The health of our society is a social determinant of health. This means that political happenings in our country that influence our daily lives, our access to resources, and who represents us in all levels of government can also influence our health. Bioethicists, health care professionals, and others may recognize this as the social determinants of health. This is because we are trained to see the world in social-determinant-jade-colored glasses (as opposed to rose-colored-glasses). Every time I hear something new about the status of our society, every article I read about a new law, every post on social media I peruse about a change to a longstanding policy, I interpret it as a potential influence on our health. Social determinants of health are everywhere. Now, more than ever, with so much changing, it is important to magnify the impact new and shifting laws and policies have on our health so that the general public can also get a taste of these social-determinant-jade-colored glasses and begin to frame news of policy changes in terms of its effect on our health. And if it’s not our personal health that is impacted by changing policies, it’s someone’s health, often those people who are already marginalized because of their geographic location, income, education, age, ability, race, etc.
A change to the grants for street safety is one such policy change that could benefit from being framed as an impact on our health. In September 2025, the U.S. Department of Transportation, under guidance from the Trump administration, canceled many previously awarded grants intended to fund street safety measures, such as pedestrian trails and bike lanes, because these measures “aren’t designed for cars.” For example, a San Diego project that included bike lanes had its $1.2 million grant canceled because it “appears to reduce lane capacity and a road diet that is hostile to motor vehicles.” Fairfield, Alabama, Boston, Massachusetts, and Naugatuck River in Connecticut are among the cities whose had their grants for pedestrian safety, bike lanes, and other public transit projects canceled by this administration. Cities like Albuquerque, New Mexico, that have similar pedestrian safety grants will also have their grants reviewed. And more reviews are coming. Transportation Secretary Sean Duffy has said that it will also review grants for green infrastructure, such as bike lanes.
At least one apparent goal of canceling these grants seems to be encouraging Americans to use cars and other motor vehicles. Vehicles are obviously useful for the quick transportation of people and goods, but they do have drawbacks when it comes to individuals’ health and the health of our environment. According to the United States Environmental Protection Agency, a typical passenger vehicle emits about 4.6 metric tons of carbon dioxide every year. Along with carbon dioxide, vehicles also emit carbon monoxide, nitrogen oxides, particulate matter (i.e., pollution so small that it can be inhaled into the lungs), and volatile organic compounds into the atmosphere. Because these toxins contribute to greenhouse gases, vehicles are a major contributor to climate change. Climate change contributes to loss of life, disruption to our lives, financial insecurities, and poor health, such as the case of natural disasters like wildfires and floods.
The toxins that vehicles emit to pollute the air we breathe can contribute to or worsen chronic illnesses like cardiovascular disease, cancer, and other respiratory diseases like asthma. Polluted air can also have greater effects on disabled people, people who are already sick, and on children and the elderly, because they are more susceptible to the effects of breathing toxic air.
Cars also contribute to pedestrian fatalities. But bicycle and pedestrian lanes greatly reduce fatalities. For example, research has found that safer roads in our cities are not due to more cyclists on the road, but due to designated bike lanes. And bike lanes don’t just protect cyclists; they also protect drivers of vehicles. For instance, cities like Seattle, San Francisco, Denver, and Chicago saw a drop in fatal crashes when designated bike lanes increased.
Access to transportation, recreation, and safe cities are social determinants of health. Public transportation, and walking and biking lanes, the kinds of resources funded by pedestrian safety grants, are needed for us to have proper health. Pedestrian safety initiatives make it safer to be outside of our homes. They encourage community and connection to nature and our neighbors. They provide a place to exercise, walk our pets, and play games and sports or a place to just exist. For some, these initiatives help with mental health. For others, whose homes are not safe spaces, outside becomes a much needed safe space; sometimes away from unstable homes. Pedestrian safety measures connect us to resources needed for health. Pedestrian safety measures also contribute to safe cities for pedestrians and vehicle drivers alike, another social determinant of health. Everyone’s health benefits from pedestrian safety efforts.
Canceling grants used for pedestrian safety is a public health issue. Canceling grants that help our cities to be safer is not just a political or economic issue. We have to look at it through the lens of “how will this political move affect my health and my neighbor’s health?” So much of our health is determined by our neighborhoods’ resources, and many neighborhoods are under-resourced and resourced-deprived, contributing to differences in health among the American people. At a time when news stories about grants, laws, and policies being reviewed, altered, or altogether eliminated seem never-ending, we cannot afford to have a singular viewpoint of these stories. We have to view these stories in terms of our health.
Our health is social and political. There are almost no political moves that do not impact our health. And if they don’t directly impact our health now, they could impact our neighbors’ health now or in the future. Therefore, especially during a time of many political changes, having our social-determinant-jade-colored-glasses on is necessary to draw accurate pictures of our current health, threats to our health, and solutions to poor health. And in 10 years, 20 years from now, when we are evaluating the reason for differences in the health of different communities and why some people have poorer health than others or higher death rates, it would be easier to have a better picture of the story of poor health if we do the work now of evaluating policy changes for their potential effects on our health.
The views expressed here solely represent the author’s views and not those of any affiliated institutions.
Keisha Ray, PhD is an Associate Professor at University of Texas Health Science Center at Houston, McGovern Medical School.