Can Public Transportation Save Your Life?

Why Europeans Live Longer

I read a very interesting article in The Atlantic this week. It got me thinking, can public transportation save your life?

Public Transportation

When we thought about where we would land in Portugal…access to public transportation was a consideration. We had learned on prior excursions to Europe that you could get just about anywhere you needed to go using public transit, your feet, and an occasional Uber. Living in Cascais gave us easy access to Lisbon by train. The Viva Lisboa card was a bargain at €20/month (since we are seniors) and allows us to get on a train, subway, bus, tram, or ferry throughout the greater Lisbon area. We have found the metro (subway) system to be well-marked, clean, reliable, and safe. We love taking the short ferry ride from Lisbon to Cacilhas. And frankly, with all the other things we would need to learn and become accustomed to when moving to a new country, being relieved of the pressures of driving in a strange new place just made sense to us.

Live Longer

But it was not until I read The Atlantic article “Why Americans Die So Much” that I even considered that it might impact life expectancy.

Americans die more from car accidents, not because our fatality rate per mile driven is unusually high but because we simply drive so much more than people in other countries. — The Atlantic

I would argue there is another health benefit of public transportation…weight control. It seems to me that populations that rely on public transportation struggle less with obesity than those that are car-oriented. Even though we are using a train, the bus, or the metro…we walk more, making it easier to control our weight.

We still have been on a tram.

Other Differences

Of course, this is just one factor. The article points out that Americans are more likely to get shot because there are more guns in the U.S. That drug overdoses in the U.S. have outpaced European countries. That disparity in income has a dramatic impact on life expectancy in the U.S. where poorer communities are more often exposed to toxic chemicals and live in more polluted areas. And then there is our health care system:

“It says something negative about the overall health system of the United States that even after we grouped counties by poverty and looked at the richest 10th percentile, and even the richest fifth percentile, we still saw this longevity gap between Americans and Europeans,” he [Schwandt] added. In fact, Europeans in extremely impoverished areas seem to live longer than Black or white Americans in the richest 10 percent of counties. — The Atlantic

Stress

One factor that was not brought up in the article, which in my opinion should be considered, is stress. I recall during a fortunately short bout of shingles being asked by the physician, “Have you had anything particularly stressful happen lately?” I had.

In researching the influence of stress and disease I found that the NIH agrees that chronic stress significantly impacts the immune system, suppressing T cell levels and raising catecholamine. Over the past 9 months, we certainly feel less stress. But whether it be the social safety net, the strong family ties, the long lunches with friends, or the weekday siestas in the park … it would seem that the locals feel less stress too.

America…The Best

I was brought up to think that America was the best at everything. We were the brightest. The strongest. The richest. And we had the best health care in the world. There are some things that the USA is very good at. Treating traumatic injury (such as car crashes or gunshot wounds) for example. But it is not just the Covid deaths in the U.S. over the last 18 months that should give one pause.

Before the 1990s, average life expectancy in the U.S. was not much different than it was in Germany, the United Kingdom, or France. But since the 1990s, American life spans started falling significantly behind those in similarly wealthy European countries. — The Atlantic

Even in a poor country like Portugal, people live longer.