Abstract

Background: Transport policy and practice impacts health. Environmental Impact Assessments (EIAs) are regulated public policy mechanisms that can be used to consider the health impacts of major transport projects before they are approved. The way health is considered in these environmental assessments (EAs) is not well known. This research asked: How and to what extent was human health considered in EAs of four major transport projects in Australia. Methods: We developed a comprehensive coding framework to analyse the Environmental Impact Statements (EISs) of four transport infrastructure projects: three road and one light rail. The coding framework was designed to capture how health was directly and indirectly included. Results: We found that health was partially considered in all four EISs. In the three New South Wales (NSW) projects, but not the one South Australian project, this was influenced by the requirements issued to proponents by the government which directed the content of the EIS. Health was assessed using human health risk assessment (HHRA). We found this to be narrow in focus and revealed a need for a broader social determinants of health approach, using multiple methods. The road assessments emphasised air quality and noise risks, concluding these were minimal or predicted to improve. The South Australian project was the only road project not to include health data explicitly. The light rail EIS considered the health benefits of the project whereas the others focused on risk. Only one project considered mental health, although in less detail than air quality or noise. Conclusion: Our findings suggest EIAs lag behind the known evidence linking transport infrastructure to health. If health is to be comprehensively included, a more complete model of health is required, as well as a shift away from health risk assessment as the main method used. This needs to be mandatory for all significant developments. We also found that considering health only at the EIA stage may be a significant limitation, and there is a need for health issues to be considered when earlier, fundamental decisions about the project are being made.

Highlights

  • Transport networks and practices are well recognised determinants of health

  • This research shows how health impacts were considered in four instances of transport infrastructure environmental impact assessment (EIA): primarily in terms of the health risks arising from air and noise associated with road projects, and as a social benefit in the light rail

  • This is despite global shifts which are broadening the issues considered in EIAs9 and a growing awareness that a focus on assessing specific risks known to health may miss many uncertainties and ambiguities associated with a project that may threaten people’s health.[23]

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Summary

Introduction

Transport networks and practices are well recognised determinants of health. Transport policy and planning, in urban settings, affect health in various ways.[1,2] Transport investment decisions influence the availability of different modes of transport (for example cars, public transport, walking and cycling) and subsequently travel behaviour. These health impacts are influenced by population characteristics including demographics and socio-economic status The recommendations from this large body of evidence revolve around better integration of transport and urban planning that reduces reliance on carbon dependent private cars and enhances opportunities for walking, cycling and public transport.[3] The importance of engaging with health issues in urban sustainability decision making (including transport) has been highlighted in recent global statements such as Habitat 21,4 and improving both health and urban infrastructure are cemented as sustainable development goals.[5] From a policy perspective, health oriented research and practice has yet to engage fully with the procedures that underpin transport planning decisions. The analysis shows how, using our approach and framework, policy-makers and affected communities can assess the quality of the content of EISs from a comprehensive public health impact perspective

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