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Posts from the Public Health Category


USC Public Health Professor Asks for Better Transportation Options to USC

Transportation issues at the University of Southern California have been in the news recently. Yesterday’s “Today’s Headlines” featured a story about how USC’s students rely on bicycles, but the administration is making it more and more difficult to bring bicycles onto campus.

Earlier in the week, the focus was on the faculty outrage that the school was canceling a program designed to make rideshare easier and more affordable in favor of a parking subsidy program. Neither story was news to Streetsblog readers. We’ve covered the strange transportation policies at USC for years, including a recent takedown of the end of the rideshare subsidies by Sahra Sulaiman.

Streetsblog has long argued that there is a direct link between transportation planning and the health of a community. While USC’s administration seems to have missed this lesson, their public health professors have not.

Professor Ed Avol, with USC’s Keck School of Medicine, has not been shy about his feelings towards the school’s transportation planning decisions.

“The notion that it is no longer feasible, or appropriate, to encourage people to use mass transit rather than drive their individual cars to park in University-owned lots, and to suggest that a reasonable partial offset to elimination of the subsidy would be to provide several parking passes to those formerly using mass transit, is convoluted logic of the highest order,” Avol writes in a letter to the Provost and Transportation Office at USC.

The full text of Avol’s letter can be found after the jump. Read more…

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Westside Urban Forum Tackles “Healthy Communities”

The panel discussing healthy communities at the Westside Urban Forum Friday morning. From left to right, Sahra Sulaiman, Clare De Briere, Jean Armbruster, and Fred Zimmerman. Photo via Rick Cole.

The panel discussing healthy communities at the Westside Urban Forum Friday morning. From left to right, Sahra Sulaiman, Clare De Briere, Jean Armbruster, and Fred Zimmerman. Photo via Rick Cole.

What is a healthy community? And what role does the built environment play in creating a healthy community?

These were the questions tackled by a Westside Urban Forum panel Friday, moderated by UCLA Professor, Fred Zimmerman, who chairs the Department of Health Policy and Management.

Also on the panel were Streetsblog L.A. Communities Editor Sahra Sulaiman, Jean Armbruster, Director of Los Angeles County Department of Public Health PLACE Program, and Clare De Briere, Chief Operating Officer of private developer The Ratkovich Company.

Overall, the conversation focused primarily on the question of access. Those living in a healthy community can access the things that are essential to their day-to-day lives more easily: schools, parks, grocery stores, etc. But the question of access turns out to be more complicated than just whether or not these things are located around the corner.

“When we are looking at building a healthy community… we have to look at the root causes,” Armbruster told the crowd of several dozen in attendance, including Santa Monica City Manager Rick Cole.

One of the root causes of problems in a community, said Armbruster, is housing affordability.

Over 50 percent of households in L.A. County are rent-burdened, she said, calling it a root cause of a lot of social ills.

People have to live far away and commute, don’t have money to spend on health insurance, healthy food, among other important things, she said. “They just need a place that they’re not going to pay way more than they can afford.”

The panel’s moderator, Zimmerman, has written on this exact point for Santa Monica Next.

Of course, housing affordability is just one — albeit large — piece of the puzzle. From the private developer side, De Briere said her company strives to knit together the urban fabric so walking to and from different buildings, transit, and other places, is not only possible, but attractive.

Currently, the Ratkovich Company is remodeling the Macy’s building in Downtown L.A. into an open-air mall that will include direct access to the Metro 7th Street station. Downtown L.A. has transformed in the past decade from a dead, mostly commercial district into a thriving neighborhood.

But for some communities, decades of disinvestment has a much more enduring legacy. Read more…


Some Thoughts on Near Roadway Air Pollution and L.A.’s Future

From Rob McConnell's presentation: air pollution spikes at freeways

From Rob McConnell’s presentation: air pollution spikes at freeways. Pollution levels drop quickly away from freeways.

I attended a forum event yesterday, entitled “The Collision of Best Intentions: Public Health, Smart Growth, and Land Use Planning.” Speakers focused  on “NRAP” – an acronym I wasn’t familiar with. NRAP stands for Near Roadway Air Pollution. It’s the study of pollution risks near freeways and other high-volume roads.

I confess that I have been only vaguely aware of NRAP. Years ago, I had heard about studies that show health issues correlate to areas close to freeways. I vaguely recall some efforts to keep schools at a tolerable distance from freeways. I am still not all that up to speed on this issue, so apologies if I have characterized anything incorrectly in this article.

