Public Transit – Improving Health and Health Equity while Fighting Climate Change

Air pollution, Climate Change, Fossil Fuels, Health Equity, Traffic, Transit Comments Off on Public Transit – Improving Health and Health Equity while Fighting Climate Change

Prepared by Kim Perrotta, CHASE, May 2024

When working to influence policies and investments in local communities, it is useful to recognize the intersection between population health, health equity, and sustainability.  Communication surveys indicate that people are more likely to support climate-related policies when they understand that those policies can produce immediate health benefits.  In addition, when investments are being made in local communities to transition away from fossil fuels that are driving climate change, it is essential that consideration be given to how those investments can improve population health and reduce social inequities. Public transit can reduce health and health inequities by increasing physical activity, decreasing traffic-related air pollution and vehicle-related fatalites, and improving affordable access to jobs, essential services and recreational opportunities.        

Transit Decreases Greenhouse Gases

The transportation sector is responsible for 24% of the greenhouse gases (GHGs) emitted in Canada.  While vehicle-kilometres travelled (VKT) per vehicle have decreased over the last 20 years, the total number of vehicles on the road has increased by 42%, leading to an increase in the total kilometres driven.[1]  A new modelling study estimates that Canada could double public transit ridership and reduce climate emissions by 65 million tonnes (MT) by 2035 if federal and provincial governments worked to expand transit service, install bus lanes, encourage more housing density near transit, and purchase zero emission buses.[2]

There is evidence that traffic volumes can be reduced substantially at little cost and without changing traffic speeds by reallocating road space to transit and active modes of transportation over time.[3] Extensive experience in Europe has demonstrated that VKT can be reduced without the use of toll road by simply reallocating road space to public transit, cyclists, and pedestrians over time.  Drivers gradually shifted to other modes of travel in response to the reallocation of road space.[4]  In the US, transit lanes have been found to increase the reliability and speed of transit vehicles, which has encouraged greater ridership and ultimately improved traffic flow for all vehicles on the roads.[5]

Traffic-Related Air Pollution Presents Significant Risks to Health

Traffic is a major source of air pollution in Canada, particularly in large urban centres.  High volume traffic corridors are a principal source of variation in levels of air pollution within urban centres.  While traffic-related air pollution (TRAP) has its greatest effect on populations that live or work within 100-500 metres of high-volume traffic corridors,[10] it can affect air quality at the neighborhood, urban, and regional scale as well.[11]

Health Canada estimates that TRAP is responsible for over 1,200 premature deaths and millions of adverse respiratory responses each year in Canada. The health-related impacts of TRAP have been valued at $9.5 billion per year.[12]  Health Canada has also determined that exposure to elevated levels of TRAP is likely to increase the risk of leukemia in children and lung cancer in adults, and may also increase the risks of breast cancer in adults.[13]  Given that 40% of people in Canada live within 250 metres of a high-traffic roads that are associated with elevated levels of TRAP,[14] these health risks represent a significant concern.  The shift to zero emission vehicles (ZEVs) will significantly reduce TRAP over time, however ZEVs will not eliminate the emissions that come from vehicle engines and tires, which are considerable.[15]

Air Pollution Presents Greater Risks for Some

While everyone is affected by air pollution, some populations are more susceptible to the negative impacts including children, older people, and pregnant women.  People who have pre-existing health challenges and those who have experienced material deprivation or social disadvantages may also be more susceptible.[16] 

A 2022 analysis conducted by Health Canada found that 8%, 25% and 44% of people in Canada reside within 100, 250, and 500 metres respectively of high-volume traffic corridors.[17] A few Canadian studies have found that populations that are materially deprived are more likely to live near high-volume traffic corridors than more privileged populations.[18], [19]

Health Canada determined that one third of the schools in Canada, that house children several hours per day, are located within 100 metres of a high-volume traffic corridor, while almost one half are within 200 metres.  It also found that 40% of long-term care facilities, that house older people 24 hours per day, are located within 100 metres of a high-volume traffic corridors, while 60% are located within 200 metres.[20]

Transit Improves Air Quality and Health

Public transit reduces air pollution in a few different ways.  First of all, much less air pollution is emitted per passenger-kilometre travelled in public transit than in private vehicles.[6]  Secondly, residents who live in neighbourhoods with high-quality, well-integrated public transit tend to own fewer vehicles, drive fewer kilometres, walk and cycle more frequently, and use public transit more often, than those who live in more car-dependent neighbourhoods.[7] 

