Transform Transportation - Strategies for a Healthier Future - Arizona PIRG Education Fund
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Transform Transportation
Strategies for a Healthier Future
Transform
Transportation
Strategies for a Healthier Future
WRITTEN BY:
JAMES HORROX AND GIDEON WEISSMAN, FRONTIER GROUP
MATTHEW CASALE AND JOHN STOUT, U.S. PIRG EDUCATION FUND
SPRING 2021
Acknowledgments
The authors wish to thank Steven Higashide, Director of Research for TransitCenter; Veena
Dharmaraj, Director of Transportation, Sierra Club; and Julie Chinitz, Policy Director, Alliance
for a Just Society, for their review of drafts of this document, as well as their insights and
suggestions. Thanks also to Susan Rakov, Tony Dutzik and Elizabeth Ridlington of Frontier
Group for editorial support.
The authors bear responsibility for any factual errors. Policy recommendations are those of
Arizona PIRG Education Fund. The views expressed in this report are those of the authors and
do not necessarily reflect the views of our funders or those who provided review.
2021 Arizona PIRG Education Fund. Some Rights Reserved. This work is licensed under a
Creative Commons Attribution Non-Commercial No Derivatives 3.0 Unported License. To view
the terms of this license, visit creativecommons.org/licenses/by-nc-nd/3.0.
With public debate around important issues often dominated by
special interests pursuing their own narrow agendas, the Arizona
PIRG Education Fund offers an independent voice that works on
behalf of the public interest. The Arizona PIRG Education Fund works to protect consumers and
promote good government. We investigate problems, craft solutions, educate the public, and
offer citizens meaningful opportunities for civic participation. For more information, please visit
our website at www.arizonapirgedfund.org.
Frontier Group provides information and ideas
to build a healthier, more sustainable America.
We focus on problems that arise from our nation’s material and technological wealth – the
problems of abundance. We deliver timely research and analysis that is accessible to the public,
applying insights gleaned from diverse fields of knowledge to arrive at new paths forward. For
more information about Frontier Group, please visit www.frontiergroup.org.
Layout: To the Point Collaborative, tothepointcollaborative.com
Cover: A bike lane and floating bus stop in Seattle. Photo: Adam Coppola Photography via Flickr (public domain)
Contents
EXECUTIVE SUMMARY........................................................................................................................4
INTRODUCTION....................................................................................................................................7
OUR CAR-DEPENDENT TRANSPORTATION SYSTEM
DAMAGES OUR HEALTH AND WELLBEING.......................................................................................9
Traffic-related air pollution harms people of all ages.........................................................................................9
Living near transportation infrastructure causes particular damage to health............................................. 11
Our dependence on cars has lethal consequences for road users.................................................................13
Driving to work damages our health and makes us less happy with our lives...............................................14
Transportation is the leading source of greenhouse gas emissions...............................................................15
WE CAN TRANSFORM AMERICA’S TRANSPORTATION SYSTEM.................................................17
Give more people the option to travel by foot, bike and transit.......................................................................17
Electrifying public transportation.......................................................................................................................23
Electric vehicles....................................................................................................................................................28
CONCLUSION......................................................................................................................................34
NOTES ................................................................................................................................................35
Executive summary
AMERICA’S TRANSPORTATION SYSTEM is Transportation is a leading cause of air
wrecking our health. pollution that shortens lives and makes
people sick.
Traffic-related air pollution kills an esti-
mated 58,000 Americans every year, and In 2019, the transportation sector produced
increases the risk of serious health condi- 55 percent of the nation’s emissions of nitro-
tions, including lung cancer, stroke, heart gen oxides (NOx) – a component of ozone
disease, asthma, and even dementia.1 More smog – 16 percent of all emissions of volatile
than 38,000 people die in vehicle crashes in organic compounds (VOCs), and 2.7 percent
the U.S. every year and millions more are of all emissions of primary particulate mat-
seriously injured.2 Even our mental health ter, often known as soot.5
and the health of our relationships are at
This pollution causes or exacerbates a range
risk – the time we spend driving, much
of serious health conditions, including:
less the time we spend stuck in stressful
traffic, is time away from family, friends, • Cancer: Diesel exhaust is classed as
exercise and leisure pursuits. a potential cancer agent by the World
Health Organization and the U.S. EPA.6
These health problems are a direct result of
Exposure to diesel exhaust has been
the way we’ve built our communities and
associated with higher rates of lung
our transportation system to be dependent
cancer and greater risk for bladder
on travel in fossil fuel-powered cars. Every
cancer.7 Particulate matter and nitrogen
year, Americans drive more than 3.2 tril-
dioxide, emitted in vehicle exhaust, have
lion miles – nearly 10,000 miles per person
both been associated with increased risk
and more miles per capita than people
for lung cancer.8
almost anywhere else in the world.3 Since
1990, the number of vehicle miles trav- • Stroke: Long-term exposure to particu-
eled by light-duty vehicles like cars and late matter is associated with an up to 21
light-duty trucks has risen by more than 46 percent higher risk of stroke.9
percent.4
• Heart and lung disease: Exposure
There is a better way. to nitrogen dioxide, found in vehicle
exhaust, has been linked to heart and
By rebuilding our transportation system
lung diseases and premature death.10
to give more people the option to spend
Exposure to particulate matter can result
less time in a car, by expanding access
in vascular damage and accelerated
to active means of travel such as walk-
decline of lung function.11
ing and biking, and by adopting zero-
emission electric cars and buses, we can • Asthma: Exposure to vehicle exhaust
make our transportation safer, healthier, causes and exacerbates childhood
cleaner and more efficient. asthma, and recent research suggests it
PAGE 4
also damages lung development even • In 2018, nearly 6,300 pedestrians and more
in non-asthmatic children, leading to than 800 cyclists were killed in traffic-
increased risk of respiratory and cardio- related accidents, with more pedestrian
vascular diseases in later life.12 and cyclist fatalities on the roads in 2018
than in any year since 1990.20
• Dementia and cognitive decline among
the elderly: One study estimates that Driving even takes a toll on the health of
between 7 and 11 percent of dementia drivers themselves. Excessive driving can
cases among individuals living within 50 lead to a range of health impacts, including: 21
meters of a major road are attributable to
traffic exposure.13 • Chronic stress and poor mental health:
Commuters who travel to work by car
The 45 million Americans who live in experience substantially higher levels of
close proximity to busy roads or other traf- stress, more negative moods and lower
fic-related infrastructure are at increased satisfaction with life than those who take
risk from the health impacts of traffic- active modes of transport.22
related pollution.14
• Obesity and high blood pressure: People
• Studies have found increased prevalence with long car commutes are more likely to
of asthma in children living within 100 be obese and to have higher blood pressure.
