Transportation Reform Is Health Reform

During the Washington budget debate earlier this year, a phrase widely attributed to White House budget director Peter Orszag was rolling off many a reporter’s keyboard: "Health reform is entitlement reform."

Orszag’s idea, in a nutshell, is that controlling the nation’s skyrocketing health care costs, which are fueled in part by the obesity epidemic, would ultimately slow the growth in spending on Medicaid and Medicare, two of the government’s three main entitlement programs.

chicago_sidewalk.jpgThe House and Senate health care bills include grants to help cities become more walkable, but those funds are in jeopardy. Photo: panuta/Flickr.

What’s happening in the background during Congress’s health care debate this summer can be summed up similarly (with credit to Orszag for the terminology): Transportation reform is health reform.

The link between walkable, bikeable, denser communities and public health is explored in depth by reporter Christopher Steiner, whose new book cites research by University of North Carolina economist Charles Courtemanche that found a causal relationship between the price of gas and U.S. obesity.

For every long-term $1 increase in gas prices, the national obesity rate drops by 10 percent, according to Courtemanche. That relationship goes a long way towards explaining why the House and Senate health care bills include "community transformation" grants to entice cities and towns into building bike paths, playgrounds, and other pedestrian-friendly improvements.

The grants are not assured of surviving the intense health care negotiations now going on in the Capitol, however, because they have become a full-fledged talking point for GOP critics in the House and Senate.

Congressional transportation wonks are focusing much of their energy on the battle over reauthorizing federal transport programs and the climate change bill, but it’s worth noting that they also have a dog in the health care fight.

  • gecko

    How true since less people will killed or injured and increased human-scale human-powered mobility addresses acknowledged biological needs. Associated noise, air pollution, and destructive environmental impact mitigation further increase health benefits.

  • Probably the most profound statement yet made on Streetsblog!

  • Glenn

    That title is so dead-on that we need to start making posters.

    I went on a road trip this weekend and encountered the largest concentration of enormous people (I’m talking beyond morbid obsesity) at a rest stop along I-95. And they were all lining up for their McDonalds as soon as they got out of their mini-vans and SUVs. Their kids were even worse looking.

    I was just horrified. I felt physicially ill looking at everyone. I lost my appetite for the rest of the day and walked the dog for an hour when I got home.

  • gecko

    Transportation reform is also economic and environmental reform.

  • Other arms of the government are catching on as well. The CDC is even co-organizing the CNU Congress next year in Atlanta. Planning is still in the early phases, but here’s a joint press release:

  • Glenn,

    I know what you mean. I’m often shocked at how fat people are once you leave the North East metropolitan areas. I just saw a friend who was born in New Jersey but recently moved to South Carolina. Every time he comes back he’s 25lbs heavier.

    Not that I should talk (grad school has been bad for my weight) but I’m only 25lbs heavier than I’d like to be, not a 125!

  • gecko

    Following the logic of Paul Krugman’s “Why markets can’t cure healthcare” at

    the same probably applies for the major transportation systems based on automobiles.

  • gecko

    The insurance industry is a special interest group deeply entrenched in both transportation and health-care industries and reducing its financial stake will result in major improvements.


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