Roadblocks to healthy infrastructure
Here's how engineers, planners, and politicians interfere with healthy lifestyles.
In March of 2022, the CDC published a study that found more than 1 in 3 students felt persistently sad or hopeless. Rates of depression, anxiety, and suicide have steadily climbed over the past decade.
More than half of the country is overweight or obese. It’s bad for the body, leading to problems like heart disease, stroke, diabetes, and cancer. And it’s bad for the mind, leading to even more anxiety and depression.
US Surgeons General have been sounding the alarm for years:
“We need to make our communities more walkable, bikeable, and accessible to public transportation. We need to create parks and green spaces where people can get outside and be active.” Dr. Margaret Hamburg
"The built environment has a profound impact on our health. The choices we make about how we design our communities can either promote health or lead to chronic disease." Dr. Jerome Adams
“Loneliness is a growing public health crisis that has profound negative consequences for our physical and mental health.” Dr. Vivek Murthy
The key message from the scientific community is this: an active and social life is healthier than an isolated and sedentary life.
The treatment for America’s ever-increasing health problems is infrastructure that promotes physical activity and social connections.
That means easy access to amenities and services. Housing, schools, parks, plazas, groceries, restaurants, places of worship, swimming pools, retail, dry cleaners, and so on. It means being able to walk, or walk to a bus stop, ride a bike or a trike, hop on a scooter – these are easy options in a healthy neighborhood.
Young and old, rich and poor, strong and vulnerable. We all benefit from healthy infrastructure.
Medical experts aren’t alone in their diagnosis. Transportation engineers, land use planners, and politicians make public statements about the need for healthy infrastructure all the time.
As a matter of fact, two of the major professional organizations for engineering and planning have special programs dedicated to improving public health.
Everyone seems to know the treatments, and yet the country continues to suffer. Why?
The planning, design, and construction of neighborhoods involves a ton of people. I’m going to focus on just three important groups who are blocking the prescriptions for healthy living: engineers, planners, and politicians.
How engineers block healthy living.
This group is responsible for junk infrastructure in two ways:
Their traffic analysis measures the success of a road in how quickly cars get through a section.
They insist the amount of car traffic will always increase, so their solutions are that we need more lanes for car traffic.
Engineers use a chart called Level of Service to grade intersections as acceptable or unacceptable. It’s the key to traffic analysis and it has nothing to do with safety. The grades are A through F, just like a school report card.
The letter grades were a stroke of genius, because everybody wants As or Bs. We’ve been trained to believe that getting Ds and Fs is embarrassing. But in the Level of Service chart, a D means you’re still getting through an intersection in less than a minute. An A means there’s nobody around to wait for. No pedestrians, no bicyclists, no outdoor dining, no window shopping.
As grades slip from Cs to Ds, the transportation department spends millions to build more car lanes, so the average driver doesn’t have to wait a full minute during rush hour. For all 24 hours in a day, the intersection is now more dangerous and any signs of community health wither away.
As if this upside down grading system wasn’t bad enough, public streets are then engineered for reckless driving. Design influences behavior. That’s a tricky subject because transportation experts aren’t trained in psychology or neuroscience.
Decades of research shows that all the basic decisions like the width of a lane, the number of lanes, bus stops and benches, the type of street lighting—these all influence how people drive.
And it turns out the default design choices of road engineers are meant for highways, not neighborhood streets. Not even the arterials that connect one neighborhood to another. The design decisions lead to higher speeds, more traffic crashes, more pedestrians hit and killed, and more cyclists hit and killed.
Everything pleasant about a community interferes with the goals of standard transportation analysis and design.
A street with no delay is a street with no life. It’s unhealthy.
How planners block health living.
Professional planners write, update, and enforce land use policy. Those are the rules and regulations about how property can and can’t be used. There are three important ways planning props up junk infrastructure:
Zoning rules that dictate where development happens.
Large area planning projects that reinforce segregated zoning.
Small area requirements for new or infill projects.
1. Rules for zoning
Planning departments at city and county levels used zoning as a powerful tool for good and for evil. Most notoriously, zoning has been used to segregate people by race and class.
But they also used zoning as a public health benefit because cities were hotbeds for pollution, filth, and sickness. In the industrial era, the idea of mixed-use development brought fears of an early grave. If a new factory was coming to town, the local government would map out a plan to accommodate all the new employees and subsequent traffic.
But as industries evolved over the decades, and technology helped to clean up cities, land use rules stayed the same.
