Infrastructure decisions act like ripples on a lake, radiating out in time and space that can both help and hinder future generations. The quality of those decisions is set here and now.
This piece was published by Oxford University Press on 25 April 2023. Follow link: Oxford Open: Infrastructure and Health
When infrastructure is done well, it forms the fabric beneath us that enables individuals, businesses, and communities to experience more prosperous and inclusive living for current and future generations. In this brief commentary paper, I offer arguments and case examples from my recent book ‘BIG FIXES: Building Bridges to an Inclusive Future’.
Unfortunately, as an infrastructure practitioner for over 30 years, I have observed a global shift among policymakers to exaggerate the benefits of investing in infrastructure without accountability and a framework for governance to assure positive long-term outcomes. In essence, infrastructure has fallen victim to short-termism.
The central thesis of my book for readers and future contributors of Oxford Open Infrastructure and Health (OOIH) aligns well with the journal’s mission for infrastructure and health scholarship that fosters ‘Big Connections’. My argument is as follows.
Is your vision of infrastructure about physical assets like roads, bridges, tunnels, power lines, water pipes, schools, and hospitals? If so, then it is too narrow. There is an urgent need for policymakers, investors and scholars to widen their perspective to consider infrastructure as a gift that current generations pay forward to future generations.
The infrastructure decisions of our forebearers act like ripples on a lake, radiating out in time and space. These ripples can amplify benefits into the future, like favourable tailwinds. But equally, where short-sightedness has taken root in the past, the consequences of earlier infrastructure decisions (or none at all) can saddle future generations with the burden of headwinds – slowing, dragging upon efforts to improve.
When a society invests in infrastructure, they express hope and optimism for the future. However, that aspiration implies a big bundle of expectations, including health and economic wellbeing and sustaining and building trust between people and the institutions created to serve them. Moreover, as environmental and social issues grow in importance, society has less room to be complacent with non-responsive infrastructure blocking adaptation and innovation to support new growth. These are examples of the lens to view ‘Big Connections’ referred to by OOIH.
At its heart, OOIH invites contributors and readers to think more critically about how institutions responsible for infrastructure and health need to change and the necessary evidence to guide reform. For example, public policy settings and procurement practices for infrastructure projects overemphasise the importance of construction and neglect the governance regimes necessary for assuring positive economic and social outcomes for decades ahead.
Infrastructure provision is a litmus test of a society’s stewardship – planning and acting responsibly long term. So it is alarming how myopic infrastructure governance has become and short-term expediency the norm in fulfilling political ambitions and satisfying powerful vested interests. Hence, this is the reason a reset is vital.
It is time for scholars to help illuminate the case for change so citizens and policymakers can be encouraged to think and act long-term. What is needed is a ‘true north’ beacon where infrastructure provision and health policy work together in making an amplified positive impact on people and the planet.
That is why I encourage readers and contributors to OOIH to adopt a wide-eyed view of infrastructure where services that flow from physical assets matter most in shaping our sense of safety, wellness, liveability and optimism for the future.
Lighting the Way
Understanding the ‘big connections’ between health and infrastructure is surprisingly vacant. There is a real opportunity for scholars to make their mark. Yet, despite its importance – researchers, policymakers and practitioners find themselves in a humble position of knowing a great deal less than we should. Unless redressed, we can expect short-termism to prevail without another competitive framework to shift decisions that address long-term impact.
Building a community of practice and a pool of scientific knowledge relevant to the challenges ahead will need people to be restless with the status quo and willing to take risks. Pursuing small and narrow questions may serve certain risk-averse work cultures; however, in this domain, it may increase the risk of irrelevance.
The task is to illuminate the field of play with floodlights – to reveal the breadth and depth of complexity – the contours of institutional, environmental and people landscapes associated with the interactions of health and infrastructure. The skill sets most valuable are subject matter experts committed to interdisciplinary inquiry and collaboration because so much of quality of life is multi-dimensional and pivots on the quality of relationships with citizens and institutions of government and business.
