Skip to main content

Advertisement

SpringerLink
Log in

Improving Decision-Making for Population Health in Nonhealth Sectors in Urban Environments: the Example of the Transportation Sector in Three Megacities—the 3-D Commission

  • Published:
Journal of Urban Health Aims and scope Submit manuscript

Abstract

Noncommunicable diseases (NCDs) represent a significant global public health burden. As more countries experience both epidemiologic transition and increasing urbanization, it is clear that we need approaches to mitigate the growing burden of NCDs. Large and growing urban environments play an important role in shaping risk factors that influence NCDs, pointing to the ineluctable need to engage sectors beyond the health sector in these settings if we are to improve health. By way of one example, the transportation sector plays a critical role in building and sustaining health outcomes in urban environments in general and in megacities in particular. We conducted a qualitative comparative case study design. We compared Bus Rapid Transit (BRT) policies in 3 megacities—Lagos (Africa), Bogotá (South America), and Beijing (Asia). We examined the extent to which data on the social determinants of health, equity considerations, and multisectoral approaches were incorporated into local politics and the decision-making processes surrounding BRT. We found that all three megacities paid inadequate attention to health in their agenda-setting, despite having considerable healthy transportation policies in principle. BRT system policies have the opportunity to improve lifestyle choices for NCDs through a focus on safe, affordable, and effective forms of transportation. There are opportunities to improve decision-making for health by involving more available data for health, building on existing infrastructures, building stronger political leadership and commitments, and establishing formal frameworks to improve multisectoral collaborations within megacities. Future research will benefit from addressing the political and bureaucratic processes of using health data when designing public transportation services, the political and social obstacles involved, and the cross-national lessons that can be learned from other megacities.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. World Health Organization. Noncommunicable diseases country profiles. Published 2018. Accessed November 12, 2020. https://www.who.int/nmh/countries/en/ 2018

  2. Beaglehole R, Bonita R, Horton R, Adams C, Alleyne G, Asaria P, et al. Priority actions for the non-communicable disease crisis. Lancet. 2011;377(9775):1438–47. https://doi.org/10.1016/S0140-6736(11)60393-0.

  3. Campos PA, Reich MR. Political analysis for health policy implementation. Health Syst Reform. 2019;5(3):224–35. https://doi.org/10.1080/23288604.2019.1625251.

    Article  PubMed  Google Scholar 

  4. Thomas YF, Boufford JI, Talukder SH. Focusing on health to advance sustainable urban transitions. J Urban Health. 2016;93(1):1–5. https://doi.org/10.1007/s11524-016-0037-x.

    Article  PubMed  PubMed Central  Google Scholar 

  5. United Nations Department of Economic and Social Affairs Population Division. World Urbanization Prospects: the Revision. United Nations. 2015. https://esa.un.org/unpd/wpp/. Accessed May 19 2021

  6. United Nations Department of Economic and Social Affairs. Revision of World Urbanization Prospects. Accessed November 18, 2020. https://www.un.org/development/desa/en/news/population/2018-revision-of-world-urbanization-prospects.html Published 2018

  7. UN-HABITAT, WHO. Hidden cities-unmasking and overcoming health inequities in urban settings Kobe: World Health Organization, The WHO Centre for Health Development and Nairobi: United Nations Human Settlements Programme (UNHABITAT); 2010.

    Google Scholar 

  8. World Health Organization (WHO). Health as the pulse of the new urban agenda: United Nations conference on housing and sustainable urban development, Quito. Geneva: World Health Organization; 2016.

  9. World Health Organization, UN-Habitat. Global report on urban health: equitable, healthier cities for sustainable development Kobe: World Health Organization, The WHO Centre for Health Development and Nairobi: United Nations Human Settlements Programme (UNHABITAT); 2016.

    Google Scholar 

  10. Woolf SH, Aron L, Dubay L, Simon SM, Zimme E, Luk KX. How are income and wealth linked to health and longevity? Washington: Urban Institute and Richmond: Virginia Commonwealth University; 2015.

