What is “Healthy Transportation” — Issues for a Health Impact Assessment

Massachusetts’ new Transportation Reform Act mandates that the Department of Transportation collaborate with Health & Human Services, Environment & Energy, and others to create a Healthy Transportation Compact.  The law also requires that the state devise a way of conducting a Health Impact Assessment of new transportation projects.  But what does it mean to have a transportation system that is healthy for the environment, for our climate, for the economy, for our communities and families, for the physical and mental wellbeing of those who are moving around and those who are being passed by? 

The first thing that assessing “healthy” requires is that we look at transportation as a system rather than as separate modes or separate networks (rail, trolley, bus, cars, trucks, bikes, planes, boats, and feet).  Massachusetts’ creation of a Department of Transportation that brings together many of the previously separate travel agencies (MBTA, Turnpike, Mass Highway, Airports) is a good first step, but true systemic thinking will require much more.

Part of that “more” is understanding that the ultimate purpose of transportation is not the expansion or maintenance of surfaces (pavement, rail, path) or even the improvement of mobility (the process of moving people and things from one place to another).  It is not even ultimately about access – making sure that all people are able to get from their starting point to their destination in a manner that allows them to take full advantage of being there: to utilize the services or join the activity that the destination provides.

The ultimate purpose of transportation is to improve our overall quality of life – to help us live healthier lives in a healthier society and healthier earth.  Transportation is simply a collection of functions whose purpose is to help promote the general welfare.  Transportation has enormous impact on the attainment of those social goals, no matter how they are defined, because it is such an intensive consumer of financial and natural resources and because it has such a powerful impact on land use and development.  (In fact, transportation and land use can be considered as two sides of the same process.)

We can argue endlessly about what we mean by “quality of life,” “healthier lives,” and “the general welfare,” but simply starting the conversation with those topics changes the entire framework for transportation decision-making.

And, fortunately, we have numerous official statements about the kinds of society we are trying to create.  These policy directives can be summarized in six categories:

  • Impacts on the Natural Environment & Energy Use
  • Impacts on Land Use and the Built Environment
  • Impacts on Safety & Physical Health
  • Impacts on Access to Goods and Services
  • Impacts on Community Strength (social capital) and Mental Health
  • Impact on Direct and Hidden (externalized) Costs to Users & Society

For example, we have policies requiring that we reduce the pollutants in our air and water, that we reduce our impact on climate change and our reliance on nonrenewable resources, that we preserve open land and green spaces, that we promote economic development and housing construction that limits sprawl, that we reduce transportation-related deaths and injuries, that we improve our population’s overall physical and mental health while eliminating the huge disparities in well-being among different ethnic and income groups, and more.  These policies are important not only for the operational impact of the transportation system but also for what happens during its construction and eventual decommissioning.

In addition, Transportation policies and projects can be evaluated according to the degree to which they:

  • Further the integration of all components of the transportation system into a coherent whole.
  • Serve all users, regardless of age, income, disability, location.
  • Make every component and mode within the transportation system have a more positive impact on the six categories (e.g. reduce pollution or use energy more efficiently).
  • Promote the public use of components and modes that have the most positive impact on the six categories.


Here are some of the questions that arise within each impact category when examining a transportation project or activity.

  • Impacts on the Natural Environment & Energy Use

What amounts of fine particulate matter (mostly from truck and train diesel exhaust), ground-level ozone (formed when tailpipe emissions from cars and trucks react with sunlight and oxygen), nitrogen oxide (NOx, which contributes to the formation of both ozone and smog), CO2 and C0 (and other green house gases), and any emissions particular to airports are being – or will be — produced?  What demographic and geographic groups are getting – or will get – the maximum exposure?

How many people are – or will be – living, working, or otherwise spending significant amounts of time within 300 feet of a roadway (the area of maximum exposure)?  What demographic and geographic groups get – or will get – the maximum exposure?

What type and level of noise and vibrations are being – or will be – produced?  What demographic and geographic groups get – or will get – the maximum exposure?

