Explore how transport can play a role in improving health and addressing health inequalities
Why transport matters for health
How transport systems are organised can play a role in improving health and addressing health inequalities. Transport can affect health directly, for example the health benefits of walking and cycling (active travel) or the negative effects of air pollution. It can also affect health indirectly through supporting other building blocks of good health, such as providing access to public services and someone’s place of work.
Explore the different ways transport can affect health below.
Increasing physical activity and minimising the time we spend sitting down helps to maintain a healthy weight and reduces the risk of cardiovascular disease, type 2 diabetes, cancer and depression. The NHS recommends that adults should do at least 150 minutes of moderate activity, or 75 minutes of vigorous activity, each week. Walking and cycling as part of our travel routine – whether for an entire journey or to access public transport – can help meet these targets.
Outdoor air pollution is associated with premature deaths and increased risk of being admitted to hospital with respiratory disease, lung cancer and cardiovascular illness. A study estimated that the impact of long-term exposure to air pollution in the UK could be 28,000 to 36,000 deaths each year.
Road transport accounts for 35% of nitrogen oxide and 12% of particulate matter emissions. These include PM10 particles (particles with a diameter of 10 micrometres or less) and PM2.5 particles (particles with a diameter of 2.5 micrometres or less), both of which are small enough to penetrate the respiratory system.
The health impact of noise is well documented too. Unwanted sound is associated with higher levels of stress, anxiety, sleep deprivation, high blood pressure and cardiovascular disease. Noise pollution can also result in cognitive impairment in children.
More in-depth analysis on air pollution will be published separately as part of the neighbourhoods and surroundings topic section.
Road collisions are a major cause of preventable death, serious physical injury and psychological trauma. In 2019, collisions in the UK caused almost 154,000 casualties and killed 1,748 people.
Collisions are also distributed unequally across society. Children and young adults in the most deprived areas are at higher risk of injury and death than those in the least deprived areas. The factors driving this are complex to isolate and include socio-economic and environmental factors such as level of crime, smaller home gardens and busier roads in deprived areas.
Policy interventions on transport can make a positive difference to people’s health. A review of transport-related interventions found beneficial impacts from campaigns to increase helmet use for cyclists and promote the use of child car seats and seat belts. Traffic-calming measures and legislation against drunk driving were also found to be effective.
An easily accessible, reliable and affordable transport system supports other building blocks of good health in many ways. It helps us connect to friends and family, as well as enabling us to access facilities that support our health, such as schools, colleges, parks, libraries and – more directly – health care centres. Research shows that people who rate public transport as ‘good’ are almost three times more likely than people who rate it as ‘poor’ to be able to access public services, such as health care or education facilities. Another study in the North West of England also found that being further away from GP practices was associated with higher use of accident and emergency departments, possibly as a substitute for primary care.
Transport also provides access to work, which is an important building block of health.
Transport systems can contribute to exclusion of certain population groups for various reasons, including a combination of personal and system-level factors:
- physical (such as disability-unfriendly transport)
- geographic (lower access to transport services in specific areas, eg rural areas)
- facilities (lower access to key facilities in specific areas)
- economic (inability to afford transport)
- time-based (inability to use transport due to other commitments, eg caring responsibilities)
- fear-based (safety concerns over transport use)
- space-based (access restricted based on security and space management strategies – for example gated communities or first class lounges).
Social exclusion is a particular problem for people with low incomes and people who live in rural or other areas with limited public transport. People on higher incomes are more likely to have cars and can travel more easily. Public transport interventions can make a difference. An evaluation of four public transport schemes in deprived areas found that these schemes had positive knock-on effects for employment and the use of health services.