Maizlish Neil, Linesch Nicholas J, Woodcock James
Berkeley, CA, USA.
Los Angeles, CA, USA.
J Transp Health. 2017 Sep;6:490-500. doi: 10.1016/j.jth.2017.04.011.
The purpose of this research was to quantify health co-benefits and carbon reductions of preferred scenarios of California regional transportation plans and alternatives with ambitious levels of active transport. The alternatives were designed to examine the efficacy of independent contributions of walking, bicycling, and transit at levels consistent with the U.S. Surgeon General recommendation for physical activity. Using data from travel and health surveys, vital statistics, collision databases, and outputs from regional and statewide travel models, the Integrated Transport and Health Impacts Model estimated the change in the population disease burden, as measured by deaths and disability adjusted life years (DALYs), due to a shift from a 2010 baseline travel pattern to an alternative. Health pathways modeled were physical activity and road traffic injuries. The preferred scenarios increased statewide active transport from 40.5 to 53.4 min person w, which was associated with an annual decrease of 909 deaths and 16,089 DALYs. Sensitivity analyses that accounted for 2040 projected age- and sex-specific population characteristics and cause-specific mortality rates did not appreciably alter the annual change in deaths and DALYs on a population basis. The ambitious, maximal alternatives increased population mean travel duration to 283 min person w for walking, bicycling, or transit and were associated a reduction in deaths and DALYs from 2.5 to 12 times greater than the California preferred scenarios. The alternative with the largest health impact was bicycling 283 min person w which led to 8,543 fewer annual deaths and 194,003 fewer DALYs, despite an increase in bicyclist injuries. With anticipated population growth, no alternative achieved decreases in carbon emissions but bicycling had the greatest potential for slowing their growth. Alternatives that included transit similarly reduced carbon emissions, but with less health benefit. Aggressive expansion of active transport is an efficacious, but underutilized policy option with significant health co-benefits for mitigating greenhouse gases.
本研究的目的是量化加利福尼亚州区域交通规划的首选方案以及具有雄心勃勃的主动交通水平的替代方案所带来的健康协同效益和碳减排量。这些替代方案旨在检验步行、骑自行车和乘坐公共交通的独立贡献在符合美国卫生局局长身体活动建议水平时的效果。综合交通与健康影响模型利用出行和健康调查、人口统计数据、碰撞数据库以及区域和全州出行模型的输出数据，估计了由于从2010年基线出行模式转变为替代模式而导致的人口疾病负担变化，以死亡人数和伤残调整生命年（DALYs）来衡量。所模拟的健康途径为身体活动和道路交通伤害。首选方案将全州的主动交通时间从每人每周40.5分钟增加到53.4分钟，这与每年减少909例死亡和16,089个伤残调整生命年相关。考虑到2040年预计的特定年龄和性别的人口特征以及特定病因死亡率的敏感性分析，在总体人口基础上并未明显改变每年死亡人数和伤残调整生命年的变化。雄心勃勃的最大替代方案将步行、骑自行车或乘坐公共交通的人口平均出行时长增加到每人每周283分钟，与死亡人数和伤残调整生命年的减少相关，减少幅度比加利福尼亚州的首选方案大2.5至12倍。对健康影响最大的替代方案是每人每周骑自行车283分钟，尽管骑自行车受伤人数有所增加，但每年可减少8,543例死亡和194,003个伤残调整生命年。随着预期的人口增长，没有任何替代方案能实现碳排放量的减少，但骑自行车在减缓碳排放量增长方面具有最大潜力。包括公共交通的替代方案同样能减少碳排放量，但对健康的益处较小。积极扩大主动交通是一项有效但未得到充分利用的政策选择，在减轻温室气体方面具有显著的健康协同效益。