The fundamental question that this conference explored was, basically: In the light of air pollution issues, is urban densification good for overall health? There are a number of corollary issues: On congested-polluted streets, is bicycling or walking healthy? Is Transit-Oriented-Development, or, more generally, infill development bad for our health?

For me, a car-free bike activist, these questions go to my fundamental core. Of course bicycling and walking are good! For me, for my community, my planet. I think that there’s a body of research that backs me up. Cyclists live longer than non-cyclists. Health benefits of cycling outweigh risks by 20:1, according to a London study. Inactivity is dangerous, in the long run. There’s also research showing that car occupants are exposed to unhealthy air quality inside cars, so, even if bicycling exposes me to roadway air pollution, I don’t think I am at any greater exposure than other folks using the road. And cyclists and pedestrians are on the edge of that pollution cloud, not in the thick of it the way drivers are.

I suspect that a lot of people make poorly informed decisions based on perceived risk. The most common example is that of the person who drives to their destination because they afraid of flying. Flying is, statistically mile-for-mile, way safer than driving.

I haven’t seen a clear study on this, but I tend to think that a similar ill-informed trade-off takes place with driving and bicycling. Replacing a perceived-dangerous ~10mph bicycle trip with a perceived-safe 50+mph car trip may well put a well-intentioned person at greater risk. Not bicycling in a polluted city, while instead driving in a polluted city doesn’t make good sense to me. My hunch is that it’s a similarly false trade-off, like driving instead of flying.

Back to yesterday’s forum.

From Rob McConnell's presentation: Asthma is worse closer to major roads.

From Rob McConnell’s presentation: Asthma is worse closer to major roads.

USC’s Rob McConnell presented on research that found clear relationships between proximity to freeways and rates of asthma and obesity. Apparently, historically, there was a general understanding that regional air pollution made asthma worse, but didn’t cause it. The current understanding is that roadway pollution causes asthma. Watch a similar talk by Rob McConnell here. McConnell also reviewed research linking NRAP with increased obesity.

These very real heath risks led researchers to investigate solutions. UCI’s Doug Houston spoke about a review of various structural tinkering to mitigate roadway pollution. Researchers have looked to soundwalls, sealed windows, taller building, vegetation, indoor air filtration, and more. Though those measures help, none of them quite solves the problem.

Read more…

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L.A. Kicks Off Citywide Plan Forums, Additional Forums Coming to Your Area

Attendees learn about and comment on L.A. City's draft Mobility Plan 2035 - at last Saturday's community planning forum in Granada Hills. Joe Linton/LA Streetsblog

Attendees learn about and comment on L.A. City’s draft Mobility Plan 2035 – at last Saturday’s community planning forum in Granada Hills. Joe Linton/Streetsblog LA

This past Saturday in Granada Hills, Streetsblog L.A. attended the first of seven planning forums hosted by the city of Los Angeles’ Department of City Planning (DCP.)

The next forum will be held in Downtown L.A. this Wednesday, March 19 from 5 p.m. to 8 p.m. at Metro HQ, just behind Union Station. Following that will be this Saturday, March 22nd from 9 a.m. to 12 noon at South L.A.’s Martin Luther King Recreation Center on Western at 39th. Planning forums continue through April 12th – full schedule after the jump.

The forums are basically an open house format. Show up any time during the open hours, peruse plans and display boards, ask questions, and submit comments. DCP is seeking community input on three citywide initiatives:

Mayor Garcetti’s staff are also promoting their Great Streets Initiative. Various local initiatives, including the Boyle Heights Community Plan Update, will be featured at the forum taking place in the corresponding location.

Saturday’s forum at the Granada Hills Recreation Center  was attended by several hundred people. Attendees included members of San Fernando Valley Neighborhood Councils, hillside homeowner associations, and members of the city of Los Angeles’ appointed Bicycle Advisory Committee. With the open house format, it’s difficult to get much of an overall sense of how the draft plans were being received. Issues overheard discussed ranged from concern over toxic soils, to the taxpayer cost of large-scale planning efforts, to the loss of a “great cut-through [for cars]” on Wilbur Avenue. Read more…


Introducing L.A.’s Proposed Health and Wellness Plan, What It Isn’t and Is

The city of Los Angeles Department of City Planning is kicking off a series of seven community planning forums starting this Saturday, March 15th, and running through April 12th. They’re at various locations from Granada Hills to San Pedro. The forums are for public feedback on three citywide planning processes: re:code L.A., Mobility Plan 2035, and Plan for a Healthy Los Angeles. This week, Streetsblog will preview each of the citywide initiatives. First off, it’s the city’s new health plan.

