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Health and Equity

people of various age groups sitting in a park

Photo source:  Ann Forsyth  http://designforhealth.net 

Relationship to public health

Negative health effects related to the transportation system can fall hardest on vulnerable members of the community, such as low-income residents, minorities, children, persons with disabilities, and older adults. Households in low-income areas typically own fewer vehicles, have longer commutes, and have higher transportation costs.

Inadequate or substandard infrastructure in low-income and minority communities can prevent people from using active transportation. It can also make walking and bicycling unsafe for those who do rely on these modes to get around, leading to higher incidences of collisions involving pedestrians and cyclists.

Low-income and minority communities are more likely to be located near highways and other transportation facilities that produce local reduced air quality, and to suffer from negative health effects such as asthma. These communities are also less likely to have convenient access to parks, healthcare, and healthy food.

Many of the strategies that transportation agencies can take to increase active transportation, improve safety, improve air quality, and improve connectivity can improve equity if they are targeted in low-income and minority communities. Examples of some of these strategies include the following:

  1. Improving pedestrian infrastructure or increasing public transportation service in low-income and minority communities to improve connectivity.
  2. Using roadside barriers, vegetation, or bottleneck removal to reduce the impacts of pollution on communities located near high-volume roads.
  3. Offering reduced public transportation fares for students or youth and working with employers to extend public transportation benefits to employees.
  4. Targeting demand response service toward communities with high concentrations of older adults and poor access to shops and services.
  5. Addressing housing affordability in a regional strategy for promoting a variety of housing options at different price points for people of all stages and walks of life.

Related indicators in the THT

To measure equity, transportation planners typically compare characteristics, or “benefits and burdens,” of the transportation system in neighborhoods with high concentrations of vulnerable populations (such as low-income households, minorities, and car-free households) to those in adjacent neighborhoods or to regional averages.

Planners might also measure whether these areas are receiving an appropriate share of resources. For example, agencies could compare land use mix between minority communities and adjacent neighborhoods to assess the presence of locally owned businesses. They might also examine whether bicycle and pedestrian funding in low-income neighborhoods is proportional to the low-income share of the population.

Neighborhood-level data are available through different sources for many indicators that can be used to measure transportation-related health equity. These include some of the data sources underlying the THT (such as the American Community Survey and the Location Affordability Index) and the additional resources described on this site.

Resources

Department of Transportation Key Issues in the Planning Process Briefing Book

This book gives government officials, transportation decision makers, planning board members, and transportation service providers an overview of transportation planning. It provides a basic understanding of key concepts in statewide and metropolitan transportation planning, along with references for additional information.  

Federal Highway Administration Environmental Justice

 A 1994 Presidential Executive Order directed every Federal agency to make environmental justice part of its mission by identifying and addressing the effects of all programs, policies, and activities on minority populations and low-income populations. The U.S. DOT's environmental justice initiatives accomplish this goal by involving the potentially affected public in developing transportation projects that fit harmoniously within their communities without sacrificing safety or mobility.

Healthy, Equitable Transportation Policy: Recommendations and Research

PolicyLink, the Convergence Partnership, and the Prevention Institute offer a comprehensive summary of research on how transportation affects health through all five of the pathways described above (Active Transportation, Safety, Cleaner Air, Connectivity, Equity), with an emphasis on protecting vulnerable populations. It offers policy recommendations for increasing health and equity in general and in relation to specific transportation modes and key transportation planning issues.

Transportation Equity Network

The Transportation Equity Network is a grassroots network of community organizations working to build healthy, equitable communities through transportation funding, policy, and projects. It provides resources and links on transportation equity, with a focus on economic development and access to jobs.

Centers for Disease Control and Prevention's National Environmental Public Health Tracking

CDC’s National Environmental Public Health Tracking Network provides a variety of state- and county-level health data. Users can compare data on certain transportation-related health impacts, including asthma rates and access to parks, by income, age, and race/ethnicity.

Centers for Disease Control and Prevention’s Injury Prevention and Control: Tribal Road Safety

The CDC’s National Center for Injury Prevention and Control works with tribal nations to implement motor vehicle injury prevention programs. This resource provides information regarding unintentional injury data related to motor vehicle crashes and provides politically and culturally effective prevention strategies.

PolicyLink Equity Atlas

Developed by PolicyLink and the University of Southern California's Program for Environmental and Regional Equity (PERE), the Atlas is a comprehensive online resource with data on demographic change, racial inclusion, and the economic benefits of equity. The Atlas includes key indicators on the largest 150 U.S. regions, all 50 states, the District of Columbia, and the nation as a whole.

Research Studies

Neighborhood Social Inequalities in Road Traffic Injuries: The Influence of Traffic Volume and Road Design

This report examines data on collisions within the city of Montreal in Quebec, Canada. The data show there were significantly more injured travelers in the poorest than in the richest areas. Differences in traffic volumes, intersection geometries, and pedestrian and cyclist volumes accounted for much of the differences between these areas.

Morency P, Gauvin L, Plante C, Fournier M, Morency C. Neighborhood social inequalities in road traffic injuries: the influence of traffic volume and road design. American Journal of Public Health 2012;102(6):1112-1119.

A Census of the US Near-Roadway Population: Public Health and Environmental Justice Considerations

This study found that larger shares of non-white and low-income persons live in areas with higher traffic volumes and density.

Rowangould G. A census of the US near-roadway population: public health and environmental justice considerations. Transportation Research Part D: Transport and Environment 2013;25:59-67.

Moving to Equity: Addressing Inequitable Effects of Transportation Policies on Minorities

This report summarizes findings on disproportionate transportation-related health impacts in communities of color, including higher asthma and pedestrian fatality rates. It describes the connections between these impacts and the built environment.

Sanchez TW, Stolz R, Ma JS. 2003. Moving to equity: addressing inequitable effects of transportation policies on minorities. The Civil Rights Project at Harvard University.

Analysis of Diesel Particulate Matter Health Risk Disparities in Selected US Harbor Areas

This report examines exposure to diesel particulate matter in marine harbor areas. It finds that low-income households, Hispanics, and blacks are overrepresented in the affected populations.

Rosenbaum A, Hartley S, Holder C. Analysis of diesel particulate matter health risk disparities in selected US harbor areas. American Journal of Public Health 101(S1):S217-S223.

Parks and Recreation in Underserved Areas: A Public Health Perspective

This report reviews research on disparities in access to parks among low-income communities and communities of color. It found that non-white and low income neighborhoods are 50% less likely to have a recreational facility in their community than are white and high-income neighborhoods.

National Recreation and Park Association. 2012. Parks and recreation in underserved areas: a public health perspective.

The Grocery Gap: Who Has Access to Healthy Food and Why it Matters

This report summarizes research on access to healthy food in low-income communities and communities of color. Studies find that these communities are characterized by a relative lack of stores selling healthy food and are more likely to suffer health consequences such as diabetes and obesity.

Treuhaft S, Karpyn A. 2010. The grocery gap: who has access to healthy food and why it matters. PolicyLink and the Food Trust.

Who Has Access to Healthy Food and Why it Matters. PolicyLink and the Food Trust.