AWA: Academic Writing at Auckland

To: The Auckland Council

Re: Auckland Unleashed: The Auckland Plan discussion document

Submitter: Hannah Feenstra, BHSc student

Position Statement

1. This submission is made in response to Q.19 on page 104 of ‘Auckland Unleashed’: ‘What initiatives should the Auckland Plan focus on to reduce greenhouse gases?’ I support development in the areas identified in section 296, page 103 of ‘Auckland Unleashed’. In particular, ‘urban planning to reduce the need to travel, while simultaneously providing better public transport and cycleways’ (p.103) has the potential to both reduce greenhouse gases and improve the health of the people of Auckland.

Executive Summary

2. As a 3^rd year student studying towards a Bachelor of Health Science at the University of Auckland I am interested in how health is determined at a population as opposed to an individual level. As a young person I also have a concern for the natural environment and hope that it will be preserved for my future children and grandchildren.

3. To improve health at a population level it is not enough to treat existing disease; efforts must also be made to address the underlying factors that determine whether someone is healthy or not. The pathways to good health are multiple and complex but one of the underlying factors that determines health is the environment in which people live. Where people live both shapes their lives and determines the types of hazards to which they are exposed. How Auckland is developed in the future therefore has the potential to influence the health of the people of Auckland, both positively and negatively.

4. Human health and the environment are intricately linked; initiatives that aim to mitigate climate change and reduce greenhouse gases can also have health benefits. The following initiatives are recommended in Auckland on the basis that action will both reduces greenhouse gases and benefit health:

• Urban development should be intensified in such a way that the need to travel long distances is reduced. This will result in improved air quality, benefiting health by reducing death and disease caused by air pollution such as respiratory and cardiovascular disease and lung cancer.
• Urban development should prioritise the needs of cyclists and pedestrians so as to promote active forms of transport. This will reduce greenhouse gases and increase physical activity, benefiting health by preventing cardiovascular disease, diabetes, colon cancer and other diseases.
  
  

Health Impacts of Climate Change

5. According to the World Health Organization (2009), climate change will not only affect the environment but will also have major negative impacts on the health of people around the world. This is because climate change will affect the fundamental determinants of health: access to clean air and water, shelter, food production and the spread of disease. It is expected that major health impacts will occur in the following ways:

• Rising air temperatures will lead to an increase in the number of deaths caused by heat waves.
• Air pollutants will increase affecting respiratory and cardiac health.
• Changes in rainfall patterns will lead to droughts, affecting the amount of water available for sanitation and contributing to an increase in diarrhoeal diseases.
• Crop yields will be reduced, especially in developing countries, leading to rising malnutrition.
• Rising sea levels and an increase in flooding and other natural disasters can result in deaths directly as well as resulting in the spread of disease due to a lack of sanitation and malnutrition due to the destruction of crops. Some populations in low lying areas will be displaced; this has a range of negative health effects.
• Vector-borne diseases such as malaria affect more people due to expanding mosquito habitats; as will food-borne illnesses.

Reducing Greenhouse Gases in Auckland: Initiatives that benefit health

Section 296, p.103: Urban planning to reduce the need to travel, while simultaneously providing better public transport and cycleways:

6. Urban planning as described in Section 374, p. 25 of ‘Auckland Unleashed’ that increases the density of residences and businesses around town centres and provides job opportunities in the areas where people live reduces the distances people must travel to work. It also means that people are nearer to shops and other services. Reducing vehicle emissions not only lowers greenhouse gases and mitigates climate change, it also benefits health.

7. It is estimated that more than 250 Aucklanders die each year because of air pollution, around twice as many as die in motor vehicle accidents in the region (Fisher et al., 2002; Scoggins, Kjellstrom, Fisher, Connor, & Gimson, 2004). Air pollution affects health in a number of ways:

Respiratory disease

Air pollution increases deaths due to respiratory disease as well as exacerbating symptoms (Kunzli et al., 2000). Exposure to traffic fumes also worsens asthma symptoms (McCreanor et al., 2007) and has been implicated in the development of asthma (Jerrett et al., 2008). Lowering vehicle emissions has also been shown to reduce the severity of asthma attacks in children (Friedman, Powell, Hutwagner, Graham, & Teague, 2001) while moving to cleaner areas has been shown to reduce the decline in lung function that occurs as a result of exposure to air pollution (Downs et al., 2007).

Cardiovascular disease

There is evidence that exposure to high levels of air pollution affects cardiovascular health both short-term and long-term (Brook et al., 2004). Short-term exposure appears to make existing cardiovascular conditions worse, increasing deaths and hospital admissions (Dominici et al., 2006). Long-term exposure increases the risk of developing cardiovascular disease (Miller et al., 2007).

Cancer

It seems likely that exposure to urban air pollution increases the risk of developing lung cancer. Some studies have found that exposure to air pollution increases the risk of developing lung cancer by up to 40% (Nyberg et al., 2000). Vehicle emissions are thought to account for this increased risk (Pope Iii et al., 2002). More recently, air pollution has been associated with a higher risk of developing cervical and brain cancers although more research is needed to determine whether this could be due to factors other than air pollution (Raaschou-Nielsen et al., 2011).

8. Recommendation: That the Auckland Council support urban development that reduces the need to travel. This will result in fewer deaths as a result of respiratory and cardiovascular disease and lung cancer.

