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February 15, 2022Episode 27. Upsides and Downsides: Transportation and public health share a complicated union.
FEATURING: Ben Ettelman
How we develop our transportation systems has direct and lasting impacts on personal well-being. Associate Research Scientist Ben Ettelman explains how newly identified pathways can help agencies ensure that the goals for efficient mobility and robust public health are inextricably linked.
About Our Guest
Associate Research Scientist
Ben Ettelman works in TTI's Center for Advancing Research in Transportation Emissions, Energy, and Health (CARTHEEH). He uses a range of quantitative and qualitative methods to develop research that informs decision-making in transportation. Ben has more than 13 years of experience in transportation planning and research in policy, emissions, air quality, public health, transit, safety, public engagement and education. Prior to joining TTI, Ben was a public involvement planner for a consulting firm in Portland, Maine. Ben holds a M.S. in community and regional planning from The University of Texas at Austin and is a member of the American Planning Association and the International Association of Public Participation.
Bernie Fette (host) (00:14):
Welcome. This is Thinking Transportation — conversations about how we get ourselves and the things we need from one place to another. I’m Bernie Fette with the Texas A&M Transportation Institute.
Bernie Fette (00:28):
The connection between transportation and human health in America dates all the way back to 1896 and the first recorded pedestrian traffic fatality in the nation. Ben Ettelman, an associate research scientist at TTI, joins us for this episode to share what researchers are learning more recently about the intersection of transportation and human well-being and what it means to how we can best achieve the goal of safe and reliable mobility. Ben, thank you for sharing your time with us.
Ben Ettelman (guest) (01:01):
Thank you for having me. I appreciate it.
Bernie Fette (01:04):
So, is the relationship between transportation and health more complex than it was at the time of that first traffic death more than a century ago?
Ben Ettelman (01:14):
Yeah, I, I think so.
Bernie Fette (01:15):
Ben Ettelman (01:16):
Well, what we’ve continued to understand, I think more broadly, you know, just in terms of how human beings interact with their environment, that a lot that we’re learning on a year-to-year basis in terms of what impacts the health of human beings. And so specifically when we talk about transportation, we think a lot about transportation safety and how human beings are physically hurt in the physical environment due to transportation. But what we’ve continued to learn and really build on over the past two, three decades is understanding all of these additional components that impact public health. So yes, it’s got quite a bit more complex over the years.
Bernie Fette (02:01):
And so the relationship’s not a simple one and to help navigate that complexity, you and your colleagues have identified a number of links or pathways that connect transportation and human health. Can you talk about how that idea got started and how it’s progressed?
Ben Ettelman (02:23):
Sure. So the concept of, of understanding pathways or these key linkages between transportation and human health is more than 20 years in the making. And so when we use the term pathways, we’re simply just talking about how to connect impacts to public health, to transportation. So here at TTI for years, we’ve worked on this quite a bit. So, you know, I would be remiss if I didn’t make the point that a lot of the work that happens throughout all of the different wings of TTI impacts how to improve public health. We have our Center for Transportation Safety. That’s a significant component for transportation health. We have the folks that are working on the facilities and the materials to try to make roadways safer, make guardrails safer. We have folks that in the Center for Advancing Research in Transportation Emissions, Energy and Health — CARTEEH — which is where I work, looking at air quality and how that impacts health.
Ben Ettelman (03:23):
So again, there’s a multitude of pathways and folks throughout the organization are working on them, but to focus on kind of the work that we’ve done within CARTEEH over the past several years is really focused on understanding how to look at a more comprehensive and holistic understanding of how transportation and health is linked. And so to really talk about that, I would need to go back to crediting my former colleague Haneen Khreis. She developed the foundation for the work that we’re currently undergoing through her research, establishing those key pathways between transportation and health. And so this concept of pathways is rooted in the field of public health. It’s been researched extensively for more than two decades, but we’re learning more and more regarding how transportation impacts health, both positively and negatively looking beyond just transportation safety, air quality and physical activity, which typically are the three components when a layperson thinks of well, how does transportation impact health?
Ben Ettelman (04:26):
People think about crashes. People think about transportation emissions and inhaling those transportation emissions. And people think about how physical activity can enhance people’s health. If people are bicycling, walking for transportation, that can enhance and improve health. But what the work that we’ve done in recent years has really helped to understand how additional components that have significant impacts on public health are related to transportation. Some of those components include noise, access — specifically to healthy destinations — access to doctors’ offices, access to parks, access to healthy food, access to green space and aesthetics, components like community severance. All of these have additional and significant impacts on the public health.
Bernie Fette (05:14):
And you talked about the positive and negative aspects of that. It sounds like what you’re describing kind of gave a, foundation for looking at transportation and health relationships as kind of a good news, bad news distinction. Is that oversimplifying?
