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Archive for the ‘transport’ Category

By Claire Beynon MFPH

BACP Travelling Fellowship
Every two years the Faculty of Public Health (FPH) awards a BACP travelling fellowship to assist members of FPH in training to undertake educational travel. This fund was established in 1994, using funds donated by the British Association of Community Physicians (BACP) on its dissolution.

At the FPH Conference in Telford in June I was delighted to receive the travelling fellowship funding based on my application to travel to Japan to experience its culture and make observations about why its levels of childhood obesity were so much lower than those in the UK, and to present my public health work at a conference in Japan.

Observations on Childhood Obesity in Japan
Before I left for Japan I read many articles that explored the differences between childhood obesity rates in the USA and Japan. Their focus was on lifestyle factors including diet and physical activity.

Whilst in Japan I met with several academics who specialised in obesity, physical activity and diet. They were all most welcoming and shared their research and experiences readily.

The key points they raised were:

  • Younger children spend less time in school. As age increases so does the length of the school day. This gives more free time for outdoor play.
  • 90% of children walk to school daily.
  • Children do three hours of physical activity each week in school time.
  • There are no cleaners in Japanese schools; part of a child’s everyday activities includes cleaning their own school – children are active when cleaning.
  • Schools often have before-school sports clubs as well as after-school sports clubs.
  • Between each lesson there is a five-minute break to allow children to run around in the play area. This is in addition to morning break, lunch and afternoon break.
  • There are multiple opportunities in school for competitive sports, with regular competitions and celebrations. Children spend time practising for these with friends.
  • Children have three hot meals a day at breakfast, lunch time and in the evening.
  • Children serve each other a cooked meal at lunch time and sit and eat this hot meal together.

Further Observations
Whilst travelling in Japan I observed a number of additional environmental factors that tip the balance in favour of walking and cycling:

  • Priority is given to the pedestrian, then cyclist, then the motor vehicle. Encouraging walking and cycling. By giving priority to more vulnerable road users speed of motor vehicles is also decreased.
  • Cyclists and pedestrians share the pavement area, which is often separated from the road with a barrier and/or low-level bushes. This makes for a safer cycling experience than the UK where cycle lanes are often shared with buses.
  • There were a number of covered shopping areas, which were accessible only to cyclists and pedestrians and proved very popular thoroughfares.

    Shopping area in Japan

    Covered shopping area where pedestrians and cyclists share space

  • There was consistent and regular signage for cyclists and pedestrians, including details of directions and distances to the nearest public transport options.
Example of road, cycling and walking space in Tokyo

Example of road, cycling and walking space in Tokyo

• The number of employed people working on any urban street was much higher than the UK, with police highly visible, construction staff, cleaners, car park attendants and others all adding to the sense that the street was a safe place.

 

Policeman on the street in Japan

Presence on streets of local police make a space feel safe

• Public art installations make walking and cycling spaces more interesting and appealing.

Street art in Japan

Example of simple art installation

We know from the 2007 Foresight Report that obesity is a complex issue with multiple factors influencing obesity levels in adults and children. My own research looking at the risk factors for obesity in children in Wales using Welsh Health Survey data showed a reduced risk of obesity for children who met the one-hour physical activity guideline.

 

The new experiences and culture that I have experienced from this educational trip make me more determined than ever to tackle childhood obesity in Wales. I am looking forward to being involved in the drafting of an obesity strategy for Wales as part of my placement with the Welsh Government and will share my experiences with other registrars and colleagues at every opportunity.

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By Dr Jennifer Mindell, Reader in Public Health, Research Department of Epidemiology and Public Health, University College London

The government is proposing to ban the sale of diesel and petrol vehicles from 2040, to address air pollution in the UK that regularly breaches health-based EU regulations.

