Safe Routes to School (SRTS)
What is Safe Routes to School (SRTS)?
Safe Routes to School (SRTS) encourages increased student physical activity through safe and active transport to and from school. SRTS promotes walking, bicycling, or other forms of active transportation among students and their families.[1, 2] SRTS can include educating the community and improving the built environment to ensure safe places for children to walk and bike to and from school.[1, 2] Key elements of SRTS include:
- City planning and engineering approaches to transportation that address built environment needs and ensure safe conditions for walking and biking
- Tools, guides, and resources to encourage participation in active transport
- Educational activities for students, parents, and community members about rules of the road and traffic safety
- Enforcement approaches to encourage safety and reduce unsafe behaviors among drivers, bicyclists, and pedestrians
- Evaluation activities to monitor and measure the impact of these programs. 
SRTS can be implemented at the state, community, or local school district level.[4-6] Competitive federal funding is available through the Moving Ahead for Progress in the 21st Century Act (MAP-21).[1, 7, 8] Depending on existing infrastructure, SRTS may require that education, transportation, public safety, and city planning agencies coordinate their efforts.[1, 3, 9]
What is the public health issue?
Physical activity is an important contributor to health, and engaging in regular physical activity can improve cardiorespiratory and muscular fitness, bone health, cardiovascular and metabolic health markers and body composition in children and adolescents, and reduce the risk for numerous adverse health outcomes, including hypertension, diabetes, heart disease, and some cancers in adulthood. In 2008 the U.S. Department of Health and Human Services (HHS) recommended that young people aged 617 years participate in at least 60 minutes of physical activity daily. Physical activity also is an important factor in achieving a healthy weight and maintaining it over time.  Currently, 17.5 percent of children aged 6-11 years and 20.5 percent of adolescents age 12-19 years have obesity. Walking or bicycling for transportation increases physical activity. However, the proportion of students in grades K-8 who walk or bike to school fell from 47.7 percent in 1969 to only 12.7 percent in 2009.
What is the evidence of health impact and cost effectiveness?
SRTS programs are associated with increased active transportation, including an increase in the number of students walking or biking to and from school.[4, 14-17] Over a 3-year period, a comparative analysis based upon a national sample of school SRTS programs found that SRTS was associated with:
- An increase in the percentage of students who walked to and from school from 7-8 percent to 15-16 percent 
- An increase in the percentage of students who biked to and from school from one percent to two percent 
A 2014 evaluation of state-level SRTS projects in Florida, Mississippi, Washington, and Wisconsin found that they were associated with significant increases in: active school travel (from 12.9 percent to 17.6 percent), walking (from 9.8 percent to 14.2 percent) and bicycling (from 2.5 percent to 3.0 percent).
Although the evidence for active transport overall is mixed, travel to and from school by bicycle has been associated with increased cardiorespiratory fitness levels among students.[17, 19] By improving the environment for walking and bicycling in urban areas, SRTS could also contribute to increased physical activity among adults and reductions in injuries involving pedestrian and bicyclist collisions. [20-22]
An analysis in New York City found that SRTS roadway modifications such as installing new traffic and pedestrian signals, were associated with reductions in childhood and overall injury rates and were projected to result in a net societal benefit of $230 million over the 50-year useful life of the modifications.
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- National Center for Safe Routes to School. Safe routes — connecting the trip to school with…. 2016. Available from: National Center for Safe Routes to School. Accessed 2016 Jun 2.
- Robert Wood Johnson Foundation, University of Wisconsin Population Health Institute. County health rankings & roadmaps: safe routes to schools (SRTS). 2015. Available from: Safe Routes to Schools (SRTS). Accessed 2015 Nov 30.
- National Center for Safe Routes to School. Elements of Safe Routes to School Programs. 2016. Available from: Elements of Safe Routes to School Programs. Accessed 2016 Jun 2.
