Health and Transportation

According to the U.S. Centers for Disease Control, transportation agencies play an important role in public health by encouraging healthy community design, promoting opportunities for physical activity by supporting active transportation infrastructure, reducing human exposure to air pollution, reducing injuries associated with motor vehicle crashes, and ensuring that community members have equal access to safe, healthy, convenient and affordable transportation.

The Federal Highway Administration is focusing on public health in transportation through partnerships between health practitioners and transportation professionals. Goals of these efforts including promoting safety; improving air quality; advancing Context Sensitive Solutions; improving access to jobs, health care and other services; and advancing multi-modal and active transportation options including walking, biking, public transportation and ride-sharing.

To further these goals across the nation, the U.S. DOT has developed a Transportation and Health Tool that provides data on transportation and public health indicators for each U.S. state and metropolitan area that describe how the transportation environment affects safety, active transportation, air quality, and connectivity to destinations. The tool provides strategies that transportation practitioners can use to further improve health benefits such as safe bicycling and walking infrastructure, expanding public transportation, integrating health and environmental planning, adopting programs such as Safe Routes to School, and adopting health performance metrics.

Roadway safety also is an important public health consideration for transportation. FHWA has recognized that “using effective safety countermeasures and encouraging safe behaviors by all road users can reduce the number of fatalities and injuries. This is particularly important for vulnerable road users like pedestrians, bicyclists, children, and older adults.”

The “Toward Zero Deaths” vision has been embraced by FHWA as well as a number of states and cities. According to FHWA, “the approach targets areas for improvement and employs proven countermeasures, integrating application of education, enforcement, engineering, and emergency medical and trauma services (the ‘4Es’).” FHWA administers the Highway Safety Improvement Program (HSIP) to reduce traffic fatalities and serious injuries on public roads. It requires that each state develop a Strategic Highway Safety Plan. A wide range of additional safety-related information is available on FHWA’s Safety website.

In addition to safety and active transportation options that promote healthy lifestyles, other important health issues in transportation include:

  • improving air quality by reducing vehicle emissions; particular benefits are seen in children, older adults, and individuals with respiratory diseases.
  • providing affordable and convenient transportation options that enable access to goods, services and opportunities that improve quality of life.
  • reducing transportation-related noise to reduce health effects like hearing loss, sleep disturbances, and other impacts associated with noise exposure.

State DOTs are working to incorporate these health considerations into their projects, programs and policies. Examples include California DOT’s Active Transportation Program.

A Transportation and Health Peer Exchange was convened by AASHTO in 2015 to share best practices and resources among state DOTs.

Livability and Sustainable Communities

Transportation provides a vital link to promote healthy and vibrant communities. In recent years, initiatives to ensure that transportation decisions and options best meet the needs of communities have been included under several labels, including livability, sustainability, smart growth, complete streets, and context sensitive solutions.

FHWA’s Livability Initiative defines livability as “tying the quality and location of transportation facilities to broader opportunities such as access to good jobs, affordable housing, quality schools, and safer streets and roads.” The initiative includes a range of tools and resources to advance these concepts – including the Livability in Transportation Guidebook and associated webinars and training videos. Support for livable communities also comes from activities such as Context Sensitive Solutions – a process under which transportation practitioners work to ensure that projects best fit the needs of communities and the environment. More information is available in the Context Sensitive Solutions section of this website and on

Work also was undertaken to leverage infrastructure policies and investments across sectors through the Interagency Partnership for Sustainable Communities, an initiative of the U.S. DOT, the Environmental Protection Agency, and the Department of Housing and Urban Development.

Bicycle and Pedestrian Transportation

Transportation agencies support bicycle and pedestrian transportation to increase options available to people, while also encouraging health benefits of these active transportation alternatives.

At the federal level, FHWA’s Bicycle and Pedestrian Programs promote bicycle and pedestrian transportation accessibility, use, and safety. FHWA issues guidance and is responsible for overseeing compliance with legislative requirements. Each state DOT has a Bicycle and Pedestrian Coordinator to promote and facilitate the increased use of nonmotorized transportation, including developing facilities for the use of pedestrians and bicyclists and public educational, promotional, and safety programs for using such facilities.

U.S. DOT’s policy regarding bicycle and pedestrian modes specifies the following:

“The DOT policy is to incorporate safe and convenient walking and bicycling facilities into transportation projects. Every transportation agency, including DOT, has the responsibility to improve conditions and opportunities for walking and bicycling and to integrate walking and bicycling into their transportation systems. Because of the numerous individual and community benefits that walking and bicycling provide — including health, safety, environmental, transportation, and quality of life — transportation agencies are encouraged to go beyond minimum standards to provide safe and convenient facilities for these modes.”

