Health & Well Being

The Nashville Area MPO is committed to forming policy, funding and research that support the improvement of health outcomes through active transportation - transportation that requires physical activity - such as transit, walking and bicycling. One-third of Americans do not drive or own cars, and 12 percent of all U.S. trips are made by walking or bicycling, yet these modes account for 14 percent of traffic fatalities and only 1.6 percent of federal transportation funding. Of the trips taken in U.S. metros, 50 percent are three miles or less; nearly 30 percent are one mile or less. And despite the fact that 55 percent of Americans want to bike more, drive less and walk more than they do now, 65 percent of trips under one mile are still taken by automobile due to inadequate facilities for active transportation.

With Tennessee ranked fourth in the nation for obesity rates, the MPO is pursuing infrastructure policies that reflect a desire for healthier options to get around communities - including safer, more convenient means to walk or cycle for routine trips.


Current Initiatives

2040 Regional Transportation Plan: Increased Policy for Health

Developed in 2015, the Regional Transportation Plan (RTP).  The MPO has increased its commitment to prioritizing transportation projects that improve health. Through the endoursed goals and objectives for the RTP, the MPO is committed to helping local communitites grow in a healthy and sustainable way by:

Aligning transportation decisions with economic development initiatives, land use planning, and open space conservation efforts.

Integrating healthy community design strategies and promote active transportation to improve the public health outcomes of the built environment.

Encouraging the deployment of context-sensitive solutions to ensure that community values are not sacrificed for a mobility improvement.

Incorporating the arts and creative placemaking into planning and public works projects to foster innovative solutions and to enhance the sense of place and belonging.

Pursuing solutions that promote social equity and contain costs for transportation and housing.

Minimizing the vulnerability of transportation assets to extreme weather events.

The three major strategies to achieve these outcomes are:

Fund and implement the Regional Vision for Mass Transit

Develop active transportation optins for walkable communities

Reinvest in strategic roadway corridors

The MPO also updated the scoring criteria used to evaluate projects.  80 of the 100 points help to ensure that projects are prioritized around improving health by increasing physical activity, improving air quality and reducing crashes for all modes. In addition, projects were evaluated for location within Health Priority Areas, which are defined by areas with high rates of at least three of the following: low income, unemployed, carless and populations over age. 

By prioritizing active transportation facilities such as transit, sidewalks and bikeway, and placing these facilities in areas where they are most needed, the MPO is working to using transportation as a prevention strategy to improve health and prevent disease. 

Read more about the tools used to evaluate bicycle and pedestrian projects and needs on the Regional Bicycle and Pedestrian Study.


Integrated Transport and Health Impact Model

Recently, the Nashville Area MPO partnered with The Center for Disease Control to implement the Integrated Transport and Health Impact Model (ITHIM) in the Nashville region. ITHIM performs a range of integrated assessments on the effects of transportation scenarios and polices at the urban and national level on public health. Learn more about the ITHIM tool here.

A final version of the report can be found here.


Regional Transportation Plan - Transportation Policy for Health

In December of 2010, the MPO adopted the 2035 Regional Transportation Plan which marks a significant shift in increasing the support for active transportation projects. Sixty of the one hundred points on which transportation projects are scored are based on positive outcomes for air quality, provision of active transportation facilities, injury reduction for all modes, improvement to personal health and equity of transportation facilities in underserved areas. Five hundred transportation projects were submitted for the plan and all roadway projects were scored using the new criteria. Projects were also reviewed for proximity to community destinations such as schools, parks, community centers and grocery stores. 75 percent of the submitted roadway projects for the estimated $6 billion in funding included an active transportation element such as a bikeway, sidewalk or greenway. In the final Regional Transportation Plan, nearly 70 percent of adopted roadway projects include active transportation infrastructure, up significantly from the estimated 2% of projects in the 2030 plan. Read a summary of the policy and funding supporting health in the MPO 2035 Regional Transportation Plan.

