Sunnyvale Highway: Data Analysis for Injury
Buford Highway: A Case Study
Welcome to the Buford Highway case study. The purpose of working through this case study is to give you the opportunity to experience the HIA process. Remember, each HIA is different and this is just one example.
Work with your team to complete the questions at the end of each section. Please do not move to the next step until you have heard the presentation about that step.
Begin by reading the background information about Buford Highway, reviewing the information given in the presentation, and answering the questions related to the screening process.
BACKGROUND INFORMATION
Buford Highway is an automobile-oriented corridor near the urban fringe of Atlanta with post-World War II style development (low density, low connectivity, and low land-use mix). The area has strip malls, multi-unit housing, a noticeable lack of pedestrian amenities, and is bisected by a seven lane highway. The street layout has high design-speeds for automobiles, long blocks, few intersections, few crosswalks, and many cul-de-sacs. This area is a classic example of suburban, low density, auto-oriented development seen in many areas across the country.
Many of the residents surrounding Buford Highway in DeKalb County, Georgia are new immigrants, with 25% living outside the U.S. prior to 1995 (see Figure 1 for additional demographic information). The average family size is also large with an average of 3.44 people per household. Many households lack automobiles or only have one automobile available per family, meaning that transit-dependency and pedestrian activity is high, despite the lack of pedestrian facilities. This increased presence of a transit-dependent population in an area that has been designed and built primarily for automobile travel has lead to increasing conflicts between pedestrians and automobiles. Along an 8 mile section of Buford Highway there are on average 19 pedestrian injuries and 4 pedestrian fatalities per year.
Many developers are interested in turning the auto-orientated development around Buford Highway into a smart growth community (high density, mixed land-use, high street connectivity) that is pedestrian orientated. However, in order to do this they must demolish the existing low income housing. While there will be a net increase in density (number of units available) most of the plans call for housing that is substantially more expensive. The DOT is also willing to make certain changes to improve the pedestrian infrastructure as long as it does not impede automobile traffic flow.
A staff of 2 public health professionals and 2 planners who can dedicate 50% of their time for 1 year has been assigned to this project. Some additional help from architects and transportation professionals is also available but there is no money to pay them for their time. The plans for the development project are currently in the conception stage and it is estimated that you will have a year to provide recommendations to the DOT, stakeholders, and developers.
Figure 1. Comparison of the Distribution of Demographic Factors in the Atlanta MSA and the Buford Highway Project Area
| |Buford Highway Project Area |Atlanta |
|% Male |60% |49.4% |
|Age 0-17 |18.9% |26.6% |
|18-29 |28.3% |18.1% |
|30-39 |23.3% |18.4% |
|40-49 |10.9% |15.7% |
|50+ |8.6% |21.2% |
|White (includes Hispanic) |47.3% |63.0% |
|Black (includes Hispanic) |20.8% |28.8% |
|Asian |4.8% |3.3% |
|Hispanic/Latino (any race) |49.8% |6.5% |
|Foreign-born |62.0% |10.3% |
|Non-U.S. residency in 1995 (age ≥5) |25.7% |4.1% |
|Highest ed completed H.S or less (age ≥25) |51.3% |40.4% |
|Avg annual household income |$45,511 |$51,948 |
|Below poverty |15.8% |9.2% |
|Total (N) |14,000 |4,112,198 |
Figure 2. Map of Study Area
Figure 3. Example of Poor Pedestrian Infrastructure
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Figure 4. Pedestrians Walking along Buford Highway
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Figure 5. Example of Pedestrian-Worn Footpaths
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SCREENING
It is time to apply what you have learned about screening to the Buford Highway case.
1. Could there be significant health impacts related to redeveloping this area?
___YES ___NO
2. Use the diagram of health determinants below to determine which health impacts are most likely to be affected.
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Figure 6. Determinants of Health
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3. Would you complete a rapid, intermediate on comprehensive assessment for Buford Highway? Why?
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SCOPING
Due to the high rates of pedestrian injuries and fatalities the DOT has decided to make changes to the design of the highway including: adding sidewalks, crosswalks, and converting the center lane to a full median. Developers have also submitted plans to develop greenspace, add intersections, reduce the total number of parking spaces, and add office and commercial space as well as thousands of housing units.
Figure 7. Buford Highway before Renovations
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Figure 8: Buford Highway after Renovations
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1. What ground rules would you set for the Buford Highway HIA (temporal, geographical and population)?
Temporal (length of time, ex. week-long survey, 5 year analysis, etc.):
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Geographical (area looked at, ex. street block, entire city, etc.):
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Population (subgroup of people, ex. children, residents, etc.):
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2. What resources are currently available? What other resources are needed to ensure success? Are there untapped resources that you could garner, if needed?
