Blog # 11

Transportation


Public transportation can provide significant health benefits. People who live or work in communities with high quality public transportation tend to own fewer vehicles, drive less, and use alternative modes more than they would in more automobile-oriented locations. This can provide large reductions in traffic crashes and pollution emissions, increases in physical fitness and mental health, and improved access to healthy food, housing and medical care. These health benefits are significant in magnitude compared with other planning objectives, but are often overlooked or undervalued in conventional transport planning. The U.S. has traffic fatality and obesity rates two or three times those of peers countries, which contribute to poor health outcomes (nearly a year shorter average life expectancy compared with the OECD average) and high per capita healthcare costs (two-and-a-half the OECD average). 

Travel activity affects public health in several ways.  For example, pollution contributes to cancer and congenital anomalies (birth defects), and sedentary living (inadequate physical activity) contributes to heart disease and strokes. 





The three major public transit providers in San Mateo County are the San Mateo County Transit District (SamTrans), BART, and Caltrain. SamTrans operates 76 routes, carrying more than 43,000 passengers each weekday and about 13 million riders per year. BART serves six stations with 36,577 average weekday station entries in the County. Caltrain boards more than 18,000 passengers each weekday at 12 stations in the county. 
Shuttle services include nine employment shuttles in San Mateo County that travel to and from BART stations, as well as two community shuttles which travel from residential areas to retail and recreation destinations.
The District also operates Redi-Wheels paratransit service for persons with disabilities, and manages shuttle services. Discounted rates are available for seniors, persons with disabilities, Medicare cardholders and youth. One child (age 4 and younger) can ride free with each adult, senior or adult-disabled farepaying passenger.

Bicycling is one of the most cost-effective, cleanest ways of reducing automobile use in San Mateo County. The bicycle emits no air pollution and is virtually silent. Cycling is both energy-efficient and space efficient. A cyclist requires only one-fifth the energy of a pedestrian to travel one  kilometer.Bicycles offer other considerable personal and social benefits over the automobile, including substantially lower acquisition and maintenance costs, as well as health benefits.A major impediment to bicycle use in San Mateo County is that the road network has been principally designed for the automobile. At times and in some locations, this means reduced safety and comfort for bicyclists. 
A total of 54 off-street and 177 on-street bicycle facilities comprising a 231-mile network were identified in the San Mateo County in the 2000 San Mateo County Comprehensive Bicycle Route Plan. As of 2010, 141 miles (61%) of the network has been completed, including 42 miles of off-street facilities and 99 miles of on-street facilities. Helping people who do not currently bicycle overcome their reluctance to do so on the roadway, as well as to make all bicyclists safer and more comfortable, requires a comprehensive set of measures. Engineering streets and roads so that they accommodate the needs of bicyclists, including space in which to ride, safe navigation through intersections, and lowering the speed differential between motor vehicles and bicycles, creates a safe operating environment for cycling. Education in safe cycling in traffic, as well as in rules of the road as they pertain to both cyclists and motorists is essential. Encouragement and cultural support in affirmation of bicycling as an accepted mode of everyday travel is needed from the wider community. Enforcement of traffic laws as they pertain both to motorists and cyclists provides legal sanctions to those who uses either mode of travel in an imprudent way. Evaluation provides valuable feedback on the effectiveness of the improvements. All of these approaches are currently being used in San Mateo County to support bicycle travel. 

Bicycling Objectives of San Mateo county:
1. Increase the number of miles of Class I, II, III and IV bikeways as part of a comprehensive network of bicycle facilities in San Mateo County.
2. Increase the number of bicycle lockers and racks in San Mateo County. 
3. Increase bicycle safety education and training in San Mateo County.
4. Establish bike sharing programs in San Mateo County. 
5. Increase bicycle mode share for all trips originating in San Mateo County over both a ten-year and twenty-five-year horizon
6. Increase bicycle mode share for trips to work over both a ten-year and twenty-five-year horizon

As a professional nurse I can work with local, and county agencies and organizations – including those with a focus on public health – to develop effective encouragement programs that promote bicycling as a safe, convenient and healthy mode of transportation. Also, I can be cooperative with public health department of San Mateo county to educate the public such as drivers and bicyclists about their rights and responsibilities, as well as traffic education and safety programs for adults and youth, encourage local school districts to implement projects and activities that promote bicycling to school among students and staff, such as Safe Routes to School initiatives, and encourage efforts to establish bike-sharing programs in communities throughout the county.

For sure the neighborhood cities like Redwood city, Burlingame, Foster city, San Carlos can benefit from advancing bicycle strategy in San Mateo and follow San Mateo cycling approach as a model.