  • The Nashville Area MPO is highlighted in a white paper by the U.S. Department of Transportation's Volpe Center as one of four leading MPOs who include health in transportation planning and policy.
    The white paper and one-pager on the paper were released in January 2013.
  • The MPO's 2035 Regional Transportation Plan was one of nine recipients of the 2012 National Transportation Planning Excellence Awards from the U.S. Department of Transportation for the inclusion of health in transportation planning, policies and programs. View a poster of the health elements included in the 2035 Regional Transportation Plan.
  • The journal Kinesiology Review recently published an article about the 2035 Regional Transportation Plan and the emphasis on health impacts through active transportation modes such as walking, bicycling and transit. Read an abstract of the article or purchase the full article.
  • The 2035 Regional Transportation Plan is featured in the National Prevention Strategy: America’s Plan for Better Health and Wellness (page 10). The National Prevention Strategy, released in 2011, is a comprehensive plan that will help increase the number of Americans who are healthy at every stage of life by preventing disease. The plan is an effort of the National Prevention, Health Promotion, and Public Health Council, which is comprised of seventeen Federal agencies.
  • The American Institute of Architects released a report in December 2012 that highlights work around the nation from communities including health in the built environment. The policy and funding work of the Nashville Area MPO is featured in the report: Healthier Communities Through Design
  • In 2015, the Houston-Galveston Area Council of Government released the 2040 Regional Transportation Plan.  The Health Framework for the plan was based on part off of the health components of the Nashville Area MPO 2035 Regional Transportation Plan.

The Relationship Between Food Deserts and Transportation

During the development of the 2035 Regional Transportation Plan, MPO staff looked at the relationship between access to food and transportation. At the time, staff did not have regional data sets that defined areas that were considered food deserts. A food desert is defined as an area without a full-service grocery store, little access to transit, walking and bicycling facilities, and a high concentration of low income populations. Staff did have data on where food was available at grocery stores, farmers markets and emergency food pantries. As each of the 500 projects submitted for the RTP was evaluated, staff recorded how many food sources were within one mile of the proposed transportation improvement, and noted if there were high concentrations of low income, minority and older adult populations in the same area. Staff noted that in these areas, it is especially important that transit, walking and bicycling facilities be provided so that residents can access food retailers without needing an automobile.

MPO staff has now obtained several datasets on food deserts, and is in the process of evaluating the adopted projects in the 2035 RTP in relation to existing food deserts.

Active Transportation Program

In addition to the scoring criteria that emphasize active transportation, the MPO adopted a funding strategy which reserves 15 percent of federal Surface Transportation Program (STP) funds, the largest federal funding source for roadways in the MPO region, exclusively for active transportation infrastructure and education. The 15 percent may be used for infrastructure projects such as crosswalks, greenways and sidewalks, or education and promotional activities such as Safe Routes to School programs, maps of bicycle and pedestrian facilities, and education and training of law enforcement and the public on bicycle and pedestrian laws. The estimated revenues between now and 2035 for the program are $115 million. The MPO awarded the first round of projects in 2012, totally $2.5 million in funding.

Mass Transit Program

Similar to the Active Transportation Program, the MPO created the Mass Transit Program which reserves 10% of STP funds to be flexed to help advance the region's policy initiative to establish a bold, new vision for mass transit. The estimated revenues between now and 2035 for the program are $77 million dollars. The MPO will award the first round of projects in 2012, totally $1.65 million in funding.

Middle Tennessee Transportation and Health Study

The MPO is conducting a Regional Household Travel Survey in 2012 that surveys approximately 6,000 households on travel behaviors and subsequent impacts on health. A subset of 600 participants will wear devices that collect information on physical activity as part of daily travel. This landmark study collects data that is integral to illustrating the relationship between transportation, physical activity and overall health. This data will be used in the next update of the MPO Regional Transportation Plan to shape additional tools and policies on health outcomes in the regional transportation planning process. Click here to read a short summary of the health components of the study.

Regional Bicycle and Pedestrian Study

In 2009, the MPO adopted the first regional study on bicycling and walking for the greater Nashville region. The regional Bicycle and Pedestrian Study establishes a strategic vision for improving walking and bicycling opportunities and feeds into the Nashville Area MPO's overall regional transportation plan, providing the basis by which future funding priorities of the MPO are established for bicycle and pedestrian accommodations. The study includes a strong emphasis on health, especially around the promotion of physical activity through active transportation, crash reduction for all modes, improved air quality, and reduction of chronic diseases such as heart disease, diabetes and other diseases related to obesity. The study includes a prioritization methodology for bicycle and pedestrian facilities that includes an emphasis on health, wellness and equity. For information about the prioritization methodology, see Technical Memo #4: Project Evaluation Methodologies.

