The Patient Protection and Affordable Care Act signed by President Obama earlier this year was a step toward expanding health coverage while lowering costs. But there’s far more to be done. A truly comprehensive approach to health must account for transportation’s role in our levels of physical activity.

The American Public Health Association tackles that in a new report titled “The Hidden Health Costs of Transportation.”

For decades, Americans have made great use of the interstate highway system, but our transportation system is outdated and in need of retooling. The promise of convenient inter- and intra-city driving came with unseen drawbacks: long commutes and gridlock that keep Americans stuck in their cars and away from their families.

It doesn’t take a doctor to figure out sitting at work for eight hours a day and driving for another 1-2 can’t be all that good for you. Where we live and how we get there matters. The APHA put it well: “transportation investments and the systems that are developed from them shape lives and communities.”

It’s not just a lack of physical activity that ails us. Our current habits expose us to high asthma rates from pollution and unsafe streets for pedestrians and bicyclists, as outlined in our Dangerous by Design report last year.

So what needs to change? One place to start is by expanding transportation options. Driving will always be a necessity, but Americans have shown their desire for public transportation with their votes and feet. Pollsters found that 82 percent of American voters believe the U.S. would benefit from an improved and expanded public transportation system, and 79 percent of rural residents shared that sentiment as well. Build it and they actually will come, it turns out. The APHA writes:

An investment in a “healthier” transportation system is critical. Providing convenient alternatives, encouraging active modes of transport, and a establishing a transportation system that fosters connectivity and social interaction can not only offset health impacts and costs, but generate health benefits.

In addition to increasing access to other transportation options, the APHA also stresses that health impacts should be considered during the planning and decision-making stages of transportation projects to the fullest extent possible.

Growing recognition of the connection between transportation, land development and health has resulted in some studies and examples where health impacts and costs have been considered and assessed. These examples not only demonstrate that health costs should be a significant factor in decision-making, but also show that calculating such costs is indeed possible.

The APHA has laid out the reasons why our long-term health is distinctly linked to how we get around, and the passage of health care reform should serve an impetus to take the right next steps. Will Congress heed APHA’s counsel as the next surface transportation bill advances?

Our transportation investments and the built environment — what we build and where — have an enormous impact on our health and the cost of our health care.

With the debate over health care reform dominating the news daily, Transportation for America and coalition members from across the country took that powerful — yet often ignored or neglected — message to Capitol Hill leaders.

T4 America’s “health fly-in” last Friday connected health professionals and advocates from across the country with their Congressional representatives to highlight the impact that transportation has on our health and wellness.

T4 America kicked off the day with a briefing from campaign director James Corless and four other nationally recognized experts on health and transportation. Then, participants from across the country, from the Pacific Northwest to New England, split up and took the message to their representatives, visiting a total of 37 Congressional offices.

Among the 25 participants in the fly-in, six hailed from national groups and 19 from state and local organizations. Several, including fourteen-year-old childhood wellness advocate Julia Lopez and UCLA professor Dr. Richard Jackson, traveled all the way from California. (Look for a full list of organizations at the bottom of the post)

During the meetings, advocates discussed how the built environment — where we live, work and play — has a profound impact on obesity rates, diabetes, asthma and other quality of life measures. And they discussed policy prescriptions that can increase walkability, grow transit ridership and make physical activity a normal part of our daily routine.

“As a pediatrician and child advocate, my job is to do what I can to make sure as many kids as possible live healthy lives, and the biggest threats to them at this time are injuries — both violent and unintentional — and obesity,” said Dr. Katherine Kaufer Christoffel, a medical and research director at Northwestern University.

“This active transportation stuff really gets at all of those things.”

Dr. Joe Thompson, Director of the Robert Wood Johnson Foundation Center to Prevent Childhood Obesity, participated as a briefing panelist but did not attend Congressional meetings. Thompson serves as the Surgeon General of the State of Arkansas, where an alarming 22 percent of children are obese and 40 percent are overweight. Thompson said the built environment is a critical component of America’s livelihood.

“If we don’t solve the upstream causes of health problems, we won’t be able to hold health care reform together,” he said.

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14 year-old health advocate Julia Lopez chats with attendees of the health fly-in after making a few remarks.

Noelle Dobson, Director of the Healthy Eating Active Living initiative at Portland’s Community Health Partnership, has been stressing the link between health and transportation through her work preparing health impact assessments for new development projects.

“This is all public health has ever been about for me,” she said.

T4 America and participating advocates were promoting three important pieces of legislation that address the health and transportation connection.

One is CLEAN-TEA, a Senate bill that would allocate ten percent of revenue from climate legislation toward clean transportation, walking and biking, and other modes that can help reduce emissions. The second is the National Transportation Objectives Act, which would create explicit, specific targets and benchmarks for the transportation bill, including goals like reducing CO2 from transportation by 40%, eliminating at-risk exposure to pollution, and tripling the amount of walking and biking we do.  Lastly is Complete Streets legislation to make our streets safe and  accommodating for all users and people — bus riders, bicyclists and pedestrians.

Most fly-in participants met with their representatives’ transportation staffers, but a few were able to meet face-to-face with the representatives themselves. Heidi Klein, a board member for the Vermont Public Health Association, got a few words in with Vermont Senator Bernie Sanders, and two fly-in participants from Montana had the chance to meet their junior Senator, Democrat Jon Tester.

Other office visits included Sen. Barbara Boxer of California, Sen. Lamar Alexander of Tennessee, Sen. Ron Wyden of Oregon, Sen. Dick Durbin of Illinois, Sen. Robert Menendez of New Jersey and Sen. Max Baucus of Montana.

Our thanks to the many advocates and supporters who worked very hard to take this crucial message to Capitol Hill.

Participating organizations:

• National Recreation and Park Association
• National Coalition for Promoting Physical Activity
• Campaign to End Obesity
• American Public Health Association
• American Lung Association
• PolicyLink
• National Complete Streets Coalition
• Trust for America’s Health
• America Bikes
• Safe Routes to School
• State and Territorial Injury Prevention Directors Association (STIPDA)