Complete Streets Policy Analysis and Examination of Influence on Travel, Health, and Health Disparities

Open Access
Sims, Dangaia Alfre
Graduate Program:
Doctor of Philosophy
Document Type:
Date of Defense:
September 07, 2016
Committee Members:
  • Melissa Jean Bopp, Dissertation Advisor
  • Melissa Jean Bopp, Committee Chair
  • Scherezade Mama, Committee Member
  • Liza Rovniak, Committee Member
  • Stephen Augustus Matthews, Outside Member
  • active transportation
  • physical activity
  • complete streets
  • policy
  • health
  • health disparities
Complete Streets policies are potentially a useful tactic for increasing rates of active travel among a variety of populations. Currently, rates of active travel are particularly low among the general population in the United States. Understanding how these policies influence travel behavior, health, and health disparities will inform future research and improve policy development. Accordingly, this dissertation aims to (1) develop and implement an appropriate checklist for examining Complete Streets policy quality, (2) identify how the presence of policies, policy language, and time since policy implementation influence the aforementioned outcomes, (3) investigate how leaders in communities with and without Complete Streets policies perceive the aforementioned outcomes. A new policy checklist was created for this study. Both this new checklist, as well as an existing checklist, were used to examine policy quality among county-level Complete Streets policies (n=52). These scores were then used to examine the association between policy quality and active travel, health outcomes, healthcare access, gathered from national datasets. Next, Complete Streets counties (n=52) were matched with control counties (n=52), to quantitatively examine differences in travel behavior, health, and healthcare access by county type, race/ethnicity, and income level. Finally, interviews were conducted with community leaders to qualitatively examine differences in the physical environment, travel behavior, health, and health disparities. Results led to seven major conclusions. First, the policy checklist used may not be of importance. Second, time since implementation was related to health outcomes; however, policy quality was not. Third, active travel was higher among control counties than Complete Streets counties; however, among certain populations, active travel was greater among Complete Streets counties participants. Fourth, health and healthcare access were greater among Complete Streets counties as compared to control counties. Fifth, no differences surfaced among the basis of county type in community leader interviews. Sixth, mixed results emerged on county leader perceptions of the previously mentioned variables. Finally, community leaders tended to believe Complete Streets policies would be beneficial in their counties. Ultimately, this dissertation informs the Complete Streets literature and may be useful by researchers and policymakers, alike, in determining the appropriate changes to be made to Complete Streets policies, as well as the populations to be targeted for future intervention. Complete Streets policies, when properly targeted and tailored, may provide widespread and long-lasting improvements in active travel, health, and health disparities.