Transportation + Healthy Schools

Transportation

Public transportation planning can affect illness and injury in a community in various ways; it can affect one's physical fitness, contribute to environmental pollution emissions and increase one's exposure to air pollution due to traffic pollution. Furthermore, it can also affect traffic accidents. With the example of my community, the modes of public transportation include walking, biking, rideshares, taxis, Cable Cars, San Francisco Municipal Transportation Agency (SFMTA) includes buses and trains that connect to other Bay Area public transits, such as Amtrak, Bay Area Rapid Transit (BART), and Caltrain. Rideshares like Uber and Lyft are the modes of transportation that seem to be dominating the streets of San Francisco as people are trying to get to point A to point B in a matter of time. I was born and raised in San Francisco, and I remembered taking the Muni across the city for a mere price of 35 cents. Given the change in the economy, everything is more expensive now and riding the Muni is now $2.25. I believe public transportation is subsidized for students because some schools or universities offer student discounts. However, I did inquire about the Muni student discount/service at the University of San Francisco, and I was unfortunately denied. The university no longer offers the Muni discount to graduate students due to the lack of students taking advantage of the benefits over the past years. With public transportation, there are also differences in pricing between the general public, students, low-income and the elderly. I am also aware of programs in SF that helps to serve the low-income by providing them with free/discounted public transportation.

Given the topic of urban planning initiatives, I feel like there is always some building or road construction in San Francisco and I do believe they are considered environmental concerns. The city is constantly developing to accommodate and adapt to the ever-changing population. As a nursing professional, I can advocate for this in my community by collaborating with city officials, businesses, agencies, and other healthcare professionals to promote health and safety in the populations that are negatively affected by urban planning. An example would be educating the community of the risks of the "built environment." I think every city could benefit from "green" urban planning especially with the two cities in my area: San Francisco and San Jose. I have noticed the increase of electric standing scooters and hybrid bikes available in the city for rent, which promotes healthy transportation options. As for rural areas, I would work with policymakers, stakeholders, the community, and other agencies to increase access to health services and other resources to protect the health of the population. The Health Impact Assessment (HIA) process can be translated to a population-based nursing action or policy by involving nurses to assess and identify the risks and benefits of urban planning/community design to ensure positive public health outcomes.

The HIA Steps are very similar to the Nursing Process.

• Screening 
• Scoping 
• Assessment
• Recommendations 
• Reporting 
• Monitoring and evaluation 

Healthy Schools

I am not aware of whether the schools in my area have an environmental health team or if the school or community health nurses are involved, but I sure do hope so. This article stated that some schools in Florida do not test for lead levels, which is very concerning for the health of the students and school staff. Some schools claimed to perform "partial testing," which is frustrating. My question is: If they are already doing the test, why not fully complete the testing? I would take action to assess indoor air quality in my local schools by using the "Walkthrough Inspection Checklist" that is provided by the US Environmental Protection Agency that is available through this site. 

From a community health standpoint, I can advocate for air quality standards in local schools by educating school staff, students and parents on ways to improve indoor air quality and identifying some of the health risks associated with bad indoor air quality. I would work with facility managers to ensure healthy and safe environments for students to learn.

President's Cancer Panel: 2008-2009 Annual Report


The statistics for cancer in Americans are devastating, and there needs to be better regulations and policies to protect the health of the public with the help of continued scientific research.

Some important key points taken from the Presidential Cancer Panel include the following:

• The United States can reduce the impact of environmental exposures if the government focuses on the precautionary regulatory approach rather than the reactionary.

• According to the National Institutes of Health (NIH), it is reported that the cost of cancer in the United States was $243.4 billion in 2009. 

"We are not creating a sustainable society in this country if we continue to bring chemicals to market that are almost untested, disseminate them widely in consumer products, and then wait decades to take action only after people have become sick. It’s just not wise." 

- Philip Landrigan, Mount Sinai School of Medicine

• It concerns me that some toxic chemicals are listed as "inactive" ingredients on pesticide labels; however, the chemicals are not required to be tested for the potential health risks it may cause.

• Another piece of information that I find interesting is the amount of radiation exposure that Americans receive from medical imaging. The panel stated, "People who receive multiple scans or other tests that require radiation may accumulate doses equal to or exceeding that of Hiroshima atomic bomb survivors." With that said, I think it is important for medical providers to order imaging when it is deemed medically necessary to reduce further radiation exposure amongst patients. 

• The topic of environmental justice needs to be addressed given that underprivileged populations have higher risks of environmental exposures from their occupations or the locations of residence. 

It is noted that the regulation of environmental contaminants in the U.S. is unsuccessful due to the following five problems:

1) Inadequate funding and insufficient staffing
2) Fragmented and overlapping authorities coupled with uneven and decentralized enforcement
3) Excessive regulatory complexity
4) Weak laws and regulations
5) Undue industry influence.