Case Example: Birthing of the ‘Weekend’
As a social, health and economic reform, the idea of a weekend off was radical and highly experimental in 19th-century Britain. But interestingly, it did not result from a government mandate but evolved through grassroots activism, trade unions and industrialists. All these vital stakeholders were concerned with the negative impacts of the industrial revolution – long hours, repetitive and dangerous work and the flow on consequences of exhaustion, family breakdown, childhood welfare, loneliness and isolation.
The activism that birthed a five-day working week required a collaborative mindset and a sense of purpose that transcended self-interest and a commitment to seeking a better outcome for the whole. These similar threads compel us again to build the case for change, in this case, for more excellent stewardship in making infrastructure and health work together to achieve genuinely transformational outcomes for current and future generations.
Infrastructure – a means to an end
Too often, modern infrastructure is slow to adapt and overly cautious in permitting innovation. These barriers can cause enormous inertia in improving wellbeing. This dysfunction must not persist.
From this perspective, I wrote ‘BIG FIXES’ because, over three decades, I observed that citizens no longer have sufficient control or agency over crucial questions of what projects get funded, why and assurances of long-term impacts.
Infrastructure must resist devolving into an endless cycle of more construction jobs and short-term economic stimulus – it is not an end in itself. Instead, infrastructure should be a means to an end – where these public assets and services are a vehicle for reciprocity by enriching connections across society, making it easier for people and institutions to adapt and be flexible to ever-changing needs and new opportunities.
New technology and digitisation of infrastructure services can renew the grassroots power of the people. However, the key to this transformation must recognise that infrastructure is a dynamic and adaptable service, not just a physical asset to build, leaving its impact for others to be concerned with later. Instead, it is a means to an end – helping others achieve whatever they deem necessary in their life and business aspirations, from decarbonising economies to more profound social and economic inclusion.
Fixing short-termism in infrastructure requires leadership across society. BIG FIXES, and OOIH, seek to challenge your perspective and help focus on the challenges and the size of the potential benefits that flow from reform. But, importantly, we first must recognise that most people take infrastructure for granted because they are busy with their own lives and probably do not think of it immediately as a real presence in shaping the quality of life. However, their busyness with other things does not suggest an indifference to infrastructure; instead, they choose to place enormous trust in those responsible for infrastructure provision to get it right.
The research community of infrastructure and health experts can help preserve and build upon that trust through evidence and case examples – because infrastructure is incredibly personal to people’s wellbeing. After all, it determines where we live, what jobs we can do, and how healthy we are. It also determines the types of jobs our children will do, so infrastructure and health research can catalyse positive change.
Alternatively, when infrastructure is poorly conceived and slow to adapt to the shifting needs of society, quality of life is at risk, and community trust diminishes in responsible institutions.
As a community of practice develops around the OOIH, we must play our part to bolster health and infrastructure policy and practice working together. If successful, then OOIH would have helped today’s endeavours to pay forward to future generations. Securing greater trust and collaboration in society is our long game – unleashing human ingenuity and creativity that fashions the future.
Case Example: Ride sharing 100 years too late
During the early 1900s, with the introduction and rapid take up of private motor vehicle ownership in the United States, a ride-sharing scheme was started in 1914 by L. P. Draper, a car salesman from Los Angeles. He observed very long queues to catch the public transport trams in the city, so he set up a sign on his car alongside these queues to say he would take passengers wherever they wanted to go for a ‘jitney’ (slang for a nickel).
Draper met with extraordinary success. By 1915 there were 50,000 rides per day in Seattle, 45,000 rides per day in Kansas and 150,000 in Los Angeles. However, Uber founder Travis Kalanick says that the thriving Jitney ride-share was
regulated and taxed out of existence within just a few years. The local monopoly public transport authorities had convinced policymakers to impose onerous conditions and licensing fees. The government, which owns the public transport monopolies, saw the ride-sharing scheme as pernicious, according to Kalanick.
Since the demise of the Jitney, the global economy had to wait almost 100 years before another scaled attempt at ride-sharing began. In the meantime, without ride-sharing, car ownership exploded, along with congestion, massive carbon emissions and wasteful spare capacity. As a result, private vehicles are typically in use for less than 10 per cent of their productive capacity.
