Guest Op-Ed: Transportation and Health: America’s Longstanding Disconnect

Ross Peterson is a consultant and subject matter expert with over fifteen-years’ experience in public and community transportation programs focusing on services for people who don’t drive.

A virus to which none of us is immune should not discriminate, yet low-income, black and indigenous people of color are disproportionate victims of COVID-19. They also have less access to essential services in large part due to transportation barriers, one of which is limited access to public transportation. These factors lead to worse health outcomes prior to and during the current pandemic. Renee Autumn Ray’s research report, “Increasing Access to Essential Health Services: The Role of Transportation in Improving American’s Health” helps illuminate the underlying social determinants of health that have led to these health disparities.

After guiding readers through a tour of American’s complex health and transportation policies, Ray makes the case for a Health in All Policies approach as we recover from the pandemic and beyond. I had an opportunity to review early drafts of Ray’s article. Perhaps as a reflection of my own need for simplicity during this time of uncertainty, I found myself drawn to the numbers, especially as related to public transportation.

Ray points out that high travel time transportation burdens are disproportionately borne by low-income workers. While much of the policy background is intricate and complex, the fundamental problem is actually quite simple: transportation is a geometric phenomenon that is subject to the laws of physics. For many modes commute distance increases, daily travel time goes up and the number of hours a wage earner can work goes down. Origin-destination pairs that defy this rule, such as living and working near high frequency heavy rail or bus rapid transit corridors are generally unattainable to low-income households due to high costs of housing.

If the only apartment a person can afford is 10 miles from their job and there are limited mode choices available, it is more difficult to emerge from sustained poverty and lower quality of life. Ray’s research report illustrates how access and mobility play a significant impact on people’s lived experiences and physical health.

One takeaway from the paper (among many) is that if we want healthier cities, we need high functioning public transportation systems that enable people of all incomes to move efficiently in their communities. Yet, over the past five years, transit agencies throughout the United States have experienced declining ridership and growing operating expenses. According to the Federal Transit Administration’s National Transit Database, nearly two thirds of transit agencies have experienced simultaneous overall ridership decreases and cost increases between 2014 and 2018.

This killer combination began well before the COVID-19 pandemic.

Transit agencies in the United States were already in bad shape before COVID hit. Many are now facing a fiscally uncertain future. Lower frequencies and route cuts could have negative economic and health impacts for already disadvantaged populations, and increase public sector expenditure needs in physical and mental health sectors.

If we hope to recover from the pandemic and build more equitable cities in the future, we should not overlook the role that public transit plays in public health. I hope policy makers will read the report and use the resources it provides to begin applying a Health in All Policies approach as we begin charting our post-pandemic future. If we invest more in public transportation systems, we can begin addressing how lack of transportation access has resulted in disproportionate health impacts to people who have already lacked access and mobility for far too long.

The views expressed above are those of the author and do not necessarily reflect the views of the Eno Center for Transportation.

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