From the Plan for a Healthy Los Angeles Health Atlas, map of zero vehicle households - click to go to health atlas website

From the Plan for a Healthy Los Angeles’ Health Atlas for the City of Los Angeles, chapter 8, map of zero vehicle households – click image to go to Health Atlas website

There’s a brand new plan on the block.

Until now, the city of Los Angeles hasn’t had a stand-alone health and wellness plan as an element of its General Plan. Formally, the new plan is titled Plan for a Healthy Los Angeles and it has its own website, blog, Facebook, Twitter, mailing list, and RSS feed.

The Plan for a Healthy Los Angeles (Health Plan) is a collaborative effort spearheaded by the Department of City Planning (DCP), with the L.A. County Department of Public Health, the California Endowment, and the project consultant Raimi + Associates.

A draft Health Plan (pdf available via Plan download page) was released February 13th for a 90-day review period. DCP is requesting public comment on the draft, via the upcoming forums which conclude April 12th, 2014, or via email or in writing. The deadline for comments is May 13th, 2014.

What may be most interesting about the Health Plan is what isn’t in it.

Streetsblog readers are familiar with the clear connections between transportation and health. Collisions kill in the short run. Car-centric systems decrease physical activity, which kills in the long run.

The Health Plan contains very little transportation planning, but instead acknowledges “the connection between health and mobility” and directs Angelenos to “please see the Mobility Plan 2035” for actual transportation plans and policies. The only transportation policy in the health plan is “increasing community access to open space and recreational opportunities, as well as to medical care facilities.”

Similarly, the Health Plan mentions but does not focus on economic development, equity, environmental justice, or housing. These are covered by the city’s General Plan Framework and the General Plan Housing Element, respectively.

So, what’s left? Quite a bit, it turns out.

The health plan focuses on six main areas:

  1. “A City Built for Health” includes: increasing goods and services in underserved neighborhoods, and promoting active design and disabled access.
  2. “Bountiful Parks and Open Spaces” includes: expanding parks (especially in underserved neighborhoods), revitalizing the L.A. River, safer parks, and community stewardship of parks.
  3. “Food that Nourishes Body and Soul” includes: urban agriculture, farmers markets, and more equitable access to healthy affordable food outlets.
  4. “An Environment Where Life Thrives” includes: reducing air pollution, increasing the number of smoke-free places, reducing impacts of oil extraction, and remediating brownfields.
  5. “Lifetime Opportunities for Learning and Prosperity” includes: supporting early childhood, lifelong learning, arts, libraries, workforce training, and youth employment.
  6. “Safe and Just Neighborhoods” includes: supporting gang prevention programs, innovative public safety, community policing, and reintegrating the formerly incarcerated.

Read more…

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What Should Doctors Do to Prevent Traffic Deaths?

When cars first became a common presence in American cities, doctors were shocked by the carnage. In 1925, editors of the New England Journal of Medicine called the bloodshed caused by motorists “appalling” and lamented children’s loss of life as “a massacre of the innocent.” The sense of urgency was still detectable a few decades later. In a 1957 report, Harvard researchers called the public health threat posed by automobiles a “mass disease of epidemic proportions.”

The medical profession was alarmed about the bloodshed that accompanied the introduction of cars into mainstream society in the early part of the last century. Since then, views have evolved considerably. Image: New England Journal of Medicine

The medical profession was alarmed about the bloodshed that accompanied the ascent of cars in the early part of the last century. Since then, views have changed considerably. Image: New England Journal of Medicine

But as time went on, the medical establishment became much more muted in its response. Public health research gravitated to relatively minor risks — like the connection between traffic collisions and diabetes or sleep apnea — instead of more significant dangers like drunk or distracted driving. In 1987, some doctors took to the pages of the Journal to criticize their colleagues for being “relatively silent about the relation between alcohol and motor vehicle accidents.”

These shifts are charted by David Jones, a doctor who studies the history of medicine at Harvard, in a recent review of how American physicians have addressed the public health threats posed by automobiles. Looking at the last century of articles about cars and public health published in the New England Journal of Medicine, Jones charted the fascinating historical trajectory of how physicians’ views on driving-related health risks have shifted, in an article that was itself published in the Journal earlier this month.

