Abstract
Background: The land transport system influences health via a range of pathways. This study aimed to quantify the amount and distribution of health loss caused by the current land transport system in Aotearoa New Zealand (NZ) through the pathways of road injury, air pollution and physical inactivity. Methods: We used an existing multi-state life table model to estimate the long-term health impacts (in health-adjusted life years (HALYs)) and changes in health system costs of removing road injury and transport related air pollution and increasing physical activity to recommended levels through active transport. Health equity implications were estimated using relative changes in HALYs and life expectancy for Māori and non-Māori. Results: If the NZ resident population alive in 2011 was exposed to no further air pollution from transport, had no road traffic injuries and achieved at least the recommended weekly amount of physical activity through walking and cycling from 2011 onwards, 1.28 (95% UI: 1.11–1.5) million HALYs would be gained and $7.7 (95% UI: 10.2 to 5.6) billion (2011 NZ Dollars) would be saved from the health system over the lifetime of this cohort. Māori would likely gain more healthy years per capita than non-Māori, which would translate to small but important reductions (2–3%) in the present gaps in life expectancy. Conclusion: The current transport system in NZ, like many other car-dominated transport systems, has substantial negative impacts on health, at a similar level to the effects of tobacco and obesity. Transport contributes to health inequity, as Māori bear greater shares of the negative health impacts. Creating a healthier transport system would bring substantial benefits for health, society and the economy.
Highlights
Introduction published maps and institutional affilTransport impacts health in many ways [1–3]
If the physical activity improvements alone were implemented, 58% of the total health gains would be realised; 37% would be realised by solely reducing injury and 8% would be realised by improving air quality (‘All’ column of Figure 1)
For the modelled cohort eliminating all road injury and air pollution caused by land transport and ensuring all people achieve at least the recommended levels of physical activity from active travel would result in substantial health gains and savings to the health system
Summary
Introduction published maps and institutional affilTransport impacts health in many ways [1–3]. Transport provides access to education, employment, healthcare, food and other amenities but car-dominated transport systems contribute to major global health challenges, including climate change, air pollution, obesity and road injury [4,5]. This study aimed to quantify the amount and distribution of health loss caused by the current land transport system in Aotearoa New Zealand (NZ) through the pathways of road injury, air pollution and physical inactivity. Methods: We used an existing multi-state life table model to estimate the long-term health impacts (in health-adjusted life years (HALYs)) and changes in health system costs of removing road injury and transport related air pollution and increasing physical activity to recommended levels through active transport. Conclusion: The current transport system in NZ, like many other car-dominated transport systems, has substantial negative impacts on health, at a similar level to the effects of tobacco and obesity. Creating a healthier transport system would bring substantial benefits for health, society and the economy
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