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WHILE THE MBTA’S announcement that it will need at least $24.5 billion to repair stations, trains, tracks, and signals drew criticism and some measure of disbelief at the magnitude of the estimated cost, the price tag is just one side of a larger cost-benefit equation Massachusetts residents must consider.

Simply put: Improving public transit will improve public health.

In the Bay State, cars, trucks, and buses are responsible for 70 percent of the 28.8 million tons of pollutants released into the air each year. One of the quickest ways to reduce pollution, take cars off the road, and improve air quality is to make public transportation reliable, affordable, and safe.

A 2022 study from the Global Observatory on Planetary Health at Boston College found that air pollution is responsible for approximately 3,000 premature deaths each year across Massachusetts, primarily from cardiovascular and kidney disease, hypertension, and diabetes. 

Among children, air pollution causes stillbirths, low birth weight, and lung and brain injury. When the air is polluted by motor vehicle exhaust, more children are born prematurely, suffer from asthma, and score reduced IQs. 

Air pollution’s health impacts are seen in every city and town across Massachusetts, regardless of location, mean income, race, or ethnicity. While pollution’s health impacts fall more severely on the state’s most economically disadvantaged and socially vulnerable communities, no locale is spared.

A rebuilt, more efficient MBTA will remove thousands of cars from the state’s roads and prevent disease, death, and harmful impacts in both children and adults. And by keeping people healthy and out of the hospital and helping us all to live longer, a rebuilt T will increase economic productivity. 

EPA studies demonstrate that every dollar spent on air pollution control in the United States since 1970 has produced an economic benefit of $30. These multibillion-dollar savings offset a significant portion of the cost of the MBTA upgrade.

Furthermore, the proposed MBTA upgrade, which is a one-time cost, is a mere fraction of the $64.1 billion spent every year to subsidize Massachusetts’ vehicle economy, according to a 2019 study by the Harvard Kennedy School of Government.  

Another benefit of public transportation is that it increases physical activity. A safe and reliable transit system incentivizes people to leave their cars at home and to walk or bike to and from T stations. The results include reduced risk for diseases such as obesity and hypertension.

With an average daily ridership of more than 750,000 people, Greater Boston residents rely on public transportation for their daily commute to work or school, medical appointments, and access to grocery stores, cultural attractions, entertainment, and Logan Airport. The MBTA is the vital connective tissue for the city and its surroundings, and despite all of its challenges, Boston without the T would be paralyzed.

With courageous, far-sighted leadership and community support, the opportunity exists to improve the MBTA, reduce harmful air pollution, ensure public safety, safeguard health, and power economic growth in the Commonwealth.

The cost of fixing the MBTA is substantial, but the cost of inaction will be even greater. Fixing the T an investment in Boston’s long-term well-being. To dismiss it as a burdensome expenditure is to do so at our peril.

Ella Whitman is a research assistant in the Global Observatory on Planetary Health at Boston College. Philip J. Landrigan, MD, is the director of the Global Observatory on Planetary Health at Boston College