Despite an article in the most recent edition of the Journal finding that distracted driving is associated with significantly increased crash rates among both novice and experienced drivers, Jones says doctors still don’t seem to be comfortable taking decisive action to prevent these kinds of collisions.

I recently spoke to Jones about his research. Below is an edited transcript of our interview.

It sounds like doctors have been a little bit hesitant to intervene.

Because of their position on the front line of disease, doctors become aware very early on of what types of things in our society are causing threats to life and health. The question is: What’s the appropriate response?

When the first cars started showing up on the roads in the 1890s, within 10 years doctors at medical journals were astonished by the rising numbers of people who were killed in driving accidents.

Pretty early on, probably by the 1920s or 1930s, most doctors would say the biggest problem with driving is drunk driving. That’s totally clear now. If you look at the leading cause of car accidents, it’s alcohol. Society has responded by criminalizing drunk driving, which is probably appropriate — although there are a lot of people who would say that the sanctions aren’t nearly strong enough.

What’s the role of doctors in all of this? One question that came up in the 1920s: Should everyone who wants a driver’s license undergo a medical examination? And many states considered those laws but none of them were seriously enacted. The doctors who responded to the New England Journal didn’t want to do that. That would have been a huge burden on physicians.

Read more…


Public Safety Committee Acknowledges the Hit and Run Crisis, LAPD Not So Much.

Council Members Mitch O'Farrell, Joe Buscaino, Mitch Englander and Mike Bonin listen to testimony from last week's hearing. Photo: Don Ward

In Los Angeles, according to LAPD crime statistics for 2011, 1273 cyclists and pedestrians were victims of hit and run crimes. In other words every single day, 3 or 4 cyclists and pedestrians become hit and run victims within Los Angeles city limits. Of these, 26 people walking or biking died as a result of the collision in which a motorist fled the scene. Another 10 victims were killed while in cars.

Mind numbing.

Because LAPD traffic division response time can typically take an hour or more to respond to collisions and with LAPD officers known to actively discourage filing reports for minor or no injury hit and runs, there is no telling what the true extent of the crisis is. Years of public comments and protests by cycling and pedestrian advocates including a focused Police Commission public comment action last year have only begun to garner the kind of attention needed to begin to solve this.

Last Friday, members of the LAPD came before the Public Safety Committee to present their report on the extent of LA’s hit and run crisis. The hearing followed a request by Councilman Buscaino in the wake of an LA Weekly exposé last December that brought light to this staggering reality on our streets. Based on the language of that report… the LAPD leadership does not yet appear ready to tackle the issue.


Several members of the “all powerful bicycle lobby,” including myself, made the early morning trip to City Hall thanks to a special LA Bike Trains group ride. Having released the report to the police commission weeks before we already knew the report was a disappointment in many ways. But this was a chance to hear what the Council Members thought and to deliver another round of public comment.

Having attended many disappointing City Council meetings over the years I had no reason to feel optimistic about this one. The formula usually goes something like… livable streets advocates show up with pitch forks, LAPD / LADOT make excuses / naysay / not feasible, politicians feign interest / read their Blackberrys and / or Tom LaBonge talks about critical mass and outlaw bike riders.

But this meeting was different – stacked with freshmen councilmembers – it struck me as a bit of a sea change.

Not only were these Council Members engaged, they were speaking nuanced livable streets language. At one point Council Member Bonin corrected LAPD Deputy Chief Downing for invoking Critical Mass as a causation for hit and run crimes stating: “The typical hit and run victim is not riding on Critical Mass.” This was immediately received with applause from the audience. Given the chance, I would have politely whispered to Chief Downing that the LAPD has been escorting a very peaceful amicable Critical Mass now for years… but I digress. Read more…


Zoning a Healthier Los Angeles?

All photographs by Iwan Baan, courtesy of No More Play / Hatje Cantz. via

(editor’s note: When I saw L.A. County was being praised for updating its zoning code to encourage wider sidewalks and bicycling facilities, I went to some zoning experts to ask them to weigh in on the county’s proposal. Occidental College Professor Mark Vallianatos answered my call. – DN)

Shock City

The Los Angeles region was intentionally planned as a horizontal city to avoid some of the perceived ills of dense European and east coast metropolises. Policy makers, planners, voters, industry and real estate interests  made choices around land use and infrastructure that enshrined the single family house, the commuter streetcar, and later, the automobile as the building blocks of L.A.   Just as London, Manchester, and New York symbolized the scale and challenges of the 19th century industrial city, Los Angeles, with its sprawl and unprecedented car culture, was the “shock city” of the 20th century, a new way of organizing urban land.

