Physical environment related to physical activity and injury prevention

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1. In your own words, define traffic safety. Tell us more about what interested you in this area of public health and share your expertise in this area.

About 12 years ago I started to become more interested in chronic disease prevention, specifically promoting physical activity. I found myself most interested in promoting active transportation, people biking/walking to work, school or stores. One of the most common reasons people don’t use more active modes of transportation is concerns about traffic safety with a secondary reason being they live too far way, inclement weather or have physical limitations.

That got me interested in how you design environments to be safer, in order to encourage people to be more physically active. I was one of the founding members of the Truckee Meadows Bicycle Alliance in 2006 who organize a local bike to work event around Reno. Bike to work month, week and day is a nationally recognized event in May that organizes specific events with the purpose of encouraging people to bike to work. Through my work early on with Truckee Meadows Bicycle Alliance a comment we heard a lot was “I am afraid of being hit by a car.” I originally got involved to promote physical activity but have now become interested in the injury prevention aspect.

About half of trips that are under a mile long are taken by car. It’s not realistic to try and convince an entire population to change their daily habits. The sub-field of chronic disease prevention is built environment, specifically looking at designing environments and infrastructure to encourage active transportation, which is relevant to public health partly because of air quality effects. Improving air quality by reducing car trips is a secondary outcome to the physical activity which we know is beneficial to chronic disease prevention and also preventing injuries is a focus of public health.

2. What are ways that urban design can take into account effects on public health? (key design elements)

One of the more common things pertaining to chronic disease prevention happening around the country is being referred to as road diet (like an eating diet). They are pretty popular now but used to be controversial. It is re-striping the road so you have bike lanes on either side and a center turn lane in the middle instead of just having two lanes in each direction. The idea is to make a space for bicyclists (which makes them safer) and you help make it safer for pedestrians since they are only crossing two instead of four primary traffic lanes. It is also safer for cars as it helps control speeds. There is evidence that road diets reduce crashes.

Motorists get worried when they start seeing lanes get taken away. Drivers worry it will slow them down. City planners and transportation engineers are typically in support of road diets now since they have seen the data. Little by little people become more accepting. Road diets in Reno have resulted in a 50% reduction in crashes. The Regional Transportation Commission (RTC) is usually in charge of making this happen. I served for 8 years (2007-2015) on the RTC Bicycle and Pedestrian Advisory Committee. The committee looked at proposals for changes to roadway engineering and gave input on these types of projects.

3. What are examples of cities/developments promoting environments that lend themselves to physical activity and/or traffic safety?

There is something called complete street – it is the gold standard of roadway design. The idea is that a street is designed for all users not just for cars. There is a National Complete Streets Coalition and I attended their conference last year. Roads should be safe, comfortable and convenient for everyone.

There are a lot of elements that come together to make streets complete. The focus of these elements is on traffic calming and injury prevention, including:

    • ● Sidewalks


    • ● Bike lanes or other bike facilities (cycle tracks)


    • ● Crosswalks


    • ● Center Island Refuge (space where pedestrian has a safe place to stand when crossing a wide road)


    • ● Curb extension (sidewalk where there is street parking and the curb extends past parked cars)


    ● Narrowing the lanes (drivers naturally slow down when lanes are narrower)

People want to walk and bike places that are pleasant and pretty which can’t be overlooked. Another piece to consider is usefulness — connecting you from where you are to where you want to go.

Portland has spent a lot of money creating space dedicated to promoting active transportation. Portland doubled their mode share of bicyclists (twice as many people use bikes as their primary form of transportation) as a result of making the environment more bicycle friendly. Davis, California is also referred to as a city that has made great strides as a bicycle friendly city. Even New York City (you think of traffic and congestion) has put in a lot of bicycle infrastructure and more people now travel by bike.

4. Describe ways in which you have promoted bicycle infrastructure in communities. What impact does that have on public health?

I also chair the Campus Bicycle Committee (Bicycle Working Group) at the University of Nevada, Reno which is part of the university’s sustainability committee. We have representatives from the university’s parking and transportation department, the facilities department and other departments on campus to work on the five E’s:
● Engineering
● Enforcement
● Education
● Encouragement
● Evaluation

For example, the committee has hosted safety workshops and received funding to have a self-service bike repair stand installed on-campus. If a student gets a flat tire or needs some other repair there is a place on campus that has all the tools for them to fix their bike. Overall, simply engaging with campus planners to encourage them to consider bicyclists as they design new buildings (i.e. bike parking that is covered and well lit) is making great strides for the campus in promoting active forms of transportation.

5. How can public health experts play a role in city planning design and development? What steps can they take?

Look for advocacy or advisory committee opportunities if you are interested in city planning and design. Seek out organizations that have opportunities for public committee involvement and find where your skill set can be helpful. Also, speak at city council meetings and open houses to express support as a member of the public to get your name and your area of expertise out there.

I go to meetings where I am the only public health professional in a room full of police officers, planners and transportation engineers. They are usually very happy to receive information on the impact to public health. I can bring to the conversation the public health perspective that they haven’t considered.

6. What steps can be taken by a public health professional to address injury prevention with built environments?

You have to get involved with the people doing the in-the-trenches work — planners, engineers and policy makers. Road diets are on roadways that are already existing by re-striping the road to fix a problem.

It is easier if you get in on the ground floor when new projects are in the works. On Nevada’s campus there are many stairs, so someone on a bicycle, depending where they are going, can only get so far. There is a new building starting construction soon where I am told they have incorporated a stair wheeling channel. Basically, it allows a bicyclist a place to easily wheel their bike up or down the stairs so they don’t have to carry it or ride really far out of their way. I was involved with the meetings with the architect to request this be a consideration of the design.

8. Anything else you feel is important to share on this topic?

Some of the specifics I have talked about today fall into a bigger picture of city and neighborhood design. Today, we focused on specific roadways but usually the best health promoting environments are ones that are multi-use (people can live near where they work, play and shop), high-density (avoiding a lot of urban sprawl) and transit-oriented (building a transportation infrastructure that gives people other choices besides using their cars for everything).

If you go in and fix one road you won’t have much of an impact. It has to be part of a larger vision of health promoting environments.