Insight: Making the Connection between Public Health and Transit

Public Health and TransitNumerous Martin Prosperity Institute Insights have looked at the relationships between transit accessibility in Toronto and various socio-economic indicators, such as income and working poor population shares. These Insights have identified several patterns between neighbourhoods with less transit accessibility and high concentrations of increased poverty levels. Recently Toronto Public Health released a report entitled Next Stop Health: Transit Access and Health Inequities in Toronto that looks at the relationships between public transit and health within Toronto. In the report, Toronto Public Health (TPH) uses the MPI’s transit score to map the availability and frequency of transit in Toronto. This Insight will provide a quick overview of the results in the Next Stop Health report.

The Report examines transit accessibility within areas of Toronto by looking at how affordable and available public transit impacts the building a healthy city. TPH argues that currently in Toronto numerous low income residents, particularly those in the inner suburbs, are experiencing a disparity in transit accessibility. In turn, the poor quality transit that many low income residents depend on is causing negative health impacts, by making it difficult to access healthy food, employment, education, recreational services and health care, amongst other things.

Exhibit 1: Percent of labour force using public transit to commute to work by employment income, aged 15+, Toronto, 2006

Exhibit 1

Notes: (1) Mode of transportation to work by total employment income of persons 15 years and over with a usual place of work or no fixed workplace address.
Source: Statistics Canada, 2006 Census of Canada (CANSIM Table: 97-561-XCB2006015.IVT)
Prepared by: Toronto Public Health, May 2012


As previous MPI Insights have demonstrated, the lowest income neighbourhoods in Toronto are the least accessible by transit. Not only are the residents with the lowest employment incomes often provided with the worst transit, they are also the most reliant on it. Exhibit 1 shows the percentages of the labour force that uses public transit within Toronto to commute to work, grouped by different employment incomes. The two income groupings, in which the highest percentage of the labour force uses public transit to get to work, are the two lowest income groups that earn from $20,000 to $39,999 or less than $20,000 a year. When examining the use of motorized vehicles as the mode of transportation to work, high income commuters are found to be 1.5 times more likely to use a motorized vehicle than the lowest income commuters (66.5% of high income commuters use a motorized vehicle).

Exhibit 2: Transit affordability (Cost of monthly transit pass as a percent of monthly minimum wage income), select Canadian cities/municipalities, 2009

Exhibit 2

Notes: (1) Figure includes Quality of Life Reporting System members with populations (2006) greater than 500,000.
Source: Federation of Canadian Municipalities, Quality of Life Reporting System. Ottawa, Ontario.
Prepared by: Toronto Public Health, May 2012


The TPH report further identifies that the health of low income residents in Toronto is being negatively affected by the poor accessibility of transit, and also by affordability. While many low income residents in the City rely on transit, many of them are provided with less transit access, at a cost that they can barely afford. Exhibit 2 presents transit affordability (cost of a monthly transit pass as a percent of monthly minimum wage income) for selected Canadian cities. As shown, Toronto has the second least affordable transit pass amongst the selected Canadian cities, coming second to the Quebec metro area. The dependence on poor transit, coupled with a less affordable transit pass creates a scenario in which performing daily duties for low income residents or those on social assistance more difficult.

The TPH report further examines how poor transit accessibility and affordability for low income residents in Toronto, is negatively affecting their health. The study found that once again, the northwest (Rexdale and Jane/Finch) and eastern (Malvern and Kingston/Galloway parts of the city that were identified as having the worst access to transit are the areas that have higher diabetes rates and also experience longer travel times to practitioners. TPH illustrates that many of the health services that aim to promote good health are unattainable by many in these areas due to barriers created by the dependence on unreliable transit access. TPH also identified that affordability can be especially problematic for families, as some of the parents interviewed mentioned that they have missed doctors’ appointments for their children due to not having transit fare. Poor transit accessibility affects poor residents in Toronto in every aspect of their lives. Not only do they often have a longer work commute, but activities that help maintain a healthy life, such as doctor and dentist appointments are made increasingly difficult, due to the lack of accessibility and affordability of transit for those most dependent on it. Furthermore, Martin Prosperity Institute research suggests that the added dimension of affordable housing options must be considered in conjunction with plans for transit expansion, in order to ensure that these outer neighbourhoods due to improved transit do not become less affordable for the current residents that currently need more accessible and affordable transit. In order to build a healthier city for all of residents, the implications of poor transit accessibility and affordability on the most vulnerable and dependent residents must be examined in for the hopes that must needed changes are made to address these issues.

To read the full report please click the following link:

Download this Insight (PDF)

The Martin Prosperity Institute at the University of Toronto‘s Rotman School of Management is the world’s leading think-tank on the role of sub-national factors — location, place and city-regions — in global economic prosperity. We take an integrated view of prosperity, looking beyond economic measures to include the importance of quality of place and the development of people’s creative potential.