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The transportation decisions that are made on a daily basis determine far more than how quickly one may get from point A to point B; they can have social, environmental, and physical consequences that collectively influence the overall health of both individuals and communities. The health impact associated with an ever-increasing number of people traveling by automobile and a concomitant increase in annual vehicle miles traveled has reached epic proportions. Growing evidence is revealing the myriad adverse health consequences arising from such an auto-dominant landscape. Ranging from mild to severe, and even to death, the consequences of transportation decisions can impact both the individual as well as the collective. Furthermore, while the physical health of an individual is most closely associated with transportation choices one makes, there are potentially serious social and psychological repercussions as well. Though driving a personal automobile affords privacy and individual freedom, this transportation choice impacts not only the decision maker but a host of other individuals as well. Perhaps most obvious is the growing obesity epidemic, which stands as the fastest growing public health problem in the United States.

Automobile Travel

In the simplest of terms, research has shown that traveling in vehicles increases the odds of obesity whereas traveling by foot decreases the odds of obesity. Certainly the correlation between increasing vehicle miles traveled and increasing obesity is well documented. With the number of total vehicle miles traveled increasing by more than 200 billion miles during the first decade of the 21st century, obesity rates in the United States soared. The adult obesity rate for men increased from 27.5 percent to 35.7 percent and from 33.4 percent to 35.8 percent for women. Currently, the national adult obesity rate stands at 35.7 percent and the child obesity rate at just under 17 percent. With more than 12 million children currently overweight, childhood diabetes is a serious and growing problem. While transportation choices can contribute to obesity, obesity can likewise affect transportation costs. Increased body weight necessitates more fuel be burned to transport the same number of travelers. For air travel, these fuel costs can run into the hundreds of millions of dollars each year. On the highway, it has been calculated that upward of 1 billion additional gallons of fuel are consumed annually due to overweight and obesity.

While obesity itself is a health concern, more problematic is its association with a host of additional diseases. Time spent in the automobile is shown to increase the likelihood not only of obesity but of heart attack, high blood pressure, and high cholesterol. Obesity has been likened to a “conveyer belt” that can lead individuals to experience a dangerous mix of obesity-related illnesses.

The Built Environment

A sedentary lifestyle where much time is spent in an automobile is a principal culprit in the obesity epidemic. Yet more than simply personal preference, use of the automobile has been necessitated by sprawling land use separated by rigid zoning codes and transportation planning that has set the automobile above all other forms of transport. As a result, people who live in neighborhoods with older or more “traditional” designs are noted for spending more time walking and in total physical activity than those who live in newer, more suburban landscapes. The post–World War II era represents a marked shift in land use and transportation planning policies, with the gridded streetscape replaced by cul-de-sacs and mixed land use replaced by single-use zoning. The sprawling design has rendered this new suburban landscape nearly unwalkable and necessitates use of the automobile for virtually all trips. As the suburban landscape has expanded, the percentage of children walking or bicycling to school has declined. Without question, the built environment has a significant impact on human health and behavior.

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