Municipal transportation policy as a population health intervention: estimating the impact of the City of Ottawa Transpo
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SPECIAL SECTION ON WHY PUBLIC HEALTH MATTERS TODAY: POPULATION HEALTH INTERVENTION RESEARCH
Municipal transportation policy as a population health intervention: estimating the impact of the City of Ottawa Transportation Master Plan on diabetes incidence Trevor Arnason 1,2
&
Peter Tanuseputro 3,4,5,6 & Meltem Tuna 4,5 & Douglas Manuel 3,4,5,7,8
Received: 15 June 2018 / Accepted: 14 December 2018 # The Canadian Public Health Association 2019
Abstract Intervention Physical inactivity is an important behavioral risk factor for chronic disease in Canada. Individual-level strategies are used in clinical medicine to target individuals for preventive intervention based on one or more risk factors. In contrast, this study examines the impact of a population-level intervention: a municipal policy outside the healthcare sector that influences the built and social environment. Research question What is the preventive effect of a municipal transportation policy to increase active transportation on a chronic disease outcome measure—diabetes incidence—when it is viewed as a population-level health intervention to increase physical activity? Methods The impact of increases in active transportation for regular commuting to work in the city of Ottawa, Ontario was modeled to estimate number of diabetes cases prevented over 10 years. As a health-sector comparison, the reduction in incidence was equated to an individual-level approach to prevention targeting those who are inactive, meant to represent a clinical preventive intervention. Results The population-level policy shift could prevent as many as 1620 incident cases of diabetes over 10 years, the largest number prevented by increases in public transit use. This population effect was equal to 17,300 inactive individuals or 12,300 inactive individuals > 45 years old undertaking a clinical preventive intervention to increase physical activity. Conclusion The results demonstrate why public health matters today as population-level interventions that exist as policies outside the healthcare sector, supported by public health, may have an unrecognized and therefore underappreciated impact on population health. Résumé Intervention La sédentarité est un important facteur de risque comportemental de maladie chronique au Canada. Des stratégies individuelles sont utilisées en clinique pour cibler les personnes qui ont besoin d’une intervention préventive parce qu’elles présentent un ou plusieurs facteurs de risque. Notre étude, par contre, porte sur l’impact d’une intervention en population : une politique municipale hors du secteur des soins de santé qui influence le milieu bâti et l’environnement social.
* Trevor Arnason [email protected] 1
Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Canada
2
Public Health Medicine Unit, Ottawa Public Health, Ottawa, Canada
3
Bruyère Research Institute, Ottawa, Canada
4
Ottawa Hospital - Civic Campus, Ottawa Hospital Research Institute, Ottawa, Canada
5
Ottawa Hospital - Civic Campu
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