The hidden health costs of transportation

American Public Health Association
May 2010

      Photo extracted from the report 

Our past and current paradigm of transportation investment has created a transportation system that is focused on road building and the private auto. This systemhas given our country an unprecedented level of individual mobility and facilitated economic growth fromcoast to coast. As important as these benefits are, they have come at a high price—costs to our environment and the health of our communities.U.S. residents—especially our children—aremore obese and overweight than ever before due in part to sedentary lifestyles and the lack of opportunity for everyday physical activity. Traffic crashes cause close to 40,000 deaths a year, and exposure to air pollution from traffic results in high rates of asthma and respiratory illness.

These negative outcomes have the largest effect on those who aremost vulnerable—the elderly, children, and traditionally underserved and disadvantaged (low income and non-white/ethnic minority) communities—themost, through greater adverse health impacts and through a relative lack of access to economic, recreational, and social opportunities. The full costs to public health of transportation are only beginning to be understood. Although health impacts—such as not being able to walk safely to school or breathe clean air—may not seem tangible, they can in fact be valued. These costs are as real and in certain instances as measurable as the costs of steel and concrete. It has often been said that “what gets measured gets done.” To date, the costs of public health impacts have been “externalized”—that is, they are not accounted for in the current framework of planning, funding and building highways, bridges and public transit. No doubt, different decisions about transportation investments would be made if health-related costs were incorporated into the decision-making process.

A look at our cities and towns confirms that sidewalks, bikeways do not compete well against cars for lane space—and transit funding is a fraction of what is spent on roads. For many years, public transit, bicycle lanes, and trails and sidewalks have suffered from a lack of investment. A more balanced transportation system is needed, or these costs will continue to grow and undermine the country’s economic health and quality of life. Fortunately, there are plenty of models illustrating how to engineer physical activity and safety back into everyday lives, and plenty of opportunities to create the political support, funding systems and evaluativemethods to do so. This document outlines some of those pathways and opportunities, and the role the public health community can play.

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Also: At the Intersection of Public Health and Transportation Promoting Healthy Transportation Policy