How are natural resources (wetlands, forests, open space) and parklands impacted?  What is – or will be –  the impact on local and regional water supplies, on animal life, on recreational opportunities?  What is – or will be – the impact on trees, flowers, and other natural features?  What demographic and geographic groups current use those resources?

How much of what kinds of energy does – or will – the vehicles use?  How much and what kinds of resources and energy does it take to construct and operate the system of which the vehicles are a part?

  • Impacts on Land Use and the Built Environment:

To what extent is – or will be – compact, mixed-use development facilitated or blocked?   What is the impact on preserving agricultural land, parklands, green or open spaces?

Do all people, regardless of method of travel, have access to major destinations and shopping areas?

Is the system designed to make it easier for people of various sizes and needs to rest, gather, and socialize through the provision of comfortable “street furniture” and other amenities?

Are non-transportation uses (e.g. festivals, play, vending) facilitated or inhibited?

At inter-modal connections is there protection from the rain (especially at transit stops), shade, and access to water fountains and toilets?

Is bicycling discouraged or encouraged, for example through the provision of adequate, safe, and convenient bicycle parking within neighborhoods near homes and at destinations?

To what extent is heavy traffic kept away from residential areas, schools, and retail shopping areas?

  • Impacts on Safety & Physical Health (via Active Transportation):

Do the roads incorporate “complete streets” (outside to inside”) and context sensitive perspective, including facilities for public transportation services?

Do sidewalks have the maximum possible width?  Are curb cuts and zebra markings close to desire-lines and sight-lines near corners?  Are walkways wide enough to allow couples moving in opposite directions to safely pass each other?

Do sidewalks have wheelchair-friendly surfaces and be clear of narrowing obstructions?  Do intersections on the wider streets have mid-point resting areas?

Are street “design speed” at or below legal limits rather “overbuilt” with safety margins for higher speeds?  Are traffic-calming and safety-enhancing measures systematically included to further reduce speed at points where vehicles and pedestrians interact?  What percentage of residential streets have speed limits of 20 mph or below?

Are appropriately designed bikeways (off-road paths, on-road cycle tracks and bike lanes), intersection facilities (bike boxes, bike traffic lights), and bike parking spaces adequate for future growth?  What is the ratio of miles of bike lanes and paths to miles of road?  Are bikeways wide enough to allow users to travel side by side and thus carry on a conversation with a colleague or child?

Is the “model user” for bicycle facilities a 50 year old female, as in the Netherlands?   Are all cycling populations being equally served, including women, children, seniors, and parents with children on their bicycles?

Have traffic and walk signal locations and timing been optimized for pedestrians (and cyclists) and coordinated along the entire route to support pedestrian, bicycle, and car throughput rather than car speed?  And are there provisions for regular public re-assessment of the adequacy of those signal settings?

Is it possible for people to walk or bike directly to important destinations?

Is the lighting appropriate (while reducing energy-wasting upward-facing illumination)?  Is the way-finding signage clear and visible no matter what mode of travel is being used?

What percentage of the proportion lives within ¼ mile of a public transportation access point?  What percentage of the area’s workforce place of employment is within ½ mile of a public transportation access point?

  • Impacts on Access to Goods and Services:

How are currently underserved populations able to get to the full range of medical care, shopping (especially fresh food and clothing), social services, jobs, recreational opportunities, and civic centers?

In what ways does the transportation system encourage development that serves all income levels?

  • Impacts on Community Strength (social capital) and Mental Health:

To what extent does the transportation system reduce commuting time for area residents and workers?

How does the transportation system directly an indirectly shape to employment opportunities for people of all skill levels?

What percentage of children walk or bike to school?

Is there a comfortable and effective process for public comment and participation in transportation planning?

All these impacts, and more, are the proper scope of the Health Impact Assessments required by the new Massachusetts Transportation Restructuring Act.  The legal opportunity has been created.  Now, it is the job of both advocates and officials to make it work.

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