County Health Rankings & Roadmaps, A Healthier Nation, County by County

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Housing and Transit

The housing options and transit systems that shape our communities’ built environment affect where we live and how we get from place to place. The choices we make about housing and transportation, and the opportunities underlying these choices, also affect our health.

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for Housing and Transit
Why Are Housing and Transit Important to Health?


Housing structures can protect us from extreme weather and provide safe environments for families and individuals to live, learn, grow, and form social bonds. However, houses and apartments can also be unhealthy or unsafe environments. Approximately 1 in 4 homes in the US is estimated to contain lead-based paint or lead plumbing; lead exposure can irreversibly harm brain and nervous system development. Improper insulation can expose occupants to extreme temperatures, associated with increased mortality, especially among the very young, old, or sick. Asthma, which affects over 20 million Americans, can be exacerbated by indoor allergens such as mold and dust, and, in some cases, asthma can be attributed to poor home ventilation or other indoor air quality concerns [1].

Housing is also a substantial expense, reflecting the largest single monthly expenditure for many individuals and families. Quality housing is not affordable for everyone, and those with lower incomes are most likely to live in unhealthy, overcrowded, or unsafe housing conditions [1]. Working together, however, communities can adopt policies and programs that ensure access to safe, quality housing for everyone. 


Transit includes public systems such as city or regional buses, subway systems, and trams as well as cars and bikes, sidewalks, streets, bike paths, and highways. Together, this varied and complex system connects people to each other, and to the places where they live, learn, work, and play.

Local transit options can support active, energy-efficient travel. Too often, however, neighborhoods lack sidewalks, safe crossings, or shared transit services that support these choices. Across the US, we depend heavily on motorized travel, especially cars, to get from place to place: in 2008, the average American drove nearly 10,000 miles. Most of our nation’s workers (8 in 10) get to work in a car. And, we often drive very short distances; almost half of all trips in America are two miles or less, and 74% of these are traveled by car [2].

Dependence on driving leads to 40,000 traffic-related deaths annually and exposes us to air pollution, which has been linked to asthma and other respiratory illnesses, cardiovascular disease, pre-term births, and premature death. It also contributes to physical inactivity and obesity—each additional hour spent in a car per day is associated with a 6% increase in the likelihood of obesity, whereas each added kilometer walked per day is associated with a nearly 5% reduction in obesity risk [2].

Creating and adopting policies that support active travel and encourage shared transportation can help to increase physical activity and reduce obesity, but also reduce traffic-related injuries and deaths and improve the quality of our environment. 

What Is the County Health Rankings Measurement Strategy?

The County Health Rankings use several measures to assess housing and transit in communities:

  1. The percentage of the population living with severe housing problems is measured using Comprehensive Housing Affordability Strategy data. Households are defined as having severe housing problems if they are overcrowded (>1.5 person per room); are expensive (housing costs over 50% of household monthly income); have incomplete plumbing facilities; or have incomplete kitchen facilities.
  2. The percentage of the working population who commute to work alone in a car, van, or truck is measured in driving alone.
  3. The percentage of the work force driving alone who spend more than 30 minutes commuting to work is measured in long commute–driving alone.

For more information about measuring Housing and Transit click here.


[1] Braveman P, Dekker M, Egerter S, Sadegh-Nobari T. Housing and health. Princeton: Robert Wood Johnson Foundation (RWJF); 2011. Exploring the Social Determinants of Health Issue Brief No. 7.
[2] Robert Wood Johnson Foundation (RWJF). How does transportation impact health? Princeton: Robert Wood Johnson Foundation (RWJF); 2012. Health Policy Snapshot Public Health and Prevention Issue Brief.