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Air quality, rising pedestrian and bike fatalities, public transportation funding, and hopeful examples of change—here’s a roundup of the current state of transportation in the US and what it all has to do with healthy places.

Let’s start with the vital, invisible thing that we all share: air. Air pollution from vehicles is harming community health across the country, especially for people of color.

The mix of gases and particulates in traffic pollution can cause heart, lung, and neurological diseases, and may even reduce kids’ performance in school. Researchers recently measured a drop over the last decade in traffic- pollution-induced asthma in the US,¹ which may have been caused by more fuel-efficient vehicles, Obama-era regulations on emissions, and a drop in vehicle miles traveled due to the 2008 recession. However, those specific conditions have been reduced or reversed under the current administration, so improvements in air quality may not last for long.

The worse news is that exposure to traffic pollution is still inequitable. Data have long shown that communities of color are exposed to traffic pollution at higher rates,² and a recent study also found a racial gap between who causes air pollution and who breathes it, with communities of color disproportionately breathing in polluted air caused by White Americans.³

Cars are also killing pedestrians and bike riders at higher rates than ever.

The 2019 Dangerous by Design report from Smart Growth America and the Complete Streets Coalition reveals that people killed while walking in the US increased by 35 percent over the past decade, while the number of vehicle miles traveled during that time only increased by around eight percent. And the 2018 Benchmarking Report on Bicycling and Walking from the League of American Bicyclists also details an increase in the bicyclist fatality rates. These numbers come despite more miles of bike lanes and sidewalk improvements in places across the country. So what’s going on?

Yes, driving has increased in recent years. But the higher death rates track more closely to the rising number of people driving distracted while using cell phones, and the number of people driving massive SUVs, which are far more likely to kill walkers and bicyclists than smaller vehicles going the same speed. Active transportation advocates agree that the biggest culprit, though, is the design of streets themselves, which prioritize and encourage high speeds at the expense of pretty much everything else.

Meanwhile, driving’s most viable alternative, public transportation, is nearing the end of its federal funding amidst nationwide decline in maintenance and quality of service.

Public transportation is a win-win-win for health equity, because it addresses multiple problems in one system. Per person, public transportation uses less energy and produces less pollution than driving.⁴ Hello, better air quality! Even people who commute by bus have better health outcomes than people who drive.⁵ And public transportation is more affordable than driving, which lowers the transportation burden on low-income communities. (The average annual cost of monthly transit passes in America’s top-10 largest cities is $1,020.⁶ The average annual cost of owning a car in America is over $8,000.⁷)

A City Lab post from earlier this year outlined a dire future for public transportation unless Congress makes bold changes. The majority of federal funding for public transportation will run out two years from now. Gas taxes, which in part fund public transportation projects, haven’t been raised since the early 90s, and the model itself has an inherent problem: as fuel efficiency improves, the tax earns less revenue per mile traveled. This status quo is a downward spiral.

Flashy tech “solutions” aren’t helping, either. Shared cars and electric cars are still just cars.

Although the stated vision of Uber and Lyft is to reduce congestion in major cities, a recent study of San Francisco found that they’ve actually increased traffic (and thus air pollution). Meanwhile, sales of electric vehicles rose a dramatic 81% from 2017 to 2018,⁸ but almost half of that growth was due entirely to Tesla sales. Even Tesla’s lowest-priced model is out of reach for most Americans.

And although electric vehicles could address air quality issues, and most are smaller than the SUVs threatening pedestrian safety, time spent sitting in cars—even electric ones—still negatively effects physical and mental health,⁹ even for children. A recent study showed that for every minute of commute time to school, kids lost 1.3 minutes of sleep, and saw an even bigger drop in exercise.¹⁰ Given these trends, shared cars and electric vehicles won’t likely be an equitable, environmentally sustainable mass-transportation option any time soon.

Now for the hopeful part: there are existing solutions we could implement today.

To start, one transportation researcher suggests policies that limit the number of vehicles on the street, “just as was done for taxi cabs a century ago in most of these cities and for basically the same reasons."¹¹ Roads with fewer cars make more space for active, public, and equitable transportation systems. Complete Streets and Vision Zero are gaining ground nationwide, and civic crowdfunding might help generate resident support for these types of projects. Despite its long-term shortcomings, raising the gas tax—right now—would also help. Data clearly show that when gas costs more, Americans drive less. However, if not done equitably, vulnerable people who have no choice but to drive will bear a higher tax burden than those with other viable options, or those who can afford the increased driving cost.

The Green New Deal, a sweeping policy proposal to address climate change and economic inequality, envisions changes such as these. The proposal’s primary goals include:

"Overhauling transportation systems in the United States to eliminate pollution and greenhouse gas emissions from the transportation sector as much as is technologically feasible, including through investment in – (i) zero-emission vehicle infrastructure and manufacturing; (ii) clean, affordable, and accessible public transportation; and (iii) high-speed rail."

Already, states and cities across the country are leading the way.

Cambridge, MA just became the first US city to make protected bike lanes mandatory, and Washington DC may soon follow. New Orleans’ mayor is committing not just to protected bikes lanes, but to a continuous network of them. And the Great American Rail Trail, a coast-to-coast bike trail, seems to finally be happening. Following a successful Open Streets event, Atlanta plans to transform part of its historic Main Street into a Dutch-style “woonerf,” wherein cars are slow-rolling guests in an otherwise pedestrian space. Meanwhile, Oregon is experimenting with pay-per-mile driving fees, and two cities have actually managed to reduce driving despite population growth. And in rural Allendale County, SC, transit access improved after a focus on coordination of existing services.

The current state of transportation in the United States is mostly one of misplaced priorities, wasted potential, and poor health outcomes. The good news is that we already know how to change it.