29: Illness arising from Road Transport

Dr Adrian Davis

Top line: Transport strategy and guidance requires a greater understanding of the range of health impacts arising from transport in order to deliver a sustainable transport system. The public health evidence base can help inform both national and local strategies.

Delivering a Sustainable Transport System (DaSTS) is the Department for Transport’s overarching road transport strategy. ‘To contribute to better safety security and health and longer life-expectancy by reducing the risk of death, injury or illness arising from transport and by promoting travel modes that are beneficial to health’ is one of its five goals. In addition, Local Transport Plan 3 Guidance states that ‘Undertaking a Health Impact Assessment should provide an evidence base to help the decision making process in developing an effective LTP, and to mitigate the negative effects on health and well-being (whether physical and/or mental health)’.1 These requirements beg the question as to ‘what the health impacts of road transport are which lead to illness?’

Historically, the main concern about health impacts of road transport has been road traffic casualties since these are acute. The contribution of traffic to noise and air pollution has become an increasing concern with rapid motorisation from the 1960s. Since the 1990s considerable public health research has revealed that many health impacts are subtle and chronic, not the least of which are the long term effects of physical activity decline arising from the substitution from walking, cycling and public transport to car use. This includes an evidence base linking car use with increased obesity risk.2 The British Medical Association’s report Road Transport and Health set out graphically a way of seeing the full range of health impacts through a Road Transport Morbidity and Mortality Iceberg.3 Considering impacts both above and below the ‘water-line’ the evidence base indicates that there is an unacceptably high disease burden as a result of current transport policy.4

The road transport morbidity and mortality iceberg. Quantified health impacts: reported serious and slight road traffic casualties; road traffic deaths; attributed respiratory and coronary illnesses due to air pollution from motor vehicles road traffic noise (e.g. sleep disturbance); Other health impacts: journeys not taken due to fear and worry; stress for travellers and residents; sedentary car dependent lifestyles in place of walking and cycling; loss of independent mobility (e.g. children and the elderly); reduced access to affordable healthy styles; reduced access to health services; social isolation and breakdown in social support networks related to community severance; loss of green spaces to motor traffic (parked and moving); non-attributed respiratory and coronary illnesses, cancers, osteoporosis and diabetes; Climate change - Vector-borne disease, migration etc...; Other impacts yet unidentified

1 http://www.dft.gov.uk/pgr/regional/ltp/guidance/localtransportsplans/ accessed 24th July 2009.

2 See Essential Evidence No 7 http://www.bristol.gov.uk/ccm/content/Transport-Streets/Walking-Cycling/cycling-inbristol/essential-evidence/essential-evidence.en

3 British Medical Association, 1997 Road Transport and Health. London: BMA. 4 Woodcock et al, 2007 Energy and Transport, The Lancet, 22;370 (9592):1078-88

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