San Mateo County has established an urban/rural boundary in the Coastal Zone. A San Mateo County in which bicycling for both transportation and recreation is safe, comfortable, and convenient. Provide people with viable travel choices and encourage use of healthy, active transportation through a safe, continuous, convenient and comprehensive bicycling network that reduces reliance on the automobile for short trips. A number of commuters travel from rural to urban areas within San Mateo county for different purposes like school, work, and shopping. The bicycle plan could encourage them to cycle as well as use public transportation in the urban area. Also, provide public training, technical assistance, along with funding could be essential support to develop bicycle plan at non-urbanized San Mateo county.





Decision making about health-related programs and policies first require credible information on causes of health burden and health disparities. Social, economic, and physical environments are the major underlying determinants of the health of populations and variations among subpopulations.

The built environment influences the public’s health, particularly in relation to chronic diseases. There is good evidence to indicate that the burden of chronic disease in the population can be reduced through an active lifestyle, proper nutrition, and reduced exposure to toxic conditions. 
Law influences the built environment in a variety of ways, ranging from environmental regulation, zoning, and building codes to economic incentives and disincentives. The public health community can use its voice, expertise, and influence to encourage legislatures and agencies to create and enforce laws designed to ensure the conditions for people to be healthy. The concluding section presents 7 strategies for accomplishing this goal.
Public health expertise is critical to the process. The following guidelines will help public health advocates become a constructive and effective voice:

1. Get involved early in the planning process. Critical decisions about land use and the built environment are made through a legal process. Once specific projects are proposed and presented to the public, it may be too late to have significant impact on what is built–the important ground rules are likely to have been set far in advance.
2. Bring data to the table. Public health scientists bring unique training in epidemiology and empirical analysis. Scientific data on the kinds of designs and land-use arrangements that encourage physical activity are lacking. Urban planners have instincts in this area, but these instincts may not be supported by sound data.
3. Help policymakers use data more carefully. Policymakers are particularly influenced by actions that are immediately measurable, and bureaucracies are set up to reward those who show positive short-term changes. For example, highway departments may be rewarded for reducing pedestrian accidents by making a road so inhospitable that few pedestrians venture out. Public health officials may be able to provide data and a perspective to counteract this tendency.
4. Be a voice that is independent of the environmental and esthetic concerns. Today, public health officials may find that they share much with the environmentalists and urban designers who promote compact, mixed-use development, but the agendas may not always be coextensive. Public health officials will be a credible and useful voice only if they maintain independence. For example, bicycle paths and sidewalks add impervious surfaces that may require felling trees or altering parkland. As a result, environmental groups that support the concept of increased walking and bicycling sometimes oppose the installation of trails and bicycle paths. Public health officials can clearly enunciate the health benefits of opportunities for safe, pleasant exercise.
5. Promote healthy activities for children and particularly teenagers. Childhood obesity is a growing problem, and the patterns for a healthy (or unhealthy) lifestyle are frequently set in childhood. The voices of children and teenagers are left out of the planning process. Teenagers in particular may have interests that conflict with the preferences of adults. Activities that attract groups of teenagers can be viewed as threatening and undesirable. For example, homeowner associations may prohibit the installation of driveway basketball nets because they are unsightly and the games may get loud. Likewise, although new residential subdivisions may be required to include recreational facilities, developers rarely include facilities that would be of interest to teenagers, preferring instead “tot lots.”
6. Be a voice for underrepresented populations and minorities. Poor, immigrant, and minority populations suffer much higher rates of chronic disease. They are also much more likely to live in substandard housing, to be exposed to environmental toxins, and to be the victims of unsafe pedestrian facilities. From the interstate highway program of the 1950s and 1960s that razed thousands of low-income housing units to rezoning for industrial uses, poor and minority populations have borne the brunt of some highly destructive land-use decisions.
7. Encourage government to lead by example, not just by regulation. Governments invest extensively in the built environment through construction and maintenance of roads, public transportation, and public buildings and facilities. These can be located and designed to encourage walking, bicycling, and other physical activity. Public health officials can be a voice to encourage comprehensive planning that considers not only the immediate purpose (e.g., Will this be a good library?), but also how the facility functions in the community to encourage healthy choices.

Public health can be an influential voice in shaping the built environment. If advocates demonstrate competence in the legal process and use their expertise effectively, physical spaces can be designed to promote healthy populations.

