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San Francisco's Vision Zero SF Injury Prevention Research (VZIPR) Collaborative

San Francisco's Vision Zero SF Injury Prevention Research (VZIPR) Collaborative is a coordinated effort between epidemiologists, trauma surgeons, nurses, geospatial analysts and other key staff from the San Francisco Department of Public Health's Program on Health, Equity and Sustainability (SFDPH-PHES) and Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG). ZSFG is the City's only Level I Trauma Center and so caters to almost all the serious injuries that occur in San Francisco. VZIPR has been working since 2014 to develop, institutionalize and utilize comprehensive injury data in support of strategic research and analyses for Vision Zero SF – San Francisco's policy and commitment to eliminate traffic deaths on city streets. SFDPH-PHES Director Megan Wier co-chairs San Francisco's Vision Zero Task Force with the San Francisco Municipal Transportation Agency.

 

VZIPR's efforts have resulted in a comprehensive Transportation-related Injury Surveillance System (TISS) linking hospital, police, emergency response and other data for more accurate, coordinated and timely monitoring of transportation-related injuries and deaths. In turn, these data support safety project prioritization, evaluation and monitoring. A pilot of the system linking 2013-2015 data was completed in early 2017 and is now being utilized to inform targeted Vision Zero efforts. San Francisco was the first city in the country to use the linked and mapped data to update its Vision Zero High Injury Network in 2017. The network identifies high injury corridors - the 13% of city streets where 75% of severe and fatal injuries are concentrated - where targeted Vision Zero investments can help save lives and reduce severe injuries. SFDPH-PHES has summarized the work in a detailed technical methodology.

VZIPR analyses also leverage TransBASESF.org, an innovative relational database management system developed and designed by SFDPH-PHES to access, manage, and apply spatial data to inform solutions to transportation problems. TransBASESF.org is a key source of data inputs into Vision Zero SF and VZIPR analyses. The TransBASESF.org beta was also the key data input to WalkFirst, San Francisco's award-winning, data-driven approach to pedestrian safety capital planning investments.

VZIPR works closely with City agencies and community stakeholders to identify and address emerging research needs in support of Vision Zero SF. Recent projects by VZIPR include an analysis of injuries to seniors and people with disabilities that is helping inform proactive injury improvements for those vulnerable populations; an analysis of the medical costs of transportation-related injury in San Francisco currently under peer review; and a predictive model of cyclist injuries at intersections, developed using machine learning and regression techniques, also under peer review. Current VZIPR efforts to implement data systems to better track injuries from emerging mobility modes – such as powered scooters – were covered by the New York Times in August 2018.

 

Vision Zero Fatality Protocol and Tracking

PHES staff worked with transportation agency and police department staff to create a citywide protocol to monitor traffic deaths, which are tracked and reported on a monthly basis.

 

Transit Equity: Addressing Barriers to Health Care Access for Vulnerable Populations

Land use and transportation planning are integral elements to providing equitable health care access. Access to health care services is associated with better overall health, higher use of preventative health services, lower rates of preventable hospitalizations, and overall health care costs. Lack of transportation is a leading barrier to access, and disproportionately burdens the poor, people of color, and those with disabilities. Addressing and removing transportation and geographic barriers can improve access to health services, improve health outcomes, and reduce health disparities.

 

The Potrero Hill Health Center (PHHC) is a safety-net clinic in San Francisco that was initially built to serve the nearby public housing developments and now serves patients from across the city. However, patients face multiple barriers in accessing health care services at PHHC, because patients are traveling farther distances to the clinic, there is steep terrain surrounding the clinic and the bus line re-routing in 2009 eliminated some stops so patients needed to walk further to catch a bus.

 

SFDPH and PHHC staff conducted an assessment to better understand the transportation and geographic barriers PHHC patients face, how these barriers affect their access to health care services, and what their potential health impacts are. Staff then worked with SFMTA to identify and implement solutions to address those issues, including increased coordination to ensure patient access to paratransit services to get to and from the clinic. In 2018, this work was featured as a part of the Centers for Disease Control and Prevention's case studies of Public Health Innovators working at the intersection of Health and Public Transportation that have the potential to improve health in five years.