Do you live in a car-centric city? Do some residents lack access to an automobile and face a distinct disadvantage when seeking services, education, and employment? Take a look at how Columbus, Ohio is reversing the auto-first thinking of traditional traffic engineering and the inequitable distribution of transportation resources.

The City of Columbus is currently developing the “Connect Columbus” Multi-Modal Thoroughfare Plan to serve as an unprecedented long-range transportation plan for the city. As a health impact assessment (HIA), the Connect Columbus Plan will establish the community’s vision and goals for the transportation system; conduct a transportation needs assessment; formalize the city’s Complete Streets Policy and develop Complete Streets Design Guidelines; designate multimodal level of service goals for each street typology; and identify priority corridors for each mode.

With a plan of this breadth, the entire City of Columbus will be affected; ensuring that an equitable perspective is taken into consideration is of utmost importance. Columbus Public Health worked with the City of Columbus Department of Public Service, Nelson/Nygaard (the consultants on the project), and community partners – while also engaging the general public – in order to discover the needs of the stakeholders involved and to discuss the equity implications of the plan.

This HIA is the latest in a series that Columbus Public Health has performed, starting with rapid HIAs and moving to intermediate and comprehensive HIAs. This particular assessment’s geographical scope was the entire City of Columbus, Ohio; however, certain disadvantaged neighborhoods in Columbus were identified and the HIA recommended that these neighborhoods be given priority when deciding upon the proposed infrastructure projects. The screening process began while the request for proposal (RFP) was being written in 2013.

The plan officially kicked off in early 2015 as we coordinated with the Department of Public Service and Nelson/Nygaard to gain a better perspective on the scope of the Connect Columbus plan. Through this scoping process, we selected physical activity, food access, air quality and traffic safety as our focus areas, and began an extensive literature review around those four topics. We also gathered and mapped demographic data to find which census tracts in Columbus have the most need. We moved through the recommendation, reporting and monitoring stages after the literature review, conducting public outreach (e.g., surveys), a social media campaign, and data modeling. The plan will conclude in the summer of 2016.

We worked hand-in-hand with the Department of Public Service and Nelson/Nygaard from the outset to ensure our voice was incorporated into the plan. We assisted with public outreach to bring stakeholders to the table during the vision and goals process, which resulted in the identification of Health & Safety and Equitable Access as two of the six main goals of the plan. We also helped create and refine evaluation measures and performance metrics that will be used to prioritize transportation investments in the plan.

For the Fact Book that explored current conditions and trends, we contributed health data on topics such as obesity and active transportation, air quality and asthma prevalence, socioeconomic status and healthy food access, and distribution of disabled and aging populations. We also conducted a transportation survey that gathered the travel behaviors, preferences, and desires from Columbus area residents. Finally, the results of a travel model comparing two alternative future scenarios will be translated into predicted health impacts, using the Health Economic Assessment Tool (HEAT). All of this data and all of the analyses performed provided new information that was made available to the general public, as well as stakeholders and decision-makers involved in the Connect Columbus Plan.

While this effort has been successful thus far, we did face a couple obstacles. For one, the Connect Columbus timeline was altered, requiring us to maintain flexibility and adapt to the changing schedule. We also had several issues obtaining the data we sought, which prevented us from running the Integrated Transport and Health Impact Model (ITHIM) model we originally planned on using, and provided some challenges for the HEAT model that we used instead. Despite these challenges, the process proved beneficial in ways that will extend beyond this project.

For example, close collaboration and communication between the stakeholders involved in a project is of utmost importance to any HIA, and the Connect Columbus HIA did just that. Building relationships with other City of Columbus departments has provided us with many opportunities to have a seat at the table when infrastructure and planning decisions are made. Without fostering such relationships, we wouldn’t be able to have the impact that we do on city-wide decisions that are being made, especially transportation-related decisions.

We prioritize and actively apply a Health in All Policies approach to our work with the end goal of working our way out of a job as HIA practitioners; meaning, if we do our jobs correctly, we won’t have to keep doing HIAs. Rather, integrating health into the decision-making process will become status quo and health and equity will exist within the everyday operations/planning of all city departments.