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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
Promote Active Transportation

Active transportation is any self-propelled, human-powered mode of transportation, such as walking or bicycling. Physical inactivity is a major contributor to the steady rise in rates of obesity, diabetes, heart disease, stroke, and other chronic health conditions in the United States. Many Americans view walking and bicycling within their communities as unsafe due to heavy traffic and a scarcity of sidewalks, crosswalks, and bicycle facilities. Improving these elements could encourage active transportation such as children biking to school or employees walking to work. Safe and convenient opportunities for physically active travel also expand access to transportation networks for people without cars, while also spurring investment in infrastructure to increase the comfort of the on-road experience to improve the appeal of active modes to all people.

Strategies recommended in existing Transportation HIAs:

  • Encourage Safe Routes to School programs to enable children to walk and bike to school safely.
  • Construct a connected network of multi-use trails.
  • Accommodate all roadway users with comprehensive street design measures such as “complete streets,” including sidewalks, bicycle lanes, and share-the-road signs that provide safe and convenient travel for all users of the roadway.
  • Separate motor-vehicle traffic from non-motorized traffic with physical barriers, such as the construction of bicycle boulevards.
  • Prioritize infrastructure improvements near transit stops and public transportation stations.
  • Provide safe and convenient bicycle and pedestrian connections to public parks and recreation areas.
  • Promote safe roadway crossing through use of small block sizes, pedestrian refuge islands, and cross-walks.
  • Provide streetscape amenities such as benches, landscaping, lighting, and public art.
  • Encourage way-finding with signs, maps, and landscape cues to direct pedestrians and bicyclists to the most direct route.
  • Encourage bicycle parking at workplaces and transit stops.
  • Encourage the development of street-level shopping and restaurants along pedestrian and bicycle routes.
  • Educate bicyclists and pedestrians on state and local laws, as well as on safe practices.



  • Dill, J. (2009). “Bicycling for transportation and health: the role of infrastructure.” J Public Health Policy 30 Suppl 1: S95-110.

A study of Portland, OR found that most bicycling occurs on streets with bicycle lanes, separate paths, and bicycle boulevards.

  • Ewing, R., T. Schmid, R. Killingsworth, A. Zlot and S. Raudenbush (2003). “Relationship between urban sprawl and physical activity, obesity, and morbidity.” American Journal of Health Promotion 18(1): 47-57.

This study used block size as a measure of urban sprawl to create a county sprawl index. It found that sprawl is significantly associated with minutes walked, obesity, and hypertension.

  • Oja, P., S. Titze, A. Bauman, B. de Geus, P. Krenn, B. Reger-Nash and T. Kohlberger (2011). “Health benefits of cycling: a systematic review.” Scandinavian Journal of Medicine & Science in Sports 21(4): 496-509.

A review of 16 studies that specifically addressed the health benefits of cycling found the studies to be high in quality and to contain consistent results that supported the relationship between cycling, cardiovascular fitness, all-cause mortality, cancer risk, and overweight or obesity risk. The studies provide evidence for a positive dose-response relationship between cycling and health effects, and they suggest that the promotion of cycling can improve public health.

  • Pucher, J., R. Buehler, D. R. Bassett and A. L. Dannenberg (2010). “Walking and cycling to health: a comparative analysis of city, state, and international data.” Am J Public Health 100(10): 1986-1992.

Researchers compared all 50 states and 47 of the 50 largest U.S cities to find that higher rates of bicycling and walking to work are associated with more adults meeting recommended levels of physical activity, fewer obese adults, and a reduced prevalence of adult diabetes. It was also found that countries with higher rates of active commuting had lower rates of obesity among their populations.

  • Pucher, J., J. Dill and S. Handy (2010). “Infrastructure, programs, and policies to increase bicycling: an international review.” Prev Med 50 Suppl 1: S106-125.

This article reviews the existing research on infrastructure and policy interventions and their effectiveness in increasing rates of bicycling in the study area. The review concluded that encouraging bicycling requires the integration of multiple and complementary interventions.

  • Saelens, B. E. and S. L. Handy (2008). “Built environment correlates of walking: a review.” Med Sci Sports Exerc 40(7 Suppl): S550-566.

Walking is consistently correlated with mixed land-use, accessibility based on distance to a destination, connectivity, the existence of sidewalks, safety, and neighborhood type.

  • Staunton, C. E., D. Hubsmith and W. Kallins (2003). “Promoting safe walking and biking to school: the Marin County success story.” Am J Public Health 93(9): 1431-1434.

The Safe Routes to School Program in Marin County, California increased rates of walking, biking, and carpooling to school.

The table lists bicycle facilities, signs, and markings permitted according to the Manual on Uniform Traffic Control Devices.

This statement reflects the Department’s support for the development of fully integrated active transportation networks.

The Federal Highway Administration answers questions on Shared Use Paths Along or Near Freeways and Bicycles on Freeways based on current federal regulations.

  • Watson, M. and A. L. Dannenberg (2008). “Investment in safe routes to school projects: public health benefits for the larger community.” Prev Chronic Dis 5(3): A90. Available at. Accessed on 19 July 2011.

This national study measured the percentage of land area within 0.5 miles of public schools in 4 U.S. Census-defined categories to assess how many people would benefit from improved active transportation corridors as part of the Safe Routes to School Program. The study found that 65.5 million people could benefit from SRTS projects, and not all were school children.

  • Winters, M., M. Brauer, E. M. Setton and K. Teschke (2010). “Built environment influences on healthy transportation choices: bicycling versus driving.” J Urban Health 87(6): 969-993.

This study looked at characteristics of the built environment that influence decisions to bike. It concluded that the built environment influences healthy travel decisions. The findings indicate that the decision to bike is encouraged by fewer hills in the route, higher intersection density, the presence of bicycle infrastructure, traffic calming, mixed land uses, and higher population density.

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