Legislative and policy guidance related to bicycle and pedestrian modes as well as funding sources and eligibility are outlined in FHWA Guidance: Bicycle and Pedestrian Provisions of Federal Transportation Legislation (updated Sept. 2015).

Under U.S. DOT policy, for projects on the National Highway System, FHWA and the states may consider design guides from the American Association of State Highway and Transportation Officials (AASHTO) and other publications for bicycle and pedestrian design standards. FHWA supports routinely incorporating bicycling and walking as part of transportation planning and also supports taking a flexible approach to bicycle and pedestrian facility design as described in its 2013 memo, Bicycle and Pedestrian Facility Design Flexibility. See also FHWA’s Separated Bike Lanes Planning and Design Guide (2015).

Other resources such as the Pedestrian and Bicycle Information Center provide information on a wide variety of engineering, encouragement, education, and enforcement topics. The Center was established with funding from the U.S. DOT and is operated by the University of North Carolina Highway Safety Research Center.

Transportation Alternatives Program

The Transportation Alternatives Program (TAP), enacted under the Moving Ahead for Progress in the 21st Century Act (MAP-21), is a key funding source for programs that support healthy transportation options.

Eligible projects include:

  • pedestrian and bicycle facilities,
  • infrastructure projects for improving non-driver access to public transportation and enhanced mobility,
  • conversion of abandoned railway corridors to trails,
  • construction of scenic turnouts and overlooks,
  • outdoor advertising management,
  • historic preservation and rehabilitation of historic transportation facilities,
  • vegetation management,
  • archeological activities related to implementation of highway projects,
  • stormwater mitigation related to highway construction or runoff,
  • reduction of vehicle-caused wildlife mortality and restoration of habitat connectivity,
  • planning, design or construction of boulevards and other roadways largely in the right-of-way of former divided highways,
  • safe routes to school projects, and
  • recreational trails.

The national total reserved for the TAP is equal to 2 percent of the total amount authorized from the Highway Account of the Highway Trust Fund for Federal-aid highways each fiscal year. This has included $809 million in 2013, $820 million in 2014, and $820 million in 2015. Guidance and other resources on implementation of the TAP can be found on on FHWA’s Transportation Alternatives Program website and MAP-21 TAP Guidance Additional information on TAP projects, including the 2014 TAP spending report, is available on the Transportation Alternatives Data Exchange website.

Safe Routes to School Program

The Safe Routes to Schools Program is a Federal-Aid program of FHWA. Created under Section 1404 of the Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users (SAFETEA-LU), it was funded at $1.162 billion for fiscal years 2005-2012 and has been administered by state DOTs. As mentioned above, MAP-21 did not provide specific funding for the program, but Safe Routes to School projects are eligible for TAP funds and for Surface Transportation Program funds.

The program was designed to encourage children, including those with disabilities, to walk and bicycle to school; to make bicycling and walking to school a safer and more appealing transportation alternative, thereby encouraging a healthy and active lifestyle from an early age; and to facilitate the planning, development, and implementation of projects and activities that will improve safety and reduce traffic, fuel consumption, and air pollution in the vicinity of primary and middle schools.

From 2005 when the program was established until 2015, the Safe Routes to School program has been used at nearly 18,000 schools teaching kindergarten through eighth grades in all fifty states and the District of Columbia. The program has reached more than 6.8 million students nationwide, with underserved schools well represented, and has demonstrated safe transportation and health benefits of active travel for these students.

For more information, link to the National Center for Safe Routes to School.

Recreational Trails Program

The Recreational Trails Program is another assistance program of the FHWA. The program provides federal transportation funds to the states for development and maintenance of recreational trails and trail-related facilities for both non-motorized and motorized recreational trail uses.

Under the program, each state receives funds apportioned by statutory formula, administers its own program, usually through a state resource or park agency, develops its own procedures to solicit and select projects for funding, and has a State Recreational Trail Advisory Committee to assist with the program.

The Recreational Trails Program funding is a set-aside from the Transportation Alternatives Program. For more details on the program, link to the FHWA Recreational Trails Program.

Public Transportation

Transportation agencies help to promote public health and healthy communities by offering multi-modal transportation options, including public transportation.

Transit is particularly important in providing access for rural and disadvantaged populations. By joining forces with bicycle and pedestrian supporters, transit can help expand the interest in active transportation.

In addition, transportation agencies have supported efforts to encourage compact, mixed-use development near transit facilities and high-quality walking environments – known as transit-oriented development. For more information and resources on public transportation link to the Federal Transit Administration website.