Participatory quantitative health impact assessment of urban transport planning: A case study from Eastern Africa.

Africa Health impact assessment Mauritius Premature mortality Urban transport planning

Journal

Environment international
ISSN: 1873-6750
Titre abrégé: Environ Int
Pays: Netherlands
ID NLM: 7807270

Informations de publication

Date de publication:
11 2020
Historique:
received: 25 05 2020
revised: 19 07 2020
accepted: 31 07 2020
pubmed: 23 8 2020
medline: 12 1 2021
entrez: 23 8 2020
Statut: ppublish

Résumé

High rates of motorization in urban areas of Africa have adverse effects on public health. Transport-related mortality will increase as a result of inadequate transport infrastructure, air pollution and sedentary lifestyles. Health Impact Assessments (HIAs) have proven to be a successful tool to predict and mitigate negative health impact of urban transport planning policies, programmes or projects. Yet, there is a gap of evidence on transport and health in African countries. The aim of this study is assessing the health impacts of transport scenarios in Port Louis (city of 119,018 inhabitants in Mauritius) using a full chain participatory HIA model. We estimated health and economic impacts associated to transport scenarios with qualitative data and quantitative comparative risk assessment methods. The health impact modeling was based on differences between the baseline and three transport scenarios (worse, good, ideal), estimating the averted deaths per year and economic outcomes by assessing health determinants of air pollution (AP), traffic deaths and physical activity (PA). Data on air pollution and traffic fatalities were obtained from public data sources. Data used to construct scenarios, establish baseline travel mode shares and physical activity were collected through (a) open-ended individual interviews (IDIs) with 14 stakeholders (b) closed-ended survey questions to 600 citizens and (c) 2 focus group discussions (FGDs) with the same 14 stakeholders from (a). In Port Louis, the worse-case transport scenario (doubling in car trips and a reduction in walking, motorcycle, and public transport), resulted in a total increment of 3.28 premature deaths per year. The good-case scenario (reducing car trips by half and increasing walking, motorcycle, and public transport trips) resulted in a total increment of 0.79 premature deaths per year. The ideal-case scenario (reduction in car and motorcycle trips and an increase in walking and public transport trips) resulted in a total reduction of 13.72 premature deaths per year. We estimated USD 23 millions of economic benefits related to mortality if the ideal-case was achieved. Participatory HIA shows that implementing transport policies aiming for less than an ideal situation may not be adequate or sufficient to avoid negative transport-related mortality in Mauritius. Urban transport planning is an opportunity to encourage physical activity in rapidly urbanizing settings of Africa. Transport policies should aim to restrict all forms of private motorized vehicles and promote active and public transport to support public health. We highly recommend the use of participatory approaches in quantitative HIA to ensure context specificity and policy relevance.

Sections du résumé

BACKGROUND
High rates of motorization in urban areas of Africa have adverse effects on public health. Transport-related mortality will increase as a result of inadequate transport infrastructure, air pollution and sedentary lifestyles. Health Impact Assessments (HIAs) have proven to be a successful tool to predict and mitigate negative health impact of urban transport planning policies, programmes or projects. Yet, there is a gap of evidence on transport and health in African countries. The aim of this study is assessing the health impacts of transport scenarios in Port Louis (city of 119,018 inhabitants in Mauritius) using a full chain participatory HIA model.
METHODS
We estimated health and economic impacts associated to transport scenarios with qualitative data and quantitative comparative risk assessment methods. The health impact modeling was based on differences between the baseline and three transport scenarios (worse, good, ideal), estimating the averted deaths per year and economic outcomes by assessing health determinants of air pollution (AP), traffic deaths and physical activity (PA). Data on air pollution and traffic fatalities were obtained from public data sources. Data used to construct scenarios, establish baseline travel mode shares and physical activity were collected through (a) open-ended individual interviews (IDIs) with 14 stakeholders (b) closed-ended survey questions to 600 citizens and (c) 2 focus group discussions (FGDs) with the same 14 stakeholders from (a).
RESULTS
In Port Louis, the worse-case transport scenario (doubling in car trips and a reduction in walking, motorcycle, and public transport), resulted in a total increment of 3.28 premature deaths per year. The good-case scenario (reducing car trips by half and increasing walking, motorcycle, and public transport trips) resulted in a total increment of 0.79 premature deaths per year. The ideal-case scenario (reduction in car and motorcycle trips and an increase in walking and public transport trips) resulted in a total reduction of 13.72 premature deaths per year. We estimated USD 23 millions of economic benefits related to mortality if the ideal-case was achieved.
CONCLUSION
Participatory HIA shows that implementing transport policies aiming for less than an ideal situation may not be adequate or sufficient to avoid negative transport-related mortality in Mauritius. Urban transport planning is an opportunity to encourage physical activity in rapidly urbanizing settings of Africa. Transport policies should aim to restrict all forms of private motorized vehicles and promote active and public transport to support public health. We highly recommend the use of participatory approaches in quantitative HIA to ensure context specificity and policy relevance.

Identifiants

pubmed: 32827806
pii: S0160-4120(20)31982-6
doi: 10.1016/j.envint.2020.106027
pmc: PMC7434638
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

106027

Informations de copyright

Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.

Auteurs

M Thondoo (M)

Barcelona Institute for Global Health (ISGlobal), Centre for Research in Environmental Epidemiology (CREAL), 08003 Barcelona, Spain; Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, 1018 WV Amsterdam, the Netherlands; Faculty of Medicine and Health Sciences, University of Barcelona (UB), 08036 Barcelona, Spain. Electronic address: meelan.thondoo@isglobal.org.

N Mueller (N)

Barcelona Institute for Global Health (ISGlobal), Centre for Research in Environmental Epidemiology (CREAL), 08003 Barcelona, Spain; Department of Biomedicine, University Pompeu Fabra (UPF), 08005 Barcelona, Spain; Department of Epidemiology and Public Health, CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain.

D Rojas-Rueda (D)

Department of Environmental and Radiological Health Sciences, Colorado State University, 80523 Fort Collins, CO, USA.

D de Vries (D)

Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, 1018 WV Amsterdam, the Netherlands.

J Gupta (J)

Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, 1018 WV Amsterdam, the Netherlands.

M J Nieuwenhuijsen (MJ)

Barcelona Institute for Global Health (ISGlobal), Centre for Research in Environmental Epidemiology (CREAL), 08003 Barcelona, Spain; Department of Biomedicine, University Pompeu Fabra (UPF), 08005 Barcelona, Spain; Department of Environmental Epidemiology, Municipal Institute of Medical Research (IMIM-Hospital del Mar), 08003 Barcelona, Spain; Department of Epidemiology and Public Health, CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain. Electronic address: mark.nieuwenhuijsen@isglobal.org.

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