Trevor Hancock: Reducing transport would improve health

In my previous column, I discussed the public-health impacts of transportation, and argued that public transit is a healthier bet.

But that leaves unanswered a set of more profound questions. Who or what are we transporting, and for what purpose? Is it about transportation or is it about mobility — or simply access?

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Fossil-fuel fired transportation is an important source of greenhouse gases and air pollution, with large health impacts. But would we be much better off if we switched to electric or hydrogen-fuelled vehicles?

Certainly we would not be creating all that air pollution — or would we? The electricity to fuel both systems has to come from somewhere, and if it is fossil-fuel fired, are we any better off? We might be locally, but on a global basis, or in the vicinity of the power station, maybe not.

Injuries and deaths from crashes would continue, as would long commutes and all the mental and social consequences. So what is the problem that transportation is supposed to solve? And what are the alternatives? Let’s look at a few examples.

First, commuting. When the Internet first started, some U.S. states argued that highway funding should go to support the “information super-highway.” Because it would keep people off the road, they could telecommute from home. To some extent, that has been true.

Using 2008 data, Statistics Canada reported in 2010 that about one in nine employees worked at home, on average one day a week. However, there was almost no growth in that proportion from 2000.

Telecommuting was certainly the case for our family. My wife worked from home for several years, as her company was in Toronto. But there was a downside; she found it socially isolating and missed the community of the office.

So how do we organize telecommuting in a way that still creates social interaction. Perhaps the answer is telecommute centres in suburban settings where people can come in for a day or two a week. Put in the technology they would need and a small coffee bar and — bingo — you would start to build a community.

Telehealth presents a second example. This technology allows physicians to consult with patients and their local care providers remotely. It is widely used by B.C.’s health authorities.

Island Health reported in 2013 that “Telehealth services are available at 48 different sites in 18 communities,” and they had completed 10,000 consults since 2007.

These programs save a lot of travel. Island Health reported patients “have saved more than 3.7 million kilometres of travel to appointments.” An Interior Health study estimated just one of its Telehealth programs saved two million patient miles and 100,000 kilometres of consultant travel over two years.

This is a large saving in patient travel costs and a reduction in GHGs and other air pollutants. It also reduces the potential for road injuries, for patients and families and for staff, especially as some of that travel would be in winter conditions.

Clearly, by removing the need to travel we can reduce emissions, increase safety and improve access.

A final example deals with transport of goods. Why does our food have to travel hundreds of kilometres to reach us, when we can grow so much of our food locally? More generally, what are we shipping halfway around the world, and why?

I have never forgotten the story told many years ago by David Morris, founder of the Institute for Local Self Reliance. He tells of contemplating a toothpick in a restaurant, wrapped in plastic and made in Japan. He knew that Japan had little in the way of timber or oil, the basic ingredients, and suddenly had the vision of a shipload of oil and another shipload of timber from America passing a shipload of toothpicks headed back to America.

While apocryphal, it makes an important point: What (or who) are we transporting where, for what purpose, to what benefit, and at what expense to our health and the health of our ecosystems?

 

Dr. Trevor Hancock is a professor and senior scholar at the University of Victoria’s school of public health and social policy.

thancock@uvic.ca

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