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3. Who are the internal and external partners you would include?
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4. What priorities and strengths do you think each partner will bring to the table?
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5. How would you involve the community? Who are your stakeholders? What are some pros and cons of having them involved?
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ASSESSMENT
Before starting your assessment you would gather information on the health outcomes that you think the project or policy will impact. Depending on the availability and quality of data, you must make a decision on whether to perform qualitative or quantitative assessment for each identified health outcome.
For the Buford highway case study, qualitative analyses were performed for
o air pollution
o automobile level of service
o economic growth, gentrification and crime
o social capital and crime
Quantitative analyses were performed for
o pedestrian injury and fatality
YOU HAVE A CHOICE
1. Perform qualitative assessment for the variables listed above (go to page 12)
OR
2. Perform the quantitative assessment for pedestrian injury and fatality (go to page 21)
QUALITATIVE ASSESSMENT
Air pollution
Several factors affect the amount of pollution that is given off by motor vehicles such as vehicle type, age, speed, driving conditions, atmospheric conditions, and time spent idling. Larger vehicles and vehicles with lower fuel mileage generally produce more pollution; however these factors are less influential than particulates from the wear of brake pads and tires and evaporating fuel from unsealed gas tanks. Diesel powered vehicles also emit more harmful byproducts than vehicles of similar size powered by gasoline; diesel exhaust contains several hundred different organic and inorganic compounds, many of which have been designated as toxic. Light-duty diesel engines can emit 50 to 80 times more particulate mass than gasoline engines and heavy-duty trucks emit 100 to 200 times more particulate mass. Slower traffic is often associated with higher vehicle emissions per mile traveled because vehicles stalled in traffic spend more time running and emit more exhaust. In addition, the air pollution emissions of short trips are disproportionately high in relation to total vehicle trips and miles traveled since these trips tend to be short and involve cold starts (starting a cold engine) that emit high levels of pollution.
Some of the potential health effects of air pollution include: headache, loss of alertness, respiratory system irritation, coughing, reduced lung function, aggravation of asthma, lung damage, restricted activity days, chest pain (for those with heart disease), and decreased learning ability in school children. In very high doses, air pollution can lead to permanent lung damage, asthma-related hospital visits, coma and death.
The redevelopment plan calls for adding a center median (estimated improvement in traffic flow) and adding several new signalized crosswalks (estimated moderate reduction in traffic flow). After the changes the new residents may walk more to local destinations but it is uncertain what mode of transportation the new residents will take. The local metropolitan planning organization estimates that there will be a 5% increase in automobile traffic and a 5% increase in the number of bus trips. Currently 50% of the buses are diesel busses.
AIR POLLUTION WORKSHEET
Please fill in the table below identifying:
• All relevant populations that will be affected
• Positive and negative health outcomes that would result
• Your degree of certainty with respect to each health outcome
|Population and population subgroups |Predicted health impacts (Positive and |Risk of impact definite (D) |
| |negative) |probable (P) speculative (S) |
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Automobile Level of Service
The redevelopment plan is likely to reduce the number of automobile crashes due to traffic calming, however reducing the flow of traffic could lead to other negative health outcomes. For instance, reducing the number of lanes may slow down ambulance response times which could decrease an individuals’ chance of survival from a cardiopulmonary event. Using national data, it was estimated that 10,811 individuals living in the county would be hospitalized for cardiovascular diseases in any given year (1.6 visits per 100 people). One study found that increasing response time from 5 minutes to 8 minutes (for 90% of the calls) would decrease survival by 2-3% and there was an additional 2% decrease in survival when response times increased from 8 minutes to 14 minutes. However, decreased response times were not found to affect survival rates for individuals who suffered from traumatic injury or those involved in road traffic accidents. In addition to distance and traveling conditions, numerous other factors have been found to affect ambulance response times such as the geographical distribution of ambulance stations, availability of vehicles to respond, and the use of ambulances for routine patient transfers.
In the county the average response time for a 911 call was 23.6 minutes and it was 14.7 minutes for a priority (life threatening) call. The police chief attributed the slow response times to the 90 vacancies in the police department, population growth, and the large area covered by the county. The police chief did not believe the long response time was due to road conditions.
Another potential side effect of the traffic calming would be that motorists divert from the highway to side streets. This could lead to an increase in traffic as well as automobile and pedestrian injuries on these streets since they were not designed to accommodate large flows of traffic. The amount of traffic on side streets would be dependent on the connectivity of these side streets to other major roads, thus it may affect some streets more than others.
