Stephen Rees's blog

Thoughts about the relationships between transport and the urban area it serves

Posts Tagged ‘type II diabetes

The Link Between Obesity, Transportation and Land Use

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There was a story tonight on the CBC TV news Vancouver at 6. It is about an important shift in the advice given to doctors. “The Canadian Task Force on Preventive Health Care released recommendations for family physicians …on prevention of weight gain and treatment of overweight and obesity.” The emphasis is shifting from treatment – which mostly does not work – to prevention, which might. As is now the practice, after the news story from back east, Andrew Chang sat down with a local expert to talk about this some more. She was a doctor from Children’s Hospital and it was all about what we teach our children to help them keep the slim figure they have in their adolescence. It wasn’t until right at the end of the interview when she used the word “environment”, and it was left mostly unexamined. But without doubt it was the most important word in the discussion.

The shift in obesity statistics for the Canadian population occurred at the same time as it did for the American and a bit later for the UK. People have become less physically active partly due to their jobs changing – but mainly due to their commuting. Most of us used to stand to do our jobs, which usually involved some muscular exertion. And we either walked or biked to work. These days we are much more sedentary both at work and at home. And we tend to drive between the two. At the same time, we have stopped cooking for ourselves and rely heavily on processed food or prepared food from commercial outlets. This was not mentioned at all and is a bit of distraction, but basically when you do your own food prep you are much more likely to control salt and sugar. Processed food contains all kinds of preservatives and flavour enhancers to prolong shelf life – and long distance shipping. When you eat out, or buy a pizza, there’s a lot of fat and carbs on your plate.

It is not at all coincidental that the people who are now getting involved in long term planning for transportation and land use are Medical Officers of Health. They were largely absent during my career as a regional planner and transportation economist but in recent years they have noticed that people who live in walkable (and bikeable) neighbourhoods have lower levels of adult onset diabetes, heart disease and obesity. Also known as “metabolic syndrome” even though it has nothing to do with metabolism and everything to do with living in suburban sprawl and driving to do anything at all.

You will not hear anything about this from Jordan Bateman or the No lobby in general. They are the people who have no intention of changing anything. They want a ground oriented house with a two car garage, in a residential area far distant from any other land use apart from schools and churches. Jordan Bateman was a Councillor in Langley. This is still his constituency. The people who listened to the “drive until you qualify” mantra. They shop once a week, spend much of their time taking their children to and from school or after school activities and will tell you they have to drive. They cannot conceive of using a bus or a bike to live like they do. And as they age their weight increases steadily and inexorably.

The Yes campaign is driven by the concept of increasing transportation choice. That phrase was key to the Livable Region Strategy, written by Gordon Campbell, and intended to guide the pattern of development in Greater Vancouver. You cannot have a Protected Green Zone and a Compact Region with Complete Communities unless you Increase Transportation Choice. Wendell Cox does not understand this. Neither do Christy Clark, Todd Stone or Kevin Falcon. The two solitudes in Greater Vancouver are the people who live in the parts of the region where they can reasonably decide for themselves which mode to use for their trips – and switch between them at will – and those who can only drive for every purpose imaginable. The second group see nothing odd at all about driving to the dog park. Or driving to the gym or community centre to walk on a treadmill or ride a stationary bike. If you suggested to them that they walk or ride a bike for any other purpose than recreation, they would tell you “it isn’t safe”. And they would be right. We equate safety with belts and airbags in cars, designed to have crash resistant crumple zones. They demand everyone wear helmets – on the ice, down the hill, on the bike. Fear of head injury – actually not that frequent in adults especially once you have deducted car crashes – vastly outweighs fear of the diseases that kill most people. All of which can be traced to weight gain in adulthood. And the study that was used to justify BC’s compulsory helmet law has since been repudiated by its own authors.