There are three main ways to improve UK air quality: reducing emissions from vehicles; driving less; and dealing with other sources of air pollution. The government’s preferred approach seems to be ‘business as usual, but less pollution from existing travel patterns’. Yet, even with this route, they are not committing to a scrappage scheme for diesel. This would produce air-quality benefits in the short-term, instead of in the 2040s – or even the 2050s and 2060s, as some individuals and businesses keep their vehicles for a long time. A scrappage scheme needs to be available to all individuals and businesses, regardless of size, and needs to encompass vehicles of all ages. Although older vehicles are known to be very polluting, no-one really knows about new vehicles! This could be complemented by financial help for retrofitting, particularly for older buses and lorries, if replacement isn’t an option.

Drivers of diesel cars are understandably aggrieved. They were urged to buy diesel engines by previous governments and given financial incentives to do so, because of the lower CO2 emissions per km. The higher emissions of other pollutants were ignored. Those with newer vehicles have no idea what their car really emits, due to the scandalous behaviour of manufacturers. This is yet another parallel with the tobacco industry (1) which designed cigarettes to produce low tar and nicotine in the laboratory but not when used by actual smokers.

Chargeable clean-air zones (low or ultra-low emission zones) are, according to a technical report issued by the government earlier this year, the most effective mechanism, but we understand that the government’s strategy will restrict charging to the last, not the first, resort. This is one of the areas, along with improved infrastructure for transport options other than private car use, that local authorities can contribute to greatly, but they need adequate powers and adequate resources. As air pollution costs the country £20 billion annually (2), the proposed figure of £255million to local authorities is a drop in the ocean.

The government is apparently also going to urge local authorities to speed traffic flows, by amending traffic-light settings and removing speed humps. What is actually needed is more calming, not less, to support smoother driving. It is not speed humps but the marked acceleration and braking that many drivers do that increases pollution. Greater use and enforcement of, and adherence to, area-wide 20mph limits without traffic calming would be better still.

Lower speeds, which would also support more and more pleasant walking and cycling, bring me to the better approach. Instead of persuading (in the next two decades) or requiring (from 2040) people to replace their existing car with an electric car, the health gains would be far greater if people travelled by public transport, walked or cycled whenever possible. As well as reducing pollution and carbon emissions, this generally increases physical activity and can improve wellbeing and reduce obesity and its consequences.

Reductions in pollutant emissions can also be achieved by reducing the need to travel. If people who could do so worked at home once a week, that would reduce their commuting by 20%. Land-use planning that encourages mixed use can shorten journeys sufficiently to make non-car options more feasible, although this will take longer. But as the government proposal for banning sales of diesel and petrol cars is to start in 2040, they are talking longer term anyway.

The government also needs to acknowledge that, although mobile sources are the largest category of pollutants, they are not the only ones. Two major contributors are buildings, including both homes and businesses, and transboundary industrial pollution from mainland Europe. Ministerial engagement with European countries will be necessary to deal with the latter. Local authorities need to be given the powers to address the former.
Air pollution is a major contributor to health inequalities. Poorer people are more likely to be exposed to higher pollutant levels. They are also more susceptible to the harmful effects of pollutants as they are more likely to have circulatory diseases (particularly heart disease and strokes) and respiratory diseases, such as chronic bronchitis or emphysema (now called chronic obstructive pulmonary disease) or asthma. Improving air quality is an important factor in reducing health inequalities.

The other option that we trust the government won’t take is to move the goal posts when (or if?) the UK is no longer bound by EU legislation. That would really be a cynical approach to the population’s health.

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1. Mindell J. Lessons from tobacco control for advocates of healthy transport. J Public Health Med. 2001; 23:91-7.

2. Royal College of Physicians, Royal College of Paediatrics and Child Health. Every breath we take: the lifelong impact of air pollution. London: RCP, 2016.

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By Elizabeth Orton

The Faculty of Public Health’s Transport Injury Prevention Network will be holding an inaugural workshop at the FPH conference in Telford on 20 June.

As well as introducing the aims and objectives of the network, the session will focus on speed reduction as a key road danger reduction strategy. We will be looking at how to improve collaboration in local government between public health and transport teams to encourage active travel and reduce road danger. We will review the evidence around 20mph zones and limits and discuss strategies for their implementation, sharing examples of good practice, tools and approaches.

Please come along and share your ideas, experiences and views with us.

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