    Google Scholar 

  11. Juma PA, Mohamed SF, Matanje Mwagomba BL, et al. Non-communicable disease prevention policy process in five African countries authors. BMC Public Health. 2018;18(Suppl 1) https://doi.org/10.1186/s12889-018-5825-7.

  12. Magnusson RS, Patterson D. The role of law and governance reform in the global response to non-communicable diseases. Glob Health. 2014;10(1):1–18. https://doi.org/10.1186/1744-8603-10-44.

    Article  Google Scholar 

  13. Meiro-Lorenzo M, Villafana TL, Harrit MN. Effective responses to non communicable disease: embracing action beyond the health sector. Washington: World Bank; 2011.

    Google Scholar 

  14. World Health Organization and UNDP. What ministries of transport need to know. Geneva: World Health Organization; 2020.

  15. Dora C. A different route to health: implications of transport policies. Br Med J. 1999;318(7199):1686–9. https://doi.org/10.1136/bmj.318.7199.1686.

    Article  CAS  Google Scholar 

  16. Frumkin H, Haines A. Global environmental change and noncommunicable disease risks. Annu Rev Public Health. 2019;40(40):261–82.

    Article  Google Scholar 

  17. Knupfer SM, Pokotilo V, Woetzel J. Elements of success: urban transportation systems of 24 global cities. New York: Mckinsey & Company; 2018.

    Google Scholar 

  18. Arnason T, Tanuseputro P, Tuna M, Manuel D. Municipal transportation policy as a population health intervention: estimating the impact of the City of Ottawa Transportation Master Plan on diabetes incidence. Can J Public Health. 2019;110(3):285–93. https://doi.org/10.17269/s41997-018-0168-9.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Ivbijaro G. Mental health as an NCD (non-communicable disease): the need to act. Ment Health Fam Med. 2011;8(3):131–2.

    PubMed  PubMed Central  Google Scholar 

  20. Schwartz JI, Guwatudde D, Nugent R, Kiiza CM. Looking at non-communicable diseases in Uganda through a local lens : an analysis using locally derived data. Glob Health. 2014;10(77):1–9.

    Google Scholar 

  21. Bornstein DB, Davis WJ. Sustaining vibrant communities - the transportation profession’s role in improving public health. Inst Transp Eng. 2014;(July).

  22. Walt G, Gilson L. Reforming the health sector in developing countries: the central role of policy analysis. Health Policy Plan. 1994;9(4):353–70. https://doi.org/10.1093/heapol/9.4.353.

    Article  CAS  PubMed  Google Scholar 

  23. Institute for Transportation and Development Policy. Lessons of Urban Transit from Bogota. Published 2009. Accessed November 17, 2020. https://www.itdp.org/2009/05/21/lessons-of-urban-transit-from-bogota/

  24. Otunola B, Kriticos S, Harman O. The BRT and the Danfo: A case study of Lagos ’ transport reforms from 1999-2019. London: International Growth Center (IGC); 2019.

  25. Hutchinson A. TransMilenio: The Good, the Bus and the Ugly. Published 2011. Accessed December 19, 2020. https://thecityfix.com/blog/transmilenio-the-good-the-bus-and-the-ugly/

  26. Filipe LN. Macario R. Policy packaging in BRT projects : a methodology for case study analysis. Res Transp Econ. Published online. 2014:1–7. https://doi.org/10.1016/j.retrec.2014.09.014.

  27. The Association of State and Territorial Health Officials. Healthy Transportation Policies. Environmental health in all policies. Published 2014. Accessed November 17, 2020. https://www.astho.org/Programs/Health-in-All-Policies/Environmental-Health-in-All-Policies/Healthy-Transportation-Introduction/

  28. Moberola D. Strengthening urban transport institutions - a case study of Lagos. Washington: World Bank Group; 2006.

    Google Scholar 

  29. Peltier-Thiberge N. Lagos’ Bus Rapid Transit system: decongesting and depolluting mega-cities. transport for development. Published 2015. Accessed November 17, 2020. https://blogs.worldbank.org/transport/lagos-bus-rapid-transit-system-decongesting-and-depolluting-mega-cities-0

  30. Suzuki H, Cervero R, Iuchi K. Transforming cities with transit - transit and land-use integration for sustainable urban development. Washington: World Bank; 2013.