The biggest challenge we face – after climate change – is the increasing cost of healthcare. Actually if we had sensible economists advising politicians, that would also be manageable, but we have built our own box to get locked into by insisting on tax cuts as the policy nostrum for every problem. As the baby boomers – people my age – retire and continue to live long after any generation that preceded them, the cost of taking care of them will balloon. Correction, is ballooning. Since we now live in nuclear, rather than extended, families that cost is borne by the public health system, not the daughters and granddaughters of the former wage earner.

I think the healthcare benefits of increasing our ability to walk, bike and take transit – every transit trip involves more walking than any driving trip – vastly outweigh the terrible burden of an extra 0.5% sales tax. If we still believed in cost-benefit analysis (nobody has paid me to do one of those in the last twenty years) then we could show that the costs of paying the tax for more transit would be more than made up in the savings in healthcare costs alone.

Of course, just increasing existing bus service frequencies will not be enough on their own. Just as we really cannot expect to see any reduction in congestion from the sales tax funded expansion alone. We need to do something radical about mixed use developments, increasing density, safe routes to school and all the rest. Just as we will need some fiscal sticks – fees and charges that change behaviour – as well as increased capacity and attractiveness of alternatives to driving. But making Vancouver and its suburbs better places to live features nowhere in the No campaign. Even sensible people like Laila Yuile have been caught up in the fallacy that somehow not paying more taxes will produce better run institutions.

Anyone who talks about transit – or transportation – as though it were a free standing issue is spouting nonsense. Transportation and land use are two sides of the same coin. The best transportation plan is a land use plan. Better land use is measured by the reduction achieved in motorised trips over business as usual. Not only that but Charles Marohn and his Strong Towns movement have shown that this form of development is actually financially more responsible and actually sustainable – in the sense that we can afford to pay for it. Which is quite clearly impossible in motordom with its freeways and  sprawling single use subdivisions.

When I ran for the provincial legislature for the Green Party, I started every speech with what I thought was an unarguable truism. We know that capitalism and communism have both failed. Neither paid the slightest bit of attention to the environment or the limits to growth. While the Liberals (federal) and NDP pay lip service to these truths, their policies are still based on economic growth and more jobs. I think it is equally obvious that we cannot continue a pattern of urban growth predicated on increased car use. It also seems to me that enough people agree or have been forced by economic realities (read huge student loans and no prospects of full time permanent employment) that car use is actually declining. But our provincial politicians are still stuck on increasing the extraction of fossil fuels – and other limited natural resources – while widening highways and building ever bigger bridges.

The anger you can hear from the No campaign is the refusal to accept the necessity of change. No-one in their right minds should be proposing dedicated taxes – or a new imposition of yet more regressive taxation. But on the Yes side, we have no choice. If we want to see transit expansion  – more bike routes, safer walking, more HandyDART for the aging population – more CHOICE in transportation – this is the only way we can do this right now. Not our doing, but those who set the rules for this thing. She Who Must Be Obeyed. She who never thinks of a plebiscite for the Massey Bridge or dualling some more highways in the heartlands. I do not think that an increase in sales tax is a Good idea at all. It is simply the easiest of the available options. No one is now talking about road use pricing. More gas tax or more carbon tax would work quite well as the price of oil is falling but we don’t get that chance either. I do know that I could more easily deal with an open house  on the sales tax increase than those I had to face back when we were proposing a vehicle levy.

I also know that the No side will not deal with any of these issues as they are not in the solutions business. They have a coalition of the unwilling. It is a diverse and motley band and includes a lot of people who think of themselves as progressive and find the whole process repulsive. It has been imposed on us by someone who thinks she can control the outcome. The Yes side is similarly heterogeneous, but what unites us is the desire to prove her wrong. We do not want the future she imagines. We don’t want this plebiscite or this sales tax either, but it is the only game in town, and it has to be won if motordom and sprawl are to be defeated. And if our waistlines are to start shrinking and our health to improve.

More on this topic can be seen on PriceTags with all sorts of references and sources