A number of modelling studies have demonstrated that public transit investments can result in significant health benefits by reducing air pollution.  In the Greater Toronto and Hamilton Area (GTHA) for example, it was estimated that improvements in the region’s transit system could avoid 154 premature deaths and $1 billion in health-related costs each year by reducing traffic-related air pollution in the region.[8]  The air quality health benefits could be even greater if transit vehicles were run on electricity instead of fossil fuels.[9]

Public Transit Fosters Physical Activity and Health

Transit use increases physical activity because most transit trips begin and end with some form of active travel.  For example, a Montreal study found that a round trip on public transit could provide 25% of the daily physical activity recommended for good health.[21]  The health benefits of transit-related physical activity can add up, particularly when combined with investments in active transportation.  In the GTHA, for example, it was estimated that improvements in the region’s public transit system could produce $1.2 billion per year in health benefits by increasing levels of physical activity.[22] 

Public Transit Increases Road Safety

In 2021, vehicle related collisions were responsible for 1,768 deaths, 8,185 serious injuries, 108,019 total injuries in Canada.  Approximately 50% of those killed were drivers, 15% were passengers, 16% were pedestrians, 2.5% were cyclists, and 13% were motorcycle drivers.[24] 

Public transit makes roads safer for all users.  One US study found that passenger fatality rates on buses were about 20 times less than that in automobiles.[25] In addition, traffic fatalities for pedestrians, cyclists, and automobile occupants, as well as transit users, decline significantly as transit ridership increases in a community.  The reduced rates of traffic fatalities in transit-rich communities have been attributed to residents driving fewer kilometres, driving at lower speeds, and avoiding high-risk driving activities such as driving while impaired, relative to those in car-dependent neighbourhoods.[26]

Public Transit Increases Access and Health Equity

Public transit can increase health equity by providing greater access to different services and opportunities.  It has been estimated that 20-40% of the people in our communities do not drive because of their age, income, or ability.[27] Statistics indicate that newcomers to the country and women who commute to work rely more heavily on public transit than other groups in Canada.[28] An efficient and reliable public transit system can provide these populations with a more affordable and independent way to access jobs, schools, essential services, and recreational opportunities.[29]

Public transit can also save people money.  It costs between $6,000-$13,000 per year to own and operate a car in Canada.[30] An efficient public transit system can eliminate the need for people to own and operate a vehicle.  This can allow people living on lower incomes to direct more of their income to essentials such as food, clothing, and rent.[31]

Women’s travel needs can differ from those of men because of the various roles they may assume for their families. Women may fold multiple trips into their days to cover grocery stores, medical appointments, schools, or childcare.  When transit is designed to focus on commuting to and from work with a single destination, it can result in greater costs and less access for women. Some communities have helped alleviate this inequity by implementing time-based transfers that allow passengers to travel for one to two hours on a single ticket.[32]

Unfortunately, at present, about 5% of Canada’s population in its eight largest cities are living in lower-income households that are in neighbourhoods with poor access to public transit.[33] This combination amplifies the disadvantages faced by these populations and increases their health risks.  Public transit can be designed to meet the needs of these populations, as well as those who live in rural or remote communities, senior populations, and those who are physically or mentally unable to drive.[34]

Policies to Promote:

  • Greater investments in public transit
  • Prioritizing low-income neighbourhoods for greater service
  • Keeping transit fares affordable
  • Promoting development patterns that make transit service efficient and affordable
  • Connecting transit service to active transportation
  • Piloting on-demand transit service for transit-challenging neighbourhoods

Download 3-page Facesheet

To learn more, see the report and blogs prepared by CHASE with the CPHA and OPHA:

[1] Government of Canada. 2022. Greenhouse Gas Emissions, Sources and Sinks, Executive Summary. Web-page.

[2] Dunsky Climate and Energy. 2024.  Transit for the Climate Modelling how transit investment can boost ridership and reduce emissions.  Prepared for Environmental Defence Canada and Equiterre.

[3] Doherty Eric. 2019. Green New Deal must Include Transportation Transformation. The National Observer. May.

[4] European Commission Directorate-General for the Environment. Undated. Reclaiming city streets for people Chaos or quality of life? https://www.onestreet.org/images/stories/Reclaiming_City_Streets_for_People.pdf

[5] National Academy of City Transportation Officials (NACTO). 2020. Transit Street Design Guide. https://nacto.org/publication/transit-street-design-guide/transit-lanes-transitways/

[6] ICF. 2008. The Broader Connection between Public Transportation, Energy Conservation and Greenhouse Gas Reduction, American Public Transportation Association.