The loss of ride-sharing services has had severe consequences as car fleets worldwide struggle to be fully effective. The mass adoption of motor vehicles has shaped every city with ever-increasing road capacity and the loss of amenities to accommodate near-empty cars. Furthermore, Kalanick argues that at least 30 per cent of cities’ building stock is devoted to car parking, again for mostly driver-only cars.
Provocation for OOIH
The demise of the Jitney is an excellent case example for the OOIH community to reflect upon and debate. With the benefit of hindsight, Jitney was an innovation taking advantage of the leap in technology with the advent of private motor vehicle ownership that upset incumbents like public transport operators. In the wash-up, Jitney’s innovative new services got set aside in favour of the status quo – public transport. However, were the benefits relative to the costs justified? And if so, how did that change over the short, medium, and long term?
Looking at Uber, Lift and other ‘mobility as a service’ businesses today, their unique business models pivot on flexibility to quickly respond to changes in demand. In contrast, traditional taxi services and public transport are more rigid and less able to change short-term supply in response to demand.
But as with the Jitney, fundamental issues emerge from modern ride-share schemes. For example, serious questions persist today about ride-share driver pay and conditions – such as access to paid sick leave and minimum wages. These questions are even more critical when ride-share drivers are disproportionately people of colour and immigrants.
How should these sensitive issues be handled, considering that the ride-share business model requires high flexibility from drivers to log on and provide service on demand? Normalising drivers to standard employment contracts will have a peculiar set of costs and benefits for the drivers and the broader ride-share ecosystem. How can these be better examined, and is the current focus on pay and conditions too narrow?
Is a border perspective needed? For example, what are the issues to consider regarding the algorithms’ governance that impact independent contractor drivers’ ability to perform their duties fairly and reasonably? Unfortunately, the transparency around algorithms that allocate and despatch jobs is poor. Furthermore, a lack of transparency is frustrating for stakeholders to trust one another and prevents a maturing of the debate to finding better solutions.
Regardless of the merits of different perspectives, the community of OOIH help must define a place where these issues are peeled back and examined rigorously with a clear objective of clarifying the short-medium-long-term consequences. As a result, we must be less compelled to react to the obvious and to drill into problems to understand the complexity at play as a crucial ingredient to mapping possible solutions with positive impacts.
Stewardship – a vital missing link
Continuing an unbroken chain of stewardship from generation to generation must be embedded as a vital goal in governing society. No matter how weak stewardship may appear, our urgent duty is to strengthen its effectiveness with evidence, frameworks and case examples that build the momentum for disrupting short-termism.
Stewardship that is ongoing and continuously improving is important because future generations are hopefully less likely to break the ripples of goodwill and competence when these are already present in peoples’ experiences.
As a researcher and infrastructure practitioner, it is astonishing how society is becoming more complex, diverse and interdependent. These developments may explain why top-down bureaucratic solutions are far less effective in meeting community needs. Instead, more nuanced grass-root responses can better fulfil a wider diversity of needs if given a chance. Moreover, communities yearn to co-create solutions that continually adapt to meet their unique needs. They also increasingly question old-world notions of centralised, one-size-fits-all edicts from government and business.
Scholars must help redirect institutional efforts to the diversity and complexity of grassroots responses that can emerge from communities to address their challenges and aspirations.
Fixing infrastructure to adapt as a service to changing needs of people is a first step to addressing many of society’s broader ills. Doing good infrastructure must draw on our better selves to think and act long-term and carry on a chain of benevolence. Stronger institutional accountability to citizens is vital in ensuring we can navigate a safe passage through the countless uncertainties we face and be more adaptive to a changing world.
Undoing short-term, reactive and low aspirational intentions in our institutions are fundamental. There is no time to waste in rebuilding trust; collaborations, accountability, and community action are essential in getting to a better place. Contributing to OOIH is worth your time and commitment.
*Garry Bowditch is an Oxford Open: Infrastructure and Health Editorial Board member and author of BIG FIXES: Building Bridges to an Inclusive Future.
 Brad Beaven, History of the two-day weekend offers lessons for today’s calls for a four-day week, The Conversation, 3 January 2020
 Kalanick, T. Uber’s plan to get more people into fewer cars, TED ideas worth spreading, February 2016.