potential social impacts of mode shift policy levers (Curl et al., 2020). Previous research has considered mode shift as one policy approach to address climate change (AEA Group, 2011; Lucas & Pangbourne, 2014; Markkanen & Anger-Kraavi, 2019) and concluded that at a macro level mode shift has positive social impacts. However, less consideration has been given to the way in which mode shift is achieved, and different mode-shift policy levers may have different health and social impacts. For example, public transport interventions to increase mode share can prioritise patronage over coverage, meaning areas with high need experience reduced services (Mattioli, 2016; Walker, 2008). Large infrastructure projects in particular often have considerable community impacts (Mottee et al., 2020), which also need to be considered as part of mode-shift interventions.

Waka Kotahi NZ Transport Agency (2019)’s mode shift strategy outlines three high-level policy levers for achieving mode shift:
1) shaping urban form;
2) making shared and active modes more attractive; and
3) influencing travel demand and transport choices.
​
Based on a review of existing evidence, Curl et al. (2020) concluded that reducing the need to travel, by shaping urban form is the most important and fairest way to encourage mode shift. In areas where people currently experience transport disadvantage, infrastructure investments that make shared and active modes should be prioritised next, with lower emphasis on influencing travel demand and transport choices through education or pricing tools. However, in areas where excess travel already occurs and transport choices are good, the focus should be on influencing travel demand and transport choices through pricing, education and awareness.

Although it is clear that mode shift away from private car use is beneficial overall, it is important that this occurs in a way which does not restrict the travel options of those who are already restricted, while widening choices for those who currently travel most. Mode shift policies that align with the Transport Outcomes Framework need to consider a broad range of economic, environmental, health and social impacts, beyond those typically considered in transport appraisal frameworks. Use of a broader range of impact assessment tools such as HIA and SIA can help achieve this.

Conclusions 

The focus on a broad range of transport outcomes, in line with the national wellbeing budget, demands a change in the ways in which transport plans and policies are assessed.

There are considerable overlaps between health impact assessment and social impact assessment, both of which are helpful in understanding the broader impacts of transport policies, plans and projects. While there are some examples of health and social impact assessments of transport policies or projects, neither approach is currently mandated.
​
Equity considerations are also largely missing from transport decision making processes. Given considerable inequities in health outcomes, many of which can be influenced by transport planning, there is a need to ensure equity is more embedded in impact assessments of transport policy and  planning at all levels. 
Download as a PDF

References 

AEA Group. (2011). Knowledge Review of the Social and Distributional Impacts of Department for Transport Climate Change Policy Options. Department for Transport. 
​
Baker, G., Baxter, J., & Crampton, P. (2019). The primary healthcare claims to the Waitangi Tribunal. The New Zealand Medical Journal (Online), 132(1505), 7-13.

Ball, J., Ward, M., Thornley, L., & Quigley, R. (2009). Applying health impact assessment to land transport planning (NZ Transport Agency Research Report RR 375. 146 pp, Issue.

Briggs, D., Mason, K., & Borman, B. (2015). Rapid Assessment of Environmental Health Impacts for Policy Support: The Example of Road Transport in New Zealand. International Journal of Environmental Research and Public Health, 13(1). 

Christofa, E., Esenther, S. E., & Pollitt, K. J. G. (2020). Chapter sixteen - Incorporating health impacts in transportation project decision-making in the United States. In M. J. Nieuwenhuijsen & H. Khreis (Eds.), Advances in Transportation and Health (pp. 343-369). Elsevier.

Curl, A., Watkins, A., McKerchar, C., Exeter, D., & Macmillan, A. (2020). Social impact assessment of mode shift. Waka Kotahi NZ Transport Agency: Wellington, New Zealand.

Farrington, J., & Farrington, C. (2005). Rural accessibility, social inclusion and social justice: towards conceptualisation. Journal of Transport Geography, 13, 1-12.

Haigh, F., Harris, E., Chok, H. N., Baum, F., Harris-Roxas, B., Kemp, L., Spickett, J., Keleher, H., Morgan, R., Harris, M., Wendel, A. M., & Dannenberg, A. L. (2013). Characteristics of health impact assessments reported in Australia and New Zealand 2005–2009. Australian and New Zealand Journal of Public Health, 37(6), 534-546.

Hickman, R. (2019). The gentle tyranny of cost–benefit analysis in transport appraisal. Transport Matters: Why transport matters and how we can make it better, 131.

Hosking, J., Macmillan, A., Jones, R., Ameratunga, S., & Woodward, A. (2019). Searching for health equity: validation of a search filter for ethnic and socioeconomic inequalities in transport. Systematic Reviews, 8(1), 94.

Levinson, D. (2010). Equity Effects of Road Pricing: A Review. Transport Reviews, 30(1), 33-57. 

