Horizontal/Subsurface Infrastructure & Transportation

"Bridges and roads as important to your health as what's in your medicine cabinet [1]

Improving infrastructure - bridges, highways and water systems, for example - also improves health care, according to University at Buffalo faculty member Korydon Smith, Professor of architecture and associate director, Community for Global Health Equity

 Two seemingly unrelated national policy debates are afoot, and we can't adequately address one unless we address the other.

     Health care reform has been the hottest topic. What to do about America's aging infrastructure has been less animated but may be more pressing.

Yet even as cracks in America's health system and infrastructure expand, political divides between parties and within parties have stalled efforts to develop policies and implement solutions. Problematically, debates over health care reform and infrastructure projects remain separate.

     As a professor of architecture who also studies health equity - the establishment of systems, laws and environments that promote fair access to health care - I believe we have reason to be concerned.

     What if a solution to bridging both the political and sectoral divides between health care and infrastructure was, literally, a bridge? Sure, bridges are core elements of infrastructure, but what do bridges have to do with health care?

     As it turns out, a lot."

 Some Gentle Suggestions:

1. Read Professor Smith's entire article.
2. Discuss Professor's thoughts with those outside of your discipline.
3. Share your opinions and suggestions.

 Thank you for reading and considering these issues.

 Cheers.

 

[1] Source: http://www.buffalo.edu/ubnow/stories/2017/08/smith-infrastructure.html downloaded 02AUG2017

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William Hayden Ph.D., P.E., CP, F.ASCE
Amherst NY

"It is never too late to be what you might have been." -- George Eliot 1819 - 1880
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The RI Section hosted a guest speaker from Bridges to Prosperity, a charity that does precisely what the article describes in developing countries.  If your section would like to host this group, please send me a message.  The premise of the article is 100% correct, but is it true in the developed parts of the USA?

There is so much that I can write about healthcare and infrastructure in the state of Rhode Island.

Infrastructure in RI is poor.  The state is moving forward with plans to toll trucks on the interstate.  The state is being used as a guinea pig by the federal government.  Truckers pay enough fees and taxes already and it is not fair to make the regulations more complicated.  Truckers will either bypass the whole state or pass the cost on to consumers.  The truckers are planning to challenge the tolls in court.  Once that happens, the tolls will either remain in place, torn down, or the toll will be applied to cars, as well.  As engineers we know the trucks cause the most damage, but it is the volume of cars that are responsible for congestion.  Overall the state supports infrastructure improvements, but relies on federal funds.  So will additional funding and improvements help healthcare in the state?  No.  

What difficulties do Rhode Islanders face in finding good healthcare?  There are only 2 insurance companies available in the marketplace.    Trump needs to keep his campaign promise to allow insurance companies to cross borders and increase competition. This would allow patients options in selecting services out of state.  

Hospitals are consolidating and being bought-out by outsiders, leading to a reduction of services offered.

Memorial Hospital merger legislation signed into law  

RI Hospital, Women & Infants clash over proposed new maternity ward 

Westerly Hospital partnership with Yale gets R.I. fast-track approval 

We are a small state, but Westerly is one hour from Providence.  No amount of infrastructure and solve these issues.  Insurance companies are not providing adequate coverage.  Hospitals are seemingly not getting paid or are guilty of monopolistic practices.  Local hospitals seem to be struggling.  Would you rather be treated 5 minutes away or travel in an ambulance 45 minutes to get the attention you need (on perfectly paved structurally sound bridges)?  

In remote areas of the west, I can see infrastructure as a more critical lifeline.  However, in extreme cases it is the cost of the rescue or the emergency transport that is problematic.  All I can say is be sure to tune in for the next season of Ice Road Truckers.

Engineers have a unique perspective to offer on public policies and should be involved with helping to shape it.  The healthcare problems that America is facing are economic and regulatory.  


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Chad Morrison P.E., M.ASCE
Professional Engineer
Greenville RI
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Bill Hayden's posting has some elements of care of a responsible citizen – that tempts one to think. Aging infrastructure, aging population . . . all those having different lifetimes of existence knock a society's door often – more so during some time than other. We tend to assume – if not professionally but certainly in emotional attachments that the things we build are going to stay for long time – because people like stability and continuity. However Nature's stability is not defined by static equilibrium but rather by dynamic equilibrium – indicating that Nature and all that we build on it, attempt to adjust while responding to imposed stresses etc. All these translate to installation-aging-decay-and eventual collapse; only to reincarnate in some fashion at a later time. In some cases of rapid technological advances and demands, the installed facilities may become simply redundant, inefficient and unattractive.

The 2017 ASCE Report Card as an attempt to attract the attention of political decision makers for funding and investments indicates a very gloomy picture of American infrastructure. One may think of the problem perhaps like this: adequacy, serviceability and compatibility. There may be local differences, but American infrastructure seems to be adequate to say the least – one often hears about over-built-up. Since many were built decades ago, perhaps lack of care in repair and maintenance made some look bad, even unserviceable. The collapse of freeway bridges while traffic on the road was a shocking reminder. One may also argue that American infrastructure is not keeping up with rapid technological advances – indicating the growing incompatibility. The example is the old railway system, which looks shamefully unattractive and inefficient compared to advances in other countries.

The correlation between good health services and well-functioning infrastructure is rightly pointed out. With crumbling infrastructure or insurmountable traffic congestion, it is hard to imagine how health and other emergency services would be able to operate effectively. The examples of developing and developed societies are the right ones – but perhaps it is not inadequacy in the case of American infrastructure.                      

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Dr. Dilip Barua, Ph.D, P.Eng, M. ASCE
Consultant - Coastal, Port and Marine Engineering
Vancouver, Canada
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