meters of a freeway.15 One study estimat- They are also less likely to do the recom-
ed that over 27,000 cases of childhood mended amount of physical activity, putting
asthma in Los Angeles County were them at increased risk of diabetes, cardiovas-
at least partly attributable to pollution cular disease, osteoporosis, metabolic risk
associated with living close to a major syndrome and certain kinds of cancer.23
road.16
America’s transportation system is the
• Living close to a major road increases the nation’s number one source of greenhouse
chances of suffering from an ischemic gas emissions and the largest single con-
stroke by 42 percent and significantly tributor to the climate crisis, which will
increases the likelihood of dying as a harm public health for decades to come.
result.17
In 2018, transportation accounted for 28 percent
• Higher levels of noise and air pollution are of the nation’s total greenhouse gas emissions
associated with increases in coronary heart – more than any other sector of the economy.24
disease (CHD) mortality. One study found If emissions continue at their current level, the
that individuals exposed to the highest impacts on public health will be severe.25
levels of noise pollution are 22 percent more
likely to die as a result of CHD than those • Extreme temperatures will kill more
exposed to the lowest levels.18 people. As climate change makes extreme
variations in temperature more common,
American society’s dependence on cars puts deaths and hospitalizations from extreme
us at risk every time we take to the roads, heat and cold will rise.26
whether or not we’re in a car ourselves.
• Shifting weather patterns and high
• Every year, approximately 38,000 Ameri- pollution will create high concentrations
cans are killed in car crashes, making of ozone in some areas, causing more
car crashes the leading cause of death for premature deaths and hospitalizations due
Americans between the ages of 1 and 54.19 to respiratory illness.27
PAGE 5
• Climate change will bring more Phasing out fossil fuel vehicles can enable
disease, as shifting temperatures lead the U.S. vehicle fleet to operate with zero
to geographic shifts of disease-carry- greenhouse gas emissions from driving
ing insects like ticks and mosquitos.28 or charging, if such a shift is accompanied
Warmer weather will increase the preva- by a transition to a grid powered by clean,
lence of pathogens like E. coli and salmo- renewable energy. Electric vehicles also ben-
nella, which thrive in hot and humid efit public health, as they do not emit harm-
conditions.29 ful tailpipe emissions that cause cancer,
asthma and other health problems.30
To address the health and environmental
damage our transportation system causes, All new light-duty cars and trucks sold
we need to completely transform the way after 2035 should be electric vehicles. To
we travel. And there are steps we can achieve this goal, policymakers should:
take right now, using proven policies and
existing technology, that can help elimi- • Set requirements to phase out fossil
nate traffic-related pollution and move fuel-powered vehicles and adopt EV
America’s transportation system towards a mandates.
greener, healthier future: • Make EVs cheaper to buy and own
Getting more people moving by foot, through tax credits and other incentives.
bike and transit can immediately reduce • Expand and improve EV charging infra-
both global warming emissions and the structure.
toxic pollutants from our car-dependent
transportation system. Walking and biking Electrifying and improving transit can cre-
infrastructure has been shown to benefit ate clean transit fleets for cities and schools,
communities in a variety of ways, including particularly if those fleets are powered by
increased safety, improved health and hap- clean energy. Electric buses emit no tailpipe
piness, and more freedom for older adults pollution and would significantly improve the
and people with mobility issues. health of children who take school buses and
the urban populations often served by buses.31
The U.S. should at least double the num-
ber of people who travel by foot, bike or U.S. transit agencies and school districts
transit by 2030. To achieve this goal, policy- should replace all transit and school buses
makers should: with clean electric buses by 2030. To
achieve this goal, policymakers should:
• Ensure that walking, biking and transit
are safe, affordable, accessible and enjoy- • Adopt electric bus commitments at all
able through infrastructure expansion levels of government, including at transit
and improvements. agencies and school districts.
• End subsidies that make driving artifi- • Provide transit agencies with financial
cially cheap to help make low-carbon and technical assistance to help them
transportation the easiest, cheapest, most make the switch to electric buses while
convenient option. maintaining or increasing service.
PAGE 6
Introduction
IN MARCH 2020, the lives of millions of our cities subsided, and by mid-April, at the
Americans changed in ways we never height of lockdown, daily carbon dioxide
thought imaginable. The turmoil caused emissions in the U.S. were down by around
by the arrival of the coronavirus pandemic one-third.34 Globally, emissions dropped an
meant the abrupt suspension of business as unprecedented 17 percent from 2019 levels,
usual. Our daily routines suddenly no lon- with almost half of that decrease attribut-
ger included long, grueling commutes; free- able to the drop in road traffic alone.35
ways all over the country emptied, and city
centers became eerily devoid of the noise, As the economy gradually opened up and
congestion and air pollution that many of us people began to get back in their cars, it
have come to accept as unavoidable facets of became clear that emissions reductions
everyday life.32 Without realizing it, we had on the scale seen during March and April
embarked on a transportation experiment were going to be short-lived.36 Yet driving
on a previously inconceivable scale. remains below its pre-COVID levels, and
some analysts suggest that more Americans
As lockdowns kicked in all over the coun- will continue to work from home long after
try, a record decline in driving was accom- the pandemic is over.37
panied by an increase in people walking,
cycling and choosing other active modes If our travel patterns could change so
of transportation.33 Many of us discovered, quickly and dramatically as a result of a
with varying degrees of surprise, that our pandemic, imagine what could happen if
daily car commutes weren’t actually neces- we made a deliberate effort to make it easier
sary after all, and that even amid the stress for Americans to live their lives without
and uncertainty of the pandemic there are spending so much time in a car.