Ben Ettelman (05:31):
Yes and no. I think that we understand that the transportation is a necessary component of our lives, perhaps less so during COVID times when we’re not commuting to work every day. Some of those components expose our society to risk, and those are the negatives, but they also provide opportunities for enhancement of health. So yes, it, it is good news, bad news. And again, this work that we’re doing is trying to help expand the collective understanding of what the good components are and what the bad components are.
Bernie Fette (06:05):
Okay. So why is it important for us to understand those pathways? I’m, I’m wondering, what do they help us do that we couldn’t do before?
Ben Ettelman (06:16):
So the pathway structures, I’ll kind of go back to talking about the big three, again: transportation safety, air quality, and physical activity. Those big three are what we’ve consistently thought about. And I think that transportation agencies like the Texas Department of Transportation, the United States Department of Transportation, they’ve given a lot of energy and effort to improving transportation safety. We put a lot of effort and energy into thinking about how to reduce transportation emissions. Emissions for individual vehicles have reduced over the years. That happens at the federal, the state level. It’s also happening in terms of how technology is changing.
Bernie Fette (06:57):
There’s a lot of focus too, at the local level, right? At the metropolitan planning organization, the MPO level, on emission reduction.
Ben Ettelman (07:05):
Absolutely. MPOs are required to have, uh, mitigation plans for emissions. So all that gets a ton of focus. And then again, when we think about physical activity over the past couple decades, there’s been significant increases from transportation organizations, thinking about how to increase physical activity, how to ensure we have pedestrian facilities that are safe, how to ensure that we provide public transportation opportunities for our customers, the members of the public who both need those and want to have alternative modes. So again, those big three, they’re getting a lot of attention. They should get a lot of attention. However, these additional pathways, these additional components are just as important, and in some cases are making as much of an impact to public health as what we would call the big three.
Bernie Fette (07:55):
And in those cases for what you’re doing, sounds like an extra layer of depth for those three. Is that correct?
Ben Ettelman (08:01):
In some cases, yes. But what I wanted to touch on is some work that again, some of my colleagues at CARTEEH recently did where they actually looked at mortality data from the Centers for Disease Control and Prevention, and were able to determine that for a case study for the city of Houston, uh, we could attribute 631 premature deaths to particulate matter, which you know, was generally associated with transportation emissions. And 350 were attributable to motor vehicle crashes. However, 302 premature deaths were attributable to traffic noise.
Bernie Fette (08:37):
Ben Ettelman (08:37):
Which was quite surprising.
Bernie Fette (08:40):
And transportation noise is not exactly something that a typical transportation consumer thinks very much about.
Ben Ettelman (08:46):
That’s exactly right. And so again, our goal and the work that we’re doing is helping our customers, the general public, have a better understanding of the risks that are out there, which in turn will help our transportation agencies have a better understanding of what they need to focus on to ensure that transportation infrastructure enhances public health, as opposed to hurting public health.
Bernie Fette (09:11):
We typically think of roadway safety countermeasures as just adding a traffic sign or lowering a speed limit or something like that. But what you’re saying, it sounds like, is that those countermeasures can take a lot more various and different forms.
Ben Ettelman (09:22):
Yep, absolutely. And talking a bit about the work that we’re continuing, that I’m leading, which is the development of what we’re calling our smart infrastructure framework. The smart framework focuses on how we can help practitioners better understand what the impacts of infrastructure are beyond again, those big three, which I think transportation agencies have an exceptional grasp on and are making huge, huge strides in improving. I would specifically tip my cap to the Texas Department of Transportation and the work that they are doing to improve transportation safety in the state of Texas. That is a huge challenge. So the work that we’re doing is trying to transition the work that Haneen did, which is more academic in nature, more focused in establishing a systematic approach to understanding the impacts to the human body, to the implementers of our transportation infrastructure. We’re trying to create a framework that will help our implementers better understand and better develop and build transportation infrastructure that actually enhances public health.
Bernie Fette (10:33):
One of the things that’s highlighted in your research, Ben, is the importance of teamwork between two disciplines — specifically engineering and public health. And that sounds very sensible. So why is that such a new concept?
Ben Ettelman (10:49):
It’s not necessarily a new concept, but it’s certainly very hard in practice to achieve when we think about how all of these different disciplines work together, and we can talk about engineers, planners, can add policy makers, and then we can add individuals who work in the area of public health, who have a really good understanding of how transportation infrastructure impacts public health. When all of those folks are doing their respective jobs, they have their own individual goals. Those goals don’t always necessarily lead to the same outcome. So the work that we are doing in CARTEEH is trying to create the ability to build bridges between these various disciplines to create better mutual understanding of how they can reach their goals together, how they can work collaboratively to ensure that public health is enhanced, as opposed to negatively impacted through these infrastructure decisions.
Bernie Fette (11:48):
That collaboration that you’re talking about, that collective work of multiple groups, seems to align well with how the World Health Organization defines wellness. Specifically, the World Health Organization says that, and I’m quoting here: “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” So in other words, being healthy is about a lot more than just not being sick. I’m wondering how that description might inform or influence the work that you and your colleagues are doing.
