Archive for the ‘health’ Category
The Eyes Have It
Canada has a public health system – but it has some strange gaps. This may be because we are so close to the US, which has a completely broken “free market” system. We can see a doctor for free, and if we go to a hospital and need treatment there that is free too. But if we need medication and don’t need hospitalization then we have to pay for the treatment. Many people get additional coverage through health insurance for things like drugs, dentistry and spectacles (eyeglasses) that are not covered by the public system. We also have to pay for anything that the eye doctor might prescribe – and my particular plan does not cover things like eye drops.
The last time I went to see the opthamologist she suggested that I get eye drops for Dry Eye. In fact she gave me a sheet of recommended products – not just eye drops but a hot compress and even an Omega 3 supplement. Now that did surprise me. Because one of the things that we keep track of in this household is the effectiveness of nutritional supplements. Most of them have not been tested in the same way that medicines are, to show that they are both safe and effective. And frankly a lot of the nutritional supplements are not necessary, if you have a balanced diet. But I do have to report that since taking Vitamin B 100 once daily the irritating rash on my legs has cleared up completely.
But is it also the case that you can find out for yourself if the nutritional supplement actually has any benefits at all. It is claimed, on the document from my eye doctor, that Omega 3 “helps decrease inflammation, promotes good health and helps dry eyes”. I find that surprising since the National Institutes of Health said “Omega-3s from fish oil supplements are no better than placebo for dry eye. NIH-funded study finds omega-3 fails to yield beneficial results in the clinic.”
“The trial provides the most reliable and generalizable evidence thus far on omega-3 supplementation for dry eye disease,” said Maryann Redford, D.D.S., M.P.H., program officer for clinical research at NEI. Despite insufficient evidence establishing the effectiveness of omega-3s, clinicians and their patients have been inclined to try the supplements for a variety of conditions with inflammatory components, including dry eye. “This well-controlled investigation conducted by the independently-led Dry Eye Assessment and Management (DREAM) Research Group shows that omega-3 supplements are no better than placebo for typical patients who suffer from dry eye.”
This was published on line in the New England Journal of Medicine, April 13, 2018.
In the current Canadian Election campaign the New Democrats are suggesting that if they become the government they will include eyes and teeth in “Medicare” (which is actually the name of the US system, not ours) – but only for households with incomes under $90,000 a year, which indicates for me that they do not understand the meaning of free universal healthcare for all which is what we were supposed to be getting … in due course, I suppose.
I think is says a lot about North America when a country like Cuba has a better healthcare – and education come to that – than either Canada or the US.
Charging people $55 for Omega 3 which is no better than placebo is a pretty sharp practice, I think. But it seems to be common. After all, the optometrist who did my most recent eye test also said that I should take Omega 3 – but at least he didn’t try to sell me anything.
Testing
I have just finished reading Walter Isaacson’s “The Code Breaker” (Simon & Schuster 2021 ISBN 978-1-9821-1585-2) It is about Jennifer Doudna, Gene Editing and the Future of the Human Race. I highly recommend it. I think it ought to have been called The Code Breakers since there were – and are – a lot more people involved. Doudna and Emmanuelle Charpentier won the 2020 Nobel Prize in Chemistry.
One of the chapters in the book describes how CRISPR was used to create tests. The important thing to note that though there were several teams all working at once they were coöperating as much as competing and all the findings and methodologies were placed in the public domain. One of the teams under Feng Zhang used a SHERLOCK process that by the end of 2020 produced “a small machine that could be used to get results in less than an hour”
“The CRISPR based tests developed by Mammoth and Sherlock are cheaper and faster than conventional PCR tests. They also have an advantage over antigen tests … can detect the presence of the RNA of the virus as soon as the person has been infected”
There are also at home tests including one that can be reprogrammed to detect “any new virus that comes along”.
The reason I want to bring this information to your attention is that once again our MOH in BC has not been keeping up. Since the beginning of the pandemic only people with symptoms have been allowed to be tested. Since many people now need a clear test result in order to go to work or travel the only way to get that has been to lie convincingly about the right sort of symptoms. And of course quite a few people who are asymptomatic will know that they have been exposed and that people in their circles have been infected. They are supposed to simply self isolate until they develop symptoms and then get a test. Of course by that time they are shedding virus copiously.
