NR_552 Week 2 Discussion, Policies for Public Good

Policies for Public Good NAME Chamberlain College of Nursing NR 552: Economics of Healthcare Policy Poirier DATE What environmental changes have employers or city planners in your area made to promote a healthy lifestyle for employees or citizens? What are the expected health and economic outcomes of these environmental changes? Week 2: Environment and Healthy Lifestyle Experts believe the built environment in which we live is a key barrier, or facilitator, to being physically active. According to Benton, Anderson, Hunter & French the built environment, refers to physical structures of the environment that have been constructed or modified by people (2016). This includes homes, buildings, open spaces, streets, bicycle lanes, parks/recreation, and trails. Built environments impact indoor and outdoor physical environments as well as social environments, thus affecting the health and quality of life of the community. Therefore, the public health community is refocusing on ways to create built environments that are optimal for human health. Since 2015, Cleveland’s elected officials, the Ohio Department of Transportation (ODOT), and Cleveland’s City Planning Commission have undertaken innovative bike lane projects to encourage safety between cars and bicycles. As of 2016, Cleveland has roughly 76 miles of bike infrastructure with more planned for the future. Since the implementation of bicycle infrastructure into the cities roadways, the League of American Bicyclists recognized Cleveland as a Bronze level Bicycle Friendly Community (BFC). The Bronze BFC award highlights the cities commitment to improving conditions for bicycling through investment in bicycling promotion, education programs, infrastructure and pro-bicycling policies. Opportunity Corridor is a three-mile planned, 35-mile boulevard that will run from Cleveland’s Innerbelt in the inner city to University Circle, a community of innovation in healthcare, education, and arts & culture (Greater Cleveland Partnership, n.d.). Opportunity Corridor is a transportation project to improve access to the jobs, education, and culture located in University Circle, thus improving the quality of life and the local environment. In the spring of 2015, Bike Cleveland, Cleveland’s leading advocacy group for cyclists, submitted a formal request to the Ohio Department of Transportation to include a protected bike lane in the design for Opportunity Corridor (Litt, 2015). The project would take five years and $331 million to redesign the roadway to accommodate a bike lane on the south side of the roadway, separated from pedestrians (Litt, 2015). The design called for building a 10-foot, two-way bike path next to a four-foot-wide pedestrian walkway. Eight-foot-wide tree lawns would separate the two pathways from the travel lanes for vehicles. In 2017, the Northeast Ohio Areawide Coordinating Agency (NOACA) allocated $8.3 million for the construction of protected bike lanes planned for 2020. The lanes would extend 2.5 miles from downtown Cleveland to Cleveland’s inner city (Litt, 2017). NOACA also allocated $6.1 million for the construction of the proposed Lorain Avenue Cycle Track, on Cleveland’s West side by the year 2022. The health and environmental benefits of increased ridership are clear and numerous. Adding bike lanes to motor vehicle roadways reduces the risk of injury, raises the probability of ridership, and increases physical activity. Safe bike lanes also tend to lower the number of vehicles on the roads, which helps to stop global warming by providing a real, healthy option to help reduce greenhouse gas emissions. In addition to health and environmental benefits, bike lanes can also stimulate the economy. Bicycling investments are a cost-effective way to build infrastructure and create jobs. The Garrett-Peltier found that bicycle infrastructure projects create approximately eight jobs per $1 million in spending (2010). These jobs include architecture and engineering industries, concrete manufacturing and sign manufacturing, as well as indirect jobs in retail, healthcare, and food services (Garrett-Peltier, 2010). Research has found that bike lanes actually may increase sales for businesses they pass by. Investing in bicycling infrastructure can enhance shopping districts and communities, generate tourism, and support local business. Money spending means tax revenue for communities. The benefits add up. Reference Benton, J. S., Anderson, J., Hunter, R. F., & French, D. P. (2016). The effect of changing the built environment on physical activity: a quantitative review of the risk of bias in natural experiments. International Journal Of Behavioral Nutrition & Physical Activity, 131-18. doi:10.1186/s Greater Cleveland Partnership. (n.d.). Opportunity Corridor. Retrieved from Litt, S. (2017, December 8). NOACA boosts protected bike lane projects in Cleveland with spending package. The Plain Dealer. Retrieved from Litt, S. (2015, April 27). ODOT likes city's new concept for protected bike lane alongside Opportunity Corridor. The Plain Dealer. Retrieved from Garrett-Peltier, H. (2010). Estimating the Employment Impacts of Pedestrian, Bicycle, and