more fulfilling ways of spending those
hours than sitting in traffic. While gasoline America’s current transportation system has
sales plummeted, sales of bikes and e-bikes been designed, built and centered around the
skyrocketed, and with fewer cars on the automobile. And it is a public health disas-
road, our neighborhoods became safer, ter. Traffic-related air pollution cuts short an
cleaner and more agreeable places to be – estimated 58,000 American lives every year,
especially in the many towns and cities that and causes or exacerbates serious illnesses
rededicated street space for pedestrians and ranging from childhood asthma to lung
cyclists to enable socially distanced indi- cancer, strokes, heart disease and dementia.
vidual mobility. Excessive driving, and especially commut-
ing, erodes our mental health, our relation-
The environmental impact of this accidental ships, and our quality of life – to say nothing
experiment was evident almost immedi- of the thousands of people every year killed
ately. The smog that normally hangs over or injured in vehicle crashes.
PAGE 7
tives to the internal combustion engine,
and EV ownership is rising rapidly as more
The problems of our car- and more car manufacturers embrace the
reality that the future of the automobile is
dependent transportation electric. Cities and school districts that have
system are staring us in the added electric buses to their transit fleets
have found them cheaper, cleaner and more
face – and they have been efficient than their old, polluting diesel
counterparts and every year brings new
for years. But the good news commitments from cities all over America
is, so are the solutions. to electrify their transit systems. Bike lanes,
bike sharing, e-bikes and e-scooters are
increasingly common sights in American
cities. And it no longer seems so outland-
To make matters worse, many of us have ish to imagine a near-future with streets
no choice but to drive. In large parts of designed for pedestrians and cyclists to
America, public transit simply isn’t a coexist safely with cars, giving people the
viable alternative to personal vehicles. And option to spend less time behind the wheel
where walking, cycling and other active and more time traveling in ways more con-
modes of transport are an option, the ducive to safeguarding our health, wellbe-
auto-centric design of our streets can make ing and environment.
these forms of transport unappealing at There has never been a more important
best, and at worst, lethal. time to fix a transportation system that too
The problems of our car-dependent trans- often makes us sick and unhappy. In this
portation system are staring us in the face report, we lay out a vision for creating such
– and they have been for years. But the a future – one based on zero-emission elec-
good news is, so are the solutions. tric vehicles, expanded public transit, and
increased access to active modes of travel
Many of the clean transportation technolo- like walking and cycling. These are the tools
gies that not so long ago seemed far off that should be front and center in the effort
on the horizon are now tried and tested to free our roads from polluting fossil-fuel-
and well on their way to becoming main- powered vehicles, in a reimagined approach
stream. Zero-emission electric vehicles to transportation that puts public health and
have proven themselves viable alterna- the environment first.
PAGE 8Our car-dependent transportation
system damages our health and
wellbeing
THE CHRONIC CONGESTION of America’s the largest single contributor to premature
roadways is not simply an inconvenience, deaths from air pollution.42
but a symptom of the failure of our nation’s
approach to transportation. Every year, Exhaust from cars, trucks, buses and other
Americans drive more than 3.2 trillion diesel- and gasoline-powered vehicles con-
miles – nearly 10,000 miles per person and tains dangerous pollutants that have been
more miles per capita than people almost linked to health impacts including heart,
anywhere else in the world.38 Among vascular and lung conditions and cancer.43
the 22 European countries for which the Diesel exhaust alone contains more than
United Nations Economic Commission for 40 toxic contaminants, including known
Europe has recent data, no country had or suspected carcinogens such as benzene,
even 70 percent as much driving per per- arsenic and formaldehyde.44 It also contains
son as the U.S.39 fine particulates (referred to as PM2.5) as
well as volatile organic compounds (VOCs)
All that driving places an increasingly and nitrogen oxides (NOx) (which are both
heavy burden on our health, safety and precursors of ground-level ozone), among
wellbeing. America’s car-dependent trans- other pollutants.45
portation system kills tens of thousands of
people per year through crashes and expo-
sure to air pollution, and hurts or sickens
many more. Car dependence is also a major
contributor to the global threat of climate
change, which will pose threats to our
health and our environment for generations
to come.
Traffic-related air pollution harms
people of all ages
Every year, approximately 107,000 Ameri-
cans die as a result of air pollution.40 Some
studies have suggested that figure could be
as high as 200,000.41 According to a recent Pollutants found in exhaust from fossil-fuel-powered
study by the Massachusetts Institute of vehicles have been linked to a range of health impacts,
Technology, around 58,000 deaths each year including heart, vascular and lung conditions and cancer.
