Transport and health

Abstract

Transport - whether walking, cycling, travelling in cars, buses, trains, ships or planes - affects health. It provides access to education, work, leisure activities, family and friends. Walking and cycling are cheap, simple, everyday, forms of physical activity, and don't require dedicated sports and exercise facilities or time. Walking or cycling to work increases fitness, potentially fulfilling physical activity recommendations. Pedestrian-permeable environments are associated with 6lb lower mean population weight. However, motor vehicles cause injury, noise and air pollution; promote inactivity; reduce social interaction; and increase inequalities. Particulate air pollution precipitates cardiorespiratory mortality and morbidity; benzene causes leukaemia; greenhouse gas emissions exacerbate climate change. Community severance, whereby access to goods, services, and people beyond a road are prevented or impeded by the traffic is important. Appleyard and Lintell's study in San Francisco and Hart's recent study in Bristol found the number of friends and acquaintances falling dramatically as traffic volume increased. It should no longer be acceptable to create a residential street with a steady flow of traffic; streets should be viewed as community facilities, not just passages for vehicles. Until the Transport and Health Study Group's 1991 report Health on the Move, these effects were considered in isolation, not holistically. This often still applies but is becoming less true for transport professionals and public health specialists. Transport contributes to health inequalities. It affects access to education and employment, important health determinants. Areas affected by community severance tend to be poorer. Social exclusion occurs when access assumes use of private cars or public transport that is unaffordable to some. Air and noise pollution and injuries are commoner in deprived areas with higher road and traffic density. Social class V children have five times the mortality rate from road traffic as social class I. The poor are both exposed to higher levels of pollution and more susceptible due to pre-existing disease. Poor diet and worse health care access further exacerbate inequalities. In 2005, 45% of people aged 70+ had mobility difficulties, as did 14% of all adults; those in the poorest fifth of households were five times likelier than the wealthiest to have mobility difficulties. Country dwellers make more trips and spend longer travelling than those in urban areas, except London. Rural households are generally further from key services often without public transport so cars are more often required. Treating car ownership as a sign of affluence for deprivation-linked resources unfairly impacts on rural communities. In 2007, cars, vans or taxis provided 84% of distance travelled in Great Britain. A shift from cars towards walking, cycling and public transport would benefit individuals, society, and the environment and reduce the negative impacts of transport. …