Nashville, when compared to similar cities like Austin, Raleigh, Denver, and Dallas, ranks dead last when it comes to the health of our citizens. That’s right: dead last.
Nashville by far has the lowest life expectancy, the worst mental health, the least physical activity and the highest rates of infant mortality, smoking, and obesity. This is unacceptable – especially for a growing, otherwise thriving city full of innovative healthcare companies and thought leaders. We can do better.
Nashville’s growth is rapidly outpacing our transportation capacity. And that, in turn, impacts the ... [+]
Health is a product both of our environment as well as the individual. It is the complex interplay between the two. And indeed, many environmental and nonmedical factors completely outside the walls of hospitals and clinics have a direct impact on a person’s health and wellbeing. Bad health affects all aspects of our lives. It translates to poor overall quality of life, less happiness, and less productivity. It also ultimately leads to falling behind.
And this is why good, commonsense policy is so important – it can help lead our communities to healthier futures. Thus, as a physician and former government policy maker, I encourage each of us to view ALL policy proposals, at every level of government, through a lens of how it will affect the mental, emotional, and physical health of each person, family, and community.
Transportation is Health
Healthy cities require an equally healthy transportation infrastructure to foster growth, connectedness, and wellbeing. It might sound cliché, but transportation truly is health. And the collaborative health nonprofit, NashvilleHealth, has identified that unequal access to social and nonmedical determinants of health, with access to transportation being a prime example, underlies much of the poor health that characterizes Nashville when we compare ourselves to other cities. And it’s only getting worse.
Nashville’s growth is rapidly outpacing our transportation capacity. And that, in turn, impacts the health and wellbeing of every one of us. This isn’t a new problem. And this year voters will have the opportunity to shape our transportation infrastructure.
The current Mayor of Nashville, Mayor Freddie O’Connell, has proposed a modest transportation plan that begins to modernize our transit infrastructure, at a time the city is seeing exciting growth in people, businesses, and cultural resources. The Transit Improvement Program (TIP) introduces a sales tax – Nashville is only one of four out of the 50 largest U.S. cities that doesn’t currently have designated funding for transportation – but the plan on the table is a scaled down version of previous bills.
“Choose How You Move gives us the opportunity to improve Nashvillians’ quality of life by supporting their well-being, lowering the cost of transportation, and making our roads safer for everyone, no matter how you choose to use them,” shared Mayor O’Connell. “The public health benefits are wide ranging: reduced traffic crashes and pollution, increased physical fitness, improved mental health, improved basic access to medical care and healthy food, and reduced financial stress for lower-income households.”
The proposed program promises to make Nashville’s transit infrastructure more efficient, accessible, and affordable. But the purpose of this article is not to debate the merits of Mayor O’Connell’s referendum. Rather, it is to look at the impact the TIP will have on our health – and the benefits are clear.
Here is how I see the Mayor’s TIP impacting the health of our residents:
Signals: Six hundred signalized intersections will be modernized with new stoplight technology. These smart signals will adjust in real time to changing traffic patterns, reducing congestion and substantially improving travel times.
Less time in traffic unnecessarily waiting at stop lights – less time slowing, idling and then accelerating – and less total time on the road reduces the levels of our body’s stress hormone, cortisol. This benefits our mental and emotional health. Studies show that longer drives to and from work, for example, impact overall employee job satisfaction as well as leisure time satisfaction. And less time commuting also reduces more generalized physical and emotional fatigue.
These signals will also improve our air quality and, in doing so, our immune system. Starting and stopping, waiting at stoplights, longer time spent in the car — each of these leads to more air pollution. And this poisoning pollution correlates directly with more heart attacks, stroke, asthma, emphysema, and lung cancer. The combination of physiological bodily stress with increased emissions and pollution suppresses the body’s immune system, making us more susceptible to infections of all types.
Sidewalks: Eighty-six miles of sidewalks will be added or upgraded (60% of which will be in traditionally underrepresented neighborhoods).
Nashville is consistently listed as one of the least walkable cities in America, and increased community walkability reduces stress, smoking, and symptoms of depression. These sidewalk improvements will allow for a third of Nashville residents to have walkable access to a transit stop, which will also reduce the need for motorized travel, decrease travel times, and reduce traffic-related air pollution. This translates to improved respiratory conditions like wheezing and asthma, less acute and chronic cardiovascular and pulmonary disease, and consequently fewer costly hospitalizations and more healthy and more productive days at work.
Many of the neighborhoods that will see a large increase in sidewalks under the Mayor’s proposal are existing hot spots for higher rates of chronic disease such as hypertension, diabetes, and obesity. Multiple studies reinforce the observations that residents with sidewalks have a significant reduction in levels of obesity and high blood pressure because they have the opportunity to walk and exercise more.
Bus Service: Bus service hours will increase by 80%. Service will be expanded to connect even more neighborhoods and will prepare Nashville for regional connections, organized through 12 transit centers and 17 park-and-ride locations.
Nashville households that make less than median income spend more than half of their income on transportation and housing expenses. Efficient and affordable public transportation allows people to commute more economically and reliably to and from work. This catalyzes access to job opportunities and increases the opportunity to participate in the local economy (both of which have a positive impact on economic productivity and growth). These same benefits will extend to increased access to health promoting behaviors such as nutritious foods, recreational activities, employment, and social interaction.
And the TIP will also enhance environmental aspects around transit corridors through the incorporation of street trees, plantings, and other green elements. Greenery around bus stops works to minimize exposure to diesel and air pollution. These green areas also provide shade, enabling safer movement around the city during extreme heat events.
Safety: Mobility options and safety will be increased by redesigning 35 high injury intersections to reduce risks.
Last year, 37 people lost their lives while walking or biking in Nashville. Well-designed pedestrian infrastructure encourages walking and cycling as convenient and desirable modes of transportation. This promotes physical activity and greener transportation, both of which are crucial for maintaining good heart and lung health, reducing obesity, and improving overall fitness and mental health.
To improve pedestrian safety, street improvements will focus on safer intersections with well-marked bikeways, improved street lighting, and more pedestrian sidewalks. “All-Access Corridors,” that improve the coordination of all modes of transportation (bus, car, bike, and walking), will be created at complex intersections. Better traffic patterns and signals help optimize the flow of vehicles, pedestrians, and cyclists, and they also reduce congestion and the risk of accidents. This benefits all road users regardless of method of transportation.
The Mayor’s TIP will help Nashvillians to more efficiently and economically navigate the city. It will also help give every Nashvillian the opportunity to be healthy. Transportation, at its most basic level, dictates our ability to navigate the world around us. And it is a key driver of health outcomes. When safe, accessible, and affordable transportation systems are in place, cities and the people that live within them thrive.
By leaning into smart, commonsense transportation policy, we can start to improve the health and wellbeing of our entire city. Modernized transportation options will ensure that all residents, regardless of their income, circumstances, or neighborhood they live in, can more easily navigate the city. This cultivates a more inclusive and better-connected community — and improves our health and well-being along the way. And every single one of us will benefit.