- McDonald NC, Steiner RL, Lee C, Smith TR, Zhu X, Yang Y. Impact of the safe routes to school program on walking and bicycling. Journal of the American Planning Association 2014;80(2):153–67.
- National Center for Safe Routes to School. Community success stories. 2016. Available from: Community Success Stories. Accessed 2016 Jun 2.
- North Carolina Department of Transportation. North Carolina safe routes to school. Available from: North Carolina Safe Routes to School. Accessed 2017 June 7.
- U.S. Department of Transportation, Federal Highway Administration. Moving ahead for progress in the 21st Century Act — a summary of highway provisions. 2012. Available from: Moving ahead for progress in the 21st Century Act. Accessed 2017 June 7.
- National Center for Safe Routes to School. In response to MAP-21. 2012. Available from: In Response to MAP-21. Accessed 2017 June 7.
- National Center for Safe Routes to School. Advancing safe walking and bicycling for youth. 2016. Available from: Advancing Safe Walking and Bicycling for Youth. Accessed 2017 June 6.
- U.S. Department of Health and Human Services. Physical activity guidelines for Americans. 2008. Available from: Physical activity guidelines for Americans. Accessed 2017 June 6.
- Ogden CL, Carroll MD, Fryar CD, Flegal KM. Prevalence of obesity among adults and youth: United States, 2011–2014. NCHS Data Brief 2015;219(219):1–8.
- CDC. Barriers to children walking to or from school—United States, 2004. MMWR 2005;54(38):949–52.
- McDonald NC, Brown AL, Marchetti LM, Pedroso MS. US school travel, 2009: an assessment of trends. Am J Prev Med 2011;41(2):146–51.
- Boarnet MG, Anderson CL, Day K, McMillan T, Alfonzo M. Evaluation of the California Safe Routes to School legislation: urban form changes and children’s active transportation to school. Am J Prev Med 2005;28(2):134–40.
- National Center for Safe Routes to School. Shifting modes: a comparative analysis of Safe Routes to School Program elements and travel mode outcome. 2012. Available from: Shifting Modes: A Comparative Analysis of Safe Routes to School Program Elements and Travel Mode Outcome. Accessed 2017 June 7.
- Chillón P, Evenson KR, Vaughn A, Ward DS. A systematic review of interventions for promoting active transportation to school. International Journal of Behavioral Nutrition and Physical Activity 2011;8(1):10.
- Lubans DR, Boreham CA, Kelly P, Foster C. The relationship between active travel to school and health-related fitness in children and adolescents: a systematic review. International Journal of Behavioral Nutrition and Physical Activity 2011;8(5):39.
- Stewart O, Moudon AV, Claybrooke C. Multistate evaluation of Safe Routes to School Programs. Am J Health Promotion 2014;28(Suppl 3):S89–96.
- Larouche R, Saunders TJ, Faulkner GE, Colley R, Tremblay M. Associations between active school transport and physical activity, body composition, and cardiovascular fitness: a systematic review of 68 studies. Journal of Physical Activity and Health 2014;11(1).
- Watson M, Dannenberg AL. Investment in safe routes to school projects: public health benefits for the larger community. Prev Chronic Dis 2008;5(3):A90.
- DiMaggio C, Li G. Effectiveness of a safe routes to school program in preventing school-aged pedestrian injury. Pediatrics 2013;131(2):290–96.
- Ragland DR, Pande S, Bigham J, Cooper J. Ten years later: examining the long-term impact of the California Safe Routes to School program. Presented at: Transportation Research Board 93rd Annual Meeting; 2014 Jan 12–16, Washington, DC.
- Muennig PA, Epstein M, Li G, DiMaggio C. The cost-effectiveness of New York City’s Safe Routes to School program. Am J Public Health 2014;104(7):1294–9.
- National Center for Safe Routes to School. Map summarized awards. 2016. Available from: Map Summarized Awards. Accessed 2016 Jun 2.