are attributable to road transportation emis- Photo: U.S. Environmental Protection Agency
sions specifically, making transportation
PAGE 9Transportation is responsible for a large known to cause or suspected of causing
share of the health-threatening pollution cancer.51 VOCs, including benzene, acetal-
that finds its way into America’s air. In dehyde and 1,3-butadiene, have been
2019, the transportation sector produced linked to various types of cancer.52 In
55 percent of the nation’s total nitrogen particular, exposure to diesel exhaust
oxide (NOX) emissions, with road traffic pollution has been associated with higher
accounting for about a third of the national rates of lung cancer and greater risk for
total. The transportation sector as a whole bladder cancer.53 Particulate matter and
produced 44 percent of the nation’s car- nitrogen dioxide have both been associ-
bon monoxide emissions, with highway ated with increased risk for lung cancer.54
vehicles accounting for 26 percent of the Exposure to nitrogen dioxide (NO2) is also
nation’s total. Transportation produced 2.7 known to shorten the life expectancy of
percent of PM10 and PM2.5 particulate mat- people with lung cancer.55
ter emissions and 16 percent of all volatile
organic compound emissions, with 8.9 • Heart and lung disease: Prolonged
percent of the national total coming from exposure to nitrogen dioxide has been
road traffic.46 linked to heart and lung diseases and
premature death.56 Exposure to particu-
Traffic pollution causes or exacerbates late matter, too – even at relatively
a range of health problems, including low levels – can result in vascular
asthma, impaired lung function, cardio- damage and accelerated decline of lung
vascular diseases and premature death.47 function.57 PM2.5 poses a particular risk
Research has linked exposure to fine par- to elderly people, children and people
ticulate matter and ground-level ozone to with heart or respiratory conditions.58
higher rates of mortality, concluding that
exposure to these pollutants, even at levels • Respiratory problems: Vehicle exhaust
below national standards, contributes to has been linked to a range of respira-
adverse health impacts.48 Ultrafine par- tory problems.59 Particulate matter can
ticulate matter (< 0.1 micron in diameter) cause inflammation in the respiratory
is especially dangerous since it can enter system and long-term exposure to nitro-
deep into lower airways, carrying heavy gen dioxide can increase the risk of
metals that are now linked to Alzheimer’s respiratory infections.60 VOCs, too, can
disease, along with odorless, toxic chemi- cause respiratory conditions. In sunlight,
cals such as polycyclic aromatic hydrocar- VOCs react with nitrogen oxides to form
bons (PAHs) that irritate the respiratory ground-level ozone, a major component
tract.49 Ozone and PM2.5 from road trans- of smog, which irritates the respiratory
portation kill almost 60,000 Americans system, causing coughing and reduced
every year, making road transportation lung capacity. NOX itself can cause
the largest single contributor to mortalities lung irritation and weaken the body’s
from these pollutants in the U.S.50 defenses against respiratory infections
like pneumonia.61
Specific health impacts of traffic pollution
include: • Asthma: Air pollution is extremely
harmful to children’s lungs, and numer-
• Cancer: Diesel exhaust is classed as a ous studies have shown that vehicle
potential cancer agent by the World Health exhaust can cause and exacerbate child-
Organization and the U.S. EPA, and at hood asthma.62 A 2010 study linked
least 19 of the hydrocarbons it contains are exposure to air pollution with altered
PAGE 10gene expression among asthmatic Living near transportation
children and research in 2013 similarly infrastructure causes particular
suggested that diesel pollution increased damage to health
children’s susceptibility to asthma by
Much of America’s vast – and growing –
turning off certain genes.63 Exposure to
network of roads traverses communities
NO2 in early childhood has been shown
where people live and breathe. The EPA
to increase the likelihood of developing
estimates that more than 45 million Ameri-
asthma.64
cans live within 300 feet of a busy road,
• Strokes: Higher levels of air pollution major transportation facility or other traffic-
have been associated with a higher risk related infrastructure.72 Unsurprisingly,
of stroke events. A 2015 meta-analysis research shows that those of us who live in
of 20 epidemiological studies carried close proximity to roads are at a particu-
out over the previous decade identified larly high risk from the health impacts of
exposure to particulate matter pollution, traffic-related pollution.73 A growing body
and especially PM2.5, as a risk factor for of studies shows that long-term residential
stroke.65 The study found that long-term proximity to busy roads can reduce life
exposure to PM air pollution is associated expectancy and cause or exacerbate a range
with an up to 21 percent increased risk of of diseases.74
stroke.
A number of studies have found an
• Dementia and cognitive decline: increased prevalence of asthma in children
Particulate matter has been linked to who live near busy roads.75 A Dutch study
dementia and cognitive decline among of 1,498 children found that asthma and
the elderly.66 People living close to major other chronic respiratory symptoms were
roads are at higher risk for developing significantly more prevalent in children
dementia (see below), thought to be due who lived within 100 meters of a freeway.76
to increased exposure to NO2 and PM2.5 A 2017 Rutgers University study of asth-
as well as sleep fragmentation due to matic children living near an industrial
noise.67 New Jersey seaport with heavy diesel truck
traffic found that greater exposure to car-
These impacts cause particular harm to bon soot coincided with markers for lung
vulnerable populations, including children, inflammation, and a UK study focusing on
the elderly, and those with heart or lung traffic within 150 meters of children’s fam-
conditions.68 Children especially are at risk, ily homes found that the risk of respiratory
as their respiratory systems are still devel- problems markedly increased the closer
oping and they inhale more air per pound children lived to a busy road.77
of body weight than adults.69 In addition,
ethnic minorities and other marginalized Research published in 2012 estimated that
groups often tend to bear the brunt of the over 27,000 cases of childhood asthma in
air pollution in American cities. One study Los Angeles County (8 percent of all cases)
in California showed that African Ameri- were at least partly attributable to pollution
cans and Latinos suffer disproportionately, associated with residential location within
being exposed to 40 percent more particu- 75 meters of a major road.78 Another study
late matter than white Californians.70 Low from Southern California, published in
income households and those that don’t 2006, found that risks for asthma increased
own a car are exposed to 20 percent more more than twofold among those living
pollution than the state average.71 within 75 meters of a major road. These
PAGE 11Living in close proximity to roads also has
significant linkages to incidences of strokes.
