Transportation Wellness Task Force

When we made the case for an active transportation policy to the UC Regents Health Services Committee, there was no opportunity for a dialogue. That is why we are very grateful that UCLA Health offered us the opportunity for such a dialogue. UCLA Health already has a No Smoking Policy, it serves antibiotic free meat, and it has recently been named LGBTQ Healthcare Equality Leader. Perhaps our medical provider should also consider its role in the (healthy or not) transport choices its staff and patients are making every day? What would President Johnese Spisso, Richard Azar (General Services), and Joe Earnest (Media Relations) think?

We very much looked forward to this meeting. The lack of conversation over many years leads to a great deal of urgency: The more you have the conversation only in your own head, the more you are disappointed about the lack of results.

"These are all good ideas." "You will not find many doctors who would oppose such initiatives." But is there a constituency that could move things ahead? "Perhaps we could look into a certification as a bicycle friendly employer." "The staircases are really difficult because of building standards and fire regulations." "The leases which govern parking cash out and bike parking improvements come from UCOP, the Office of the President." "Perhaps we could do some bike commuter courses for staff, or something in the Vital Signs magazine." I like the idea of a UCLA Health branded bike rack said the President, perhaps we can do it like a wrap, and we shook hands on that (Full list here). In the end, it is about an institutional attitude, and that needs time. But health impacts and climate impacts don't wait for us to make up our minds. Urgency? And how!

Thirty minutes with the leadership of a national "Best in the West" health care institution is one big deal. We recognize this and we appreciate it. On the other hand, the institution has no plan how to increase cycling among staff and clients, it has no plan how to improve bicycle facilities at all its locations, it does not assess the health effects of all this driving. UCLA Health has a community relations department, but it does not get involved in local planning discussions, does not remind Caltrans and METRO that the I-405 widening has discouraged more people to ride a bike to UCLA Health destinations. It is mum about a the slow death of a Great Streets Initiative for Westwood Blvd that would have included a much needed bikelane to our Medical Plaza, torpedoed by homeowners in Holby Hills and LA city council-member Paul Koretz. But a health system that prides itself on its local connection - "See you in the Neighborhood" - can ill afford to remain quiet when neighborhoods fail to safely accommodate the modes of transport doctors recommend most often.

Supporting healthy and sustainable modes is not about privileges for a few determined and reckless bike riders: It is about inviting the entire community to consider that car-centric policies and organizations have made us unwell. And that a health provider must not unwittingly lend support to the false notion that everybody drives in LA. A first class health system at a world class university should really be a leader on the bike-path towards healthy communities. It would be good to establish a formal forum in which active transportation advocates and public health experts can help the UCLA Health to address the unhealthy car bias of the organization. We would call it the Transportation Wellness Task Force.

Transportation Wellness Task Force.
(Draft Remit) 
The purpose of the task force is enhance transportation wellness for staff, patients and the communities where UCLA Health operates. It provides a comprehensive perspective on the health implications of transport choices - for the individual, the enterprise and for the community.

The purpose of the task force is

• to integrate the public health research into the daily practice of a large medical institution
• to provide recommendations to the leadership for programs and investments which improve transportation wellness for staff, patients and the community
• to identify facilities improvements that would encourage more to use healthy modes
• to identify areas where improved messaging can increase the visibility and attractiveness of healthy modes
• to identify perverse incentives and address their impact on transport choices
• to share its recommendations with related institutions in the UC Health system 
• to pursue certification of these efforts and to educate the public 
• to support the collection of trip data for staff and patients for scholarly analysis, including a quantitative study the health benefits delivered over a longer period, to engage campus expertise from urban planning and public health, and to contribute to a discussion of transportation wellness in the academic community
• to make its insights available in the context of local and regional transport planning, and to provide community facilitation to increase availability of healthy options in the communities where UCLA Health operates 

The members of the task force represent the following areas of expertise:

• Public health 
• Population health, diabetes prevention 
• UCLA Transportation Planning
• UCLA Health - Marketing 
• UCLA Health - Sustainability
• UCLA Health - Community Relations 

Two members of the committee use a bicycle for their commute. The task force produces an annual report.

The following have supported the establishment of such a task force:

Bicycle Academy Meets UCLA Health

In preparation for a meeting with UCLA Health leadership (Johnese Spisso, Richard Azar, Nancy Jensen) we have put some words to paper to remind everybody of the larger picture: How active transportation and health in our communities belong together. And how our Health System should educate itself, and the community, about the impacts of too much driving and too little walking and cycling.

