America Has To Fix Traffic And Transportation If It Ever Wants People To Get Healthier

You don’t have to be an expert to understand that, as a country, the U.S. isn’t exactly healthy. Yes, that applies to the state of our representative democracy, but it’s also true of the people who live here. Compared to other developed countries, we spend more on healthcare but don’t live as long — even though our life expectancy did tick up in 2024 — and our leaders should be embarrassed by how poorly we compare on basically every other measurable health outcome. It’s much easier to point out a problem than it is to actually fix anything, though, as RFK Jr. is currently demonstrating. And that’s at least in part because our transportation infrastructure is designed to make us less healthy.

It isn’t the kind of thing most people want to hear, but if we want to improve our health outcomes, almost everything related to transportation is going to need to be rethought. There’s just no way to continue building sprawling suburbs full of isolated neighborhoods that require everyone to drive everywhere, fill cities with parking lots instead of housing and demonize public transportation if we also want Americans to get healthier. Not even if fast food restaurants start to fry their French fries in saturated fat again, and all funding for medical research gets cut off. 

Outside of the occasional salad, fast food is generally about as unhealthy as food gets. It’s packed full of more salt than you would ever use in your own cooking, while also being incredibly high in calories and generally lacking important vitamins and other micronutrients found in fruits and vegetables. Ask any registered dietitian, and they’ll tell you cutting down on fast food in favor of eating at home is one of the best decisions you can make. So if we want the population to get healthier, finding ways to encourage people to eat less fast food is a necessary part of that. And what’s one factor that causes people to eat more fast food? Traffic. 

A study published in the Journal of Urban Economics earlier this year that looked into the relationship between fast food consumption and traffic found that the worse traffic got, the more fast food people ate. The study found that “[o]n average, a one standard deviation increase in weekday traffic delay — equivalent to a 31 second per mile increase in delay — is associated with a 1% increase in fast food visits. In Los Angeles alone, that would work out to about 1.2 million additional fast food visits every year. If the heavier traffic occurred close to meal times, drivers were even more likely to stop for fast food. Meanwhile, grocery store visits also dropped slightly when traffic increased. 

If you could reduce congestion, that would, in turn, reduce the amount of fast food people eat. New York recently instituted congestion relief pricing in one of the busiest parts of the city, which decreased travel times almost overnight. However, that program was really only possible because NYC has a mostly functional public transportation system that people can take instead of driving, and it’s close enough to being a real city that you can walk or ride a bike if you don’t need to go particularly far. Revamping most other metro areas won’t be cheap, easy or fast, and it’ll likely be close to impossible under the current parking-obsessed administration, but the status quo sure isn’t working. 

An earlier study published in the American Journal of Preventive Medicine looked at how the environment people lived in influenced obesity, which is strongly correlated with worse health outcomes. It found that the more you increase land use mix — an industry term for the variety of commercial, industrial and residential buildings in a given area — the lower the likelihood of obesity across gender and ethnicity. The researchers also found that an extra hour spent in a car every day correlated with a 6% increase in the likelihood of obesity, while each kilometer walked was associated with a 4.8% reduction in the likelihood of obesity. Converting that second stat to miles works out to a 7.7% decrease per mile walked. 

Again, these results aren’t shocking. It makes sense that people who walk more are healthier and that living in a walkable area makes it more likely that you’ll walk places. The problem is convincing cities, suburbs, and towns to increase their land use mix. Voters tend to hate anything that involves walking or making driving ever so slightly less convenient, even if worshiping at the altar of Euclidean zoning kills them faster. And that’s even before you get to the U.S.’s disproportionately high road deaths. Even if you never get flattened by a Dodge Ram 1500, refusing to allow restaurants, grocery stores and other shops near where people live and requiring them to drive everywhere makes the population less healthy overall. 

We also know elevated stress levels are bad for you, especially if your stress level remains high for long periods of time. As the Mayo Clinic put it, “Chronic stress can wreak havoc on your mind and body.” And yet, when researchers working on a study published in Traffic Psychology and Behavior looked at the difference in stress levels between car commuters and train commuters, they found that drivers had “significantly higher levels of reported stress” and also reported more negative moods than those who took the train. That study looked at the New York metropolitan area, one of the few metro areas with a train system they could compare with car commutes, but there’s no reason to think it wouldn’t hold true in other cities if they built good public transportation systems of their own. 

Not everyone wants to live in a city, which is fine, but even those people would benefit from urban design that gets them out of their cars during their commutes. Getting people out of their cars also means at least a little more walking, which we’ve already established is better for people’s overall health. Meanwhile, the more we double down on forcing as many people as possible to drive as much as possible, the more stress we add to people’s lives. And that’s exactly what the current Transportation Secretary is doing. 

There are also far more studies that show the downsides of driving everywhere all the time than we could possibly include here. Unfortunately for everyone in the U.S., we’re currently stuck with an administration that doesn’t believe in science, including a Secretary of Health and Human Services who’s seemingly determined to bring back as many old-timey diseases as possible, so from a health perspective we’re screwed for however long Republicans remain in power. They’re also hostile to any policies that discourage driving everywhere all the time, so there won’t be any federal support for improving transportation infrastructure and reducing traffic. 

And when the federal government is reportedly canceling student visas without telling the students or their universities, then disappearing them without due process, shipping anyone who’s Venezuelan and has a tattoo to another country’s prison without due process and threatening to get rid of district courts that refuse to allow the administration to ignore people’s Constitutional rights, we have much bigger things to worry about than revamping transportation policy. 

Still, that doesn’t mean individual states can’t continue to fund projects that actually will make their residents healthier. Local governments can change their zoning laws to allow people to live closer to where they work and play. Citizens can show up at meetings and demand elected officials finally listen to someone who isn’t an elderly homeowner who only gets their news from Facebook and NextDoor. Because if we want to improve America’s health outcomes, that’s going to require taking a completely different approach to transportation. The part where it would also open up the roads for enthusiasts to better enjoy their fun cars is just a bonus.