Active travel and social justice: Addressing disparities and promoting health equity through a novel approach to Regional Transportation Planning.

Public health impacts of transportation policies and infrastructure investment are becoming better understood, particularly for those associated with physical activity. Yet health impacts are not routinely evaluated within the context of the development of a Regional Transportation Plan (RTP) and subsequent programming and investment processes. This is particularly concerning because the spatial distribution of planned transportation infrastructure potentially has significant health equity implications for vulnerable populations at greater risk of chronic disease. This study discusses the application of the National Public Health Assessment Model (NPHAM) - a new approach that expands several scenario planning tools to include health - for the San Joaquin Council of Governments 2018 RTP. It demonstrates how quantifying health impacts at a finer spatial scale (census block groups) helps assess the extent to which RTP strategies are likely to benefit or harm health. It further enables a spatial form of health equity analysis that can help planners understand where infrastructure is most needed to meet social equity goals. To the knowledge of the authors, this is the first example of a quantified, health equity analysis of transport physical activity and a health outcome - body mass index - associated with an RTP; it demonstrates significant advancement in transportation planning practice and policy.