Air pollution was a huge worry for Metro Vancouver in the 1970s and early 1990s, but health care and traffic congestion have taken over as bigger concerns, according the latest Urban Futures survey released today.

The 2012 regional survey, which replicates two surveys in 1973 and 1990, found health care was the most pressing challenge among 1,407 people surveyed, followed by traffic congestion, homelessness and increasing housing supply.

Air and water pollution, which held first and second place in 1973 and 1990, fell to fifth and sixth place last year. Concerns about crime also fell from No. 4 in 1972 to 11 last year.

Ken Cameron, director of PlaceSpeak, a new startup that provides a virtual consultation forum, said the results reflect the work that's been done in the past 40 years to address the earlier concerns, as well as highlight what's needed to deal with rising issues like health care and transportation.

Health care had been ranked ninth on the priority list in 1973 and third in 1990. The survey suggests the change in ranking may reflect in part the aging population, as well as concerns over reliable service delivery.

"Health care may be a function of aging population but it's seen as a critical need," Cameron said. "I've got the feeling people are feeling the health care system is under stress."

Traffic congestion has also become a bigger issue - rising from sixth and seventh respectively in the 1973 and 1990 surveys - as a result of public policy to emphasize transit, walking and cycling over single-occupant vehicles.

But the survey found the significance of those issues varied across the region, and by the age of the respondents. Those under 35, for instance, were less likely than the older demographic to see health care and transportation as critical priorities and were more sensitive to socio-economic difficulties.

Housing supply, which may reflect the difficulty many encounter finding an affordable first home, and homelessness were bigger issues for the under-35 set than for those who were older.

Individual respondents in Vancouver also aren't as worried as those in the rest of the region about health care, ranking it "fairly consistently as the third most important issue in the region," behind homelessness and housing, which were generally ranked third and sixth respectively in other municipalities.

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Health care, transportation top concerns, survey says