In part the reluctance to test was due to Bonnie Henry casting doubts on the veracity of tests – especially fast ones. I am not any sort of scientist or a medical professional but I think I have learned enough from just this one book to understand that the policy of restricting tests was as misguided as the early reluctance to endorse masks and the more recent foolish gesture of “opening up” by ending the indoor mask mandate far too soon and then have to reintroduce it as the numbers of infected persons rose dramatically again. Phase three need not have happened at all, but our system has never tried to achieve zero COVID and continues to put the unvaccinated (these days mostly young children) at risk.
Free tests distributed by the feds largely go unused in BC
Breastfeeding and environment act on climate at birth
I did not write that headline. It comes from a Press Release in my inbox from The Quebec Breastfeeding Movement . I clicked on the Google translation which I am pasting below – with some amendments to the English. I did look for a suitable illustration as none were provided but all I could find were those from sources which require a paid license for use.
This is not something that I expect the mainstream media here will cover, but it makes a good case. I have long been an advocate for breast feeding and divested from Nestlé in part due to my disgust at the misinformation in their advertising in third world countries, where mixing formula with local water creates a health risk as well as being very expensive.
—————————–
Canada is warming twice as fast as the rest of the world and three times faster than the United States. Breastfeeding has a positive impact on climate change, protects the environment and saves resources. Include it in strategies to reduce greenhouse gases is easy, profitable and socially acceptable.
Breastfeeding is the most environmentally friendly way to feed a baby: no packaging, no waste, no preservative additives, no transport. Its environmental impact is more tangible in industrialized countries than in developing ones. Increasing breastfeeding rates not only reduces the production of infant formula – a highly processed food – but it also reduces drug consumption through its impact on health.
“Many women breastfeed less than they wanted to at the outset,” says Raphaelle Petitjean, contract coordinator of the Quebec Breastfeeding Movement (QAM). The presence of supportive breastfeeding environment has a positive influence on the decision to breastfeed and facilitates further supporting breastfeeding women by concrete measures. “Breastfeeding is an individual decision, but establishing a supportive environment is a company responsibility,” says Marie-Eve Desforges, responsible for external affairs of the QAM.
In this election year, let us unite our voices to recall that breastfeeding is also an environmental issue.
About
The Quebec Breastfeeding Movement is an independent community organization whose mission is to contribute to making a supportive breastfeeding environment, in the context of optimal development of young children as well as the well-being of women, families and society . These environments must respect all women and all families.
Book Review: “Reimagining Our Tomorrows”
Making Sure Your Future Doesn’t Suck
by Joe Tankersley
Published by Unique Visions Inc ISBN 978 1 7326281 2 0 US$10.99 paperback
“Futurist Joe Tankersley explores a world where technology is used for good and we have the resources to build communities that care.”
I have been doing quite a few book reviews lately but they have not really been particularly relevant to the purpose of this blog. So they have been appearing on my other blog which deals with anything outside of the scope of “Thoughts about the relationships between transport and the urban area it serves.” This blog reaches a wider audience that includes people interested in planning and urbanism, as well as the direction in which we are moving thanks to rapid technological change and the need to change where we get our energy from.
It is also necessary for all of us to take some time out from the terrible news we see every day. Terrible isn’t just the appalling toll of deaths and injuries on our transportation system and our seeming inability – or unwillingness – to take that seriously. Or the choices we still seem to be making at the ballot box that produce very little real change. Or the bleak prospects facing Ontario, the US and the UK thanks to their short sightedness. We need a source of hope. And hopefully some direction. This book is not really intended for me. I cannot claim to be “an experienced changemaker trying to keep up with the pace of disruption”. But I do hope that some of you reading this are “doers and dreamers anxious to ensure our best days are still ahead of us”. And I would not have started writing this blog in the first place if I did not think that we need to change direction and that there are already lots of examples of places that seem to be managing better than we are.
Tankersley used to work for Disney. And he learned a lot there about the value of storytelling and of how to think positively about the future. It doesn’t matter much if he is “right”. What matters is that he offers an alternative view to the “present trends will continue” narrative that seems to dominate our main stream media and professional planners. It is not inevitable that we will remain wedded to fossil fuels, and internal combustion engine cars. It is also not necessary that we keep on doing what we always have done and expecting a better outcome.
Reading this book was not effortful. That seems to me to be a Good Start. It also doesn’t stir in me the need to argue. (Unlike what happens whenever I post something to Twitter or Facebook and get blow back from people I neither know or indeed want to.) Just one small quibble if I may, which I hope gets picked up in the next edition.
the village wasn’t self-reliant when it came to just seafood [the rest of the paragraph is about growing vegetables]
p131 ‘Reimagining sustainability’
What he meant was that the village wasn’t just self-reliant for seafood, it was also better than that for growing food in general and (by the way) energy production.