    Google Scholar 

  31. Jiang B, Liang S, Peng Z, et al. Review transport and public health in China : the road to a healthy future. Lancet. 2017;390(10104):1781–91. https://doi.org/10.1016/S0140-6736(17)31958-X.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Heinrich Böll Stiftung and Fabulous Urban. Urban planning processes in Lagos - policies, laws, planning instruments, strategies and actors of urban projects. Urban development and urban services in Africa’s largest city. Abuja: Heinrich Böll and Zurich: Fabulous Urban; 2018.

  33. Rodriguez DA, Vergel E. BRT-oriented development in Quito and Bogotá. Cambridge: Lincoln Institute of Land Policy; 2013.

    Google Scholar 

  34. Energy Sector Management Assistance Program. Good practices in city energy efficiency, Bogota, Colombia – Bus Rapid Transit for urban transport. Washington: World Bank; 2009.

    Google Scholar 

  35. Mann J. Bogota slashed pollution and road deaths with one simple tool: a bus. Cities Transport and Infrastructure: Published; 2018. Accessed December 19, 2020. https://apolitical.co/en/solution_article/bogota-slashed-pollution-and-road-deaths-with-one-simple-tool-a-bus

    Google Scholar 

  36. Yang S, He L. Transport pollution in China – evidence from Beijing. Energy Environ. 2016;27(3-4):377–88. https://doi.org/10.1177/0958305X15627545.

    Article  Google Scholar 

  37. Lagos State Ministry of Transportation, Lagos Metropolitan Area Transport Authority, United Nations Environment Programme, Institute for Transportation and Development Policy. Lagos non-motorised transport policy – empowering pedestrians and cyclists for a better city. Nairobi: UNEP; 2018.

    Google Scholar 

  38. Carrigan A, King R, Velasquez JM, Raifman M, Duduta N. Social, environmental, and economic impacts of BRT systems. Bus rapid transit case studies from around the world. Washington, DC: EMBARQ - World Resources Institute; 2013.

  39. Bel G, Holst M. Evaluation of the impact of Bus Rapid Transit on air pollution. Barcelona, Spain: Research Institute of Applied Economics, University of Barcelona; 2015.

    Google Scholar 

  40. Gwilliam K, Kojima M, Johnson T. Reducing pollution from urban transport. Washington, DC: The World Bank; 2004.

    Google Scholar 

  41. Chun J, Moody J, Zhao J. Transportation policymaking in Beijing and Shanghai : contributors , obstacles and process. Case Stud Transp Policy. 2019;7(4):718–31.

    Article  Google Scholar 

  42. Bocarejo JP, Velasquez JM, Díaz CA, Tafur LE. Impact of Bus Rapid Transit systems on road safety. Transp Res Rec J Transp Res Board. 2012;2317(1):1–7. https://doi.org/10.3141/2317-01.

    Article  Google Scholar 

  43. Special Unit for South-South Cooperation. Bogotá, Colombia Bus Rapid Transit project - Transmilenio, case study. New York, NY: United Nations Office for South-South Cooperation; 2012.

  44. Jin F, Wang J, Teqi D. Urban transportation In Beijing, China: challenges , causes and implications. Pap Appl Geogr Conf. 2009;32:57–66.

    Google Scholar 

  45. Deng T, Ma M, Wang J. Evaluation of Bus Rapid Transit implementation in China : current performance evaluation of Bus Rapid Transit implementation in China : current performance and progress. J Urban Plan Dev. 2013;139(3):226–34. https://doi.org/10.1061/(ASCE)UP.1943-5444.0000150.

