Health On The Move 2

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Quote from Sir Liam Donaldson:

“Public health needs ideas, it needs inspiration, it needs champions.  Such are the scale and complexity of the challenges that must be addressed.

“The causes of ill health, the solutions to some of our major health problems and the sustainability of our environment are intricately interwoven with the way that we move from place to place both locally and across the globe.  The scope of any analysis in this area of public health also needs to encompass the way that goods and services are accessed and the ways that groups of people gather.

“Health on the Move 2 is a clear and comprehensive account of what would constitute a healthy transport system.

“The report is unusual in that it blends evidence, authoritative opinion from experts in their field as well as creativity.  It is not only an educational tool and a series of recommendations for policy-makers, it is a powerful basis for advocacy.  No-one should underestimate the scale of changes required to realise the vision for the future set out in this ground-breaking report.

“If just a small number of towns and cities in the country would act on the ideas and evidence in it then we would begin to see the shape of a new future in which every move is a healthy move.”

Sir Liam Donaldson

Chief Medical Officer for England

(1998 – 2010)

Health on the Move 2 is intended primarily for transport and public health professionals and other policy- and decision-makers working at national, regional or local levels in the public, private or voluntary sectors.  The opening chapter presents the Transport and Health Science Group’s vision for a healthy transport system – one that promotes the health of the population, reduces inequalities, and is sustainable for the environment.

Public health practice examines scientific evidence, develops a vision that flows from that evidence, and puts forward policy proposals that flow from that vision.  That is what this book does.

Section II of this report, chapters 2 to 10, presents the evidence on which our conclusions are based.

Section III sets out implications for professional practice.  Chapter 11 considers clinical aspects of transport-related disease (chapter 19 in Section IV covers the role of the NHS as transport providers and users); chapter 12 is directed towards transport and planning professionals, providing information on why health and inequalities considerations are relevant to and should inform their thinking.

Section IV, chapters 13 to 22, discusses the policy implications of these facts for various players.  Chapter 21 sums up our recommendations, with chapter 22 concluding this report.

Those who are uncomfortable with epidemiological analysis can read a relatively analysis-free version of the book by concentrating on chapter 1, section 2.3, chapter 3, section 4.3, chapters 5 and 6, sections 7.2.5, 7.3 and 7.4.4, and chapters 10 to 22.  If that was all that we had written, it could be treated as mere opinion.  If that is all that you choose to read then you must forego the right to dismiss it in those terms and understand that these opinions are rooted in scientific evidence.

Living with healthy transport

Jean checked her diary for the day. It wouldn’t be necessary to go into HQ. But there were some meetings which would need her to use the video facility at her local neighbourhood work station. She pondered whether to go to the work station for the whole day or whether to work at home in the large office that they had built in the garage when they gave up the cars. She’d rather like the company, she thought, and Angela was always there on a Tuesday so she’d be able to ask Angela for advice about storing her parents’ motorised transport contraptions once they convert their garage into a downstairs bedroom. It had taken her so long to persuade them to do this but, of course, her parents’ generation had grown up in the days of private transport and found it hard to abandon old attitudes. Angela always used the community transport bus door to door whenever she needed to go further than her self-propelled wheelchair could manage. Jean had only ever used this when she had heavy luggage but she wondered if it would answer all her parents’ travel needs too now they had finally given up driving regularly.

Coming back to the present she settled down to eat her breakfast. Bacon from the pig farm in the next village. Eggs from her own hen. Toast and marmalade, made from good Sheffield oranges grown in the multi-storey farms of the Don Valley.

David had overslept. Not surprisingly after the late night he had had the previous evening. As she was finishing her breakfast he joined her, spent a few minutes bolting down some cereal (from the multi-storey farms at Ringway, built on the site of the old airport) and rushed out to get his bicycle.

“It’s pouring down” she said “Why don’t you walk?” “Too late” he said as he pedalled off to the station.

Jean followed him but she walked along the covered walkway to protect her from the rain. It was a nice street. Rose gardens and trees and children’s play areas filled the gaps between the opposing houses. On a sunny day Jean would have wandered amongst them, chatting to neighbours and watching the children play in the street out of harm’s way but today the weather called for being under cover. Half way to the work station there was the facility that Jean had pressed so hard for when the street was being designed – the open air swimming pool. As she passed the swimming pool, the delivery van bringing the shopping up to the local shop for people to collect was picking its way along the carriageway. Unlike the straight direct cycleway, motor vehicles had to negotiate the gaps between the obstacles rather than having a protected carriageway. Jean watched the van, its guidance devices, speed regulators and obstacle detectors all fully engaged, as it inched gingerly along the edge of the pool. It reminded her of the incident last winter when the council had only had had enough grit to do the pavements, cycleways and busways and the roads had been closed. The delivery van driver had foolishly ignored this and had ended up in the swimming pool and winner of You Tube’s Idiot of the Week.

As Jean arrived at the work station, checked her booking of the videoconference for the meeting that afternoon, switched on her computer, and started to write a lecture for medical students setting out the evidence for the powerful health benefits of social networks, David was arriving at the Metro station.

He inserted his card and keyed adult single with cycle to Emmerdale into the journey planner. A recorded voice came over the intercom. “Next but one service from Platform 3. Change at Angerfield, which is the fourth station, for a bus to Emmerdale from stand E.” Then a real human voice replaced it as the controller intervened. “The Emmerdale bus is demand-responsive and you are the only person booked on it today. If you’d prefer we could let you have a car from the Car Club for the normal bus fare and without road charges.” They often made this offer when he was going to Emmerdale. Usually he took it but today he was feeling tired and he didn’t think it would be safe so he declined, collected his tickets and made his way to the platform. The freight train to the shopping distributive warehouse at Angerfield was passing as he reached the platform, then the fast train to the city drew up into the platform making the wayside stop that it made here once an hour instead of running through non stop as it did the rest of the time. David knew this train stopped at Angerfield. They wanted him to wait for the tram because he would get no benefit from the train due to the connection and they liked to keep short distance passengers on the trams if they could. But he rather fancied the plusher seats of the train so he climbed aboard, stored his cycle in the cycle van and lounged back into a seat. The train flashed past the three intervening tram stops and overtook the freight train as it manoeuvred itself into the shopping sidings. Then the train drew up at Angerfield. He made his way to stand E and relaxed in an armchair watching the trolley buses come and go as he waited for his own bus. While he waited, he thought about their holiday. 15 days on a cruise train. They started with a day in Paris, then a slow daytime ride across the Alps with a break at Innsbruck. Full days spent, in Venice, Bled, Dubrovnic, Athens, Istanbul, Samarkand, St Petersburg, Narvik and Bergen, sometimes linked by high speed overnight travel, sometimes interspersed with slow, looking out of the window days. He thought Samarkand and Athens would be the highlights of the trip.