The local metropolitan planning organization stated that during peak traffic times Buford Highway has a good Level of Service (LOS) and with the proposed changes the LOS during peak times would be reduced to fair after the proposed changes. Reducing the LOS on Buford Highway will likely increase traffic which could lead to road rage, obesity (due to increase sedentary activity), and decreased physical activity for those individuals who have to spend more time in their automobiles. However, it is also possible that individuals who currently use Buford Highway during peak times would 1) choose an alternate route 2) try taking public transportation, or 3) make their trip during non-peak hours.
AUTOMOBILE LOS WORKSHEET
Please fill in the table below identifying:
• All relevant populations that will be affected
• Positive and negative health outcomes that would result
• Your degree of certainty with respect to each health outcome
|Population and population subgroups |Predicted health impacts (Positive and |Risk of impact definite (D) |
| |negative) |probable (P) speculative (S) |
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Economic Growth, Gentrification, and Crime
Gentrification has been defined as “the unit-by-unit acquisition of housing, displacing low-income residents by high-income residents” and it is independent of the structural condition, architecture, tenure, or original cost of the housing. Gentrification typically occurs slowly over many years as the original population is replaced by a new population with a different social class, culture, income level, and lifestyle.
Gentrification usually has a differential impact on those that own their homes versus those that are renting either homes or apartments. Those that are renting may face greater pressures to move to other areas to find affordable housing as the average rent prices increase in the area. Thus gentrification has a disproportionately negative affect on renters who are typically in the lowest income brackets. Gentrification is exacerbated in areas when lower density housing developments replace higher density housing units, when efforts are not made to provide affordable housing, and when urban reinvestment is not made available to existing residents.
The peer reviewed literature regarding the impacts of gentrification on crime has been mixed. One theory predicts that crime rates will fall as higher income individuals replace those with lower incomes because rates of crime are lower in groups with higher incomes. In addition, the new residents often improve and renovate their property which can install greater neighborhood pride, they may form neighborhood patrols to help decrease crime rates, and they often have more political clout to get other improvements (increased police presence, better lighting, etc.) from the local government.
However, another theory predicts that crime will rise because the individuals with higher income are now seen as targets for crime related activity. In addition, the social disruption that occurs from displacement may destroy social ties within the neighborhood leading to decreases in the neighborhood’s collective efficacy (joint belief of the neighbors ability to reach their goals) and thus lead to increased crime.
A study that examined 14 neighborhoods found that personal crime rates decreased after gentrification while there were no changes in property crime arrests. However, another study found that aggravated assault and murder rose while property crime declined in gentrified areas.
The redevelopment plan is expected to lead to increased economic growth and vitality in the area. The plan also calls for an increase in housing units from 1,000 units to 2,000 units with 5% of the new units being subsidized housing saved for the current residents.
Figure 9: Summary of Neighborhood Impacts of Gentrification
|Positive |Negative |
|Stabilization of declining areas |Displacement through rent/price increases |
|Increased property values |Secondary psychological costs of displacement |
|Reduced vacancy rates |Community resentment and conflict |
|Increased local fiscal revenues |Loss of affordable housing |
|Encouragement and increased viability of further development |Unsustainable speculative property price increases |
|Reduction of suburban sprawl |Homelessness |
|Increased social mix |Greater take of local spending through lobbying/articulacy |
|Decreased crime |Commercial/industrial displacement |
|Rehabilitation of property both with and without state |Increased costly and changes to local service |
|sponsoring | |
|Even if gentrification is a problem it is small compared to the |Displacement and housing demand pressures on surrounding poor |
|issue of urban decline and abandonment of inner cities |areas |
| |Loss of social diversity (from socially disparate to rich ghettos)|
| |Increased crime |
| |Under-occupancy and population loss to gentrified areas |
| |Gentrification has been a destructive and divisive process that |
| |has been aided by capital disinvestment to the detriment of poorer|
| |groups in cities |
ECONOMIC GROWTH, GENTRIFICATION, AND CRIME WORKSHEET
Please fill in the table below identifying:
• All relevant populations that will be affected
• Positive and negative health outcomes that would result
• Your degree of certainty with respect to each health outcome
|Population and population subgroups |Predicted health impacts (Positive and |Risk of impact definite (D) |
| |negative) |probable (P) speculative (S) |
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Social Capital and Crime
“Social capital" is a term often used to describe the amount of formal and informal social networks, group membership, trust, reciprocity, and civic engagement in a neighborhood. Putnam described how these “networks of civic engagement foster sturdy norms of generalized reciprocity and encourage the emergence of social trust” (Putnam, 1995). A decline in American civic engagement over time has been witnessed through reduced participation in various civic associations and more notably a decrease in the proportion of Americans who socialize with their neighbors. In adults, higher levels of social capital and social connectedness have been linked to decreased risk of mortality (all cause, ischemic heart disease, and cardiovascular disease), higher levels of self-rated health, physical activity, and a lower prevalence of mental health problems.
