Can Safe Routes to School and Transportation Policy Impact Child and Adolescent Health? A State-Level Policy Analysis

Policies that encourage supportive environments for walking and bicycling have been noted to be effective; however, the impact on health is not well documented. This study examined the relationship between state-level policies and markers of children and adolescent health and health-related behaviors. This policy review gathered information from sources on state-level active travel policies, funding, school activity policies from the 2024 Safe Routes to School State Report Cards (summary score), and child health outcomes by state. Overall scores were significantly associated with several physical activity variables, rate of children and adolescents with overweight/obesity, child chronic health conditions, poverty rates, and neighborhood access to activity resources, most in the hypothesized direction. Differences between the top and bottom scoring states were noted for several activity variables, health, and environmental variables. These findings provide a rationale for legislators to consider laws and policies within their own states to combat poor youth health outcomes.