It is not  itemized agenda for a meeting. I'd call it the necessary background music for an attempt to find a path forward to help our Health System to recognize how active modes should become a part of its healing mission. We wanted to recap the large issues on paper so that in the meeting itself we can focus on the specific steps the organisation can take to move beyond the car bias which is still so well entrenched in our region. It is time to recognize the negative health impacts of such a bias and to reap the large health benefits which happen when active modes are properly supported. In the meeting we want to focus on small steps, measurable outcomes, specific projects, clear directions, both for staff and for patients. All this is complex enough, because it involves so many parts of a large organisation: Facilities, medical expertise, marketing, community relations.

But make no mistake about it, when a health system wants to change its attitude towards active modes, it will take some decisive leadership for the organisation to make the changes that are needed. Changes that will make sure that UCLA Health remains at the forefront of medical progress and community health impacts.

If you want to participate in this discussion, have suggestions for low hanging fruits that could be part of this program, or want to support our effort, please get in touch!

More Healthy Cycling? Meet the Regents!

It is really easy

Tuesday February 6, 2018. The Regents Health Services Committee is meeting at UCLA. The time: 12:15 pm in the new Luskin Conference Center (agenda). This is a sub-committee of the UC Regents tasked to guide the UC Health system. During public comment, the Bicycle Academy will highlight the need for our state-wide health provider to address its automotive bias and to assert more clearly, in actions and in words, that cycling is good for you. We no longer can afford to ignore what public health experts are teaching us about the health benefits of active transportation. Please join us for this event, and share how you want this health system to improve its attitude towards active modes of transport. 

We will remind the Regents and the experts present that a bicycle friendly health system 

1. offers significant financial benefits because for a self-insured employer a healthier workforce means real savings
2. offers a low cost yet highly effective way to improve population health, well-being and disease prevention in the community

We will also remind the Regents and the experts 

1. that in spite of wide-spread anxieties about bicycle use, obesity and its attendant co-morbidities are a far bigger public health hazard than cycling injuries
2. that the lack of active living options is responsible for a large part of our fast growing health expenditure
3. that guidance from the highest level of the organisation is required, comparable to the surgeon generals warning about smoking, 
4. that the established division between transport planning and health policies effectively prevents accessing the multiple benefits (health, sustainability, community) of the medical device with two wheels
5. that other health systems (NHS, Canada) have developed guidance that requires medical offices and hospitals to prioritize active modes, and to collaborate with local authorities to achieve a street network that can safely accommodate active modes
6. that the League of American Bicyclists offers a program that can certify a Hospital as a Bicycle Friendly Business
7. that there is a large unmet demand for CDC accredited Diabetes Prevention Programs with an emphasis on safe and confident cycling, or similar "Cycling on Prescription" programs
8. that this innovative program is very much of the Golden State, that it should be spearheaded by an academic health center, and that it should be initiated right here, on the most healthy campus of the system (etc)

We will ask the Regents to adopt motion to convene a working group of UC Health, UC Sustainability and UC Marketing and bicycle experts or advocacy groups, to design a UC branded bicycle rack that would serve to assert and advertise UC Health's support for active modes. Once a health system manages to put its logo on a bike rack, great things happen.

Did it ever occur to you how weird it is that your medical office offers plenty of car parking, and nothing for bikes? Were you ever looking for a staircase in a medical office but only found the elevator? Did you ever feel your doctor should assert more firmly the health benefits of active transportation? Then the Regents committee should hear from you. 

Our proposal has already received a good amount of support. Regent Lansing, the chair of the committee, has expressed interest. Dr Stobo, Executive Vice President of UC Health, expressed interest in the financial savings that a healthier workforce would mean for UC as a self-insured employer. He did not object to the proposal to share this with the regents and the experts. Even the good folks from AARP, who have shown great leadership in healthy transport issues, expressed support. This committee is a sympathetic and powerful forum. Because we are looking for an explicit medical acknowledgement of the benefits of active modes, the issue exceeds the level of facilities management and requires an rarely seen level of collaboration between health policy and transport planning at the highest level. We hope that the Regents can establish some guidance for the entire UC Health system to recognize the bicycle as a cheap and effective medical device. A medical office without bicycle parking really does send the wrong message. And a location webpage with advertises valet parking for cars, but is quiet about walking, cycling and transit routes, should not be difficult to remedy, once the regents have given the necessary guidance. 

We hope to see you on Tuesday. A few more talking points are here.

Update: Public comment has been recorded and is available here https://youtu.be/BdT5KkY5ZJk?t=140

UCLA Athletes as bicycle advocates

This is an invitation for UCLA Athletes to join us for the meeting of the UC Regents Health Services Committee at UCLA on the 6th of February 2018. The meeting of Bruins, of Athletes and the Health System, is a meeting of giants. Because UCLA is really about our athletes, and about the campus health business. Five hospitals and 160 medical offices throughout LA county, the budget of UCLA Health actually exceeds that of the rest of the campus, that little world-class university we also call UCLA.