And the quibble is simply a matter of word sequence affecting meaning. It probably made sense to him when he said it – but on the page the sense is reversed.
I think that is about the only thing I felt the need to quote.
The book also has two pages of book references, and a page of online links – followed by the “Help Me Spread Optimistic Futures” page – from which I learned that the book is self published (linked above) and there is a Facebook page.
I hope that at least some of you will find something inspiring in these pages. The idea of finding new uses for McMansions and suburban malls is indeed not just encouraging but spot on, and something our planners need to embrace wholeheartedly. There is even a paean for a future design of cargobike which I know will appeal to some of you.
Infographic courtesy of Prof Chris Oliver
Worth following him on Twitter
AFTERWORD
I was reading a news item about a murder investigation which uses the iPhone native app “Health” – meaning you get it and it runs by itself. I did not know that. It seems in the case mentioned that the app shows that the suspect was “climbing flights of stairs” on the day when the victim was dumped in a river. So the cops can link the phone to the area, and time and activity.
So I looked at my iPhone and it turns out that it has been tracking my physical activity. Yesterday (February 6th) I walked 3.3km and took 4,643 steps. Not bad, eh?
Weekly Photo Challenge: Ascend
The Ascent from Wreck Beach to the road around Point Grey – also known as the University of British Columbia – where we had parked the car is 201 steep steps. As you can see from my photo.
My partner went up them at some speed and I trudged up behind her, not trying to keep up necessarily, but not wanting to lag too far behind.
Wreck Beach, by the way, is one of the famous attractions in Vancouver, and is even included on the sightseeing bus tours. Its fame stems from the designation as “clothing optional”. Such beaches are of course common in other countries. In North America, attitudes to public disrobing are still strongly influenced by puritanism – or prurience. In February there were very few people on the beach and all were well wrapped up. There is an album of the photos I took that day on flickr.
What is missing of course is the moment when I decided to sit down on the steps, to catch my breath. There was a handrail and a support post, but a huge gap between the handrail and the step. I leaned against the post – and passed out. I have a heart condition, and at one time would faint with some frequency under stress. Once I came to Canada and did that, a thallium stress test was ordered which showed that I have cardiac ischemia – and subsequent investigations showed that the blockage in the artery was very old and calcified. So usually I no longer push myself to the point when I faint. I suppose I had simply forgotten to be careful enough. Anyway, no great damage was done – someone stopped on his way up to make sure that we got back to the car safely. I was more embarrassed than anything else.
I still tackle ascents – this one is on the Baden Powell Trail near Quarry Rock
which we did in 2016 with no ill effect.
And this one in the Pantheon in Paris
And so far I am doing fine.
How do you make people in Hope healthier?
The story comes from Jesse Johnson at the CBC.
Residents have higher rates of chronic disease, are more to likely smoke and their life expectancy is well below the rest of the region.
…lack of access to health services and an aging population both contribute to the problem.
We’re looking at a population that has moved from the urban areas to the more rural area of Hope in their retirement age to support a lifestyle they are seeking, in terms of outdoor activities.
The article goes on to discuss initiatives the Health Authority is taking to improve access health care services.
But the best thing we can do for the people of Hope – and the rest of the Fraser Valley – is not treatment but prevention. Prevention is always better than cure.
There is currently an air quality advisory in the region due to the fire at Harrison Lake. Not just the smoke but the haze – seen as a white mist over mountains – due to ground level ozone which forms in sunlight due to reactions between pollutants from burned fuels – VOCs, NOx and SOx. Absent wildfires, these pollutants here are mainly due to the use of fossil fuel fired internal combustion engines in our transportation system. For many years we relied on AirCare to keep that in check, but now we rely on the computers that control our engines. But that is just a bandaid – what we really need to do is reduce the use of cars for most of our transport needs. We aren’t doing badly – in the city of Vancouver half the trips now are taken by noncar modes – walking, cycling and transit. The rest of of the region has been encouraged to increase car use, by widening the freeway and spending heavily on making car use the most favoured mode. Strangling resources for transit was a deliberate provincial policy which, we must now trust, will be reversed.
The air pollutants released by internal combustion engines in Metro Vancouver get blown up the valley by the prevailing winds. As the valley narrows, and the sides get steeper, the concentrations get worse. Air quality concerns are actually fairly low in Vancouver, but are significant in Hope. Telling people to limit their activities and stay indoors helps relieve immediate symptoms – difficulty breathing – but makes other serious health problems worse – heart disease, diabetes, and obesity – the top three killers in our society. The people who really suffer from bad air quality in the Valley are the agricultural workers who have no choice about strenuous activity outdoors on hot, sunny days.
