Impacts of Enhanced Transit on Health


Sharing results and recommendations with decision makers


What is the current status? What are the health effects of potential impacts?

Enhanced transportation systems have significant potential to positively impact health and equity within their affected communities.


The places we work, live, and play have greater implications on our health. Specifically, our environments can also play a role in encouraging health promoting behaviors such as bicycling, walking, access to employment, education, healthcare, and healthy food options. As part of our built environment, transportation systems with design elements that encourage health promoting behaviors and aim to reduce health disparities can improve both our larger state of health and well-being within our communities.

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From an equity perspective, access to enhanced transportation options may help to mitigate the negative health impacts experienced by socially vulnerable populations.


Transportation systems developed with equity in mind can improve access to opportunities that facilitate a healthy life, such as:

  • Employment centers & job opportunities

  • Business centers

  • Parks & green spaces for recreational activities

  • Schools and universities

  • Hospitals, medical centers, clinics, etc.

  • Community centers, places of worship, and other places of social community connectedness.


Social Vulnerability Index

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When looking at the Social Vulnerability Index (SVI), it is important to consider equity. During times of the COVID-19 pandemic, we all have seen how emergency situations affect some groups more than others.

The CDC/ATSDR Social Vulnerability Index (SVI) measures the impacts of external stressors on health during times of emergency. The CDC/ATSDR SVI is a measure of community resilience, and utilizes 15 variables from the US Census to determine areas with increased susceptibility to human suffering and economic losses in event of an emergency. Overall, there are four primary themes that affect social vulnerability, which are:

The CDC’s social vulnerability index is ranked into four themes,

1. Housing and transportation

2. Race/ethnicity/language

3. Social economic status

4. Household composition


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Overall Social Vulnerability (CDC/ATSDR Social Vulnerability Index, 2020)
Poor Health Outcomes that exceed the Palm Beach County rate, (PLACES Project, CDC)
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SVI & Poor Health Outcomes (PLACES Project, CDC, & CDC/ATSDR Social Vulnerability Index, 2020)
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Life Expectancy
(Florida Charts, 2019)
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Existing scientific literature suggests these factors impact the extent to which a community is vulnerable for human suffering and financial loss, particularly during a time of uncertainty. SVI findings are significant indicators on the state of health equity within a given community.

Integrated Transportation and Health Impact Model

The health analysis of the transportation alternatives assessed potential health impacts in terms of the following factors:

  • Social vulnerability

  • Equity

  • Ambient stress

  • Construction impacts

  • Construction costs

  • Risk of physical injury

  • Traffic patterns

  •  Green spaces


Integrated with the Transit-Alternative health analysis, the Integrated Transportation and Health Impact Model, or ITHIM, captured measures of physical activity, air pollution, and road traffic injuries. 


The Transit-Alternative Health Score quantifies the impact of each measure on health for each of the listed scenarios. Values are assigned based on literature review and professional/technical expertise.


Health impacts of each transportation alternative were reported on a scale from 1 – 5, where: 

  1 = Impact on health is negative

  2 = Impact on health is somewhat negative

  3 = Impact on health is neutral

  4 = Impact on health is somewhat positive

  5 = Impact on health is positive


As part of the larger Transit-Alternative Health Score, the ITHIM is a modeling tool that quantifies the impact of changes to active travel behavior patterns on health.

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Depending on the design features included within the multimodal alternatives considered by the Palm Beach Transportation and Planning Agency (TPA), the ITHIM predicts shifts in the number of vehicle miles traveled (VMT) to Personal miles traveled (PMT).

  •  Proposed alternatives are divided into categories based on projected shifts in VMT to PMT.