Transportation and Health Resource Hub - Active Transportation and Physical Activity
A NATIONAL INVESTIGATION ON THE IMPACTS OF LANE WIDTH ON TRAFFIC SAFETY: Narrowing Travel Lanes as an Opportunity to Promote Biking and Pedestrian Facilities Within the Existing Roadway Infrastructure. (2023)
This report explores the feasibility and benefits of narrowing vehicle lanes to improve sidewalk and bike lane infrastructure within existing roadways. Through a comprehensive national study involving data from 1,117 street sections across seven cities, the research examines various street design factors and their association with traffic safety outcomes. The findings indicate that narrower lanes (specifically 9-foot and 10-foot lanes) do not increase crash rates and may even reduce them, particularly on roads with 30-35 mph speeds. This study underscores the potential for lane width reduction projects to enhance safety without compromising traffic flow.
Rethinking Streets Book Series 
This book series showcases different ways to think about street design through evidence and real-world examples. These books provide case studies of various treatments from different cities across America and Canada including Bike Streets, Transit Streets, Main Streets, Urban Mixed-use Streets, and more. Each book brings a unique perspective on how to design our streets with vulnerable users in mind.
Universal design guide book 
This document provides guidance regarding universal design for affordable housing. Developed with Regional investment partners and funders, the authors worked collectively with a local affordable housing developer to first define and secondly create "universal design" by applying the guide book principles to new development in the Portland Metro area. The guidelines address a full range of affordable housing topics and demonstrates how to apply them.
Transportation research circular E-C239, arterial roadways research needs and concerns: Informing the planning, design, and operation of arterial roadways considering public health
Arterial roads provide regional and local access to diverse economic and cultural resources that can positively influence community health. At the same time, arterial roads have been linked to various types of cancer, respiratory and cardiovascular diseases, poor birth outcomes, injuries, noise, and air pollution. They represent a prime opportunity for transportation and public health practitioners to work together to directly improve community health. Practitioners can learn from seven case areas covering research questions and salient concerns for practice. The document also includes over 250 questions that could be expanded into formal research problem statements.
Tennessee’s built environment and health case studies
This collection of case studies in Tennessee, primarily in rural communities, address the integration of health through master plans, corridor studies, sidewalk improvements, multi-modal access, and even a community kitchen. Each short case study (1-2 pages) has key lessons and recommendations that can be used by local advocates, community leaders, and governmental staff to identify strategies for integrating health. These case studies demonstrate the possibilities of integrating health into rural communities and small towns.
Systematic literature review of built environment effects on physical activity and active transport - an update and new findings on health equity
This systematic review—a review of the body of evidence on a subject—identified which environmental interventions increase physical activity for residents while also considering intervention costs. Furthermore, this study examined how the effects of these interventions differ by ethnicity and socioeconomic status. Interventions such as parks and playgrounds and active transportation facilities showed an increase in active transportation, visits to parks, and physical activity. There was some evidence that these kinds of interventions benefit socioeconomically advantaged groups more than other groups.
Planning a healthy Tennessee
Planning a Healthy Tennessee demonstrates the connections between specific community design features and health outcomes, and provides a real-world example of each feature. While applicable to a wide audience, particular emphasis was given towards its educational use within the design, development, and planning fields. The content is applicable to both rural and urbanized areas. Community design features positively impacting most of the social determinants of health merit consideration by transportation and land use professionals working across the rural-urban spectrum. Many healthy design features already exist in most communities, and they should be expanded on or replicated where practicable.
NCHRP research report 932: a research roadmap for transportation and public health management
The purpose of A Research Roadmap for Transportation and Public Health is to build upon thebody of literature strategic agendas, and research needs regarding calls for integrating transportation and health and to provide a plan for funding research over the next decade that can lead to greater consideration of health issues in transportation contexts. This report produced recommendations for integrating health into transportation, derived from a research process that involved both stakeholder engagement (including representatives from federal, state, and local transportation and health-related agencies) and a review and synthesis of existing literature (including peer-reviewed literature, grey literature such as reports, conference proceedings, magazines, and other published works). This report identified research needed to support specific agency processes to incorporate health; research gaps and needs and how research is translated into practice; research needed for emerging health issues; priority research problem statements, and developed an implementation plan for guiding research ideas into funded projects.
Metropolitan planning organization ideas to improve and provide more walking and bicycling projects
The initiatives spearheaded by the MPOs profiled in this guidebook have resulted in more walking and bicycling projects in communities across the country. The enclosed case studies, illustrating eight distinct strategies, provide inspiration, ideas, and replicable tactics for MPOs to emulate or consider. Eight case studies explain how regions have implemented walking and bicycling projects. The cases detail contextual factors, partnerships, timelines, steps in the decision making processes, and how communities dealt with barriers to implementation.
