Commuting patterns and premature death in US counties

Background: In 2014, the County Health Ranking model of health was modified to include housing and transit as explicit predictors of health. This change was made due to a growing understanding of the impact these factors have on the health of individuals. 

Objective: To use the data from County Health Rankings to better understand what the commuting patterns are in US counties and to understand the relationship between these patterns and rates of premature death. This research also examines important county characteristics that modify these relationships.

Methods: The County Health Rankings data were used to test the association of premature death with two commuting patterns: commuting alone and long commutes among those who commute alone. A model was then constructed to examine the relationship between these commuting patterns and premature death while controlling for the rural/urban nature and demographics of the counties.

Results: Seventy-six percent of the US workforce drives alone to work. County-level data show that both commuting alone and long commutes among those who commute alone are positively associated with increased premature death. Communities that are more rural are less likely to have commuters who drive alone to work, but among those who do, the drive is more likely to be longer than 30 minutes.

Discussion: Commuting patterns have a significant association with premature death in US counties. Communities need to ensure that workers have options for getting to work other than driving alone in their cars for long periods of time.