Grappling with History – Improved Awareness of Structural Inequality and Health Outcomes in the Transportation Sector
The COVID-19 pandemic has further illuminated the structural inequalities plaguing the United States. COVID-19 health impacts were not equally distributed among demographic groups in the United States, and certain factors predicted worse outcomes. Exposure to the air pollutant Nitrogen Dioxide, or NO2, through proximity to highways was associated with higher case fatality and mortality rates. The legacy of disparate transportation infrastructure in the United States influenced the demographically influenced outcomes of the COVID-19 pandemic. Steps need to be taken to codify equity-based planning metrics for future transportation plans and prioritize assessment of historically disadvantaged groups with respect to nearby transportation infrastructure. Prioritizing equity and sustainability in transportation planning can improve long-term health outcomes of community residents, decrease inequality between racial groups, and assist in reaching climate goals.
A study assessing the role of urban air pollution and COVID-19 fatality by Liang et al found a statistically significant correlation between exposure to NO2 and COVID-19 case-fatality and mortality rate. A 4.6 parts per billion (ppb) increase of NO2 was associated with an 11.3 percent case fatality rate and 16.2 percent mortality rate in COVID-19. Another study found links between exposure to traffic-related air pollution and poor COVID-19 outcomes. Lipsitt noted that COVID-19 hospitalization rates for Black and Hispanic populations were around 4.7 to 4.6 times higher in the United States. This study also found that an 8.7 ppb increase in NO2 was associated with a 35-60 percent increase in mortality rate. The results from these two studies demonstrate worse outcomes in COVID-19 among individuals experiencing higher amounts of traffic-related air pollution.
In 2010, over 11 million people in the United States lived within 150 meters of a major highway. In the report assessing proximity, major highways were defined as interstates (Class 1) or other freeways and expressways (Class 2). Multiple demographic metrics were assessed and the greatest disparities between who lived near major highways were race/ethnicity, nativity, and language spoken at home. While 3.7 percent of the population lived near major highways there was a greater proportion of certain populations: 5.4 percent of Asian/Pacific Islander Americans, 4.4 percent of Black Americans, and 5.0 percent of Hispanic Americans. Transportation-generated air pollution was far from the only predictive factor for disparate COVID-19 outcomes but serves as an example of one of many structural elements.
The creation of the Interstate Highway System improved connectivity between cities and states but came at a permanent cost to ethnic minority communities across the United States. In Miami, 10,000 homes were demolished along with a predominantly Black business community for highway construction. Throughout the United States, there are examples of how minority communities were negatively impacted by the development of the highways. The Interstate Highway System also created and perpetuated a long-lasting reliance on car transportation. Land planning and zoning patterns also exacerbated this trend, but the comprehensive network of interstates hinders the development of transit-oriented transportation planning. The disparate outcomes of COVID-19, exacerbated by exposure to traffic-related air pollution, highlight the continuing effects of the Interstate Highway System on inequality in the United States.
Oregon has devised transportation equity system evaluation measures which include affordability, access to travel options, access to jobs, access to community places, share of safety projects, exposure to crash risk, and high-value habitat impact. The metrics reflected the priorities identified by the historically marginalized communities. Creating a uniform equity evaluation standard for transportation planning is just one of many methods planning organizations can use to emphasize equity. A more human-oriented design process for transportation planning cannot alone solve the disparate health outcomes in the United States but is a key element to improving upon the existing structural inequalities.
Equity and sustainability metrics should be integrated into the most foundational parts of transportation planning agencies. The guidelines for evaluating and increasing transportation equity are out there and the research exists. It is time now to incorporate and implement that work into state departments of transportation, metropolitan planning organizations, and the manuals guiding transportation engineering. The direct role in health outcomes dictated by the legacy of the federal highway system exacerbated unequal health outcomes in COVID-19 and incorporating equity metrics in transportation planning can help close the gap in health outcomes among minority communities in the United States. A new transportation system cannot be built from the ground up, but current plans do not exist independent of the history they were built on. Reframing the priorities of planning organizations to fit the goals of a healthier, more sustainable, and more equal society will benefit community members and improve health, sustainability, and equity outcomes of future transportation infrastructure. It is time for a framework shift in transportation planning where equity is placed at the forefront of future plans.