Transportation Inequities: How Built Environments Impact Health

Imagine walking a mile or so home from the bus stop with your hands full of groceries. Imagine walking a mile or so to the bus stop when you are ill so that you can go to the doctor. This is the reality for so many Americans. Inequities in transportation contribute poor health outcomes reported for low-income people, particularly those of color. Specifically traffic-related air pollution and minimized autonomy to safely practice active forms of transportation (e.g. walking, bicycling). The structural and built environments that low-income people of color occupy have been heavily influenced by histories of racism in infrastructure and neighborhood development in the United States and continues to influence people’s health today.

A historical factor contributing to modern day inequities in transportation includes the expansion of suburban living, which took place in the 1950s. Suburban living was an exclusionary phenomenon that served as an extension of Jim Crow ideology–there were restrictive covenants that barred most Black, Asian and Hispanic families from living in suburban neighborhoods at all. It was commonly believed that the presence of people of color in subdivisions would lower the value of the properties and banks refused to loan money to people living in the inner city, which were primarily occupied by people of color. Suburban living promoted the use of automobiles for transportation because the sprawled out living meant that more people needed cars to get around. This expansion to suburbs led to the vast expansion of America’s highway system.

The highway boom resulting from the rise of suburbia in the mid-twentieth century, which consisted of the building of the American interstate highway system, was completely destructive for the thriving Black neighborhoods of that time as well as other communities of color. Not only was housing destroyed for prospering Black communities, but churches and businesses were lost as well. Losing pivotal local institutions altered the sense of community that Black populations experienced, which has implications that are still felt today.

Seeing that highway infrastructure has historically been built through black and brown neighborhoods, it is not surprising to see that communities of color are still likely to live near highways. Hispanic people are 38% more likely and Black people are 30% more likely than White people to live within 300 meters of major highways, where rates of respiratory and cardiovascular diseases are increased.[1] The EPA estimates that the heavy concentration of minuscule air particles from highway traffic causes up to 100,000 annual deaths in the U.S., which serves as one mechanism for the number of chronic illnesses that people of color disproportionately experience. These preventable conditions have taken their toll on the healthcare system, specifically in safety net medical centers which are more likely to treat patients of color who are low income. The health costs associated with poor air quality from the U.S. transportation system is roughly $50 to $80 billion dollars, with the presence of communities near major highways and roadways driving the costs.[2]

Low-income people of color are also more likely to live in communities that do not support active transportation. Only 49% of low-income neighborhoods have sidewalks and only 5% have requirements for bicycle lanes, which limits the health benefits that low-income persons of color could gain from walking and biking.[2] Not having the physical infrastructure necessary to navigate one’s neighborhood safely leads to an increase in road injuries as well. Black people and Hispanic people are twice as likely to be killed while walking compared to white people. Likewise, black people are 30% and Hispanic people are 23% more likely to be killed while bicycling than white people.[2] Living in a physically underdeveloped neighborhood without a car also makes it harder to access public transportation, which makes accessing grocery stores and medical care increasingly difficult. People must walk to bus stops that are often just outside of their neighborhoods, which can be a journey in an of itself.

Low-income people of color are also more likely to live in communities that do not support active transportation.

Black and brown people are stigmatized for our disproportionate rates of chronic and infectious diseases. The social and physical environments forced upon black and brown people, however, often constrain our agency and influences our health behaviors. Living in a highly polluted environment or in a neighborhood without sidewalks has health consequences that go beyond individual control. There is a lot of work to be done to improve the infrastructure of low-income neighborhoods of color in ways that can enhance rather than disrupt our communities.

References

1. Boehmer, T. K., Foster, S. L., Henry, J. R., Woghiren-Akinnifesi, E. L., Yip, F. Y., National Center for Environmental Health, CDC, & Agency for Toxic Substances and Disease Registry. (2013, November 22). Residential Proximity to Major Highways – United States, 2010. In CDC Home. Retrieved from https://www.cdc.gov/mmwr/preview/mmwrhtml/su6203a8.htm
2. Zimmerman, S., Lieberman, M., Kramer, K., & Sadler, B. (2015). At the Intersection of Active Transportation and Equity (Rep.). Oakland, CA: Safe Routes to School National Partnership. doi: https://www.apha.org//media/files/pdf/topics/environment/srts_activetranspequity_report_2015.ashx?la=en&hash=4B088BB4405E6FA97B6E552CEEED8D7B6958A265