All across the country, local development rules require or incentivize development patterns that spread everyone and everything across the landscape. Work zone, school zone, shopping zone, entertainment zone, and a sleep zone. Then each category started getting more prescriptive sub-categories.
So, for example, townhouses are put in their own zone away from the single-family houses. And forget about having a corner grocery store on a street with houses.
And with all the land uses spread out in their own zones, the obvious outcome is that Americans drive everywhere all the time.
Not just work commutes, but all the errands before, during, and after work. Half of America’s car trips are less than a few miles long. We're in a car-first environment because of the organized zones developed by planners and approved by local leaders.
2. Rules for large area projects
Local governments put together comprehensive plans that cover large areas of land and long time horizons. These projects start with land use, but then incorporate transportation systems.
So two of the groups blocking healthy infrastructure begin to work in tandem. Plans take shape for more ways to move cars around the zones, because the assumption is that land uses should be segregated.
It goes back to the industrial-era mindset of cleaning up dirty cities.
Networks of wider roads and bigger intersections take shape.
These large-area plans get the attention of the state department of transportation, where more planners are drawing maps for road expansions at regional and statewide levels.
3. Rules for small area projects
New and infill development projects are where the engineers and their traffic analysis get heavily involved.
Local planning departments set the rules for the type of traffic studies that have to be performed, and the grades they expect to see on the Level of Service report cards. They also set the rules about the amount of car storage a development has to provide.
So for instance, let’s say an empty nest couple wants to convert their garage to a music studio and offer piano and drum lessons. Before you even think about the traffic impact studies they’ll have to pay for, keep in mind this type of home-based business is probably illegal where you live.
The planning profession has worked so hard at perfecting the process of organized land use that it’s lost sight of the outcomes. Healthy infrastructure violates the rules written and enforced at the local government level.
Which brings us to the third group setting up roadblocks.
How politicians block healthy living.
Everything politicians do is influenced in some way by lobbying. The more money, the more influence. Infrastructure and all its adjacent fields are no different.
So let’s do a quick exercise in following the money. There are two economic powerhouses who know exactly what they want from elected leaders.
1. Transportation (Big Road) is a trillion dollar industry
In 2022, they spent $286 million buying policy and power. Two-thirds of those lobbyists are former government employees. The revolving door of employment means it’s in a politician’s best interest to get deals done with lobbyists, because pretty soon that’s where they’ll be working.
Massive public works projects always get spun as wins for a community. Some are, but most aren't. The reason is that there’s not much profit in walkable infrastructure compared to automotive infrastructure.
And if you’re wondering how successful they are, Big Road wins 3 out of 4 bills that they champion. 75% is an incredible hit rate.
2. Pharmaceuticals (Big Pharma) is a trillion dollar industry
In 2022, that industry spent $374 million on lobbying, more than any other industry. More than two-thirds of Congress gets donations from Big Pharma.
After NBC reported that childhood obesity rates affect nearly 1 in 5 kids, the pharmaceutical industry came up with a solution: weight loss drugs. 2023 is the first year that the American Academy of Pediatrics included anti-obesity drugs in its guidelines.
At the same time, media outlets—who get 75% of their advertising revenue from Big Pharma—are declaring exercise as a mark of political extremism. The very thing the medical community has been begging Americans to do, is being labeled socially dangerous.
Being part of a trillion dollar industry doesn’t make corporations evil for developing drugs or highways, but it does mean their motives should be kept top of mind.
These massive industries prioritize profit, and it’s clear that sick and car-dependent Americans are good for business.
In contrast to the junk we’ve been given…
Healthy infrastructure is designed to fit who we are as humans. It leads to more social interaction, which improves mental and physical health, which leads to fewer pills sold, which leads to lower profits for Big Pharma.
And that same healthy infrastructure makes walking and bicycling convenient, which leads to less dependency on cars, which leads to lower profits for Big Road.
Taking a stand for healthy infrastructure is not in a politician’s best interest if they have their eyes set on a national position.
Are we doomed?
Only if we ignore who’s setting up roadblocks to healthy infrastructure. I’m giving some examples of how engineers, planners, and politicians play a role because the parts they play are so important. They also tend to blame each other for anything wrong with the built environment.
Things can get better in the end. This stuff is fixable at the local level, since so much of it grows out of local land use policies.
You make the case well by bringing in the mental health aspects, in addition to physical health (EG, walking more). This nation was certainly built around cars and not humans!
Big road rivaling big pharma on lobbying spend wasn't on my bingo card