Ben Ettelman (12:25):
Yeah, Bernie, that is a core tenet to the work that we do. Thinking about transportation safety. You know, typically we think well, if you’re getting from point A to point B and you’re not physically harmed in that process, then we’ve been successful. And we think about physical health, but let’s also think about mental health. There are a range of aspects of our built environment that impacts mental health. That’s one of the pathways and, and of the considerations that we’re really thinking about quite a bit, which is how to minimize and eliminate stress, anxiety, mental anguish, that’s associated with transportation infrastructure. It’s not as obvious as the physical harm that can be caused by a traffic crash, for example. However, they do lead to compromising our physical health. So for example, stress can lead to obesity, risk of cancer, unhealthy diet, Alzheimer’s.
Bernie Fette (13:25):
Ben Ettelman (13:25):
Absolutely. And this is how the work that CARTEEH is doing with the smart framework is trying to help practitioners understand a far more comprehensive and holistic approach to recognizing the impacts to public health that our transportation infrastructure presents.
Bernie Fette (13:44):
The work that you’ve been describing seems to have a lot of layers and a lot of academic basis. I’m curious about the practical side. I’ve seen mention of a tool kit or toolbox in your research as well. Can you talk about what’s in that toolbox and how organizations can bring your research into practical use?
Ben Ettelman (14:06):
Yeah, that’s a, a critical component of what we’re currently working on within CARTEEH. So again, tipping my cap to Dr. Khreis for establishing this very thorough and comprehensive list of pathways. The work that we did over the past year was to really try to understand how to make sure that that research is applicable and implementable by those who are responsible for transportation infrastructure. What we’ve done is we’ve transitioned from increasing our understanding of these pathways of these connections, to developing a framework that will help our practitioners understand how the decisions they make impact public health, but more importantly, providing them with a toolkit that includes strategies, key performance indicators, tools, to improve and enhance the public health of the transportation infrastructure that they’re planning and building. For example, I live in the city of Austin, Texas. The major interstate that runs through the city, I-35, is in the process of being redesigned and redeveloped by TxDOT and The City of Austin.
Ben Ettelman (15:18):
There are a wide range of health impacts that the public are interested in. So the public is very, very interested in ensuring that this highway that runs north/south, when it’s rebuilt, restore some of the connection between the eastern and western portions of our city. So one of the components that the Texas Department of Transportation and the City of Austin are pursuing is looking at creating caps that would go on top of the highway to provide better pedestrian access, would provide better opportunities for these communities to be reconnected. Not only is this critical for improving access for people on both sides of the highway to have access to facilities and amenities, some directly improving health, but it also helps for transportation safety. Whereas we have a significant problem in Texas, specifically in Austin with pedestrians crossing freeways, like I-35 and being seriously injured and in many cases killed by being struck by vehicles. So that’s a great example of understanding that we wanna make sure that the highway’s safe, but we also have to consider these additional components like community severance and how those impact public health.
Bernie Fette (16:39):
Okay, Ben; in 50 words or less, what is it that keeps you motivated to show up to work every day?
Ben Ettelman (16:47):
Yeah, that’s a really hard one. So I’ve been very lucky working at Texas A&M Transportation Institute. I’ve had the opportunity to work with a wide range of researchers on a wide range of projects and disciplines. I have started working in the area of public engagement and planning. That was my background. I’ve since transitioned to working on a lot of transportation safety, specifically pedestrian safety, working on air quality, health and energy topics in the Center for Advancing Research in Transportation Emissions, Energy, and Health. And what really makes me excited about my job makes me, you know, excited to jump out of bed and come to work every day is that we’re really able to focus on creating practical and implementable solutions that will make the transportation world a better place, and in turn, the world a better place — specifically with the work that we’re doing here, it’s focusing on improving the health of the general public, but those are areas where we’re making measurable differences, measurable improvements to the world around us. And there’s just about nothing better than that.
Bernie Fette (17:54):
Ben Ettelman, associate research scientist at TTI. Thank you for having this conversation with us, Ben. It’s been very enlightening. Thank you.
Ben Ettelman (18:05):
Thank you, Bernie. It’s been a pleasure. Really appreciate it.
Bernie Fette (18:10):
The concept of health has evolved over time. Just as transportation has also changed. Being healthy today is about far more than just not being sick. Recognizing that transforming complexity, it’s important that we understand more about the everyday experiences that can affect our health. And transportation is one of the most common of those experiences.
Bernie Fette (18:35):
Thanks for listening. We hope you’ll join us again next time, when we visit with Jett McFalls to hear about how new research at TTI is helping to protect endangered species living near road construction projects.
Bernie Fette (18:50):
Thinking Transportation is a production of the Texas A&M Transportation Institute, a member of the Texas A&M University System. The show is edited and produced by Chris Pourteau. I’m your writer and host, Bernie Fette. Thanks again for listening. We’ll see you next time.