One study found that living within 100
meters of a major road increases the chances
of suffering from an ischemic stroke by 42
percent.82 It also increases the likelihood
of dying as a result: a 2013 study of 1,683
stroke patients observed that patients living
100 meters or less from busy roads had a
20 percent higher rate of poststroke mortal-
ity than those living more than 400 meters
away.83
Traffic-related noise and air pollution have
also been linked to a range of cardiovascu-
lar diseases. A 2012 study of coronary heart
disease (CHD) mortality among urban resi-
dents of Vancouver, Canada, for example,
Apartments above a New York City freeway. A growing
found that higher levels of noise and air pol-
body of research shows that living close to busy roads can
lution were associated with higher levels of
reduce life expectancy and cause or exacerbate a range of
CHD mortality. Individuals exposed to the
diseases. Photo: Jim Henderson via Wikimedia Commons
most noise were 22 percent more likely to
die as a result of CHD than those exposed
to the least.84
associations, the study concluded, were Strong links have also been found between
strongest among children with no paren- traffic-related air pollutants and heart
tal history of asthma who had lived at the attacks. Research published in 2007
same address since early in life.79 observed a “significant increase” in the
odds of heart attacks associated with
Not only does living near busy roads increasing exposure to traffic within 100
increase a child’s likelihood of develop- meters of patients’ homes.85 A 2002 study
ing asthma and other respiratory dis- from the Netherlands found that living
eases, it also damages lung development within 100 meters of a freeway or 50 meters
even in otherwise healthy, non-asthmatic of a major urban road was associated with
children. A study published in The Lan- increased incidence of death from heart
cet in 2007 found that children who lived attacks, among other cardiopulmonary
within 500 meters of a freeway since age conditions.86
10 had developed “pronounced deficits” in
lung function by the age of 18, compared Living near roads can increase the risk
to children living a mile away or more, of cognitive decline in older adults.87 A
suggesting that exposure to traffic 2012 study among community-dwelling
pollution is dangerous for all children, not seniors in Boston found that residential
just vulnerable subgroups.80 Poor lung proximity to a major roadway was associ-
function in later life is known to be a major ated with “statistically significantly poorer
risk factor for respiratory and cardiovascu- performance” on cognitive tests of verbal
lar diseases.81 learning and memory, psychomotor speed,
PAGE 12language and executive functioning, with Part of the reason for these high levels of
participants who lived less than 100 meters fatalities among cyclists and pedestrians
from a major road performing worst.88 A has to do with our unsafe infrastructure.
2017 study of residents of Ontario, Canada, High fatality and injury rates for pedestri-
similarly found increased incidence of ans and bicyclists are in part the result of
dementia among those who lived in close road and community design that prioritizes
proximity to heavy traffic.89 The study vehicle throughput and speed.96 The risk
found that those most at risk were indi- of death for a pedestrian hit by a car more
viduals who lived closest to the roads, than doubles, from 10 percent to 25 percent,
who lived in major urban centers and who if the speed of the car increases from just
had never lived elsewhere.90 The study 23 mph to 32 mph.97 For a pedestrian hit by
concluded that among individuals with a car moving at 42 mph, the risk of death is
dementia who live within 50 meters of a 50 percent.98
major road, between 7 and 11 percent of
cases are attributable to traffic exposure. 91 Many roads also lack basic infrastructure
that improves safety for walking and
biking, like sidewalks and bike lanes.99
Our dependence on cars has lethal A study of pedestrian crashes from the
consequences for road users early 1990s found that, of the 2,885 inci-
American society’s dependence on cars dents where such data was available, more
puts us at risk every time we take to the than 80 percent took place on roads with
roads, whether or not we’re in a car our- no sidewalk.100 Another study found that
selves. The current design of our roadways
puts people who walk or bike in particular
danger. Unsafe, car-oriented infrastructure
discourages people from biking, walking
or using public transit – further cementing
car dependence and exacerbating the risks
it poses to public health.
Every year, approximately 38,000 Ameri-
cans are killed in car crashes, making
car crashes the leading cause of death for
Americans between the ages of 1 and 54.92
In 2018, nearly 6,300 pedestrians and more
than 800 cyclists were killed in traffic-
related accidents – increases of 3.4 percent
and 6.3 percent, respectively, from 2017.93
In some urban areas, pedestrian fatalities
account for up to 40 percent of all traffic- Roads without infrastructure for walking and
related deaths.94 Between 2009 and 2018, biking make it less safe and more difficult to get
pedestrian and cyclist deaths as a propor- around without a car. This area of Shady Cove,
tion of total traffic-related fatalities on Oregon, was later the focus of an improvement
America’s roads rose by 6 percent, with project to add sidewalks and bike lanes.
more pedestrians and cyclists killed in 2018 Photo: Oregon Department of Transportation
than in any year since 1990.95
PAGE 13the risk of cycling on roads with physi- • Longer commutes are linked to poor
cally separated bike lanes was about one diet and lack of exercise. A 2012 study
ninth that of riding on roads with no bike of commuters in Texas found that
lanes.101 individuals with longer commutes were
less physically active, more likely to be
Unsurprisingly, when people perceive that obese, and had greater body mass index
an activity – like walking or biking – is (BMI) and waist circumference and
likely to put their safety at risk, they will be higher blood pressure.109 A commute of
less likely to do it. According to a research 10 miles or more each way is associated
review by Active Living Research, “[s]afety with higher blood pressure, the study
concerns, both real and perceived, are a found, and participants who commuted
major deterrent to active travel.”102 more than 15 miles were more likely
to be obese and less likely to do the
Driving to work damages our health and recommended amount of physical activ-
makes us less happy with our lives ity, putting drivers at increased risk of
The public health danger from our depen- diabetes, cardiovascular disease, osteo-
dence on cars doesn’t just come from pollu- porosis, metabolic risk syndrome and
tion and road accidents. Driving also takes certain kinds of cancer.110 Another study
a toll on the health of drivers themselves – found that every hour sitting in a car was
and Americans drive a lot. associated with a 6 percent increase in
the odds of obesity.111
Around 85 percent of Americans commute
by car every day.103 These commutes take a • Commuting is linked to poor sleep. A
toll on us, physically and psychologically, study published in 2018 found that each
leading to health problems ranging from additional hour of commute time means
headaches, backaches, digestive problems 15 minutes of sleep loss, and that individ-
and concentration issues to a range of uals with longer commutes had greater
potentially extremely serious conditions:104 variability in sleep duration and less
stability of sleep rhythms than those with
• Long car commutes can lead to chronic short commutes.112 The 2012 Regus Work-
stress and poor mental health.105 A 2011 Life Balance Index found that commutes
study of New York commuters found that of more than 45 minutes were associated
those who travel to work by car experi- with poor sleep quality and exhaustion.113
ence “significantly higher” levels of stress Sleep loss is in turn linked to a range of
and more negative moods than those health problems, including diabetes and
who took active modes of transport.106 obesity.114
A 2014 study by researchers in Canada
found that people with longer commutes • Commuting by car harms our relation-
had lower satisfaction with life, and a ships.115 Studies have shown that people
2011 study – also from Canada – found with longer commutes are less likely
that traffic congestion and long commutes to spend time with family and friends,
were associated with higher stress contributing to higher rates of stress and
levels.107 In the latter study, 36 percent of reduced life satisfaction.116 An analysis
full-time workers with a commute of 45 of commuting data from Sweden found
minutes or more said that most days were that couples with longer commutes are 40
“quite or extremely stressful,” compared percent more likely to split up than those
to 23 percent of those with commutes of with shorter commutes.117 One study on
less than 15 minutes.108 the psychological costs of traffic conges-
PAGE 14tion even found a connection between
extreme traffic and higher incidence
of domestic violence, with a 9 percent
increase in incidents of domestic abuse on
days with extreme traffic.118
Transportation is the leading source of
greenhouse gas emissions
In 2018, America’s transportation sector
emitted 1,882 million metric tons of green-
house gases (MMTCO2e), accounting for
28 percent of the nation’s total greenhouse
gas emissions – more than any other sec-
tor of the economy.119 U.S. transportation
emissions now account for approximately 4
percent of total global greenhouse gas emis-
sions.120
Around 85 percent of Americans commute to work by car.
