Department of City and Regional Planning

Drinking water and sanitation services in high-income countries typically bring widespread health and other benefits to their populations. Yet gaps in this essential public health infrastructure persist, driven by structural inequalities, racism, poverty, housing instability, migration, climate change, insufficient continued investment, and poor planning. Although the burden of disease attributable to these gaps is mostly uncharacterised in high-income settings, case studies from marginalised communities and data from targeted studies of microbial and chemical contaminants underscore the need for continued investment to realise the human rights to water and sanitation. Delivering on these rights requires: applying a systems approach to the problems; accessible, disaggregated data; new approaches to service provision that centre communities and groups without consistent access; and actionable policies that recognise safe water and sanitation provision as an obligation of government, regardless of factors such as race, ethnicity, gender, ability to pay, citizenship status, disability, land tenure, or property rights.

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The years 2020-2021 during the COVID-19 pandemic witnessed increases in firearm violence in many cities across the USA. We present data from Sacramento, Stockton, and Richmond, California that suggests firearm homicides during the pandemic did not increase in all communities or disproportionately burden the African American community. More specifically, we found that in these cities, there was a 5-52% decrease in gun homicides during the 2020/2021 period compared to the 2018/2019 period for neighborhoods with a gun violence prevention program operating there. We also found a 24-83% reduction in gun homicides in census tracts with > 20% Black populations in Sacramento and Stockton during the 2020/2021 period compared to the 2018/2019 period. In two cities, there was a 15-42% decrease in the number of African American men under 35 years old that were victims of a gun homicide in 2021 compared to 2018. We also found that the gun violence program operating in these cities called Advance Peace interrupted 202 street-level conflicts where guns were present across the three cities in 2020/2021 compared to 178 of the same conflicts in 2018/2019. These interruptions likely saved hundreds of lives and we estimate contributed to between US $65 and $494 million in savings. Advance Peace is a program that engages those at the center of gun violence, frequently young, Black men under 35 years old, and offers them the Peacemaker Fellowship, an intensive, 18-month program of 24/7 mentorship, social services, and life opportunities. The program is delivered by community resident "credible messengers," who conduct the mentorship and interrupt conflicts in the streets. While these findings are descriptive and preliminary, we know of no other program that was in operation before and during the pandemic in each of these cities that engaged the hard-to-reach but highly influential population at the center of gun violence.

Urban scaling is a framework that describes how city-level characteristics scale with variations in city size. This scoping review mapped the existing evidence on the urban scaling of health outcomes to identify gaps and inform future research. Using a structured search strategy, we identified and reviewed a total of 102 studies, a majority set in high-income countries using diverse city definitions. We found several historical studies that examined the dynamic relationships between city size and mortality occurring during the nineteenth and early twentieth centuries. In more recent years, we documented heterogeneity in the relation between city size and health. Measles and influenza are influenced by city size in conjunction with other factors like geographic proximity, while STIs, HIV, and dengue tend to occur more frequently in larger cities. NCDs showed a heterogeneous pattern that depends on the specific outcome and context. Homicides and other crimes are more common in larger cities, suicides are more common in smaller cities, and traffic-related injuries show a less clear pattern that differs by context and type of injury. Future research should aim to understand the consequences of urban growth on health outcomes in low- and middle-income countries, capitalize on longitudinal designs, systematically adjust for covariates, and examine the implications of using different city definitions.

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Researchers have improved travel demand forecasting methods in recent decades but invested relatively little to understand their accuracy. A major barrier has been the lack of necessary data. We compiled the largest known database of traffic forecast accuracy, composed of forecast traffic, post-opening counts and project attributes for 1291 road projects in the United States and Europe. We compared measured versus forecast traffic and identified the factors associated with accuracy. We found measured traffic is on average 6% lower than forecast volumes, with a mean absolute deviation of 17% from the forecast. Higher volume roads, higher functional classes, shorter time spans, and the use of travel models all improved accuracy. Unemployment rates also affected accuracy-traffic would be 1% greater than forecast on average, rather than 6% lower, if we adjust for higher unemployment during the post-recession years (2008 to 2014). Forecast accuracy was not consistent over time: more recent forecasts were more accurate, and the mean deviation changed direction. Traffic on projects that opened from the 1980s through early 2000s was higher on average than forecast, while traffic on more recent projects was lower on average than forecast. This research provides insight into the degree of confidence that planners and policy makers can expect from traffic forecasts and suggests that we should view forecasts as a range of possible outcomes rather than a single expected outcome.

Supplementary information

Local and regional governments in the U.S. rely increasingly on voter-approved local option sales taxes (LOSTs) to fund transportation capital investments, maintenance, and operations. LOSTs typically present voters with lists of local transportation projects and programs to be funded by a ¼ to 1 percent sales tax increase. Most research on LOSTs are case studies, which make generalizations about LOSTs difficult. We conducted a comprehensive, multi-jurisdictional analysis of LOST measures in California, the U.S. state with the greatest number of LOST measures. We examined 76 LOST measures put to voters between 1976 and 2016 to assess factors associated with voter support. LOSTs in California are enacted by counties, which we examined in addition to smaller intra-county geographies using both regression models and case studies. We tested several explanatory variables for association with voter support including macroeconomic and political context, planned measure expenditures, voter characteristics, and spatial distribution of proposed projects. We found that funding dedicated to public transit and returned to local jurisdictions predicts support at the county level, and that LOSTs that create new taxes—as opposed to extending or renewing existing taxes—are less popular with voters, all else equal. Our analyses of sub-county geographies revealed that political party affiliation is the strongest predictor of local voter support for LOSTs and that voters living adjacent to funded projects tended to be more supportive of LOSTs.

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