The more we can be successful in increasing transit mode share, plus walking and cycling, the better the health outcomes will be, and the lower the demands for treatment. The cost benefit analysis for this kind of policy approach seems to be absent. Our obsessions have been with environmental assessments of major projects, but these have often been deliberately slanted to “reducing congestion” – which is a chimera.
“Adding highway lanes to deal with traffic congestion is like loosening your belt to cure obesity” – Lewis Mumford. (source)
Equity, Opportunity and Good Health
A free public lecture from SFU Continuing Studies and The City Program
How Transportation Affects the Essential Qualities of Life In Metro Vancouver
Thursday, 30 April 2015 7:30 PM at SFU Segal School of BusinessTransportation connects us to our community, our place of work and our friends and family. The way transportation infrastructure is designed and the modes of transportation that we have access to impact our lifestyle and our health.
The lecture reviewed some of the evidence from other jurisdictions, but focused primarily on the findings from the My Health My Community project that surveyed 28,000 Metro Vancouver residents in 2013/14.
While there are clear dividends in health for active transportation users, current transit infrastructure does not equally benefit all communities in Metro Vancouver. Access to transportation widens opportunity and is a significant equity issue in Metro Vancouver.This lecture was in collaboration with the 2015 ITE QUAD Conference, May 1-2 at the Pan Pacific Hotel, Vancouver.
It is fortunate that the text and illustrations that were used for this lecture are all available on line. I noticed that several people were trying to photograph the illustrations used, but that turns out to unnecessary too.
The talk was preceded by a presentation by Dale Bracewell, the Manager of Active Transportation at the City of Vancouver. He started by stating that Vancouver now designs its active transportation projects to meet the needs of all ages and abilities. The overarching goals are set by Transportation 2040 but that includes the interim goal of 50% of trips by walk, cycle and transit by 2020. The City has set itself objectives in the fields of Economy, People and Environment. The active transportation program fits within the People category and the Healthy City Strategy, which has a four year Action Plan. Walking and cycling are now the fastest growing transportation mode which reflects Vancouver’s high Walk Score. A panel survey is conducted annually with the City’s Health Partners.
Walking has increased by 19% while the collision rate has fallen by 20%. The collision data also needs to be seen within the context of the City’s Vision Zero. Cycling has increased by 41% while collisions have fallen by 17%. It is clear that the safety in numbers effect is working. Vancouver has installed a series of automated bike counters. He had a set of graphics which I have yet to find but the data is available as a large pdf spreadsheet.
This is the counter at Science World which now has the biggest count – even greater than the Burrard Bridge
The counters show cycle use growing between 7 and 15% over the last year. The Lion’s Gate Bridge now equals Hornby and Dunsmuir, even before the new safety measures for cyclists have been introduced.
Hornby Street still moves as many vehicle now as it did before, simply because the two way separated bike lane replaced on street parking. There are still 14,000 cars a day, but cycle traffic has increased 50% to 2,700 per day. At the same time there are 5,000 people on the sidewalk, with pedestrians showing a clear preference for the side with the cyclists rather than the parked cars. The street is now moving more people overall.
He also added a plug for an upcoming conference in Vancouver next year pro walk pro bike pro place September 12 – 15, 2016
Dr. Jat Sandhu is the regional director of the public health surveillance unit at the Vancouver Coastal Health Authority. He stressed that his remarks are his own personal views.
He started by contrasting the experience of driving a car in congested traffic on the Sea to Sky Highway with that of riding a bike on a path next to the North Arm of the Fraser River – the stress of the former versus the relaxation of the latter. He grew up in Hong Kong and described his boyhood commute to school from Stanley to Kowloon: and one and half hour combination of buses and ferry to cover the same distance as the Canada Line from Richmond Brighouse to Waterfront.
He cited the work of Larry Frank at UBC who has published the all embracing literature review on health and transportation, looking at physical activity, air quality, mental health, injuries and equity. “Urban Sprawl and Public Health”. He also pointed to USC study of the Los Angeles to Culver City Exposition LRT which reduced daily vehicle travel by households of between 10 to 12 miles a day which a 30% reduction of CO2 emissions.
It is known that daily physical activity helps maintain a healthy weight, reduces the risk of chronic disease and grants a 40% reduction in the risk of premature mortality. Yet only 40% of the population meet the recommended activity levels. Obesity is now overtaking smoking in the mortality race. Physical inactivity is a large part of the problem as shown by a study of commute time against obesity in Atlanta GA (Am J Prev Med 2004). He also pointed to the lack of transit equity citing the Next Stop Health study in Toronto.