Healthy community design training
The Healthy Community Design Training made the connection between health and the built environment to transportation and land use professionals across Tennessee. The training demonstrates the strong link between health and community design, shows what makes for health promoting or health defeating community design, and provides policy considerations concerning a range of design features and decisions. The training is primarily intended for presentation to groups of local government officials and employees involved in land use and transportation decisions. Through tangible examples, presenting the Healthy Community Design Training matures the conversation on good community development practices.
Health promoting community design: outline of expected returns
This toolkit provides general findings from project returns of health-promoting projects. With a better informed understanding of project outcomes, practitioners can expand efforts to create healthier and more livable places. This resource demonstrates that health promoting community design features hold the potential to provide economic, health, and ecological co-benefits to communities. Case studies from across the country, consolidated here, provide useful reference for those considering how or why to build healthier communities.
Health economic assessment tool for walking and cycling (HEAT)
The World Health Organization’s Health Economic Assessment Tool (HEAT) for walking and cycling is a user-friendly web-based tool to assess health impacts of active travel. Originally developed for WHO's Region of Europe the tool has been expanded for global use. As active travel inherently results in often substantial health benefits as well as not always negligible risks, assessments of active travel behavior or policies are incomplete without considering health implications. HEAT makes it easy to obtain ballpark estimates of health impacts and carbon emissions related to walking and cycling. HEAT caters to a broad audience of policy makers, advocates, urban and transport planners and practitioners, and researchers alike.
Considering health in US metropolitan long-range transportation plans: a review of guidance statements and performance measures
Transportation influences health primarily and most directly through traffic safety, air quality, physical activity, and accessibility. Despite the importance of all four components, only safety and air quality are typically considered during institutionalized transportation planning processes. This paper assesses how health impacts are considered in transportation planning by focusing on the long-range transportation plans that US metropolitan planning organizations develop. By assessing the state of the practice and discussing potential approaches, this review informs a stronger and more comprehensive consideration of health within the institutionalized structure of US metropolitan transportation planning.
Children’s transport built environments: a mixed methods study of associations between perceived and objective measures and relationship with parent license for independent mobility in Auckland, New Zealand
This mixed methods study investigates whether parent perceptions of the neighborhood environment align with objective measures of the neighborhood built environment, and how perceived and objective measures relate to parental preferences for children's independent mobility (supporting active travel and physical activity). Parental preferences for independent mobility was only associated with a need for safer places to cycle (positive) and objectively assessed cycling infrastructure (negative) in adjusted models. Overall, the study findings indicate the importance of safer traffic environments for children's independent mobility.
Built environment evaluation guide
This guide provides a resource for evaluating the health impacts of built environment projects. It details how to evaluate a project using a logic model that is based on a range of metrics and suggests data inputs to the process. It focusses on physical activity promotion, capacity building, and community engagement. Used extensively by Tennessee practitioners and the TN Department of Health's Healthy Development Coordinators with its community partners, the guide has been used to evaluate over 130 Healthy Built Environment grant projects across Tennessee to gather feedback on the effects on the built environment.
Autonomous vehicles and public health
This report suggests that while autonomous vehicles (AVs) can increase some health risks (air pollution, noise, and sedentarism), proper regulation can reduce motor vehicle crashes and associated heath impacts, and reshape cities to promote healthy urban environments. Creating a Public Health framework and implementing policy recommendations for autonomous vehicles that include fully electric vehicles in a system of ridesharing and ridesplitting before the complete introduction of AVs into the market will yield public health benefits.
Associations of children’s active school travel with perceptions of the physical environment and characteristics of social environment: a systematic review
This study documents a systematic review of 37, English-only, published studies related to school-aged (5-13) and travel mode choice. The study extracted data, assess quality and evaluated the evidence presented using a vote-counting technique to document associations between school travel modes as well as social and sociodemographic characteristics. The authors found that active school travel was associated positively with safety, walkability and neighbourhood social interactions, and negatively with travel distance and car ownership. They did not find sufficient evidence for social characteristics.
Associations between the neighbourhood built environment and out of school physical activity and active travel: an examination from the Kids in the City study
This study examined selected objectively-measured and child-specific built environment attributes in relation to proportion of out-of-school time spent in moderate-to-vigorous physical activity (%MVPA) and active travel in a group of ethnically and socio-economically diverse school-aged children in Auckland, New Zealand. The researchers found that the ratio of high speed to low speed roads and improved streetscape for active travel were related to %MVPA on weekdays only. Local destinations (particularly schools) along a safe street network may be important for encouraging children's activity.
