Public transportation can include buses, trains, trams, trolleys, ferries, paratransit, or rapid public transportation systems. Investments in public transportation have potential traffic safety, air quality, active transportation, and accessibility benefits, thus improving associated personal health outcomes.
Public transportation has substantially lower crash rates and lower crash severity than automotive travel. A 2014 study found that public transportation travel has less than half the total death rate as automobile travel per passenger mile, and public transportation passengers have about one-tenth the fatality rate per mile as automobile passengers (Litman, 2014). Public transportation uses less fuel and produces lower levels of carbon monoxide (CO), volatile organic compounds (VOC), and carbon dioxide (CO2) per passenger mile relative to private vehicles.
Public transportation also influences health because most public transportation users walk or bicycle to access public transportation. A 2005 study found that 29% of respondents to the 2001 National Household Travel Survey were able to achieve 30 minutes or more of daily exercise through walking to or from public transportation. A 2013 study noted that from 2001 to 2009, the estimated number of public transportation walkers whose public transportation-associated walking time was 30 minutes or more increased 31%, from approximately 2.6 million to 3.4 million. For older adults and persons with disabilities, paratransit services provide vital links to reaching medical and other essential services.
The cost of public transportation is often lower than the costs associated with other forms of transportation (e.g., personal vehicles). Another way to expand public transportation use is to fund and improve public transportation station area planning, to ensure that it is integrated with active transportation modes and infrastructure (e.g., bicycle-sharing stations) and public transportation-oriented development.
To encourage the use of public transportation, incentives may be offered to help reduce the cost to the user, including free or discounted bus, rail, or public transportation passes. Other incentives include employer-provided subsidies, reimbursements, partial payments, or pre-tax payroll reductions. Such incentives have been shown to increase public transportation use, and use of active travel options such as walking and bicycling, particularly among college students.
Related Transportation and Heath Tool Indicators
- Commute Mode Share
- Complete Streets Policies
- Housing and Transportation Affordability
- Miles Traveled by Mode
- Physical Activity from Transportation
- Public transportation Trips per Capita
- Road Traffic Fatalities by Mode
- Road Traffic Fatalities Exposure Rate
- VMT per Capita
How can this strategy result in health benefits?
- Address chronic disease (e.g., asthma, diabetes, heart disease)
- Improve access to health-supportive resources
- Improve equity
- Increase physical activity
- Improve safety
- Reduce motor vehicle-related injuries and fatalities
- Reduce transportation's contribution to air pollution
How has this worked in practice?
The Effect of Light Rail Transit on BMI and Physical Activity - Charlotte, NC
The LYNX Blue Line, the first light rail transit (LRT) service in the Charlotte, North Carolina, region, provides daily service and operates for approximately 10 miles, extending from I-485 at South Boulevard to Uptown Charlotte. The Blue Line LRT service evolved from Charlotte’s 2025 Integrated Transit/Land Use Plan, which identified appropriate public transportation technologies and focused growth and development along five primary transportation corridors within the region. Further plans for fixed guideway public transportation expansion under development include extension of the Blue Line, a Gold Line streetcar system, the Silver Line Bus Rapid Transit, and the Red Line regional rail service. When complete, this system will include 25 miles of regional rail, 21 miles of light rail, 16 miles of streetcar, and 14 miles of Bus Rapid Transit, and a complementary enhanced bus public transportation network. A study of data collected before and after completion of the Blue Line found that persons who used the line for commuting reduced their in body mass index (-1.18) and their odds of becoming obese over time (81%), suggesting that LRT combined with land use strategies could improve health outcomes.
Where can I learn more?
A Practitioner’s Guide for Advancing Health Equity: Community Strategies for Preventing Chronic Disease developed by CDC provides information on policy, systems, and environmental improvement strategies designed to reduce health inequities and help communities incorporate the concept of health equity into public health practice.
The American Public Transportation Association (APTA) provides information on meetings and conferences, government affairs and policy, a resource library, weekly newsletter, and media center to engage members on public transportation, including bus, paratransit, light rail, commuter rail, trolleys, streetcars, subways, ferries, and high-speed rail.
The Federal Transit Administration transit-oriented development website includes information about the benefits of transit-oriented development, funding opportunities, research and resources.
Evidence base
The American Public Transportation Association (APTA). Public Transportation: Benefits for the 21st Century; 2007.
Besser LM, Dannenberg AL. Walking to Public Transit: Steps to Meet Physical Activity Recommendations. American Journal of Preventive Medicine 2005;29(4):73-280.
Freeland AL, Banerjee SN, Dannenberg AL, Wendel AM. Walking Associated With Public Transit: Moving Toward Increased Physical Activity in the United States. American Journal of Public Health 2013;103(3):536-542.
Gallivan F, Ang-Olson J, Liban CB, Kusumoto A. Cost-effective approaches to reduce greenhouse gas emissions through public transportation in Los Angeles, California. Transportation Research Record: Journal of the Transportation Research Board 2011;2(2217):19–29.
Graham-Rowe E, Skippon S, Gardner B, Abraham C. Can we reduce car use and, if so, how? A review of available evidence. Transportation Research Part A: Policy and Practice 2011;45(5):401–18.
Kettel Khan L, Sobush K, Keener D, Goodman K, Lowry A, Kakietek J, Zaro S. Recommended community strategies and measurements to prevent obesity in the United States. Morbidity and Mortality Weekly Report 2009;58(RR-7):1-29.
Lachapelle U, Frank LD. Transit and health: mode of transport, employer-sponsored public transit pass programs, and physical activity. Journal of Public Health Policy 2011;30(Suppl 1):S73–94.
Litman T. Evaluating Public Transit Benefits and Costs: Best Practices Guidebook. Victoria Transport Policy Institute; 2014.
MacDonald JM, Stokes R J, Cohen D A, Kofner A, Ridgeway GK. The effect of light rail transit on body mass index and physical activity. American Journal of Preventive Medicine 2010;39(2):105-12.
Martin A, Suhrcke M, Ogilvie D. Financial incentives to promote active travel: an evidence review and economic framework. American Journal of Preventive Medicine 2012;43(6):e45-57.
Morabia A, Mirer FE, Amstislavski TM, Eisl HM, Werbe-Fuentes J, Gorczynski J, Goranson C, Wolff MS, Markowitz SB. Potential Health Impact of Switching From Car to Public Transportation When Commuting to Work. American Journal of Public Health 2010;100(12): 2388-2391.
National Safety Council. Injury Facts, 2005-2006 Edition; 2006.
Petersen E. Transit subsidies in New York and Chicago: Local, state, and federal assistance in a historical context. Journal of Public Transportation 1997;1(4).
Shapiro RJ, Hassett KA, Arnold A. Conserving Energy and Preserving the Environment: The Role of Public Transportation. Washington, DC: APTA; 2002.
Sorenson P, Wachs M, Daehner EM, Kofner A, Ecola L, Hanson M, Yoh A, Light T, Griffin J. Moving Los Angeles: Short-term policy options for improving transportation. Santa Monica: RAND Corporation; Monograph Report 748; 2008.
Su Q, Zhou L. Parking management, financial subsidies to alternatives to drive alone and commute mode choices in Seattle. Regional Science and Urban Economics 2012;42(1-2):88–97.