The My Health My Community survey covers the entire area covered by Fraser Health and Vancouver Coastal Health. What makes Canadians sick? 50% of the time “your life”.
The study asked respondents 90 questions about their socio-economic status, health, lifestyle, healthcare access, built environment and community.
The transportation report on Metro Vancouver released last week is the first of a series of reports from this data, intended to inform the discussion of the transportation plebiscite in this region. It draws from the survey responses from residents of the region – which is a subset of the survey mostly conducted on line, but with supplementary paper surveys to ensure adequate coverage of ethnic minorities. It covers only those over 18 years of age. Its target was a 2% sample which may seem small but is much better than the 0.5% sample of the typical transportation survey. Census data to neighborhood level was used to ensure a representative sample. It was a one year process, and results have been weighted to correct for age, gender, education and geography. Of 34,000 respondents, 28,000 live in Metro Vancouver: 80% of those make daily trips for work or education.
55% car driver or passenger
29% transit
10% walk
4% bike
2% other
Only Vancouver, New Westminster, Burnaby and the City of North Vancouver have over the Metro Vancouver average for active transportation modes.
I think the two maps are perhaps the most useful representations I have seen especially since they also map the Mayors’ Council’s proposals. What I think would be immensely more useful is a map of the non-active modes with the road projects that have been built in this region in the last ten years or so. While Dr Sandhu points to the goodness of fit of the proposals to correct some of the grosser transit inequities of this region, I think a map of “motordom” showing how the widening of Highway #1 (ongoing) the increase of traffic speeds on the Sea to SkyHighway, the impact of the South Fraser Perimeter road and the increase of capacity along Highway #10 through South Surrey, as well as all the various interchange improvements financed by development (200 St and Highway #1 for instance) as well as the Golden Ears Bridge and the new bridge over the CP yards in Port Coquitlam vastly overshadow anything that might happen as a result of the Mayor’s plan. I do not have the technical competence to produce such a map overlay myself, but I do hope one of you does.
By the way, the originals of these maps are huge: click on them to enlarge and see the details.
Among some of the other results he quoted:
The median commute time is 30 minutes: for car users it is 25 minutes and for transit 45 minutes. He said that reducing travel time for transit users should be a target, though absent the data on distance I am not sure that actually tells us much. To some extent, people choose how long they are willing to travel – and for some, such as West Coast Express users – the travel time will be viewed in a positive light. However, as a selling point for the Yes side in the plebiscite “Less time in your car, more time in your community” works well.
The determinants of transit use include age: the two biggest groups are 18 to 29 and those over 70. In both cases there is often a financial incentive for transit use (UPass, concession fares). 14% of transit users have a chronic health condition which he said points to the need for more HandyDART, which is included in the plan. There is a 50% higher transit usage by ethnic minorities – except for South Asians – with the highest usage among recent immigrants – who of course are not eligible to vote. Neither, come to that is Dr Sandhu. Only 75% of respondents are Canadian citizens. Transit use decreases with increases in income.
He also produced a graph showing municipalities by commute mode and the incidence of obesity. He said the correlation coefficient (r²) was 0.99 [which as far as I am concerned is unheard of].
He also showed the WalkScore map of the region – which I wish I could find on line. The web page I link to is not exactly what I was looking for!
The current transit infrastructure does not equitably benefit all communities. This is a social justice issue as it impacts access to education and employment. The proposed investments will be positive in this regard. The greatest health legacy of the Olympic Games was [not the creation of his position] the Canada Line. Metro Vancouver is 4th in transit use in North America, only behind the very much larger populations of New York, Montreal and Toronto. We have a relatively small population of 2.5 million and thus “do not have the same tax base”.
Q & A
1. A question about the aboriginal use of transit which seemed to be explained by lower income and the availability
2. Some people use different modes for the same trip on different days: walking or cycling in good weather for instance. Or more than one mode during one trip. The reply was that the choice of mode had been “collapsed down” and respondents were asked to pick their primary mode
3. A technical discussion of the sample compared to household survey which replaced the long form censu s
4. A question about income which produced the response that the City of Vancouver saw similar levels of active transportation across the city, but immigrants were more economically active than the population in general – a reflection of federal immigration policies.
5. Do people realize how walkable their neighborhood really is? Don’t we need more education?
The study helps the Health Authorities feed information into the OCP and community partners, as well as their interactions with nonprofits and school boards
6. “I have not heard the word Translink used. Is there going to be more bus service?”
