Taking public transit improves mental and physical health

By Naveed Saleh, MD, MS | Fact-checked by Barbara Bekiesz
Published June 18, 2024

Key Takeaways

  • Compared with driving, riding buses and other forms of public transport increase levels of physical activity, cardiovascular health, and cognitive health.

  • Public transport access is crucial for marginalized communities, particularly minorities, women, young adults, low-income workers, individuals with disabilities, and the elderly. Improved access can reduce health disparities and support better health outcomes for these groups.

  • Physicians and other HCPs can play a role in promoting public transportation by advocating for better access in their communities.

Automobiles hold a special place in the hearts of Americans. The ability to get behind the wheel and drive anywhere aligns broadly with the right to freedom that defines what it means to be an American. It should come as no surprise that transportation policies and planning, as well as infrastructure investments, have favored roads over public transportation.

“Public transportation options consistently face competition for funding from public investments in highways and surface transportation, as well as competition for ridership from taxis and ride-sharing services,” write authors publishing in Health Affairs, a peer-reviewed journal of health policy research.[]

However, the authors assert, public transportation yields better health outcomes in terms of air quality, increased physical activity, decreased collisions, and more. 

Public transit health benefits

We all know that public transportation is better for the environment, but it’s also healthier on a personal level. Some proven health benefits include the following.[]

  • Increased physical activity levels (more than two-thirds of riders walk to their stop or station)

  • Improved aerobic fitness

  • Enhanced cognition and mental health

  • Weight maintenance

  • Decreased risk of chronic conditions

  • Reduced deaths from car crashes

  • Less air pollution and associated injury to the community

Although on the decline, deaths from traffic accidents are still high. In 2023, an estimated 40,990 people died in motor vehicle accidents, a reduction from the 42,514 deaths recorded in 2022.[]

Increased access to public transport may also reduce health disparities and bulwark equity efforts in less-obvious ways, such as by making healthier food options more widely available, by facilitating medical care, and by providing more employment options.[]

A report from the Victoria Transport Policy Institute, an independent think tank, underscores the value of public transport.[] “People who live or work in communities with high quality public transport tend to drive significantly less and rely more on alternative modes (walking, bicycling, and public transit) than they otherwise would,” the report notes. “This reduces traffic crashes and pollution emissions, increases physical fitness and mental health, and provides access to medical care and healthy food. These impacts are significant in magnitude compared with other planning objectives, but are often overlooked or undervalued in conventional transport planning.”

Special considerations

Public transportation plays a crucial role in the daily lives of many Americans, particularly among certain demographic groups. Research highlights that racial minorities show a significantly higher dependence on public transport compared to their White counterparts. For instance, 24% of Black households do not own a car, contrasting sharply with just 7% of White households without a vehicle.[]

This reliance is echoed in findings from Health Affairs, which found that, in 2019, a mere 5% of all US workers commuted using public transportation, with the highest usage seen in major metropolitan areas like New York City and Chicago.[]

Others who rely more heavily on public transportation include women, young adults, and low-income workers. Lack of access to public transportation also disproportionately affects individuals with disabilities and the elderly. 

For marginalized communities, access to public transport is a two-sided coin. On the obverse, lack of such transport contributes to racial and economic disparities by disproportionately limiting mobility for minority populations. On the reverse, increased access to public transport can improve health in populations at highest risk.

What can be done

Experts cite the long-term need for more metrics demonstrating how access to public transportation affects individual and population health outcomes/equity.

Moreover, it’s important to understand how state transportation laws impact local decision-making. The California Healthy Places Index provides an example.[]

“Improving public transportation access requires multiple steps, all designed to prepare communities and households for climate-related hazards and to support community resilience and action to reduce risks,” noted the California Healthy Places Index. The organization offers a Public Transport Indicator that “measures the percentage of people living close to convenient, reliable transit, as defined by a half-mile or ten-minute walk, that comes every fifteen minutes or less during peak commute times.”

Physicians have a unique opportunity to advocate for improved access to public transportation, which is a vital resource for many underserved populations. By collaborating with local transportation planners, they can articulate the health-related benefits of accessible public transit, identify community needs, and support projects that enhance mobility for all. Such efforts can lead to significant improvements in public health, particularly for racial minorities, low-income workers, women, young adults, individuals with disabilities, and the elderly, ensuring that everyone has the opportunity to lead healthier, more connected lives.

What this means for you

Promoting the use of public transportation in patients, family members, and loved ones can directly improve public health measures. Some benefits of opting for public transit over cars, on an individual level, include increased physical activity, improved aerobic fitness, better mental health, decreased risk of chronic conditions, reduced air pollution, and reduced risk of death related to motor vehicle accidents. Physicians and other HCPs may feel inclined to get involved in advocacy efforts by collaborating with city planners.

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