[7] Cervero Robert. 2007 as cited by Litman T. 2020. Evaluating Public Transportation Health Benefits. Prepared for the American Public Transportation Association by Victoria Transport Policy Institute.

[8] Medical Officers of Health in the GTHA. 2014. Improving Health by Design in the Greater Toronto-Hamilton Area.

[9] Environmental Defence and the OPHA. 2020. Clearing the Air. Analysis conducted by Dr. Marianne Hatzopoulou and Laura Minet leading a team from the University of Toronto’s Transportation and Air Quality Research Group (TRAQ). June.

[10] Health Canada. 2022. EXPOSUR TO TRAFFIC-RELATED AIR POLLUTION IN CANADA: An assessment of population proximity to roadways

[11] Health Effects Institute. 2022. Systematic Review and Meta-Analysis of Selected Health Effects of Long-term Exposure to Traffic-Related Air Pollution.

[12] Health Canada. 2022. Health Impacts of Traffic-Related Air Pollution in Canada.

[13] Health Canada. 2022. Traffic-Related Air Pollution: An Umbrella Review-Based Human Health Risk Assessment on Selected Cancer Types

[14] Health Canada. 2022. EXPOSURE TO TRAFFIC-RELATED AIR POLLUTION IN CANADA: An assessment of population proximity to roadways

[15] Health Canada. 2022. Health Impacts of Traffic-Related Air Pollution in Canada.

[16] World Health Organization. 2023. Air Quality and Health – Webpage.

[17] Health Canada. 2022. EXPOSURE TO TRAFFIC-RELATED AIR POLLUTION IN CANADA: An assessment of population proximity to roadways

[18] Health Canada. 2022. EXPOSURE TO TRAFFIC-RELATED AIR POLLUTION IN CANADA: An assessment of population proximity to roadways

[19] Doiron D et al. 2020. Healthy built environment: Spatial patterns and relationships of multiple exposures and deprivation in Toronto, Montreal and Vancouver. Environment International 143.

[19] Government of Canada. 2023. Greenhouse Gas Emissions by Sector. Webpage.

[20] Health Canada. 2022. EXPOSURE TO TRAFFIC-RELATED AIR POLLUTION IN CANADA: An assessment of population proximity to roadways

[21] Morency C et al. 2011. Walking to transit: an unexpected source of physical activity. Transport Policy 18.6

[22] Medical Officers of Health in the GTHA. 2014. Improving Health by Design in the Greater Toronto-Hamilton Area.

[23] Allen 2008 and Bell Cohen 2009 as cited by Litman T. 2020. Evaluating Public Transportation Health Benefits. Prepared for the American Public Transportation Association by Victoria Transport Policy Institute.

[24] Canada. 2023. Canadian Motor Vehicle Traffic Collision Statistics: 2021

[25] Beck Laurie et al. 2007. Motor Vehicle Crash Injury Rates by Mode of Travel, United States: Using Exposure-Based Methods to Quantify Differences American Journal of Epidemiology, Volume 166. April.

[26] Litman, Todd. 2014. A New Transit Safety Narrative. Journal of Public Transportation. Vol. 17.

[27] Litman, Todd. 2017. Evaluating Active Transportation Benefits and Costs. Victoria, British Columbia, Canada: Victoria Transport Policy Institute.

[28] Canada Department of Finance. 2020. Supporting Canadians and Fighting COVID19: Fall Economic Statement. December.

[29] Lucas Karen at al. 2016. Transport poverty and its adverse social consequences. Transport – Proceedings of the Institution of Civil Engineers. Volume 169 Issue 6, December

[30] CAA. 2020. Calculating Car Costs. https://carcosts.caa.ca/

[31] Bell and Cohen 2009 & Sengupta et al. 2013 as cited by Litman T. 2020. Evaluating Public Transportation Health Benefits. Prepared for the American Public Transportation Association by Victoria Transport Policy Institute.

[32] Drimonis 2015 as cited by Daniel K & Perrotta K. 2017. Prescribing Active Travel for Healthy People and a Healthy Planet: A Toolkit for Health Professionals. Prepared for the Canadian Association of Physicians for the Environment (CAPE).

[33] Allen Jeff & Farber Steve. 2019. Sizing up transport poverty: A national scale accounting of low-income households suffering from inaccessibility in Canada, and what to do about it. Transport Policy. Volume 74, February 2019, Pages 214-223

[34] Federation of Canadian Municipalities. 2019. Building Better Lives Together. November.

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