Road Infrastructure. Retrieved from PROFESSOR RESPONSE TO POST: Thank you, Carole. It is refreshing to see communities implement strategies to address safety and increasing physical activity. I wonder if there could be other incentives to encourage people to take a bike to work? RESPONSE TO PROFESSOR POST: Dr. Poirier According to the League of American Bicyclists the number of people who bike to work increased by 51% from 2000 to 2016 (2016). I discovered that Cleveland, OH had a 68% increase from 2011 to 2016 in bicycle commuters and we rank 3rd as one of the largest cities where bike commuting is growing the fastest (League of American Bicyclist, 2016). With further research, I learned about the Bicycle Commuter Tax Benefit. On December 22, 2017, the President signed into law the Tax Cuts and Jobs Act and with this enactment, revisions were made to the Qualified Transportation Fringe Benefits. Previously, employers were allowed a deduction for the cost of qualified transportation fringe benefits provided to employees, including bike commuting. Under the newly-passed tax reform bill, employers may provide tax-free qualified transportation fringe benefits to employees for parking, transit and commuter highway vehicles, but the employer cannot deduct the expenses for providing tax-free qualified transportation fringe benefits (National Center for Transit Research, 2018). As of 2018, the only possible tax benefit of the Bicycle Commuter Tax Benefit is the deduction for costs associated with the benefit, which can be claimed by an employer. Any reimbursement given to employees under a Bicycle Commuter Tax Benefit program is taxable as income to the employee. The provisions of the Tax Cut and Jobs Act related to the Bicycle Commuter Tax Benefit expire in 2026 (National Center for Transit Research, 2018). Some U.S. based corporations offer monetary incentives such as Honest Tea, headquartered in Bethesda, MD, offers its employees that bike or walk to work an extra $27.50 in their monthly paychecks (Mazzoni, 2014). Patagonia, headquartered in Canada and the U.S, has a Drive-Less program that pays its employees to walk, bike, carpool or use public transportation to work. Patagonia pays its employees $2 per trip, up to two trips per day, earning up to $500 (pre-tax) per year (Mazzoni, 2014). Lastly, the Clif bar company located in Emeryville, CA, Sustainability Benefits Program includes an incentive of up to $500 to purchase or repair a daily commuter bike and employees who walk, bike, or take public transportation to work can also earn points redeemable for rewards like cash, massages, or Clif gear (Mazzoni, 2014). Reference League of American Bicyclist. (2016). Where we ride: An analysis of bicycle commuting in American cities. Retrieved on July 17, 2018, from Mazzoni, M. (2014, May 9). 3p Weekend: Top 5 corporate bike-to-work incentives in the U.S. Retrieved on July 17, 2018, from National Center for Transit Research. (2018, January 18). Commuter tax benefits. Retrieved on July 17, 2018, from RESPONSE TO PEER POST: Linda, Thank you for an informative post regarding workplace environment and wellness programs. I agree that an employee's workplace environment is a key determinant of the quality of their work and their level of productivity. Employees working in an unsafe and unhealthy environment are prone to occupational disease and it impacts on employee’s performance. Creating a work environment in which employees are productive is essential to increased profits for any organization or business. According to the U.S. Centers for Medicare & Medicaid Services wellness programs, “allow your employer or plan to offer you premium discounts, cash rewards, gym memberships, and other incentives to participate. Some examples of wellness programs include programs to help you stop smoking, diabetes management programs, weight loss programs, and preventative health screenings” (n.d.). Aside from the financial benefits of implementing wellness programs, other aspects of the work environment that show improvement include workplace culture, team collaboration, mental health stability or less burnout, and productivity. At the Cleveland Clinic, the Healthy Choice program is a discount program run by our Employee Health Plan (EHP). The program rewards employees with a discount, up to 30 percent off, on their health insurance each year for taking action to manage your health. There are five different levels of discounts: Bronze, Silver, Gold, Platinum, and Diamond. • Bronze is the base health plan cost, meaning the person did not fulfill any of their personal program requirements. • Diamond is the biggest discount (30 percent off), meaning the person and their spouse, if he or she is on the plan, fulfilled all program requirements. • The levels in between are when the person and their spouse fulfill some but not all program requirements The purpose of the program is to encourage employees to make healthy lifestyle choices to improve their wellbeing, thus making it less expensive to insure EHP members when compared to the national average. Reference U.S. Centers for Medicare & Medicaid Services. (n.d.). Wellness programs. Retrieved from