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Transportation Health Impact Assessment Toolkit

This website is archived for historical purposes and is no longer being maintained or updated.

The Healthy Community Design Initiative, also known as the Built Environment and Health Initiative, is no longer a funded program and the information on this website is not being reviewed and updated on a regular basis.


Strategies for Health-Oriented Transportation Projects and Policies
Ensure Equitable Access to Transportation Networks

Transportation projects and policies should ensure that all people have access to safe, healthy, convenient, and affordable transportation. A lack of efficient alternatives to automobile travel disproportionately affects such vulnerable populations as the poor, the elderly, people who have disabilities, and children. These groups are more likely to experience limited access to jobs, health care, social interactions, and healthy foods.

Strategies recommended in existing Transportation HIAs:

  • Ensure public participation in transportation planning and decision-making.
  • Prioritize socio-economic status in project selection.
  • Provide multimodal transportation options and ensure safety and accessibility of the roadway for all users.
  • Construct buffer zones to mitigate the adverse health effects and risks of environmental exposure to air pollution, noise pollution, and the heat island effect.
  • Use the Universal Design Principles.
  • Provide mixed-income, affordable housing.
  • Install audible and visual pedestrian crossing signals.
  • Encourage healthy food outlets in neighborhoods and provide transportation infrastructure to ensure access to healthy foods for all residents.
  • Encourage brownfield redevelopment.



  • Gordon-Larsen, P., M. C. Nelson, P. Page and B. M. Popkin (2006). “Inequality in the built environment underlies key health disparities in physical activity and obesity.” Pediatrics 117(2): 417-424.

The reduced availability of recreational facilities for census block groups with lower socio-economic status and high minority populations nationwide is associated with higher rates of overweight and obesity health outcomes.

This guide to healthy community design includes strategies for promoting livability and social equity for all people, regardless of income, race, ethnicity, age, ability, or gender.

  • Inagami, S., D. A. Cohen, A. F. Brown and S. M. Asch (2009). “Body mass index, neighborhood fast food and restaurant concentration, and car ownership.” J Urban Health 86(5): 683-695.

Residents without automobiles who lived in areas with a high density of fast-food restaurants had higher BMIs than residents without automobiles who lived in areas with a low concentration of fast-food restaurants. The study suggests that transportation options determine access to healthy food and that those who are able to travel further away have wider access to healthier food options. The concentration of fast-food restaurants in a neighborhood may adversely affect the health status of residents without automobiles.

  • Kochtitzky, C. S., A. L. Freeland and I. H. Yen (2011). “Ensuring mobility-supporting environments for an aging population: critical actors and collaborations.” J Aging Res 2011: 138931. Available at: Accessed on 21 July 2011.

Connected transportation service and comfortable pedestrian and bicycle facilities improve access to a productive lifestyle for people of all ages. This study identified urban and regional planners, parks and recreation professionals, and transportation engineers as key actors in ensuring the mobility of the elderly. It provides direction for the role these professionals can play in improving the health of aging populations.

  • Larson, N. I., M. T. Story and M. C. Nelson (2009). “Neighborhood environments: disparities in access to healthy foods in the U.S.” Am J Prev Med 36(1): 74-81.

A review of the literature found that across studies, better access to supermarkets is related to a reduced risk for obesity, regardless of physical activity levels. Greater access to convenience stores, on the other hand, is associated with an increased risk of obesity. Neighborhood residents able to shop at a supermarket had healthier diets than those who were unable to do so. Policy interventions are needed to ensure more equitable access to healthier food.

  • Litt, J. S., N. L. Tran and T. A. Burke (2002). “Examining urban brownfields through the public health “macroscope”.” Environ Health Perspect 110 Suppl 2: 183-193.

Brownfield revitalization in urban areas is a necessary intervention to improve public health and minimize existing health disparities.

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  • Page last reviewed: October 19, 2011 (archived document)
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