Leyden’s (2004) research on social capital and walkable neighborhoods found that people living in walkable, mixed-use neighborhoods had higher levels of social capital than those in car-oriented suburban areas. Residents in more walkable communities were more likely to trust others, be socially engaged, be politically active, and know their neighbors. Increased levels of walking reinforce social capital by facilitating neighborhood social interaction which decreases perceptions of danger.
Jane Jacobs, author of The Death and Life of Great American Cities (1961), was the first to describe the concept of “eyes on the street,” where a greater density of residents and different land uses may enhance feelings of safety and deter criminal activity by increasing the presence of pedestrians and everyday visual surveillance. Ross and Mirowski (2000) found that people who lived in the city of Chicago were more likely to walk than were residents of the suburbs, small towns, and rural areas. She hypothesized that increased density allows for walking for transport and applied Jacobs’ concept of “eyes on the street” to describe how an organic process of community interaction and involvement works to counteract fear for personal safety. By decreasing crime and feelings of vulnerability and increased community interaction both can have significant positive effects on social capital in a community.
Other researchers have correlated increased social capital with quantifiable reductions in crime rates. Another study found that lower levels of fear for safety was associated with higher levels of social trust. One researcher noted that social capital contributes to crime prevention by helping to maintain social order. He described the conceptual link between social capital and crime by suggesting “the safest communities are not those with the most police and prisons but those with the strongest community structures” (Graycar, 1999).
In DeKalb County there were 4,018 crimes per 100,000 people in 2000. Over half of the crimes (53.9%) were larceny, followed by burglary (20%), motor vehicle theft (17.5%), robbery (5.5%), aggravated assault (2.6%), rape (0.4%), and murder (0.1%).
SOCIAL CAPITAL AND CRIME WORKSHEET
Please fill in the table below identifying:
• All relevant populations that will be affected
• Positive and negative health outcomes that would result
• Your degree of certainty with respect to each health outcome
|Population and population subgroups |Predicted health impacts (Positive and |Risk of impact definite (D) |
| |negative) |probable (P) speculative (S) |
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Quantitative Assessment
PEDESTRIAN INJURY AND FATALITY REDUCTION WORKSHEET
Below are a series of questions related to assessment for injury reduction; please complete them to the best of your abilities.
1. Where would you find baseline data on pedestrian and auto injuries?
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2. Where would you find data on ways to reduce pedestrian and automobile injuries?
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WALK THROUGH QUANTITATIVE ASSESSMENT
Step 1: Finding Baseline Data
In this case there was good enough baseline and effect estimate data for a quantitative analysis. However, if you were unable to find this type of data in your own community you would want to conduct a qualitative assessment instead. There are several places to get data on injuries and fatalities depending on the level of detail you need for your study.
National data is available in the
o Published literature
o On-line at the Federal Highway Administration (FHWA) Website
Local level data is available at
o The Department of Transportation
o The Police Department
Available data usually includes date, time, number of injuries, number of fatalities, type of collision, harmful event, lighting condition, road surface, and directions that the vehicles were traveling at time of impact.
Problems with these types of data:
1) Pedestrian injuries are often underreported so it is best to search in both databases and determine which collisions are duplicated or missed.
2) Data is often missing, in the Buford case 38% of the data was missing from year 1998 and 67% of the data was missing from 1999 in the DOT file.
3) If they do not collect location information you cannot determine where the crash occurred.
For this case study, the Police Department dataset was used since it was more complete. Also, because it included collision location it was possible to determine where each collision occurred. As mentioned previously, along an 8 mile section of Buford Highway there were on average 19 pedestrian injuries and 4 pedestrian fatalities per year. There were also 250 automobile injuries and 0 automobile fatalities per year.
Step 2: Finding an Effect Estimate
The next step would be to find an effect estimate for injury reduction. The changes that the DOT was planning on making are called “traffic calming” measures since they serve to slow down traffic and make it safer for pedestrians. When these traffic calming measures are placed into an area the number of injuries and fatalities that will be prevented can be calculated using Collision Reduction Factors (CRFs). The best place to find collision reduction factors is in the published literature or on the FHWA website. For example, putting in sidewalks has a CRF of .65 for pedestrians; in other words putting in sidewalks would be expected to reduce the number of pedestrian injuries and fatalities by 65%.
