Trains, Transit, and Public Health

If you've followed the link from the New York Times Magazine's letters page, welcome to The Pump Handle! We're a public health blog covering issues from healthcare to worker health and safety to water and sanitation; see our About page for the story behind our name. The full version of my post about Amtrak is here.

What I said in that post was that it makes sense to invest in intercity rail because intercity car and air travel might become prohibitively expensive and/or time-consuming in the future -- whether due to a carbon tax, oil supply issues, traffic and air travel hassles, or something else. But Amtrak is also important as part of a system that lets people get around without cars.

Note that "letting people get around without cars" is not synonymous with "take people's cars away." The goal is to have multiple transportation options available, so people can take different modes in different situations. Maybe you take the bus to work, drive a car to the grocery store or day care, bike to a friend's house, and hail a cab when you leave a restaurant at 10pm (or a party at 2am). Maybe you drive most of the time, but are glad that other options are there when your car breaks down. A system that allows people multiple choices about how to get around under different circumstances is good for public health in many ways:

• Exercise: Many people get far too little physical activity. Walking -- even if only to the bus or train stop -- and biking are good ways to get exercise while getting where you need to go.
• Air quality: Walking, biking, and riding public transportation mean less pollution per passenger mile traveled than solo driving.
• Safety: People who are too impaired to drive safely -- due to alcohol, prescription medication, physical impairments, or an inability to put down a cell phone -- are less likely to get behind the wheel and endanger themselves and the public if they have other options available.
• Equity: Car ownership is expensive, young teens can't get licenses, and people need to stop driving when they get too old to do so safely. Safe sidewalks and good public transit allow people to get where they need to go, regardless of how young, old, or poor they are.

For cities that were planned with the assumption that single-occupancy vehicles would be the dominant form of transportation, it takes some work to allow for other modes. In the 13 years that I've lived in Washington, DC, the city has done a great job improving pedestrian and bicycling infrastructure and bus service, and several new subway stations have opened. Car-sharing programs make it easy to forgo car ownership, and that's good both for individual households (who save on car-ownership expenses) and for the city (which experiences less pollution and congestion and probably fewer car crashes than it would if everyone were driving everywhere).

Forgoing car ownership is also easier if out-of-town destinations are accessible by something other than car. I appreciate being able to take Amtrak to Baltimore, Philly, and New York -- and, judging by the ridership numbers on the Northeast Regional line, I'm far from alone. Amtrak is good for public health not only because it's a lower-emission form of travel, but because it makes it feasible for people to live without a car.