By far the leading sources of U.S. transport Research shows that all this driving takes a toll on our
emissions are light-duty vehicles like cars mental and physical health. Photo: prvideotv via Pixabay
and light trucks. In 2017, these vehicles
accounted for nearly three-fifths of trans-
port emissions and one-sixth of America’s
vehicle also includes the emissions pro-
total greenhouse gas emissions.121 In recent
duced during its production, from the
years, emissions from these kinds of vehi-
extraction of raw materials to the construc-
cles have been on the rise. Between 2013 and
tion and assembly of its component parts
2017, the annual distance Americans drove
and the extraction and shipping of fuels.125
in light-duty vehicles grew by 200 billion
Quantifying the impacts of such a sprawl-
miles, and annual emissions from these
ing and complex process is difficult, but one
vehicles rose by 36 million metric tons.122
recent estimate suggests that almost a quar-
The typical American vehicle is heavy, ter of a car’s total lifetime carbon emissions
inefficient and powered by fossil fuels. An are produced before it even hits the road.126
analysis comparing the United States with
The climate impacts of a car-dependent
seven countries plus the European Union
transportation system must also take into
found that the average U.S. passenger vehi-
account the emissions associated with
cle emits more CO2 and consumes more fuel
building and maintaining that system’s
per mile than the average vehicle in all but
infrastructure. A 2019 lifecycle analysis of
three countries, and is bigger, heavier and
a provincial road in Italy showed the build-
has a more powerful engine than the aver-
ing and maintenance of roadways, includ-
age vehicle in any other country.123 For every
ing raw materials, fuels, transportation and
gallon of gas we put in our cars, we pump
construction site set-up, are responsible for
roughly 24 pounds of CO2 and other harm-
more than 47 percent of a road’s total envi-
ful emissions into our atmosphere.124
ronmental impact, while the actual use of
But the climate impacts of our automobile the road (i.e., environmental impacts from
dependence don’t just come from tailpipe traffic, maintenance and so on) is respon-
emissions. The total carbon footprint of a sible for the other 53 percent.127
PAGE 15This transportation system is a major con- Climate change will bring more dis-
tributor to our changing climate, and if ease. Shifting temperatures will also
emissions continue at their current level, the lead to geographic shifts of disease-car-
impacts on public health will be severe.128 rying insects like ticks and mosquitos.136
Climate change influences human health Changes in air and water temperatures
and disease in a range of different ways, and other climatic conditions can affect
including intensifying existing threats to the transmission of the pathogens that
public health and creating the conditions for cause diarrheal diseases, such as sal-
new ones to emerge. monellosis and campylobacteriosis.137
Warmer weather will increase the preva-
Extreme temperatures will kill more peo- lence of pathogens like E. coli and sal-
ple. Many cities have seen sharp increases monella, which thrive in hot and humid
in fatality rates during heat waves in recent conditions, and warming seas will see
years, including from heat stroke and related an increase in bacteria in seafood. Cli-
problems, as well as cardiovascular, respira- mate change may even bring about new
tory and cerebrovascular diseases.129 Extreme diseases.138
heat also brings a rise in hospital admissions
for cardiovascular, kidney and respiratory
disorders.130 As the frequency and intensity ***
of extreme temperatures increase in the com-
ing decades as a result of climate change,
these numbers will rise.131
According to the EPA’s 2019 Automotive
Climate change will create high concentra- Trends report, new vehicles are at a his-
tions of ground-level ozone and air pol- toric low in terms of the grams per mile
lution. Ozone will increase in some areas of CO2 they produce and a historic high in
and decrease in others, as the climate crisis terms of fuel efficiency.139 Since 2004, new
will affect the weather patterns in different vehicles’ CO2 emissions have decreased 23
regions differently. Exposure to ozone is percent and fuel economy has increased 30
linked to premature deaths and hospitaliza- percent.140 And yet, over this period, there
tions due to various respiratory illnesses.132 has been no corresponding reduction in
Estimates suggest that, by 2050, climate total greenhouse gas emissions from trans-
change could lead to as many as 4,300 portation.141 Instead, over the last decade,
additional premature deaths every year in emissions from the transportation sector
the U.S. from the health effects of ozone and have been on the rise.142
particulate matter pollution.133
This is largely because we’re driving
Climate change will bring more severe more. In other words, making our vehicles
natural disasters. Larger floods, wildfires cleaner and more energy efficient – while
and winter storms can result in death and important – isn’t enough to address our
injury and cause major damage to infra- transportation system’s role in accelerating
structure. Droughts can devastate water climate change. To mitigate our impact on
quality and have negative impacts on respi- the climate, and to alleviate the many other
ratory health, as can wildfires.134 Wildfire health impacts of a transport system cen-
smoke contains particulate matter, carbon tered around fossil-fuel-powered vehicles,
monoxide, nitrogen oxides and VOCs and we need to completely overhaul the way
can significantly damage air quality.135 we travel.
