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On the Right Track

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CALIFORNIA HAS BROKEN GROUND on one of the most ambitious transportation projects in the state’s history — a $64 billion highspeed rail system that will link Los Angeles to San Francisco via the rural Central Valley, reaching speeds up to 220 miles per hour with connections to the major cities en route. But the implications of California High-Speed Rail extend well beyond the ability to get from one place to another.

“Transportation affects health in so many ways,” says Dr. Brian Cole, lead analyst for FSPH’s Health Impact Assessment (HIA) Group, which conducts and provides technical assistance on HIAs for a wide range of public policies and projects. “This project will have significant effects, both direct and indirect, through changes not only in transportation habits, but also in economic development and how communities are structured. And the decisions and actions by both the state authority and local governments can go a long way toward maximizing potential benefits and minimizing potential harm.”

With that in mind, in 2014 the California High-Speed Rail Authority asked a Fielding School team headed by Cole to assess the potential health implications of the system as a whole, as well as conducting an HIA focusing on the Fresno-to-Bakersfield portion of the planned project — identified as an area of particular concern by the California Environmental Protection Agency based on the population’s environmental exposure, health risks, and socioeconomic status. The Fielding School group has been a national leader in the growing HIA movement, which draws on interdisciplinary expertise to assist decision-makers and communities in weighing potential health effects of major projects and policies.

High-speed rail’s health impact stems from providing communities with an additional transportation option, likely to be less expensive than owning and operating an automobile. Among the benefits, using public transit as opposed to a car typically adds walking time associated with getting to and from the stop. “If you have an otherwise sedentary population and give them an extra 15 minutes a day of physical activity, that can be huge,” Cole says. Moreover, highspeed rail development often leads to improvements in local transit service and in pedestrian and bicycle infrastructure, which can also increase physical activity.

Combating sedentary lifestyles isn’t the only potential health benefit. “It’s very difficult to get people to drive less, so anything that helps to reduce vehicle miles traveled — which is associated with traffic risks, air pollution and greenhouse gas emissions — is likely to have a positive health impact,” says Dr. Michael Jerrett, professor and chair of FSPH’s Department of Environmental Health Sciences and a member of the study team. In particular, the Fielding School researchers say, people who live close to highly traveled roads may see a benefit from reduced roadway emissions. In addition, Cole notes, avoiding the need to endure stressful commutes on congested roadways can bring mental health benefits to high-speed rail commuters.

The population in the San Joaquin Valley region covered by the Fresno-to-Bakersfield route may also benefit from increased economic opportunity, the Fielding School researchers point out. “Many of these communities are heavily dependent on agriculture and have high seasonal unemployment rates and significant social problems,” Jerrett says. In the short term, the project is likely to produce a major influx of transportation- and infrastructure-related jobs. And for the long term, high-speed rail expands the pool of available employment by making it easier for the area’s residents to commute to jobs much farther from their homes. Greater economic development in the region can help to diversify the rural economy; it is also likely to draw more professionals, including those in health fields, which could provide much-needed relief for a medically underserved region.

The FSPH team is also weighing the potential for negative effects. “There have been cases in which these types of projects have connected between places but divided within,” Jerrett says. He points to noise and traffic-safety concerns around the high-speed rail station, and the tendency of past projects to route the trains through areas that place a disproportionate share of these burdens on low-income populations and people of color. The Fielding School researchers point out that a major project such as high-speed rail changes land-use patterns, and “smart growth” policies are critical to bringing together housing, retail, and services in a way that promotes community cohesion and improves quality of life. The FSPH group has partnered with Cultiva La Salud, a community-based public health organization in the San Joaquin Valley, to provide input for the HIA and use the results in its ongoing work to promote health. “Depending on how they are implemented, transportation projects such as this can either divide communities or bring them together,” Cole says. “We are trying to point to ways that this project can be steered in a direction that will maximize the benefits.”