Driving to UCLA

Remember how much our best athletes love the bicycle. Of course they would love to see more people cycling. A few images to do the talking:

Bill Walton jumped on his bicycle to get that famous haircut in Westwood

Bill Walton next to his sculpture with bicycle

Kareem Abdul Jabbar

Kareem as Grand Marshall for the 1979 Bike-a-Thon, Marina del Rey

And, yes, the wooden Bike, aka "The Coach" (?)

So when the UC Regents Health Services Committee meets at UCLA on the 6th of February 2018, this is a great opportunity to remind them that our athletes are watching how they bring this great tradition of cycling to all the medical establishments the UC system provides throughout California. Because a medical office or a hospital should be optimized for healthy modes of getting around, modes that are healthy for our bodies and healthy for our environment. 

And if you don't quite know what to say to the Regents, here is some language that may come in handy

We applaud the sustainability effort underway for the UC Health system, which is led by Paul Watkins of the UCLA Medical Center in Santa Monica. But the bicycle has not yet received the attention it naturally deserves in a medical context. Bicycles are wonderfully effective in preventing disease, improving health and achieving sustainability in our communities. A comprehensive program which includes staff, patients, but also negotiations with local agencies in charge of transport planning, is beyond the scope of the current effort. A broader initiative is urgently needed to reap the manifold benefits an increase in active transportation will bring. Its natural starting point are the UC Health campus locations and countless UC branded medical offices throughout California. In our vision UC Health is committed to improve its communities, creating instances of bicycle perfection in a geography that urgently needs more of them.

Given a broad body of scientific evidence, the Executive Vice President of UC Health should issue a declaration about the medical benefits of active transportation. Such policy guidance would lead the way for UC Health to become a more bicycle perfect institution throughout the state. The design of a UC Health branded bicycle rack, complete with a health related message, may be a suitable first step to assert and market this insight.

Public health experts tell us that automobilitis and the lack of physical activity account for a large proportion of poor health in our communities. Now is the time for UC Health to devote resources to liberate our communities from our sickening addiction to cars. An academic health center is a natural leader for such a broad effort. The state of California is the right place for this. This committee can make this happen. 

We support the proposal developed by the UCLA Bicycle Academy that lists a number of concrete steps through which a culture of health and sustainability can be generated. For those who have grown up to believe that the car is the only safe place on our roads, this proposal may seem scandalous. But the true scandal would be a UC Health system that fails to decisively support and encourage active transportation.

(See also: https://bicycleacademy.blogspot.com/2018/01/the-abc-123-of-bicycle-friendly-health.html)

The ABC 123 of a Bicycle Friendly Health System

Some steps towards a UC Health system that decisively supports and encourages active transportation.

• A design-guide for a UC Health branded bike rack in collaboration with UC marketing (color, design, health message on rack, placement according to APBP) 
• Review and improve access and attractiveness of staircases for all premises
• Evaluate the financial benefit for UC as a self-insured employer if more employees use active modes for their commute
• Pay staff  who commute by bike 10 cents for every mile cycled
• Normalize cycling and transit options on all "directions and parking" webpages which consistently assume that everybody drives 
• Create media opportunities for UC Leadership to be shown with a bicycle
• Evaluate improved productivity and work satisfaction if more staff uses active modes for the commute
• Conduct an annual Blessing of the Bicycles ceremony 
• Apply for certification as Bicycle Friendly Business through the League of American Bicyclists (Precedent: Seattle Childrens Hospital, etc)
• Offer CDC accredited Diabetes Prevention Programs which emphasize safe and confident cycling education
• Encourage development of "Cycling on Prescription" programs
• Develop a Public Service Announcement Campaign: "Surgeon General's Warning: Driving causes Obesity and Diabetes, Start Cycling now to Greatly Reduces Serious Risks to Your Health." (Preecedent: Cyclists are always Fragile campaign by the American Academy of Orthopaedic Surgeons
• Create the position of a Sustainable Transport Improver at each medical campus
• Engage with local agencies to improve transportation infrastructure for active modes in the communities were UC Health operates. Bring the voice of medical experts to the planning process
• Offer and advertise free bicycle valet parking at all locations that provide valet parking for cars
• Ensure that Capital Programs reviews all current and new off-campus premises for active transportation improvements

Because these interventions touch many different parts of the organisation, this proposals requires strong leadership.