The Tangle of Health and Zoning

This simplified history of zoning is context to consider as both the County and City of Los Angeles are revising zoning laws with a goal of promoting health. We should acknowledge a central irony in this topic. Land use rules implemented in the past to protect public health have today become health hazards. As Emily Talen puts it in her book City Rules: How Regulations Affect Urban Form, “[z]oning contributed to health problems by spreading people out, increasing their reliance on automobiles and a sedentary lifestyle.” Rules that kept peoples’ homes in different districts than heavy industry were rapidly expanded to separate all commercial uses from residential zones. Starting in the 1930s, Los Angeles began required new buildings to provide on site parking for cars, subsidizing driving at the same time that separate use zoning was undercutting walking. Zoning has also long been used to segregate people by income and race. For instance, one of the first  zoning laws adopted in Los Angeles discriminated against Chinese-owned laundries and single family zones were “protected” from apartment buildings.

The exclusionary effect of some land use regulations contributed to clustering of “concentrated disadvantage:” in neighborhoods with high poverty, unemployment and crime and with few amenities.

In addressing health through land use, the County and City have a chance to undo the damage of earlier rules while also addressing new challenges and opportunities. 

Los Angeles County Healthy Design Ordinance Read more…


BNSF Falsely Claims Marginalized Communities “Better Off” with Proposed Railyard; Public Hearing Tonight

The proposed site for BNSF's SCIG railyard.

In a sadly misunderstood and ill-grounded editorial, the Press-Telegram endorsed Burlington Northern Santa Fe’s (BNSF) proposed 153-acre railyard project west of the 710 freeway, the Southern California International Gateway (SCIG). The endorsement comes right before a public hearing featuring demonstrations from some 20 community organizations who will offer evidence denouncing the benefits of the project as well as proposals for a new site.

The initial draft environmental impact report (DEIR) released September of last year was re-visited due to overwhelming complaints from community members and groups, particularly the South Coast Air Quality Management district. BNSF then re-circulated the EIR (RDEIR) in a study that was, in some sense, relatively the same as the first which, by the way, stated clear and significant health hazards.

When asking BNSF to comment in regards to the fact that the RDEIR is heavily contested, BNSF correspondent Lena Kent replied, “The updated DEIR completed by the [Port of Los Angeles] affirms that building SCIG is better than the no project alternative or continuing with the current use at the site. The report shows that residents, students, teachers, and workers nearby would be better off with the project than without the project, in terms of air quality and health risk improvements, as well as all of those living, working, and going to school along the I-710 freeway. We think if folks review the report, the benefits will be clear.”

Sounding oddly reflective of BNSF’s (obvious) support of the project, the P-T continued along the same lines with their stance:

“[BNSF] says its proposed [SCIG] railyard would eliminate about 2 million [sic] annual truck trips, with most of the relief targeted for the Long Beach (710) Freeway. […] The revised report essentially says the same as the study released last year: that local residents and schools are better off with BNSF’s proposed railyard[.]”

Firstly, it seems no one has actually read the report. Read more…


Spring Into Health this Weekend at a Family Festival at Martin Luther King Jr. Recreation Center

Kids have their faces painted at the Spring Into Health Festival at MLK Park. photo: Kim Kumpart

“Celebrate Health!” is the main message of the the Spring Into Health Festival that will be held this weekend at Martin Luther King Jr. Recreation Center from 10 a.m. to 2 p.m.

The event is more a health “festival” than “fair,” said North Area Neighborhood Development Council (NANDC) representative Yelba Castellon. It is an opportunity for the community to celebrate healthy living by participating in activities related to health, fitness, and the environment, in a family-oriented, fun setting.

This year, about 40 local community organizations will be present, offering a variety of services. In the area of fitness, the 24th St. Theater will be offering yoga classes while the Southern California Tennis Association will offer tennis lessons. Organizations like Community Services Unlimited, Revolution Foods, Tree People, and the L.A. Food Bank will offer help with gardening (and offering plants people can take home), nutrition, and cooking. There will be entertainment, an Easter Egg Hunt, and arts and crafts, as well as a raffle for bikes, scooters, and skateboards.

The NANDC tried to ensure that most of the organizations were very local, said Castellon, so that there would be continuity after the festival. If people found a particular clinic or organization that met their some of their health needs, they would easily be able to follow up and visit them after the festival. Read more…