However, there were several problems with calculating CRFs for Buford Highway. One of the biggest problems was that the DOT planned on putting in several different CRFs at one time. This was a problem when attempting to calculate a total CRF since most of the published literature only looks at one CRF at a time. By using a formula which was provided by senior transportation engineers it was possible to add several CRFs together. For this assessment we are going to use the formula below:
CRFt = CRF1 + (CRF2 ) (1-CRF1) + (CRF3) (1-CRF1) (1 – CRF2)
Where CRFt = CRF of combined countermeasures
CRF1 = CRF for the first countermeasure
CRF2 = CRF found the second countermeasure
CRF3 = CRF for the third countermeasure
For example to calculate the reduction in pedestrian injuries from adding sidewalks and medians you would find their respective CRFs (Figure 10) and put them into the formula below.
CRFt = CRF1 + (CRF2 ) (1-CRF1)
CRF1 = 0.55
CRF2 = 0.65
CRFt = 0.55 + (0.65)(1 - 0.55)
CRFt = 0.55 + (0.65)(0.45)
CRFt = 0.55 + 0.29
CRFt = 0.84
Therefore you would expect an 84% reduction in pedestrian injuries and fatalities through the installation of sidewalks and medians.
Figure 10: Collision Reduction Factors Associated with Different Types of Road Improvements
|Improvement Measure |Pedestrian Collision CRF|
|Replacement of two-way left-turn lane with raised median |55% |
|Sidewalks |65% |
|Added/improved pedestrian crosswalks |19% |
Now it’s time for the real assessment! Take all three Collision Reduction Factors from Figure 10 and calculate the total collision reduction factor for pedestrian collisions.
CRFt = CRF1 + (CRF2 ) (1-CRF1) + (CRF3) (1-CRF1) (1- CRF2)
CRF1 =
CRF2 =
CRF3 =
CRFt =
WALKTHROUGH
The next step is to use the total expected collision reduction factors and determine the expected accident reduction (the estimated number of pedestrians injured or killed each year after putting traffic calming measure in place) and the total number of injuries and fatalities prevented.
EAR = BCR – (BCR x CRFt)
EAR = expected accident reduction
BCR = baseline collision rate
CRFt = CRF of combined measures
Once again using the sidewalk and median example we found a total collision reduction factor of 84%. As mentioned earlier, there were 19 pedestrian injuries and 4 pedestrian deaths on average every year.
Pedestrian injuries:
EAR = BCR – (BCR x CRFt)
BCR = 19
CRFt = .84
EAR = 19 – (19 x .84)
EAR = 19 – 16
EAR = 3
Thus, after the medians and sidewalks were installed, you would have an expected accident reduction of 3 pedestrian injuries a year (16 less).
Pedestrian deaths:
EAR = BCR – (BCR x CRFt)
BCR = 4
CRTt = .84
EAR = 4 – (4 x .84)
EAR = 4 - 3
EAR = 1
After the medians and sidewalks were installed you would expect 1 pedestrian fatality per year (3 less).
Now it’s your turn to calculate the expected accident reduction for
1) Pedestrian injuries
2) Pedestrian deaths
The CRFt you will use in this assessment is the one you calculated earlier which included adding sidewalks, crosswalks, and center medians.
Pedestrian injuries:
EAR = BCR – (BCR x CRFt)
BCR =
CRFt =
EAR=
Pedestrian deaths:
EAR = BCR – (BCR x CRFt)
BCR =
CRFt =
EAR=
Step 3: Sensitivity Assessment
Another important part of performing quantitative assessment involves performing sensitivity assessment. For instance, studies show that adding sidewalks has a range of injury reduction from 65% to 75% and reducing speed limits have been found to reduce injuries by 15% to 30% (see Figure 11). Thus, to perform a sensitivity assessment you would replicate the assessment using both the highest and lowest values to get a range of possible values.
Figure 11: Researched Collision Reduction Factors
|Measure |Reported Collision Reduction Factors |Source |
|Replacement of two- way left-turn|45% |All collisions |(1) |
|lane with raised median | | | |
| |43% |Injury collisions | |
| |78% |Pedestrian fatalities | |
| |25% - 40% |All collisions |(2) |
| |41% - 61% |Pedestrian collisions |(3) |
| |90% |Pedestrian fatalities |(4) |
|Sidewalk |68% |Pedestrian collisions |(5) |
| |50-90% |“Walking along roadway” pedestrian|(6) |
| | |collisions | |
|Added/improved pedestrian |25% |Pedestrian collisions |(5) |
|crosswalk | | | |
| |25% - 48% |All collisions (unsignalized |(7) |
| | |intersections only) | |
1) Parsons P, Waters MI, Fincher J. Georgia study confirms the continuing safety advantage of raised medians over two-way left-turn lanes. 2000. Presented at the fourth national conference on access management, Portland, Oregon.