7. Eric Doherty pointed out that just increasing bus service shows diminishing returns without a greater commitment to bus priority. He also mentioned feelings of superiority when he rode on a bus to the ferry and passed all those car users stuck in congestion.
I responded that bus priority measures are one of the most cost effective ways of improving the attractiveness of transit, but requires a level of enforcement not so far seen here.
REACTION
Gordon Price was really impressed by the cycling data. There’s nothing like a few good figures to destroy some long held misbeliefs.
The health study simply confirms what we have long known, but seem reluctant to act on. My own views on this were set out in a post in published earlier this year. I want to acknowledge the recent promotion of that post on Twitter by Brent Toderian which has had a very significant impact on my WordPress statistics.
The talk was in a larger room than usual, and was linked to the ITE Quad conference, but was poorly attended. The discussion was really rather muted.
Choosing the happy city
There is a storify based on the #happycity hashtag,which now features many more pictures thanks to the recent Twitter upgrade
At SFU Woodward’s on Wednesday March 26, 2014 the third in the Translink series.
Choosing the Happy City
Charles Montgomery
There were many empty seats even though SFU had “oversold”. If you reserve a seat at one of these events and then find you cannot attend, please remove your reservation as soon as you can. There were people who would have liked to be there. But at least there was also a live stream and the event will be added to the Youtube site in due course.
The introduction was made by one of Fraser Health’s public health officers. Happiness is fundamental to health. We need a system that promotes physical activity. Urban form and transportation determine how people choose to move around, and also affordability of housing and access to green space. People who live in the suburbs of Vancouver walk more than other places. We must improve and maintain choices especially for non urban places. She made the point that some policies which seek to deter car use can adversely affect the mobility of people who live in places where there is no other choice but to drive for many trip purposes. There is an inequity in adopting such deterrents before there are adequate choices fro everyone.
Charles Montgomery started his presentation with two “exercises” – the first to identify Translink staff “the institution we love to hate”. He invited audience members to hug a member of Translink staff if they were near them. The second related to two images of dorms at Harvard University. One was a traditional building, the other a somewhat forbidding modern block. Most people indicated they preferred the traditional building, as did newly arrived students. But a study showed that there was no difference in the happiness of the students after three years. Many factors determine happiness not just the design of the buildings but social environment within them is important.
The idea of idea of increasing happiness is not new. Early economists called it maximizing utility. However often “we get it wrong.I think pursuit of happiness is a good thing. We can measure it. … More pleasure than pain, healthy, in control, meaning, security but strong social connection underlies all of these. Both the GDP and creativity in a city depends on opportunities for social interaction. He showed a three dimensional graph of space time prisms, which showed the people who are more dispersed find it harder to connect. They spend much less time in the spaces and times when they can meet others. The edge of the urban agglomerations are the least likely to be socially active. If you live in the exurbs you do not have the time, energy or willingness to join things or even vote.
The shortness of the the commute time is the best indicator of satisfaction. “How we move is how we feel”, and even only five minutes of walking or cycling improves mood and regularly moving under our own power also improves health. Equally driving a nice car on an open road also improves our mood. The trouble is that open roads are rare – and impossible to find at commute times. Driving even a nice car in a congested city is like piloting a fighter jet in terms of the stress experienced. People rate the experience of using transit lowest of all mostly due to the loss of control and that the trips on transit tend to be the longest.
In Greater Vancouver 40% of all trips could be done in 20 minute bike ride. In cities the design of the built environment determines both our behaviour and our bodies. If we build infrastructure for cycling – making it safer – more people will cycle. People will walk 800m to shop in a good urban environment but less than 200m in the typical suburban big box centre. The huge parking lots are a deterrent to walking even short distances.
He cited Larry Frank’s work in Atlanta showing maps of destinations available within a 10 minute walk of home. While there are many in the traditional city centre in the suburbs there are none. It is not surprising then that people who live in the suburbs on average have 10 pounds more in weight
Status interventions
– Equity
Having low social status is bad for health. When transit viewed as a “hand out for the undeserving” – he used the notorious ads in the Georgia Strait some years ago for a GM car dealer which had a bus with the words “creeps & weirdos” as the destination sign – it is unsurprising that it is difficult to persuade people to change modes. Enrique Penalosa redesigned the city of Bogota and it was all about equity. He cancelled a new freeway but built the Transmilenio BRT based on the Curitiba example.