Lucas, K., & Pangbourne, K. (2014). Assessing the equity of carbon mitigation policies for transport in Scotland. Case Studies on Transport Policy, 2(2), 70-80.

Markkanen, S., & Anger-Kraavi, A. (2019). Social impacts of climate change mitigation policies and their implications for inequality. Climate Policy, 19(7), 827-844. 

Mattioli, G. (2016). Transport needs in a climate-constrained world. A novel framework to reconcile social and environmental sustainability in transport. Energy Research & Social Science, 18, 118-128. 

Mattioli, G., & Colleoni, M. (2016). Transport disadvantage, car dependence and urban form. In Understanding mobilities for designing contemporary cities (pp. 171-190). Springer.

Ministry of Transport. (2018). A framework for shaping our transport system: Transport outcomes and mode neutrality. 

Ministry of Transport. (2019). Vehicle Purchase Feebate Scheme: Preliminary Social Impact Assessment. 

Mottee, L. K., Arts, J., Vanclay, F., Miller, F., & Howitt, R. (2020). Reflecting on How Social Impacts are Considered in Transport Infrastructure Project Planning: Looking beyond the Claimed Success of Sydney’s South West Rail Link. Urban Policy and Research, 1-14.

Nieuwenhuijsen, M. J., Khreis, H., Mueller, N., & Rojas-Rueda, D. (2020). Chapter fourteen - Health impact assessment of transport planning and policy. In M. J. Nieuwenhuijsen & H. Khreis (Eds.), Advances in Transportation and Health (pp. 309-328). Elsevier.

Pereira, R. H. M., Schwanen, T., & Banister, D. (2017). Distributive justice and equity in transportation. Transport Reviews, 37(2), 170-191.

Rajé, F. (2003). The impact of transport on social exclusion processes with specific emphasis on road user charging. Transport and Social Exclusion, 10, 321-338.

Schuitema, G., Steg, L., & van Kruining, M. (2011). When Are Transport Pricing Policies Fair and Acceptable? Social Justice Research, 24(1), 66-84.

Smith, N., Hirsch, D., & Davis, A. (2012). Accessibility and capability: the minimum transport needs and costs of rural households. Journal of Transport Geography, 21, 93-101.

Thomopoulos, N., Grant-Muller, S., & Tight, M. R. (2009). Incorporating equity considerations in transport infrastructure evaluation: Current practice and a proposed methodology. Evaluation and Program Planning, 32(4), 351-359. 

Vanclay, F. (2003). International Principles For Social Impact Assessment. Impact Assessment and Project Appraisal, 21(1), 5-12. 

Waka Kotahi NZ Transport Agency. (2016). Social Impact Guide. 

Waka Kotahi NZ Transport Agency. (2019). Keeping Cities Moving: Increasing the wellbeing of New Zealand's cities by growing the share of travel by public transport, walking and cycling. 

Waka Kotahi NZ Transport Agency. (2021). Monetised Benefits and Costs Manual. 

Walker, J. (2008). Purpose-driven public transport: creating a clear conversation about public transport goals. Journal of Transport Geography, 16(6), 436-442. 
​

