"I don't know anybody who grew up saying, 'I want to be a transportation advocate,'" says Kim Irwin. For the past five years, Irwin has been one of the city's most outspoken public health champions. As director of Health by Design, an initiative of the Alliance For Health Promotion, a nonprofit coalition with offices along the Canal Walk downtown, Irwin has found herself enmeshed in ongoing discussions about mass transit because of its demonstrable impact on public health.
Growing up in Kendallville, outside Ft. Wayne, Irwin dreamt of being a doctor. But after completing her undergraduate studies at Northwestern University she eventually decided to study public health at IUPUI.
Irwin's experience at Northwestern was formative. There was no public transportation to speak of in Kendallville, so learning to find her way around Chicagoland, via bus and elevated train, was a new experience. "It was how we got around," she says today. "I loved it."
Before enrolling in grad school, Irwin worked in the long-term care field, where she was able to see firsthand how transportation options - or the lack of them - affect the lives of older citizens. She also lived in Denver when that city inaugurated its light rail system. She began to see the various ways infrastructure, our streets, sidewalks, housing and the ways we plan our communities relate to health.
"We know that where people live, what your ZIP code is, is one of the best predictors of your life expectancy," Irwin says. She wants to help create environments where the barriers to healthy decision-making are reduced. While Irwin allows that some people find this approach Big Brother-like, "the reality is the way our world has evolved and the way most places exist, healthy choices can be impossible, let alone difficult to find."
This is particularly true when it comes to getting around the Indianapolis metro area. Indy has a notoriously underfunded bus system, IndyGo, for a community its size. IndyGo has proven itself to be inadequate in getting most people to and from work, or to such essential stops as grocery stores and health care providers. Irwin argues that public transit isn't just another urban amenity. It is actually a public health essential that must be addressed in a systemic way.
"For decades, in public health, we have thought that having information and education changes behavior. If we tell people they should eat fruits and vegetables, they will do that. For a certain percentage of the population that works. But for the vast majority of people, it's not that simple. So the idea that we can shoot information at people and think that's going to lead to a healthy lifestyle, when we're not backing it up with environments that are supportive and policy systems that support healthy behavior, makes it very hard."
Public health advocates like Irwin find themselves talking not just to members of the public, but to the elected politicians who are responsible for creating policies and making laws. Politicians whose votes, in other words, govern how our environment is designed. Now the issue is not just a matter of scolding people to eat their greens, but debating the role of government in a supposedly free society.
"We always tend to default to the argument that it's a free country and choice," says Irwin. "But the reality is that what we have gotten, whether by intention or through default, is limited choice. We do not have good choices in this community for transportation. We just don't. We are very auto-dependent."
A free society, argues Irwin, should be one where people have an abundance of choices - to drive their cars, or take the bus, ride a bike, or, whenever possible, walk, in order to get wherever they need to go.
"Nobody's trying to take cars away by putting more transit on the roads. I'm going to still have a car, just like most people in this community. But someone like me would say there is a tremendous cost to public health, to the environment, that comes with auto emissions. There are calculations that tell us what that is. ... We don't pay for the real cost of driving our cars when we drive them. That's an externalized cost that other people and future generations will bear."
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