– Freedom
This is represented by our having mastery of our movement. In one experiment they used skin conductance cuffs on people in a mockup of a subway car. Even though this was staged at a party, as the space available to the group in the car became more restricted so their stress levels rose. He showed a picture of the Navigo card in Paris which is much more than a transit ticket. It also gives access to Velib bike sharing – and (he claimed) car sharing (which if so is a change since I was in Paris). “It also gets you cookies” But mostly it gives people the freedom to live with less stuff. they do not need to own a car or a bike [and can get around without worrying about either being stolen]
He then showed picture of the land the province has recently put up for sale in Coquitlam. This “swathe of Burke Mountain will not be well connected”. But families can save $10k a year by not owning a car. He cited Daniel Kahneman’s Book “Thinking, Fast and Slow” We are rightly fearful of house fires and build new suburbs to allow access to big fire trucks, with wide roads and sweeping curves – like a race track. Streets aren’t safe enough for kids to play on – but we somehow think that we have made them “safer” and the areas they serve. There was a notorious experiment on children with Oreos. They could take one immediately or wait awhile and then get two. He says that the problems we require that we slow down and consider their complexity.
The challenge is the cost of congestion, but we attempt to solve it by designing disconnection. He illustrated this with a picture of the new Port Mann Bridge construction and remarked that we only realized that the new bridge was not needed until after it opened. All the traffic and people that now use it could have been accommodated if the old bridge had been tolled and a rapid bus service along Highway #1 introduced. [This was actually something that the Livable Region Coalition pointed out at the time, by the way. No-one believed us.]
“We did it before” He showed a slide of the Livable Region plan from the 1970s. And he also showed the “Leap Ahead” transit plan which its authors (Nathan Pachel and Paul Hillsdon) estimated would cost $6.5 bn but could be paid for with a $0.05 sales tax.
Referendum = fast brain disaster
“The best thing to do is cancel the referendum.” However since that is unlikely we can save ourselves by adopting the recommendations that Roger Sherman used to win the second Denver referendum. Their program was called “Fast tracks” It was a clear plan and fully costed designed to appeal to the core values of the voters. Most of them drive so it has to show how improving transit improves life for drivers
It is not enough to present a clear picture – it has to have a champion, preferably a celebrity and since Brad Pitt is unlikely to be available he suggested Diane Watts
Bring it back to happiness
Working together is good for us build more resilient community
Q&A
The first question pointed out that the Leap Ahead plan did not seem to have much for the North Shore
“Now is not the time” to determine the details – though it does have a fast bus, and I suggested adding another SeaBus
The second noted that he used an illustration of Disneyland. Expectation of good time in built form
Tests in Disneyland show that architecture that speaks to us is good for well being
Technology in design of transportation
Vehicle sharing systems, driverless cars, use of Car2Go in East Vancouver shows that is a bedroom community. there are plenty of cars there overnight but none during the day. We have to have more activity in our residential areas – this is not a technology problem.
Eric Doherty pointed out that he had not mentioned climate change
“While it feels good to do the right thing but not everybody agrees on what that is. Trying to convince people to think like us does not work”. Gateway sucks did not work – it did nothing to convince people who had to drive that there was any concern over their needs.
How do we overcome this mindset of entitlement?
Golden (referring to the first presentation in this series) got all the players in the room and respecting others point of view. sophisticated comm??
Q from twitter on codes
Self reports on happiness higher in small towns
Rural areas
Everybody can benefit from a village
Codes for rural community Gordon Price commented “The City is not shaped by market forces”
Nathan Woods (Unifor) said: We need $3m and Brad Pitt. How do we get that?
Developers stand to benefit – they have the resources. The Surrey BoT strongly supports transit
Can you supply examples of success of postwar planning
Lewis Mumford
False Creek
New Urbanists
Seaside FL
Lean urbanism
Forest Hills Gardens NY (GP again)
Is a dense urban environment enough?
Towers are as bad for lack of trust as exurbs
Just pushing us together is not enough
“Lazy tower style in Vancouver”
Town houses, courtyards, green space
Example of Copenhagen – can we transfer that here?
The answer would be Long and complex. But in one word- Experiment – just line Janette Sadik Kahn did with bike lanes in New York
Gordon Price pointed out how really emotional the fight over bike lanes here had become
Change is very difficult. Regarded as intrusive
One action for individuals?
Started out as a journalist feeling I had no right. We can all change a bit of the city. Those of us who live here have the right to change where we live
What has surprised you in the reactions since the book came out
Jarret Walker told me that on these examples its not the planners who are the problem. “We know that. You have to convince the politicians … and the people.”