Walker, L., & Curl, A. (2021). Social and Distributional Impact Assessment in Transport Policy. In R. Vickerman (Ed.), International Encyclopedia of Transportation (pp. 361-367). Elsevier.
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    • Issue #16 SIA for rural resilience and wellbeing >
      • SIA for rural resilience and wellbeing: Intro
      • The drivers and agents of on-farm change in Aotearoa New Zealand
      • Social-ecological assessment for remote and island communities
      • The Impact of Substandard Rural Housing on Resilience and Wellbeing in Te Tai Tokerau
      • Success factors for planning regeneration in rural areas
    • Issue #15 Economic methods and Impact Assessment >
      • Economic methods in impact assessment: an introduction
      • The Nature of Economic Analysis for Resource Management
      • The State-of-the-Art and Prospects: Economic Valuation of Ecosystem Services in Environmental Impact Assessment
      • Economic impact assessment and regional development: reflections on Queensland mining impacts
      • Fonterra’s policy on economic incentives for promoting sustainable farming practices
    • Issue #14 Impact assessment for infrastructure development >
      • Impact assessment for infrastructure development - an introduction
      • Place Matters: The importance of geographic assessment of areas of influence in understanding the social effects of large-scale transport investment in Wellington
      • Unplanned Consequences? New Zealand's experiment with urban (un)planning and infrastructure implications
      • Reflections on infrastructure, Town and Country planning and intimations of SIA in the late 1970s and early 1980s
      • SIA guidance for infrastructure and economic development projects
      • Scoping in impact assessments for infrastructure projects: Reflections on South African experiences
      • Impact Assessment for Pacific Island Infrastructure
    • Issue #13 Health impact assessment: practice issues >
      • Introduction to health impact assessment: practice issues
      • International Health Impact Assessment – a personal view
      • Use of Health Impact Assessment to develop climate change adaptation plans for health
      • An integrated approach to assessing health impacts
      • Assessing the health and social impacts of transport policies and projects
      • Whither HIA in New Zealand….or just wither?
    • Issue #12 Risk Assessment: Case Studies and Approaches >
      • Introduction
      • Risk Assessment and Impact Assessment : A perspective from Victoria, Australia
      • The New and Adaptive Paradigm Needed to Manage Rising Coastal Risks
      • Reflections on Using Risk Assessments in Understanding Climate Change Adaptation Needs in Te Taitokerau Northland
      • Values-Based Impact Assessment and Emergency Management
      • Certainty about Communicating Uncertainty: Assessment of Flood Loss and Damage
      • Improving Understanding of Rockfall Geohazard Risk in New Zealand
      • Normalised New Zealand Natural Disaster Insurance Losses: 1968-2019
      • Houston, We Have a Problem - Seamless Integration of Weather and Climate Forecast for Community Resilience
      • Innovating with Online Data to Understand Risk and Impact in a Data Poor Environment
    • Impact Connector #11 Climate Change Mitigation, Adaptation, and Impact Assessment: views from the Pacific >
      • Introduction
      • Climate change adaptation and mitigation, impact assessment, and decision-making: a Pacific perspective
      • Climate adaptation and impact assessment in the Pacific: overview of SPREP-sponsored presentations
      • Land and Sea: Integrated Assessment of the Temaiku Land and Urban Development Project in Kiribati
      • Strategic Environmental Assessment: Rising to the SDG Challenge
      • Coastal Engineering for Climate Change Resilience in Eastern Tongatapu, Tonga
      • Climate-induced Migration in the Pacific: The Role of New Zealand
    • Impact Connector #10 Climate Change Mitigation and Adaptation >
      • Introduction
      • Is a “just transition” possible for Māori?
      • Adapting to Climate Change on Scale: Addressing the Challenge and Understanding the Impacts of Asia Mega-Cities
      • How responding to climate change might affect health, for better or for worse
      • Kanuka, Kereru and carbon capture - Assessing the effects of a programme taking a fresh look at the hill and high country land resource
      • Wairoa: Community perceptions of increased afforestation
      • Te Kākahu Kahukura Ecological Restoration project: A story within a story
    • Issue #9 Impacts of Covid-19 >
      • Introduction to Impact Connector Issue 9 – Impact assessment and Covid 19
      • Covid-19 fast-track consenting: climate change legacy key to success
      • Tourism – the long haul ahead
      • Making sense of the impact of Covid-19: planning, politics, and the public good
    • Issue #8 Social Impact Assessment >
      • Challenges for Social Impact Assessment in New Zealand: looking backwards and looking forwards
      • Insights from the eighties: early Social Impact Assessment reports on rural community dynamics
      • Impact Assessment and the Capitals Framework: A Systems-based Approach to Understanding and Evaluating Wellbeing
      • Building resilience in Rural Communities – a focus on mobile population groups
      • Assessing the Impacts of a New Cycle Trail: A Fieldnote
      • The challenges of a new biodiversity strategy for social impact assessment (SIA)
      • “Say goodbye to traffic”? The role of SIA in establishing whether ‘air taxis’ are the logical next step in the evolution of transportation
    • Issue #7 Ecological Impact Assessment >
      • The future of Ecological Impact Assessment in New Zealand
      • Ecological impact assessment and roading projects
      • EcIA and the Resource Management Act
      • Professional Practice and implementation of EcIA
      • EcIA in the Marine Environment
    • Issue #6 Landscape Assessment >
      • Introduction
      • Lives and landscapes: who cares, what about, and does it matter?
      • Regional Landscape Inconsistency
      • Landscape management in the new world order
      • Landscape assessment and the Environment Court
      • Natural character assessments and provisions in a coastal environment
      • The Assessment and Management of Amenity
      • The rise of the THIMBY
      • Landscape - Is there a common understanding of the Common?
    • Issue #5 Cultural Impact Assessment >
      • Introduction
      • Potential of Cultural Impact Assessment
      • The Mitigation Dilemma
      • CIA and decision-making
      • Insights and observations on CIA
      • Achieving sustainability through CIA
      • CIA - Enhancing or diminishing mauri?
      • Strategic Indigenous Impact Assessment?
    • Issue #4 Marine Environment >
      • Introduction
      • Iwi, Impact Assessment and Marine Environment
      • Sea-Bed Mining Application in Taranaki
      • The wreck of the MV Rena
      • High Court RMA Controls on Fishing
      • Initiatives in the Pacific Islands
      • SEA in an NZ context
    • Issue #3 Strategic Environmental Assessment
    • Issue #2
    • Issue #1
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