Evaluation of Policies

In 2011, the Centers for Disease Control - Division of Nutrition, Physical Activity and Obesity (DNPAO) reviewed policies included in the 2035 Regional Transportation Plan that are inclusive of the impacts of transportation on health, with a focus on obesity. The review is a pre-evaluation assessment of the MPO's policies around physical activity, with the intent of collecting an evidence base of policy-based initiatives for the purpose of wide-spread replication.

Building on the CDC pre-evaluation assessment, the Center for Training and Research Translation (Center TRT) issued a report on the health elements of the MPO's 2035 Regional Transportation Plan as an emerging physical activity intervention. The intent of the report is to provide public health practitioners with the best available evidence and approaches related to the prevention and control of obesity The Center TRT is based in the Center for Health Promotion and Disease Prevention at the University of North Carolina at Chapel Hill, one of the Prevention Research Centers supported by the Centers for Disease Control and Prevention (CDC). View the report and supporting documents. Also, Listen to a TRT webinar with the Nashville Area MPO discussing the intervention.

Health Impact Assessment of Transit Oriented Development

The Nashville Area MPO worked with two interns from the Vanderbilt University Masters of Education, Community Development and Action program on a pilot Health Impact Assessment (HIA) of a proposed Transit Oriented Development (TOD). The TOD is a proposed transit station identified as part of the MPO Northeast Corridor Mobility Study. The interns conducted a thorough literature review of HIAs, focusing on those with a transit component. They developed a set of criteria that should be considered in the development of a TOD. The criteria and recommendations were incorporated into the conceptual designs of the transit station. In addition, the interns also worked with architecture students from the University of Knoxville and MBA students from Vanderbilt Owen Graduate School of Management on design and financing projects for the proposed TOD. A final phase of the HIA is currently underway and includes a survey to 1,000 area residents around the proposed TOD site on their assessment of how the built environment impacts their health, and a series of community conversations on the same topic. Read the final paper written by intern Laura Stamm on the Health Impact Assessment. Also available is a paper by Stamm on the importance of Community Engagement in the HIA process and a literature review on the relationship between the built environment and health.

Hamilton Springs TOD School Siting Health Impact Assessment

In partnership with the Brown School of Public Health at Washington University, the Nashville Area MPO completed a rapid Health Impact Assessment (HIA) of a proposed school site within the Hamilton Springs Transit Oriented Development (TOD) in Lebanon, Tenn. The HIA concludes that if a school were sited within the TOD, all residents would live no more than a half-mile from the facility, thereby creating the potential for all students to walk or bicycle to school. The report also concludes that if the retail food environment were to receive careful consideration, the TOD might include a full-service grocer, while limiting or prohibiting more unhealthy food options, enabling TOD residents to make food choices that would better promote health. The rapid HIA was developed in order to help influence decision-points in the TOD's school-siting process, namely building placement and features, the supporting transportation network, and surrounding land uses.

Tennessee Obesity Taskforce

The Tennessee Obesity Taskforce is funded by the Centers for Disease Control and was formed to develop and implement Tennessee's first statewide nutrition and physical activity plan to reduce obesity and chronic disease in the state by 2015. The Eat Well, Play More Tennessee Plan was developed by a broad-based, statewide coalition and is being implemented by over 600 partner agencies across the state including scientists, clinicians, city planners, school officials, state agencies, policymakers, transportation experts, nutritionists, parents, and representatives of our most vulnerable populations. The plan strives to build lasting and comprehensive efforts to address obesity and other chronic diseases through a variety of nutrition and physical activity strategies that reduce the barriers to daily physical activity and access to healthy foods. Leslie Meehan from the MPO served as a co-chair of the Taskforce during its development in 2010-2011. The website for the Tennessee Obesity Taskforce and the Eat Well Play More Tennessee plan is

Dedicated Staff - Transportation and Health

The environment in which a person lives is attributable for upwards of 70 percent of a person's health. Transportation decisions have an enormous impact on health - from providing opportunities for physical activity, connecting people to communities and providing accessibility to healthy foods, jobs, schools and transportation options. Mental health and quality of life are also impacted by transportation. Because of the strong link between transportation and health, the MPO created a Director of Healthy Communities position in the winter of 2011. By having a dedicated staff person overseeing regional transportation impacts on health, the MPO is able to ensure that health is considered in various transportation studies, policies and projects. Leslie Meehan, an employee of the MPO for over six years, is serving in this role. .

For More Information

Rochelle Carpenter
Senior Policy Advisor

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