    Article  Google Scholar 

  46. Emmanuel SA, Taiwo SO. Urban transportation system design and feasibility analysis a case study of Lagos Mega - City. Bhúmi Plan Res J. 2018;06(02).

  47. Deng T, Nelson JD. Bus Rapid Transit implementation in Beijing: an evaluation of performance and impacts. Res Transp Econ. 2013;39(1):108–13. https://doi.org/10.1016/jretrec.2012.06.002.

  48. Georges D. Bus Rapid Transit developments in China-perspectives from research, meetings, and site visits in April 2006. Washington, DC: United States Federal Transit Administration. Office of Research Demonstration, and Innovation; 2006.

  49. World Bank Group. Project performance assessment report Nigeria – Lagos Urban Transport Project. Washington, DC: The World Bank; 2016.

  50. Oliver TR. The politics of public health policy. Annu Rev Public Health. 2006;27(104):195–233. https://doi.org/10.1146/annurev.publhealth.25.101802.123126.

    Article  PubMed  Google Scholar 

  51. Matsumoto N. Analysis of policy processes to introduce Bus Rapid Transit systems in Asian cities from the perspective of lesson-drawing: cases of Jakarta, Seoul, and Beijing. Hayama: Institute for Global Environmental Strategies; 2007.

    Google Scholar 

  52. Burandt S, Gralla F, John B. Actor analysis in case studies for ( regional ) sustainable development Abstract : Key words : Klíčová slova : 2015;10(1):1–14. https://doi.org/10.14712/18023061.433

  53. Klopp JM, Harber J, Quarshie M. A review of BRT as public transport reform in African cities. Gothenburg: Volvo Research and Educational Foundations (VREF); 2019.

    Google Scholar 

  54. Yamili Y, Mallqui C, Pojani D. Barriers to successful Bus Rapid Transit expansion: developed cities versus developing megacities. Case Stud Transp Policy. 2017;5(2):254–66. https://doi.org/10.1016/j.cstp.2017.01.004.

    Article  Google Scholar 

  55. Hidalgo D, Carrigan A. Lecciones Aprendidas de Mejoras En Sistemas de Autobuses de Latinoamérica y Asia. Modernización Del Transporte Público. Washington, DC: World Resources Institute; 2010.

  56. Center for Public Impact. TransMilenio: renewing Bogotá’s transport system. Case study. London: Center for Public Impact; 2016.

  57. Lara YA, Fernando G, Mario d Q, Gpe GP. Señalización y seguridad vial en buses de tránsito rápido : el transmilenio en Bogotá. Infraestruct Vial. 2017;19(33):15–25.

    Google Scholar 

  58. Gaduh A, Gracner T, Alexander D. Autobuses de tránsito rápido para una mejor movilidad urbana: ensãnzas de Bogotá y Yakarta. GlobalDev: Research that Matters, July 29. Published 2019. Accessed December 19, 2020. https://www.globaldev.blog/es/blog/autobuses-de-tránsito-rápido-para-una-mejor-movilidad-urbana-enseñanzas-de-bogotá-y-yakarta

  59. Becerra JM, Reis RS, Frank LD, et al. Transport and health: a look at three Latin American cities. Cad Saúde Pública. 2013;29(4).

  60. Hook W, Fjellstrom K, Oscar ED. Options for financing Bus Rapid Transit in China. New York, NY: Institute for Transportation and Development Policy; 2006.

  61. de Oliveira JAP, Doll CNH, Siri J, Dreyfus M, Farzaneh H, Capon A. Urban governance and the systems approaches to health-environment co-benefits in cities. Cad Saúde Pública. 2015;31(suppl 1):25–38. https://doi.org/10.1590/0102-311x00010015.

    Article  PubMed  Google Scholar 

  62. Kübler D. Megacities and the challenge of governance. In: Governance issues in megacities: Chinese and international perspectives. Zurich: University of Zurich; 2012.