An integrated conceptual model of environmental needs for New Zealand children’s active travel to school
This study correlated data from New Zealand children, their parents, school representatives, and objectively-assessed environmental features to generate a model enabling how these variables interrelate with each other and active travel to school. It demonstrates the complexity of active travel to school and reinforces that increasing active travel modes needs multi-faceted approaches to be successful.
Bicycle count data: what is it good for? A study of bicycle travel activity in central lane metropolitan planning organization (chapter 6: health analysis)
This report documents a myriad of uses for bicycle traffic counts including the ability to use counts in statistical modeling of bicycle miles traveled (BMT) in a medium sized urban area in Oregon. Chapter six documents the data and analysis steps necessary to estimate BMT and to use those estimates in a health impact model in order to demonstrate the health and economic benefits of that activity. An estimate of health care cost savings in Central Lane MPO reveal that health care costs are $3.3 to $16.2 million less each year due to the physical activity associated with bicycle activity. Being able to clearly communicate these economic benefits and cost of illness reduction can help agencies that deliver Medicaid and Medicare see the connection between infrastructure spending and costs of providing care.
Oregon Avenue protected bicycle lane: a case study of a health & transportation partnership in Klamath Falls, Oregon
This document summarizes the planning and coalition building process that delivered a protected bike lane to rural Oregon. This case study documents the efforts of two Sky Lakes Health System workers embarked upon to merge thinking and funding from the health and transportation domains in order to tackle a lack of active transportation infrastructure in Klamath Falls. Study findings offer transportation and public health professionals a model for collaboration even when funds are in short supply and new infrastructure designs cause initial anxiety with potential users.
Integrating health and transportation in Nashville, TN, USA: from policy to projects
This journal article describes the integration of health into regional transportation planning, scoring criteria, policy, project prioritization, data collection, modeling and funding. This transformed $7 billion worth of transportation spending in the greater Nashville area, prioritizing health and equity over volume and speed of cars on roadways. It is possible to positively address health in transportation policy and funding. Transportation agencies can think creatively to include health in data collection and modeling.
The integrated transportation and health impact tool in Nashville, TN, USA: implementation steps and lessons learned
This article describes the implementation of Integrated Transportation and Health Impact Tool (ITHIM) in greater Nashville, TN, and the important lessons learned. ITHIM is a scenario planning tool that sets active transportation targets and calculates the resulting positive or negative impacts on population health. ITHIM also has the capability of monetizing healthcare savings from averted injury and disease. This resource provides a methodology for MPOs and state DOTs to calculate the potential health impacts and healthcare savings from increased walk, bike and transit trips.
Framework for better integrating health into transportation corridor planning
The Health in Transportation Corridor Planning Framework is a detailed worksheet to help practitioners incorporate health into corridor planning studies at every stage of the planning process. It can be used within an existing corridor planning process and is flexible and adaptable to many different issues and contexts. Cases studies from the five transportation agencies that tested the Framework Five transportation are available here.
Metrics for planning healthy communities (APA)
Inside this "Metrics for Planning Healthy Communities" report is a set of Healthy Planning Metrics that can be used to assess, measure, monitor, and report progress toward healthy planning goals. Key built environment indicators and policies are identified for five healthy communities domains to promote health and measure health inequities. This document encourages planners and allied professionals to think about the different domains of health that they influence through their work.
Leveraging the built environment for health equity: promising interventions for small and medium-sized cities (Urban Institute)
This research project identified changes to the built environment that small and medium-size cities can make to promote health and health equity. This document explores ten interventions to improve health equity through land use, transportation, and environmental systems. In addition to presenting these interventions, the document includes 13 promising practices for small and medium-size cities that are focused on how to apply a health equity lens to built environment interventions and how to overcome implementation challenges.
Partnering with metropolitan planning organizations to advance healthy communities
This resource highlights the importance of transportation to human health, environmental health, and equity. It describes how public health professionals can work in the transportation field to affect health outcomes. Specifically, it describes the role of Metropolitan Planning Organizations (MPO) in the development of regional transportation plans and the opportunities for incorporating health into MPO plans and processes.
At the intersection of public health and transportation: promoting healthy transportation policy
The purpose of this American Public Health Association document is to demonstrate how important transportation is to public health. This resource details the pathways by which transportation affects health, such as physical activity, safety, air quality, and equity. In addition, this document provides an overview of federal transportation programs and spending that are used or can be used to improve health.
Active transportation and real estate: the next frontier
Developers, owners, property managers, designers, investors, public officials, and others involved in real estate decision making can learn from the case studies described in this report to create places that both support and leverage investments in active transportation infrastructure, such as bike lanes and trails. In the process, they can create real estate value and promote economic, environmental, and public health goals.