Transportation and How it Contributes to Health Outcomes [The Built Environment Series Part IV]

Transportation is more than just a means of getting from point A to point B. It is an integral component of our health system and functions as a social determinant of who gets to participate in society. In keeping with the theme of this series, the built environment is of course, at the center of it all. To jog your memory, the built environment constitutes the physical design of our neighborhoods, roads, transit networks, food environment and public spaces. Welcome to part IV of the series where we'll be exploring how transportation fits into the equation of how the built environment determines health outcomes.

When the built environment supports safe, reliable, affordable transportation, people can have easier access to healthcare, employment, education, grocery stores and social connection. When it doesn’t, entire communities are cut off from opportunity and experience reduced access to the tools that are required to help them thrive.

Transportation isn’t neutral. It’s a mirror of policy choices, historical disinvestment and the values embedded in our infrastructure.

Here is how transportation infrastructure impacts health:

1. Access to Healthcare: Distance Becomes a Diagnosis

In many communities, especially those shaped by redlining and chronic underinvestment, healthcare facilities are often far away. This translates to long travel times to clinics and hospitals, increased potential for missed appointments due to unreliable transit, delayed care for chronic conditions and higher emergency room use because preventive care is inaccessible.

When public transit routes don’t connect to major medical centers, or when buses run infrequently, sidewalks are unsafe, or there’s no protected bike infrastructure, access to healthcare becomes a privilege of geography. As a result, the built environment can determine whether someone can get to a doctor before a condition becomes life‑threatening.

2. Access to Employment: Transportation as Economic Mobility

Jobs cluster in areas with strong infrastructure. However, workers don’t always live there.

If neighborhoods lack reliable transit, safe walking routes, affordable transportation options, connections to job-dense areas, then employment becomes harder to secure and harder to keep.

Transportation is one of the strongest predictors of economic mobility. A poorly designed built environment traps people in cycles of long commutes, unpredictable travel times and limited job choices. A well-designed one expands opportunity. In turn people have access to income that can be utilized to maintain their health and sanity.

3. Access to Grocery Stores

Food access is not just about store availability as we discussed in part II, it’s also about the ability to

reach those stores. Neighborhoods without supermarkets often also lack safe sidewalks, bus routes that connect to grocery corridors, bike lanes or even affordable ride-share or taxi options. This forces families to rely on corner stores, fast food or expensive delivery services. The result is predictable: higher rates of diet-related chronic disease, increased food insecurity and fewer opportunities for culturally relevant, fresh foods. When transportation fails, nutrition suffers.

4. Road Design and Accident Prevention

The built environment determines who is safe on the road and who isn’t.

Car-centric design can create high-speed corridors through residential neighborhoods. These include dangerous intersections, limited crosswalks, poor lighting and few protected bike lanes. These conditions disproportionately harm pedestrians, cyclists, children, older adults and people with disabilities.

Communities with well-designed roads that include protected bike lanes, wide sidewalks and safe crossings are more likely to see significantly fewer traffic related injuries and deaths. Safety is not about individual behavior. It’s about infrastructure.

5. Transportation as a Public Health Intervention

When transportation systems are designed with equity in mind, they become powerful public health tools that provide the benefits listed below:

• Shorter commutes which reduce stress and strain on mental health.

• Walkable and bikeable neighborhoods that increase physical activity.

• Reliable transit that makes attendance at medical appointments.

• Access to grocery stores to improve diet quality.

• Safe streets that prevent traffic related injuries and deaths.

  
  

Thus, in the grand scheme of public health, transportation is not merely a method of mobility, it’s prevention, access and opportunity. The built environment shapes transportation, and determines its efficacy. In turn, transportation shapes everything else: healthcare access, job opportunities, food security and safety. If we want healthier, more equitable communities, we have to design transportation systems that connect people to the resources that sustain life.