Try not to scare people
Someone from modo talked about Share Vancouver and its implication for resilience, during disasters for instance
Life changed in New York with Sandy. How can we create that sense of urgency?
Experiment Granville St what are we learning?
The questioner felt that all the changes we have seen have been controlled by the business community
Times Sq occurred with support from the BIA – who have benefitted as rents are now going up. The police closure of Granville St at weekends was a response to violence. It gave more space for people to move around and thus reduced conflicts
Councillor Susan Chappelle from Squamish said that they were trying to get a regional transportation dialogue going – they are outside the Translink area with a small transit system provide by BC Transit. They remain “disengaged”. The immense changes he talked about are not translated into budget of small town. In the current situation “Words are used, with no change happening.” Squamish is left disconnected
The measures are the same for reducing GHG and increasing happiness. Should we encourage commuting [between Squmish and Vancouver]? The industrial zoning is out of date.
Can design offset crime? Social justice?
Some people assert “None of this is going to work until we overthrow the 1%” But his work shows that the way we design cities has an immediate impact. It’s an equity issue. Many people complain that they can’t afford to live here but then they oppose the density increase essential [to get reduced housing/transportation combination cost reduced]
Some who was arranging a summit of cultural planners pointed out how hard it was to get a large meeting to places which did not have good connections. Change the way transit works to support the summit
BC Transit should take cue from TransLink interagency approach We can crowd source all kinds of stuff
btw People actually talk on the #20 bus
Big issue is transit funding. A city has found solution?
Richmond is the only place where car ownership has fallen – obviously a response to the Canada Line
See the example of the Los Angeles referendum which was not just about transit – it paid for everything with something for everyone
REACTION
This was by far the best presentation in the series so far, in large part because it was not read from a script. He was speaking to the slides he was showing but clearly enjoyed interacting with the audience. It was indeed a performance – and a good one at that. On the other hand there did not seem to be a great deal that was new or remarkable in the content. Working in this field for forty years means that I have actually witnessed exactly the same set of prescriptions proffered for a what at the time seemed like different problems – congestion, growth, inequity, sustainability, bad air quality, global warming. And now happiness – or its absence.
I have got into a lot of trouble for stating unequivocally “transit sucks” to transit management. They of course would rather boast of their accomplishments, how well they do under difficult circumstances, and how resistant politicians are to pleas for more money. But the fact remains that despite increasing expenditures, the overall transit mode share is very difficult to change. We know what the solutions are – we always have done – but we seem reluctant to embrace the changes necessary. And he is probably right that we have an elite stuck in fast brain mode whenever they deal with these situations. He actually cited Kevin Falcon – more than once – and it seems to me he is right. The Jordon Batemans of course simply play to that preference. It is a lot easier than actually thinking clearly (slowly) and then acting.
Transit investments lead to healthier people
A Media Release from UBC with a link to the whole research paper – actually hosted by Translink – and dated August 20 last year
No surprises here – but useful back up to the argument that we ought to spend more on transit. Not that I expect that to influence people like Jon Ferry, [The Province, paywalled] who is pretending to be open minded!
A new report from the University of British Columbia shows that transportation and health are closely linked and recommends that health outcome be considered in transportation planning.
The report, funded by TransLink and Vancouver Coastal Health Authority as part of updates to Transport 2040, the regional transportation strategy, presents a range of opportunities for Translink to incorporate health into its planning.
“This report documents how prioritizing transit, bike and pedestrian infrastructure will positively impact health,” says the study’s lead author Lawrence Frank, Professor and Director of the Health and Community Design Lab, part of UBC’s School of Population and Public Health. “It looks at encouraging active transportation, such as walking, cycling and transit, and reducing air pollution and traffic collision risk.”
Dr. Lawrence Frank. Photo: Amanda Skuse
Previous research by Frank has shown that every hour a person spends in a car each day makes them six per cent more likely to be obese, while each additional kilometre a person walks makes them five per cent less likely to be obese.
Sedentary lifestyle is a major cause of many chronic diseases such as obesity, heart disease and some cancers. Many chronic diseases are preventable and active transportation and other sustainable transportation choices offer the possibility of prevention and even treatment through increased physical activity. The costs of these diseases are projected to increse by more than $1.5 billion in B.C. over the next 2 to 3 years.
“TransLink’s consideration of the health impacts of transportation systems could help offset the rising costs of health care in the Vancouver area and promote an active lifestyle that will benefit all Canadians,” Frank adds.
The full report is available at here.
Stephen Rees's blog 