9. Cycleways and ease of access to public transport are important considerations for urban development as these reduce the need for car use; making spaces pedestrian-friendly should also be prioritised to encourage cycling and walking as forms of transport. Promoting active transport has a number of health benefits:

Increased physical activity

The benefits of physical activity are extensive and well established and include lowered risk of cardiovascular disease, diabetes and colon cancer, some of the leading causes of death in New Zealand (Ministry of Health, 2011; U. S. Department of Health & Human Services, Centers for Disease Control and Prevention, & National Center for Chronic Disease Prevention and Health Promotion, 1996). Despite this, only 44% of Aucklanders meet the recommended guideline for physical activity (Sport and Recreation New Zealand, 2009). Designing urban environments around the needs of pedestrians and cyclists can make cycling and walking a more attractive option for people and result in higher levels of physical activity (Handy, Boarnet, Ewing, & Killingsworth, 2002).  Even increasing active transport to 5% of distance travelled could have major health benefits (Lindsay, Macmillan, & Woodward, 2011).

Reduced exposure to air pollution

If people use active modes of transport more often it means they travel by car less often. This again decreased vehicle emissions and has the health benefits described in section 7 above.

10. Encouraging more people to walk and cycle could have unforeseen effects. For example, more pedestrians and cyclists could be injured or die in accidents involving motor vehicles. However, the health benefits as a result of higher physical activity levels and reduced air pollution are likely to outweigh the negative impacts of any increase in pedestrian and cyclist injuries (Lindsay et al., 2011).

11. Recommendation: The Auckland Council should prioritise the needs of cyclists and pedestrians in the development of public spaces. This will reduce greenhouse gases and increase physical activity levels, improving health.

References

Brook, R. D., Franklin, B., Cascio, W., Hong, Y., Howard, G., Lipsett, M., et al. (2004). Air Pollution and Cardiovascular Disease. Circulation, 109(21), 2655-2671.

Dominici, F., Peng, R. D., Bell, M. L., Pham, L., McDermott, A., Zeger, S. L., et al. (2006). Fine particulate air pollution and hospital admission for cardiovascular and respiratory diseases. Journal of the American Medical Association, 295(10), 1127-1134.

Downs, S. H., Schindler, C., Liu, L. J. S., Keidel, D., Bayer-Oglesby, L., Brutsche, M. H., et al. (2007). Reduced exposure to PM10 and attenuated age-related decline in lung function. New England Journal of Medicine, 357(23), 2338-2347.

Fisher, G., Rolfe, K. A., Kjellstrom, T., Woodward, A., Hales, S., Sturman, A. P., et al. (2002). Health effects due to motor vehicle air pollution in New Zealand. Wellington: Ministry of Transport.

Friedman, M. S., Powell, K. E., Hutwagner, L., Graham, L. M., & Teague, W. G. (2001). Impact of changes in transportation and commuting behaviors during the 1996 Summer Olympic Games in Atlanta on air quality and childhood asthma. Journal of the American Medical Association, 285(7), 897-905.

Handy, S. L., Boarnet, M. G., Ewing, R., & Killingsworth, R. E. (2002). How the built environment affects physical activity: Views from urban planning. American Journal of Preventive Medicine, 23(2, Supplement 1), 64-73.

Jerrett, M., Shankardass, K., Berhane, K., Gauderman, W. J., Künzli, N., Avol, E., et al. (2008). Traffic-related air pollution and asthma onset in children: A prospective cohort study with individual exposure measurement. Environmental Health Perspectives, 116(10), 1433-1438.

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McCreanor, J., Cullinan, P., Nieuwenhuijsen, M. J., Stewart-Evans, J., Malliarou, E., Jarup, L., et al. (2007). Respiratory effects of exposure to diesel traffic in persons with asthma. New England Journal of Medicine, 357(23), 2348-2358.

Miller, K. A., Siscovick, D. S., Sheppard, L., Shepherd, K., Sullivan, J. H., Anderson, G. L., et al. (2007). Long-term exposure to air pollution and incidence of cardiovascular events in women. New England Journal of Medicine, 356(5), 447-458.

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Nyberg, F., Gustavsson, P., Järup, L., Bellander, T., Berglind, N., Jakobsson, R., et al. (2000). Urban air pollution and lung cancer in Stockholm. Epidemiology, 11(5), 487-495.

Pope Iii, C. A., Burnett, R. T., Thun, M. J., Calle, E. E., Krewski, D., Ito, K., et al. (2002). Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution. Journal of the American Medical Association, 287(9), 1132-1141.

Raaschou-Nielsen, O., Andersen, Z. J., Hvidberg, M., Jensen, S. S., Ketzel, M., Sørensen, M., et al. (2011). Air pollution from traffic and cancer incidence: A Danish cohort study. Environmental Health: A Global Access Science Source, 10(1).

Scoggins, A., Kjellstrom, T., Fisher, G., Connor, J., & Gimson, N. (2004). Spatial analysis of annual air pollution exposure and mortality. Science of The Total Environment, 321(1-3), 71-85.

Sport and Recreation New Zealand. (2009). Sport, Recreation and Physical Activity Profile: Auckland Region 2007/08. Wellington: SPARC.

S. Department of Health & Human Services, Centers for Disease Control and Prevention, & National Center for Chronic Disease Prevention and Health Promotion. (1996). Physical activity and health: a report of the Surgeon General. Atlanta: U. S. Department of Health and Human Services.

World Health Organization. (2009). Protecting Health from Climate Change: Connecting science, policy and people. Geneva: World Health Organization.