Ref Type: Generic
2) National Cooperative Highway Research Program. Roadway safety tools for local agencies: A synthesis of highway practice. 2003;
3) Centre for Transportation Research and Education ISU. Iowa's statewide urban design standards promote improved access management. 2005;
4) Bretherton. Gwinett County DOT. 6-15-2004. 6-15-2004.
Ref Type: Personal Communication
5) Shen J. Development and application of crash reduction factors: A state-of-the-practice survey of state departments of transportation. 2004. Transportation Research Board annual meeting.
Ref Type: Generic
6) National Cooperative Highway Research Program. A guide for reducing collisions involving pedestrians. 2003; Volume 10 of NCHRP report 500 2003
7) Federal Highways Administration and Institute of Transportation Engineers. Toolbox of countermeasures: Toolbox of countermeasures and their potential effectiveness to make intersections safer. 2005;
Step 4: Listing Assumptions
Finally, it is important that you list all of your data sources and assumptions so that others can judge the value of your work.
Assumptions for Injury Assessment on Buford Highway:
1. Traffic calming measures used to calculate individual CRFs that have been used in different parts of the country will have the same effect along Buford Highway.
2. The residents will use the new sidewalks and crosswalks.
3. If the traffic is diverted onto other streets, there will not be an increase or decrease in pedestrian injuries on those streets.
4. The CRFs were directly applied to the number of expected accidents per year without taking into account how the accident occurred, since this data was not available for pedestrian accidents. Data was not available on the number of pedestrian accidents that occurred due to improper crossing, which could have an effect on expected injury reductions if pedestrians continue to cross improperly after the built environment is modified.
5. It was assumed that the best available estimates for CRFs were used, which included personal communication with local transportation agencies, realizing that the level of predictive certainty for most of the CRFs is unknown. The NCHRP (2005) found a medium-high level of certainty for reducing the number of lanes and adding raised medians, a medium-low level of certainty for marked crosswalks, reducing the speed limit, and adding a pedestrian refuge island, with all other pedestrian improvements getting an unknown rating.
REPORTING
Remember it is important that reporting is considered from the beginning. You want to be establishing relationships with people you will be reporting to, telling them about their project and updating them along the way. This shouldn’t just be thought of at the very end of the process.
1. Based on the analysis you conducted earlier, create a draft list of recommendations for mitigating the expected negative health impacts and promoting potential positive health impacts.
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2. What process would you use to prioritize these recommendations?
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3. Who do you think should receive a report or presentation for Buford Highway? What type of format do you think will be the most effective for each group? How can you most effectively present the data you collected in the report?
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4. What responses do you think you’ll encounter when presenting the results of this study?
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EVALUATION
1. What kind of data would you collect for each type of evaluation?
Process: a)
b)
Impact: a)
b)
Outcome: a)
b)
2. What types of evaluation would you use for this case study?
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ANSWER KEY
SCREENING
1. Do you think that there will be significant health impacts related to redeveloping this area? Yes, there will likely be significant health outcomes.
2. Which health impacts do you think will be most likely to be affected?
The ones that will most likely be affected are pedestrian and automobile injuries and fatalities, physical activity, air pollution, noise pollution, gentrification, social capital, crime, and automobile level of service.
3. Would you complete a rapid, intermediate on comprehensive assessment for Buford Highway? Why? Intermediate to comprehensive. There are likely to be significant health impacts, there is potentially unfamiliar information, the results are likely to be valued by the stakeholders and decision makers, there is dedicated staff who will be able to gather sufficient data, due to the high rates of injuries and fatalities it is worth the time to perform the HIA, and since there is a long time period to deliver recommendations this would likely be an intermediate or comprehensive HIA.
SCOPING
1. What ground rules would you set for this case (temporal, geographical or population)?
For the geographical ground rules you need to determine what section of the highway you’re going to examine since it runs for hundreds of miles. The most logical selection for this HIA would be the section of the highway that is being redeveloped since they are not redeveloping the entire highway. For this project you also need to select the population that is likely to be most affected by the changes. The people living along the highway and those that walk along the highway are probably the groups that will be most affected by the changes. For this case study a ½ mile radius from the highway was chosen since that is the distance that people would be expected to walk to access transit and shopping. Additional information was also gathered about the number of people who drive along the highway each day. Time limits for the assessment were set at 1 year since significant reductions in injuries and fatalities would be expected over that time period.
