There can be no question about the transformative power of today’s metropolitan economy.  Major cities around the country hope to ride the wave of the growing financial, research-based, and digital business sectors.  City leaders are doing what they can to make the place attractive to exploding numbers of higher-income young professionals these firms employ as well as the upper-income suburban baby boomers now seeking the convenience and vitality of urban life.   Working within market trends requires skill but has the advantage of moving with the economic current.  In contrast, urban leaders who wish to expand the benefits of economic growth to the entire population have a more limited and challenging set of options.

Public Health has its origins in catastrophe, the realization that if an out-of-the-ordinary pestilence is suddenly sickening large numbers of people there must be a general cause rather than individual failures.  In contrast to Medicine, which traditionally is about treating an individual’s existing disease, Public Health seeks to keep large groups from getting sick.  In contrast even to Preventive Medicine, which tends to focus on increasing compliance with medical prescriptions, Public Health is about wellness and well-being – a holistic concern with an entire population’s overall quality of life.  And in Massachusetts, a national leader across a wide range of Public Health issues, one of the most innovative and powerful strategies to improve population health has been the Mass In Motion program.

Everyone officially puts “safety first.” Everyone wants to prevent accidents. Car crashes are treated as lead stories on TV news – the images are horrific and we all fear our vulnerability. But, in fact, our roads are safer than ever. In 1956, when Interstate construction began, the national fatality rate was 6.05 per 100 million Vehicle Miles Traveled (VMT). By 2011, the fatality rate had dropped to 0.8 per 100 million VMT on the Interstate and 1.1 (the lowest ever recorded) nationwide, even though about 85% of people including those in metro areas, still get to work by car. (Massachusetts has the nation’s lowest fatality rate, 0.62!)

Studies have shown, and the Traffic Engineering Profession has internalized, that highway accidents go down when there are wide lanes, gentle curves, no sight-line obstructing hills, limited entering/exiting locations with long ramps, no visual distractions other than large and uniform directional signage, and the absence of slower or more vulnerable traffic.   The Interstate is safest when it is “error tolerant” and forgiving of driver distraction. (Other contributors along the same lines: slide-resistant pavement, break-away sign and light poles, and better guardrails.

But the reality is that safety lapses aren’t the biggest transportation-related source of injury. In fact, putting too much emphasis on preventing car crashes can make non-highway streets more dangerous – not only for pedestrians and cyclists but also for car occupants! Car accidents cause half as many deaths and several multiples fewer health problems than transportation-caused air, water, and noise pollution.   The amount of paved land in our cities makes us more vulnerable to climate change, rising temperatures, and floods while housing sprawl makes us less resilient in terms of agriculture and disaster-recovery.   Most subtly, life in and around automobiles changes the way we relate to our neighbors and friends, reducing our collective social capital and our individual life style satisfaction.

City after city has found that making their streets safer and friendly for everyone – more walkable, bikeable, transit accessible and “socializable” – makes them more attractive to current and prospective residents and businesses. Not to mention the positive impact on reducing pollution, promoting public health, and dealing with climate change issues. The basic idea of a Complete Street is pretty straightforward: a travel corridor that has specific infrastructure for all modes including cars, bikes, foot, and (if present) buses, trucks, and trolleys. (Although having a multi-use – bike and walk – path alongside a railroad track is now allowed in Massachusetts, this combination is beyond the scope of most Complete Streets policies.)

City after city has found that making their streets safer and friendly for everyone – more walkable, bikeable, transit accessible and “socializable” – makes them more attractive to current and prospective residents and businesses. Not to mention the positive impact on reducing pollution, promoting public health, and dealing with climate change issues. The basic idea of a Complete Street is pretty straightforward: a travel corridor that has specific infrastructure for all modes including cars, bikes, foot, and (if present) buses, trucks, and trolleys. (Although having a multi-use – bike and walk – path alongside a railroad track is now allowed in Massachusetts, this combination is beyond the scope of most Complete Streets policies.)

Every year I am part of a group that does a one-day ride from Boston to Provincetown, about 146 miles. We’ve done it in blazing heat and nor’easter rainstorms – that was the year we later realized that each of us was secretly hoping our bike would fail so we’d have an excuse to drop out and go home. But we support each other and always make it. Of course, we end up exhausted. But we’ve learned that stopping every 15 or so miles for a snack and rest allows everyone to pull through. It’s always a great adventure and earns us great story-telling rights for months afterwards.

It’s bad enough that rain-water run-off from our streets takes oil-derived toxins, metal and synthetic dust into our soil then into our groundwater and rivers.   But it also turns out that human-injected poisons seep up from below our roads, destroying plant life, killing soil, and creating explosive danger on the surface as well. The volatile poison is natural gas.  And local groups are just beginning to measure its unwanted presence.

So long as it stays in the mind-bogglingly large network of gas pipelines running down almost all our streets to business and residential locations, natural gas is a much better fuel than coal or oil or gasoline. But it’s a dangerous amendment to the soil and the air above it if it leaks out. And it is leaking – a lot, as we’re just beginning to discover. There are more than 3,300 natural gas leaks in Boston and at least 20,000 across the state, releasing between eight and twelve billion cubic feet of natural gas each year.

Boston Public Health Commissioner, Barbara Ferrer, says that while Boston has many Public Health needs, the three biggest challenges facing the city are reducing violence, making a positive health impact an explicit goal of every policy in every department, and using the new provisions of the Patient Protection and Affordable Care Act to get hospitals and other health-care providers to do more about prevention.

MassDOT’s recently issued Healthy Transportation Policy Directive could actualize the most profound transformation in the state’s transportation system since the anti-highway movement convinced Governor Frank Sargent to cancel the massive Inner Belt project (the first time any state had done this) and his Transportation Secretary, Alan Altshuler, got the state’s Congressional delegation to pass legislation allowing Highway Fund money to be used for mass transit.   If carried through, it will push Massachusetts to the front of national efforts to modernize our transportation infrastructure.

Movement building requires organizing activities and programs that have inherent value and meet people’s immediate needs while also raising their awareness of the importance of larger reforms and putting pressure on relevant officials and power brokers to implement those changes.   It’s a tricky combination to achieve.  Providing free breakfast to low-income kids, for example, makes access to good nutrition more affordably available but doesn’t necessarily force the commercial food system to change.

In recent years, enthusiasm for Open Streets programs has spread among progressive transportation, community renewal, and other advocates wanting to change the way cities use their largest physical asset, the space normally devoted to car traffic and parking.  The excitement has its roots in the CicloVia program started nearly 40 years ago in Bogota, Columbia, where over two million people, nearly a third of the city population, come out for a few hours every weekend to play, exercise, do yoga, dance, walk, run, bicycle, enjoy endless vendor offerings, and simply hang out with each other along nearly 76 miles of car-free roads. (The roads aren’t “closed to cars”, they are “open for people”!)   Open Streets are now held around the globe including at least 90 US cities.