PAGE 16We can transform America’s
transportation system
TRANSFORMING OUR transportation Give more people the option to travel
system into one that is safe, healthy and
environmentally friendly is a huge and by foot, bike and transit
complicated endeavor. But there are several In 2017, more than four in five trips taken
steps we can take right now, using tools by Americans were made by car, pickup
and technologies already available, that truck, SUV or van.143 Shifting some of these
can do the bulk of the heavy lifting. Three trips to transit, walking and cycling is an
goals, which are achievable with proven important way to reduce air pollution and
policies and existing technology, can help greenhouse gas emissions from transpor-
eliminate pollution from cars and light tation, even if all vehicles are eventually
trucks and move America’s transportation powered by electricity from renewable
system towards a greener, healthier future: sources.
• Doubling the number of people who Shifting modes of travel can make an
travel by walking, biking and public immediate impact on air pollution and
transit by 2030. health, even as the nation transitions its
• Ensuring that all personal vehicles sold automobile fleet to electric vehicles, builds
after 2035 are electric. its infrastructure for charging them, and
transitions to an electricity system powered
• Expanding public transportation and by 100 percent clean energy. Shifting from
electrifying all transit and school buses driving to transit, cycling and walking cre-
by 2030. ates an opportunity to address the many
other impacts of widespread automobile
By rebuilding our transportation system to dependence, including dangerous and
give people the option to spend less time congested streets. Improved walking and
in a car and more time traveling by healthy transit infrastructure can bring vital acces-
means such as walking and biking, and by sibility improvements for older adults and
adopting clean vehicle technologies that people with mobility issues.144
do not produce the dangerous emissions of
fossil-fuel-powered vehicles, we can reduce Making it easier for people to travel with-
the health and environmental impacts of out a car brings valuable benefits for our
our car-dependent transportation system health and the health of our communi-
and build healthier, safer, better connected ties. Research shows that communities
communities. with more walking and biking see more
PAGE 17user enjoyment, better health, improved to work have a 27 percent lower risk of
economic activity, stronger communities developing cardiovascular disease and a
resulting from positive interactions between 36 percent lower risk of dying from it.150
neighbors, and more neighborhood secu-
rity.145 A 2014 study from the UK found Reducing driving will also reduce car
that commuters who stopped driving and crashes, which take an enormous toll, both
started walking or cycling to work experi- economically and in terms of lost lives.
enced higher levels of wellbeing, with the There were more than 36,000 people killed
likelihood of feeling constantly under strain in crashes in 2018.151 And in 2010, the last
or unable to concentrate at least 13 percent year for which data is available, the total
higher when commuting by car.146 Walking economic impact of car crashes including
and cycling can also provide the proven lost lives, injuries and property damage
health benefits that come from increased amounted to $242 billion.152
physical activity:
THE GOAL
• Research published in The American The U.S. should at least double the num-
Journal of Preventive Medicine in 2013 ber of people who travel by foot, bike or
found that people who walk to work transit by 2030.
are 17 percent less likely to have high
blood pressure than those who drive, Doubling the number of people who travel
and people who commute by bike are by foot or bike or on transit by 2030 is the
around half as likely to have diabetes as beginning of the kind of transformative
those who drive. The study also found change that is needed if the United States is
that cycling, walking and using public going to end its damaging dependence on
transit were all associated with lower risk the automobile. It is, however, an ambitious
of obesity than driving.147 A 2012 study mid-term goal – one that can drive emission
showed that an hour of walking each day reductions in the short term and push the
can even help override the effects of a nation to build more sustainable communi-
genetic predisposition to obesity.148 ties with more transportation options in the
long run.
• A recent study from the UK found that
commuters who walked, cycled or took By doubling the number of people who
public transit at least part of the way to travel primarily on foot, bike or public
work were 11 percent less likely to devel- transit, America can improve public health,
op cardiovascular disease and 30 percent reduce emissions, enhance communities,
less likely to die from it than people who and substantially ease the task of moving
commuted solely by car.149 to a zero-emissions transportation system.
Specifically, achieving this goal would:
• Research published in the British Medical
Journal in 2017 found that, compared to • Increase walking, biking and transit
those who drive or take public transit, travel by more than 100 billion miles,
cycle commuters were 41 percent less assuming that the current distance
likely to die prematurely, 46 percent less traveled by these modes were to double.153
likely to develop heart disease and 52 If this increase were to be matched by
percent less likely to die from it, and 45 a parallel decrease in miles traveled by
percent less likely to develop cancer and car, vehicle carbon dioxide emissions
40 percent less likely to die from it. The would be reduced by approximately 32
same study found that those who walk million metric tons.154 While this does
PAGE 18not take into account potential increases Ensure that walking, biking and transit are safe,
in emissions from new transit routes, a affordable, accessible and enjoyable
rapid transition to electric buses would
Ensuring that active transportation options
reduce the greenhouse gas impacts of
and public transit are safe, affordable, acces-
those additional trips.
sible and enjoyable is key to increasing the
• Reduce overall transportation energy use, number of people who travel without a
making the task of repowering the trans- car.160 Places that have invested in improved
portation system with clean energy far infrastructure and better service have seen
easier. subsequent improvements in safety and
increased transit ridership. Two approaches
• Benefit public health and wellbeing. in particular – adopting “complete streets”
Studies have found that people who walk principles and investing in transit improve-
or bike to work are happier with their ments – can get more people traveling by
commutes.155 If the U.S. were to double foot, bike and transit.