2. What resources are currently available? What other resources are needed to ensure success? Are there untapped resources you could garner if needed?
You currently have 2 staff that have half their time for a year as well as other professionals who have agreed to provide unpaid help. To ensure success you will need dedicated staff time which remains throughout the process, buy in from HIA staff supervisors, the ability to communicate with non-traditional partners, and the ability to organize the community and to work with community groups. Untapped resources could include policy makers, community groups, and community members who care about this issue.
3. Who are the internal and external partners you would include?
Partners would include local organizations and community groups that represent the minority groups that live in this area, the community, the Department of Transportation, the Federal Highway Administration, policy makers such as County Commissioners and local mayors, and police departments. Ideally you will form a small tight working group and have a larger group of individuals serving as an advisory panel.
4. What priorities and strengths do you think each partners will bring to the table?
You would expect the community groups and the community to be positive about the changes since they are the ones who will most likely benefit from the changes. However, there are likely to be community members who oppose these changes for various reasons. The DOT and FHWA’s main concerns usually involve automobile level of service and they do not usually invest a lot of money into non-motorized travel. There may be some resistance to having public health officials and planners involved in their projects. Local policymakers and police could either be supportive since they see the need for changes or they could be unsupportive since they do not want attention brought onto a problematic situation.
5. How would you involve the community? Who are your stakeholders? What are some pros and cons of having them involved?
The cons involve time and money and having to find a way to incorporate their input with the scientific analyses. The pros include getting buy in for the changes, determining if anything was missed in the scientific assessment, and providing solutions to problems. For instance, the community groups may be able to help educate the community how to use the new pedestrian activated signals and encourage them to use crosswalks instead of crossing in undesignated locations.
ASSESSMENT: QUALITATIVE
Air Pollution
Too little is known about potential congestion, traffic speeds in the project area, and drivers’ responses to quantitatively predict air pollution effects. However, there may be small changes in air pollution in the study area, individuals driving in cars and riding on diesel buses, will be exposed to the most pollution. Since the study area is relatively small a region-wide impact on air pollution will probably be negligible.
|Population and population subgroups |Predicted health impacts (Positive and |Risk of impact definite (D) |
| |negative) |probable (P) speculative (S) |
|People who live along the highway |Increased air pollution |Speculative |
|(minority and transit dependent) | | |
| | | |
| | | |
|People who drive along Buford Highway | | |
| |Increased air pollution |Speculative |
| |Increased time spent in cars |Probable |
Automobile Level of Service
While a large number of people in the County are likely to be hospitalized for cardiovascular diseases it is unclear 1) how much longer if would take ambulances to get to their destination if the changes were made to Buford Highway 2) if there is any decrease in survival for response times over 14 minutes, and 3) how many ambulances currently take Buford Highway. From what was indicated by the police chief, traffic does not appear to be one of the major barriers faced by emergency response vehicles, however reductions in the automobile level of service may still lead to reduced response times. Therefore, with the current data it is not possible to quantify the expected decrease in survival from cardiopulmonary events.
There is also not enough data on the amount of time that would be added onto drivers commute time. If the delays were only a few minutes, significant changes in road rage, obesity, and physical activity would not be expected. However, if the changes lead to significant increases in travel time there could be noticeable health outcomes.
|Population and population subgroups |Predicted health impacts (Positive and |Risk of impact definite (D) |
| |negative) |probable (P) speculative (S) |
|People who drive along Buford Highway |Reduction in risk for automobile accident |Probable |
| |Road rage | |
| |Increased obesity |Speculative |
| |Decreased physical activity |Speculative |
| | |Speculative |
|People who rely on ambulances |Increased response time to cardiovascular events which could | |
| |decrease survival rates | |
|People who live around Buford Highway | |Speculative |
| |Increased risk of pedestrian accidents on side streets | |
| | | |
| | |Speculative |
Economic Growth, Gentrification, and Crime
The proposed plan would increase density and land-use, both of which have been linked to lower crime rates. In addition, the plan would increase walkability which has been linked to increased social capital and areas with high social capital have been found to have lower crime rates. While 5% of the new units will be saved for current residents the majority will be displaced. While the changes to the built environment suggest there would be a decrease in crime rates it is unclear how gentrification would affect crime rates.