Blog # 12

Healthy Schools

There are community nurses in San Mateo county involved in local schools and have responsibility to maintain students health. Family Health and General Field Nursing provide services in homes, local clinics, offices and schools as well. Services are free for adults, children and families on Medi-Cal, and on a sliding fee scale for other San Mateo County residents. They provide following services in native languages.

• Help identify individual and family needs
• Connect clients to community resources
• Education about specific health issues

Tongan Health project have collaborated with the Pacific Islander Initiative within the Behavioral Health and Recovery Services Division to understand and address the issues identified by the Pacific Islander community in San Mateo County. The work began with a collaboration on a cancer screening outreach effort and has evolved into the Mana Program for Pacific Islander Students at San Mateo High School.

Students and school staff deserve and expect a healthy and comfortable environment in which to learn and teach. Within the school environment, reduced indoor air quality (IAQ) due to a lack of fresh air, chemical and biological contaminants, temperature, and humidity has resulted in student and staff health concerns. These concerns may be expressed as complaints of: headaches, rashes, tiredness, respiratory or eye irritation; and may result from single or multiple factors. An open and proactive response to an expressed IAQ concern can prevent a minor situation from becoming a major problem.

To assess indoor air quality of local schools, I would assess the following factors and interview with students to answer as many of the following questions.

	YES	NO
Classroom is free of any evidence of water damage.
The cages of classroom pets are cleaned regularly (if applicable).
Classroom contains hard-surfaced furniture that is easy to clean.
Does your classroom refrain from using air fresheners (sprays, perfume, etc.)?
Classroom is vacuumed or swept daily.
Trash is removed from the classroom daily.
School has a plan to address indoor air quality.
There is a routine maintenance schedule for changing air filters throughout the school building.
School vehicles, buildings and grounds are “Smoke Free.”
School has emergency maintenance procedures for removing water and excessive moisture caused by flooding, broken pipes or leaks etc.

As a health professional, I can collaborate with the EPA to address disproportionate exposures to air pollution in communities, improve communication with the students' parents on steps to reduce exposures. In addition, I can help local schools to recognize how the health benefits associated with clean air, including fewer missed days at school due to illness, far outweigh the costs of air pollution control. 
Assessing exposures near public schools in the vicinity of freeways, industrial facilities, and power plants should be a priority, and the impact of land-use planning and infrastructure decisions on air pollution exposure needs to be reexamined. Also, visiting local schools to talk about environmental conservation on asthma awareness days, disseminating information about the Air Quality Index can be effective approaches. So I can set an example for young people by thinking globally and acting locally.

NEWS

• 03.02.19
• 7:00 AM

We have to fix fashion if we want to survive the climate crisis

The industry churned out 100 billion pieces of clothing for 7 billion people in 2015. The problem is so bad, some brands are burning unsold inventory. The waste has got to stop.

BY ELIZABETH SEGRAN

For the past three decades, fashion brands have perfected the art of manufacturing cheap clothing by relying on poorly paid labor in developing countries, inventing inexpensive plastic-based materials, and increasing the speed of production. And because most brands project what customers will want to buy six to nine months in advance, designers rarely get their predictions right. There are always some looks that nobody wants to buy. When brands churn out thousands of new looks every season, the problem of unsold inventory just scales up. The New York Times reports that a power plant in Vasteras, the Swedish town where H&M launched, relies partly on burning products that the company cannot sell as a fuel source.It is becoming increasingly clear that the fashion industry is contributing the the rapid destruction of our planet.  A United Nations report says that we’re on track to increase the world’s temperature by 2.7 degrees by 2040, which will flood our coastlines, intensify droughts, and lead to food shortages. Activists, world leaders, and the public at large are just beginning to reckon with the way the fashion industry is accelerating the pace of climate change.





Cuyana, whose tagline is “fewer better things,” is one; the company’s founders, Karla Gallardo and Shilpa Shah, believe in doing extensive focus groups and consumer research to create long-lasting and versatile products that respond to a clear need in the market. The brand’s website encourages women to think carefully before making purchases. 
Convincing women to buy less has not hurt Cuyana’s bottom line. While the eight-year-old brand is hard to compare to fashion giants, it recently announced that it was profitable. 
These startups are under a decade old, and they’re still small compared to enormous conglomerates like H&M, Gap Inc., and Inditex, which owns Zara. But one thing is for sure: These startups are growing while fast-fashion brands are on the decline. Their focus on marketing durability and timeless style hints at a sea change among consumers, who appear to be tired of the status quo of large companies competing on price while compromising on quality. Time will tell if fashion giants will realize there’s money to be made in selling fewer but better products. Not only would we be more more satisfied with our clothes–we’d be preserving the planet on which we wear them.