    Google Scholar 

  63. Mendis S. The policy agenda for prevention and control of non-communicable diseases. Br Med Bull. 2010;96:23–43. https://doi.org/10.1093/bmb/ldq037.

    Article  PubMed  Google Scholar 

  64. World Health Organization. Health 2020 priority area four: creating supportive environments and resilient communities. In: Ziglio E, editor. Copenhagen: World Health Organization Regional Office for Europe; 2018.

  65. De Leeuw E. Engagement of sectors other than health in integrated health governance, policy, and action. Annu Rev Public Health. 2017;38:329–49. https://doi.org/10.1146/annurev-publhealth-031816-044309.

    Article  PubMed  Google Scholar 

  66. McQueen D, Wismar M, Lin V, Jones C, Davies M. Intersectoral governance for health in all policies. Eurohealth. 2012;18(4).

  67. Cavoli C, Christie N, Mindell J. Titheridge H. Linking transport, health and sustainability : better data sets for better. J Transp Health. Published online. 2014:1–9. https://doi.org/10.1016/j.jth.2014.08.001.

Download references

Acknowledgements

We thank Leona Ofei for her support in formatting this paper. The Rockefeller Foundation–Boston University 3‐D Commission (Grant number: 2019 HTH 024).

Author information

Authors and Affiliations

  1. Rockefeller Foundation-Boston University 3-D Commission on Determinants, Data, and Decision-making, Boston, USA

    Opeyemi Babajide, Diogo Correia Martins, Nason Maani, Salma M Abdalla, Eduardo J. Gómez, Montira J. Pongsiri, Sheila Tlou, Gabriel Matthew Leung, Georges C. Benjamin, Eric Goosby, Katie Dain, Jeanette Vega, Zahra Zeinali, Sandro Galea, Jeffrey Sturchio & Nana A. Y. Twum-Danso

  2. London School of Hygiene & Tropical Medicine (LSHTM), London, UK

    Diogo Correia Martins & Nason Maani

  3. Department of Epidemiology, Boston University School of Public Health, Boston, USA

    Nason Maani, Salma M Abdalla & Sandro Galea

  4. Lehigh University, Bethlehem, USA

    Eduardo J. Gómez

  5. Stockholm Environment Institute-Asia Centre, Bangkok, Thailand

    Montira J. Pongsiri

  6. Nursing Now, Geneva, Switzerland

    Sheila Tlou

  7. LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China

    Gabriel Matthew Leung

  8. American Public Health Association, Washington DC, USA

    Georges C. Benjamin

  9. Institute for Global Health Sciences, University of California, San Francisco, San Francisco, USA

    Eric Goosby

  10. NCD Alliance, Geneva, Switzerland

    Katie Dain

  11. National Research and Development Agency (ANID Chile), Santiago, Chile

    Jeanette Vega

  12. Rabin Martin, New York, USA

    Jeffrey Sturchio

  13. The Rockefeller Foundation, New York, USA

    Nana A. Y. Twum-Danso

Authors
  1. Opeyemi Babajide
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Diogo Correia Martins
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nason Maani
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Salma M Abdalla
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Eduardo J. Gómez
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Montira J. Pongsiri
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sheila Tlou
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Gabriel Matthew Leung
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Georges C. Benjamin
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Eric Goosby
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Katie Dain
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Jeanette Vega
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Zahra Zeinali
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Sandro Galea
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Jeffrey Sturchio
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Nana A. Y. Twum-Danso
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Salma M Abdalla.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Babajide, O., Martins, D.C., Maani, N. et al. Improving Decision-Making for Population Health in Nonhealth Sectors in Urban Environments: the Example of the Transportation Sector in Three Megacities—the 3-D Commission. J Urban Health 98 (Suppl 1), 60–68 (2021). https://doi.org/10.1007/s11524-021-00561-y

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11524-021-00561-y

Keywords

Search

Navigation