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Transportation equity, health, and aging: a novel approach to healthy longevity with benefits across the life span

One of the most neglected social determinants of health is access to adequate transportation. While housing, education, social inequality, and income are widely recognized as important factors of well-being, it is striking that the public health discourse on transportation has overwhelmingly emphasized the negative aspects. These include crashes, injury, mortality, pollution, lack of exercise, and noise. A worthy public health emphasis on active mobility through walking and cycling may have also overshadowed the central role of transportation as driver or passenger in an automobile for the majority of the US population who do not have access to effective public transportation or who have compromised personal mobility. Recent evidence points to the negative consequences of restricted personal vehicle transportation on an individual’s independence, emotional and social well-being, and life expectancy. Therefore, there is a need for a balanced perspective that can appropriately weigh actual safety risks against the real health consequences of restricting mobility, and a partnership between the fields of health care and transportation could facilitate this balance.