Although gentrification will almost definitely occur, there is insufficient information about the population being displaced to make certain estimates about how gentrification will affect their health. For instance, there is no information about the availability of affordable housing in other nearby areas or about the financial security of home owners (can they afford the tax increase?). There is also no baseline data about the mental health of this group or how the move will affect their ability to find new jobs or access transportation to their old jobs.
|Population and population subgroups |Predicted health impacts (Positive and |Risk of impact definite (D) |
| |negative) |probable (P) speculative (S) |
|Home owners |Increased financial stability with increased home value |Probable |
| |Decreased financial stability due to tax increases | |
| |Decreased crime |Probable |
| | | |
| |Homelessness |Speculative |
| |Housing insecurity | |
|Renters |Decreased social capital |Speculative |
| |Increased crime |Probable |
| |Depression, anxiety, and other mental health problems |Probable |
| | |Speculative |
| | |Speculative |
Social Capital and Crime
Many of the changes to the built environment would be expected to lead to increases in social capital for the new residents (increased density, increased greenspace, and increased walkability). However, any potential increases in social capital for the new residents will likely take some time to occur as they get to know their neighbors. The largest decreases in social capital for the current residents will occur when they are forced to relocate to another location. Their disruption will likely vary by the distance of their new housing from their existing housing and the number of people they know who move with them to a similar location as well as the quality and amenities of their new neighborhood.
|Population and population subgroups |Predicted health impacts (Positive and |Risk of impact definite (D) |
| |negative) |probable (P) speculative (S) |
|Current residents |Decreased social capital |Speculative |
| |Increase risk of morbidity and mortality |Speculative |
| | | |
| |Increased social capital | |
|New residents |Decreased risk of morbidity and mortality |Speculative |
| | |Speculative |
| | | |
| | | |
| | | |
ASSESSMENT: QUANTITATIVE
1. Pedestrian Assessment: Total Crash Reduction Factor
CRFt = CRF1 + (CRF2 ) (1-CRF1) + (CRF3) (1-CRF1) (1 – CRF2)
CRF1 = .55
CRF2 = .65
CRF3 = .19
CRFt = CRF1 + (CRF2 ) (1-CRF1) + (CRF3) (1-CRF1) (1 – CRF2)
CRFt = .55 + (.65)(1 - .55) + (.19)(1 - .55)(1 - .65)
CRFt = .55 + (.65)(.45) + (.19)(.45)(.35)
CRFt = .55 + .2925 + .029925
CRFt = .87
2. Pedestrian injuries: Estimated Accident Reduction
EAR = BCR – (BCR x CRFt)
EAR = 19 – (19 x .87)
EAR = 19 – 16.53
EAR = 2.47≈3
3. Pedestrian deaths: Estimated Accident Reduction
EAR = BCR – (BCR x CRFt)
EAR = 4 – (4 x .87)
EAR = 4 – 3.48
EAR = .5≈1
REPORTING
1. Potential Recommendations.
Make as many pedestrian improvements as possible, educate pedestrians about using signals and crosswalks, encourage developers to reserve a certain number of new units for low income residents, encourage developers to save greenspace, encourage green development (LEED certified buildings) and make buildings physical activity friendly (nice well lit stairs), and encourage policy makers to approve mixed use development.
2. What process would you use to prioritize these recommendations? You would prioritize them based on the health impact they will have as well as their feasibility.
3. Who do you think should receive a report or presentation? What type of format do you think would be the most effective? How can you most effectively present the data you collected in the report?
Local organizations/community groups, the community, local businesses, the Department of Transportation, the Federal Highway Administration, policy makers, and police departments. The DOT and FHWA may want to read the full HIA report but you should also have a presentation and a 1 pager (executive summary) available for those that do not have the time to read the entire report. Have an interactive presentation for the community and community groups since they will likely have a lot of questions and feedback on the HIA. Policy and decision makers usually do not have a lot of time to read full reports so have a quick presentation and a 1 page summary available to give to them.
4. What responses do you think you’ll encounter when presenting the results of this study?
Opposition from the community, community groups, local businesses, and possibly policymakers (NIMBYs, NIMFYs – Not In My BackYard, Not In My FrontYard). Transportation officials may not like other groups looking at the health effects of highways – territory problems & highlighting the negative aspects of roads. For this case study, some of the largest oppositions to the center medians were from local business owners since they thought that they would decrease business. Always be ready to find opposition where you may not expect it.
EVALUATION
1. What kind of data would you collect for each type of evaluation?
Process: a) Correspondence
b) Meeting notes or personal log of experiences
Impact: a) Final copy of policy or plans
b) Interview decision makers
Outcome: a) Injury data
b) Gentrification/income data
2. What types of evaluation would you use for this case study?
You should always try to at least collect process and impact evaluation data. Since this information is very important and should not take a lot of time and resources to collect. Your ability to collect outcome evaluation data is usually limited by the data that is collected by other sources available to you. Additionally, staff time and the length of the project may affect your ability to conduct an outcome evaluation.
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