WADOHThis data is included as part of the Environmental Health Disparities Version 3.0 map. To see this map, visit our webpage . For more technical information on this map and the model used, visit our technical report (link) . Background Transportation expenses are a key social determinant of health. For many, transportation takes up a large part of their budget. This can make it harder for people to afford other important things, like housing, food, or services such as healthcare. People in rural areas often face bigger challenges with transportation costs. These areas have longer distances and fewer public transportation options, so people rely more on private vehicles. Owning a car is more expensive than using public transportation and creates more pollution. Driving longer distances also costs more and produces more emissions. Rural areas may already have pollution from nearby highways and agricultural operations. Emissions from long drives add to this concern. Limited transportation options in rural areas also impacts safety. Transportation infrastructure gaps can make it harder to evacuate in emergencies like wildfires or floods. This puts people in rural areas at greater risk from environmental threats. Less financially supported households may live farther away from cities because that's where they can find cheaper housing. But living farther away means they also spend more on transportation, even though they are less likely to have the means to afford it. Transportation costs also affect health directly. When people can't afford transportation, they may not get the medical care they need or may delay it. This can lead to long-term health problems, like chronic conditions, stress, and depression. Evidence In the U.S., transportation is the second-largest household expense. People in rural areas spend more on transportation than those in cities [1]. Less financially supported households in rural areas tend to be located closer to highways, exposing residents to more air pollution [2]. High transportation costs can cause delays in medical care and worsen health problems [3, 4]. In rural areas, people may face more risk from things like wildfires, which can lead to respiratory problems and even death [5]. Data source This measure utilizes the transportation expense component, variable "T_80ami", of the Housing and Transportation Index from the 2019 data release from the Center for Neighborhood Technology (CNT) . Methods The U.S. Census Bureau's American Community Survey (ACS) asks detailed questions on social and economic topics. This measure shows transportation costs as a percentage of income for a region's average household. It incorporates data on auto ownership, auto use, and transit use from the 2019 ACS. ACS data is collected and processed, refer to ACS General Data Users Handbooks . For more information, refer to CNT Methodology documentation . Caveats The index is intended for use by researchers, developers, planners, and policymakers to enhance their understanding of the cost burden of transportation. Factors such as car ownership can change quickly, so this measure be less accurate than measures that change more slowly. Additionally, this measure relies on the median household income for the entire census tract, which makes it less likely to identify tracts with significant income disparities. This measure uses data from the ACS. The ACS is known to undercount some populations, especially people who do not have stable housing. This measure is aggregated across the census tract and does not represent each individual community within the tract. These data should always be supplemented with local data and equitable engagement for more accurate insights. Sources Bureau of Transportation Statistics. (2023). Transportation Economic Trends: Transportation expenditures by household income and geography . U.S. Department of Transportation. Retrieved from https://data.bts.gov/stories/s/ida7-k95k American Lung Association. (2024). Who is at risk from air pollution? Retrieved from https://www.lung.org/clean-air/outdoors/who-is-at-risk World Health Organization (WHO). (2012). Health and environmental impacts of transportation. WHO Regional Office for Europe. Cristancho, S., Peters, R., & Manderson, L. (2008). Transportation barriers to health care in rural areas: A case study. Journal of Rural Health, 24(4), 387-394. Giving Compass. (2024). The physical and mental toll of wildfire smoke on rural communities . Giving Compass. https://givingcompass.org/article/the-physical-and-mental-toll-of-wildfire-smoke-on-rural-communities Citation Washington Tracking Network, Washington State Department of Health. Web. "Transportation Expense". Data obtained from the Center for Neighborhood Technology, 2022. Published September 2025.ArcGIS FeatureLayerhttps://hub.arcgis.com/datasets/a15810eeaaf944e7a9be54584e75a21c_0engState of Washington Geospatial Open Data PortalPublicTransportation Expense [Washington (State)]Web servicesWashington (State)Last Modified: 2025-07-30