The Health Equity Blog’s mission is to contribute to the discussion of health policy using evidence and research, to explore the opportunities for health equity through policy change, to raise awareness about health disparities, and to increase public advocacy for health equality.

According to the CDC, “Health equity is achieved when every person has the opportunity to ‘attain his or her full health potential’ and no one is ‘disadvantaged from achieving this potential because of social position or other socially determined circumstances.’”

Achievement of full health potential is necessary in all aspects of life – from running errands to relationships with loved ones. Some people are born into environments that limit their ability to achieve their full health potential. We believe that because society created many health inequalities, society can also fix them.

Monday, December 23, 2013

The hidden costs of car-centricity

The costs of car-centricity
I am a huge fan of public transportation. I am lucky that I can choose where I live based on the availability of public transportation. In the United States, there are millions of people that do not have the option of public transportation. Many cities are built so that driving is essential for every errand. Stop and think for a second how much money cars cost - the purchase of cars, insurance policies, repairs, parking and the gas. Those are the costs to the individual and they are substantial. Now think about the costs of cars to society - increased obesity and respiratory conditions are among the largest costs. All of these costs could be reduced if we start to improve our cities to be less car-centric and more person-centric.

Car centricity and obesity
On the very basic level, obesity = calorie intake > calories burned. So, if you eat more than you burn, you gain weight. Walking burns calories, while driving doesn’t. Imagine that instead of driving to work, you walked 3 blocks to a bus stop. That would be 6 blocks of walking without even trying!  Researchers have found that the more we drive as a nation, the more obese we become. The map below shows the link between obesity and car commuting.
Obesity rates are highest in Appalachia and the Southeast United States. Image: Planetizen
The American Public Health Association (APHA) estimates that cost of obesity associated with inactivity for society is $142 billion dollars annually for the United States.

Car-centricity and respiratory conditions
Car exhaust exacerbates respiratory conditions and is linked to heart conditions. Children, the elderly, and low-income individuals are at a greater risk than the general public to develop car exhaust related illnesses. While children and the elderly are at special risk due to the structure of their lungs, low-income individuals are at a great risk because the neighborhoods in which they reside are more likely to contain massive highways. The costs associated respiratory conditions include health costs, like doctors appointments and ER visits, as well as premature death. The APHA estimates the cost of air pollution in the United States  from traffic to be $50-80 billion dollars annually.

How to decrease car-centricity
Unfortunately it is not possible for most Americans to take public transportation instead of driving.  Cities are built up around the use of cars and cars are very much part of the American culture. Emerging research suggests that younger Americans are driving less. I do not think that higher taxes on cars or toll ways are a good option. People have to get to work and should not be punished because for centuries American cities have been build around car use. However, mixed-use developments are a promising step in the right direction. Mixed-use development integrates commercial and residential areas into one building that emphasizes pedestrian functionality. Major investment in both city and regional trains is also imperative. On a smaller level, I encourage businesses to offer mass-transit passes to employees or organize ride-share programs.  Americans are interested in more public transportation options. However, our dependence on the car is structural and it will take time to modify the American culture, change human behavior, and re-design cities and regions with better mass transportation options.

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