walking and biking mileage, Americans
would burn an extra 2.7 trillion calories Create “complete streets” that work for everyone
in 2030.156
There are a wide variety of design and pol-
icy factors that affect the safety and quality
GETTING THERE of walking and cycling, ranging from road
To double the number of people who travel design, to speed limits, to infrastructure
by foot, bike and transit, the U.S. must make elements like sidewalks and bus and bike
these forms of travel the cheapest, easiest, lanes.161 Many of these elements fall under
most comfortable and safest options avail- the concept of “complete streets,” which, as
able.157 That will mean undertaking a vari- described by the U.S. Department of Trans-
ety of initiatives, including providing better portation, are “streets designed and oper-
infrastructure and changes to transporta- ated to enable safe use and support mobility
tion finance. for all users,” including “people of all ages
and abilities, regardless of whether they
While policies for encouraging increased are travelling as drivers, pedestrians, bicy-
transit use and active forms of transport are clists, or public transportation riders.”162 By
varied, they can also reinforce each other the end of 2018, nearly 1,500 communities
and make the path forward far easier. For across the U.S. – primarily towns and small
example, the design changes that make suburbs – had adopted “complete streets”
cycling safer also typically make walk- policies.163
ing more pleasant.158 Because around 90
percent of transit trips are accompanied Cities that have implemented complete
with walking trips for a part of the journey, streets policies typically see more walking
improved walking conditions make transit and biking, and less driving.164 Good bicycle
more accessible. Similarly, increased transit infrastructure, including separated bike
ridership will mean more people walking lanes, is associated with both greater cyclist
to and from rail and bus stops.159 And poli- safety and higher rates of cycling.165 Research
cies that reduce subsidies to driving can has found that, for U.S. cities with over
make all forms of non-auto transportation 250,000 people, each additional mile of bike
more attractive, particularly if paired with lane per square mile increases the share of
increased funding for those modes. people who bike by about 1 percent.166
PAGE 19Complete streets also increase safety. A cling appear to be an effective route to
study published in the American Journal of improving the safety of people walking and
Public Health found that protected bike lanes bicycling.”169
can reduce injury risk by almost 90 per-
cent.167 Another study assessed impacts of Complete streets policies can be particularly
adding complete street elements – including effective when tied to a broader strategy to
a raised median, redesigned intersections improve safety, including so-called “vision
and sidewalks – to a suburban four-lane zero” strategies to eliminate all traffic fatali-
road in New Jersey. The study found that ties. “Vision zero” strategies include not just
after the changes were implemented, pedes- complete streets and other improvements to
trian “exposure risk” – the time it takes the built environment, but also engagement
pedestrians to cross a street, where they with public health officials, law enforcement
are exposed to oncoming traffic – dropped and community members, the collection
by 28 percent.168 As more people use the and application of data on traffic deaths,
roads for walking and biking, safety likely and a focus on safe speed limits.170
increases further: A study in the journal
Injury Prevention determined that there is Expand and improve transit
“safety in numbers” for pedestrians and Cities and transit agencies need to maintain,
bicyclists, and that “[p]olicies that increase expand and improve public transit service.
the numbers of people walking and bicy- There are many ways to do this, including
By designing streets to serve pedestrians, bicyclists and transit – including by adding infrastructure
like this separated bike lane in Vancouver – cities can encourage low-carbon transportation and make
streets safer for everyone. Photo: Paul Krueger via Flickr, CC BY 2.0
PAGE 20adding routes, building better platforms decrease in driving. From 2010 to 2017, the
and transit stations, allocating dedicated percentage of commuters getting to down-
bus lanes and reducing the cost of riding. town Seattle via transit grew from 42 per-
Improving frequency, reducing passenger cent to 48 percent, while the share of trips
crowding, and ensuring safety and reliabil- in single-occupancy vehicles fell from 35
ity are all important ways to improve rider percent to 25 percent.177
satisfaction.171 With local transit systems fac-
ing serious revenue crises due to the sharp Maintaining, improving and expanding
drop-off in ridership during the coronavirus public transit should begin with ensuring
pandemic, enabling cities to undertake these maintenance of existing systems. Among
improvements will require significant – and other things, this will require increasing
immediate – investment of federal funds.172 funding to the Federal Transit Administra-
tion’s “State of Good Repair” program to
Experience shows that this investment is address the current $98 billion backlog in
worthwhile. While every region is differ- needed transit repairs, while also invest-
ent, the evidence is clear that when transit ing more in other funding mechanisms
service is expanded or improved, more to allow for the expansion and construc-
people ride. A TransitCenter analysis of tion of new public transit.178 Grants or loan
the National Transit Database found that assistance programs, such as competitive
in 2018, transit ridership increased in seven programs like Better Utilizing Investments
of the 35 regions with the highest tran- to Leverage Development (BUILD) grants
sit usage.173 Of those seven regions, six – and Capital Investment Grants, are another
Seattle, Houston, Austin, San Antonio, Las opportunity to fund more low-carbon trans-
Vegas and Pittsburgh – had either substan- portation options.
tially increased transit service since 2013, or
had recently reoriented their transit net- Allocation of federal grant money for transit
works to meet growing demand.174 projects can be expedited by easing federal
red tape for small-scale transit projects with
In Seattle, for example, ridership levels have clear environmental benefits. Federal fund-
increased since 2014, when voters approved ing programs that are currently limited to
the Seattle Transportation Benefit District capital expenditures could be expanded to
Proposition 1 to generate about $50 million also support operating expenses, encourag-
each year to invest in the city’s transit sys- ing transit agencies to increase service on
tem. The initiative has added nearly 7,000 already-existing bus and rail lines. Fund-
weekly bus trips to the city. It has provided ing programs should include requirements
every public high school student with free, that hold states accountable for setting and
unlimited transit passes.175 Perhaps most meeting goals that reduce per capita miles
importantly, the initiative has given more driven, and the allocation of federal funding
people access to high-frequency transit should favor direct financial support to local
service, increasing the percentage of house- governments pursuing innovative land-use
holds that live within a 10 minute walk of and demand management transportation
“10-minute service” (a route with an average programs. In addition, increased federal
of a trip every 10 minutes in each direction) funding – for example through the Passen-
from 25 percent to 67 percent.176 ger Rail Improvement, Modernization and
Expansion (PRIME) federal grant program
As service has expanded and improved, – should be allocated for railway improve-
Seattle has seen an increase in transit use, ment and expansion, including for the elec-
as well as other low-carbon modes, and a trification of rail lines across the country.
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