Public Transportation Saves Lives: A Health in All Policies Approach

Unintentional injuries are the 5th leading cause of death in the US, a third of which are due to vehicles, and the United States leads the developed world in traffic deaths. Technological advances (airbags) and policy (seatbelt laws) have reduced motor vehicle fatalities over the past few decades. However, compared to more than 35,000 deaths that occur on public roads every year from motor vehicles, there are less than 150 fatalities on rail & bus combined representing a nearly a 300 fold increased risk. We studied how many lives have been saved as a result of public transportation using data on transportation fatalities from the top 100 cities with mass transit over the years 1982-2009. Compared to cities with low mass transit volume, we found a significantly lower fatality rate among cities with medium or high volume of mass transit trips. Over the study period, we estimate that the current levels of mass transit have saved at least 20,000 lives, and that further increases in mass transit volume could reduce deaths from motor vehicles even further. We discuss policy options and urban design efforts that can be used to increase mass transit use and ultimately save lives. We conclude that efforts to increase the use and scope of mass transit should be branded as a critical public health tool to reduce injuries and death.