Abstract

This Health Impact Assessment (HIA) informed the decision of expanding public transportation services to rural, low income communities of southern Doña Ana County, New Mexico on the U.S./Mexico border. The HIA focused on impacts of access to health care services, education, and economic development opportunities. Qualitative and quantitative data were collected from surveys of community members, key informant interviews, a focus group with community health workers, and passenger surveys during an initial introduction of the transit system. Results from the survey showed that a high percentage of respondents would use the bus system to access the following: (1) 84% for health services; (2) 83% for formal and informal education opportunities; and (3) 81% for economic opportunities. Results from interviews and the focus group supported the benefits of access to services but many were concerned with the high costs of providing bus service in a rural area. We conclude that implementing the bus system would have major impacts on resident’s health through improved access to: (1) health services, and fresh foods, especially for older adults; (2) education opportunities, such as community colleges, universities, and adult learning, especially for young adults; and (3) economic opportunities, especially jobs, job training, and consumer goods and services. We highlight the challenges associated with public transportation in rural areas where there are: (1) long distances to travel; (2) difficulties in scheduling to meet all needs; and (3) poor road and walking conditions for bus stops. The results are applicable to low income and fairly disconnected rural areas, where access to health, education, and economic opportunities are limited.

Highlights

  • There is wide recognition that the built environment plays a major role in determining health behaviors and outcomes at the individual and community level

  • Organization/World Health Organization (PAHO/WHO), U.S Environmental Protection Agency (USEPA), U.S Centers for Diseases Control and Prevention (USCDC), and U.S Department of Transportation (USDOT), that public transportation can play a significant role and that public health outcomes are influenced by multiple modes of transportation for different types of users of public transportation services [1,2]

  • In our review of the literature, we found no Health Impact Assessment (HIA) that focused on public transportation in rural areas

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Summary

Introduction

There is wide recognition that the built environment plays a major role in determining health behaviors and outcomes at the individual and community level. There is growing recognition by many planning, development, and health organizations, such as the Pan American Health. Organization/World Health Organization (PAHO/WHO), U.S Environmental Protection Agency (USEPA), U.S Centers for Diseases Control and Prevention (USCDC), and U.S Department of Transportation (USDOT), that public transportation can play a significant role and that public health outcomes are influenced by multiple modes of transportation for different types of users of public transportation services [1,2]. Health Impact Assessment (HIA) has emerged as a beneficial tool for assessing direct and indirect public health impacts of infrastructure improvement such as public transportation. Res. Public Health 2017, 14, 629; doi:10.3390/ijerph14060629 www.mdpi.com/journal/ijerph

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