Transport
Trends | Active travel | Social exclusion
About 4 mins
Why transport matters for health
Transport shapes how we move, what we can access and the surroundings we are exposed to. Transport can affect our health directly. Walking and cycling (active travel) have a positive effect, while air and noise pollution can have a direct negative impact.
Transport also influences our health indirectly by supporting access to other building blocks of good health. For example, it can connect us to work, shops and public services, and enable us to take part in social or community activities, which can all benefit our health.
Higher transport costs can create a financial strain, limiting resources to spend on other goods and services that support good health. It can also limit access to health care, employment and social activities.
Transport systems including infrastructure such as roads, railways and bus routes; reliable, accessible and affordable public transport services; and provision of cycle lanes and safe walking routes, all play a role in improving health and addressing health inequalities.
How have transport trends influenced our health?
How we travel has changed over time. In recent decades, overall travel by private transport, such as by car, has increased. Bus use has declined, except for some major cities such as London and Manchester. These shifts have made people and places increasingly car dependent.
How we travel directly shapes our health. Greater road traffic increases exposure to air and noise pollution. In 2024, road transport contributed 30% of harmful nitrogen oxide emissions. Road traffic injuries also remain a significant health concern, especially for children and young people.
Both road collisions and air pollution are distributed unequally across society. Children and young adults in the most deprived areas are at higher risk of injury and death from road collisions and more likely to live in polluted neighbourhoods than those in the least deprived areas.
Transport is shaped by policy and investment decisions. These influence travel behaviour and related inequalities and health outcomes. Structural factors such as road building have likely contributed to increasing car travel along with insufficient investment in bus, rail and active travel networks. Generally, public transport fares, particularly for trains and buses, have risen faster than the cost of motoring and the general cost of living, influencing mode choice.
Transport related policy interventions can make a positive difference to people’s health. Key interventions include low emission zones, traffic calming measures, drink-driving legislation, as well as campaigns to promote cycling helmets, bus subsidies, child car seats and seat belts. In London, the length of the strategic cycle network has increased over five-fold to 431 kilometres since 2016. During this time, harmful nitrogen oxide levels reduced by over 50% at sites in central London, with low emission zones seen as a key driver.
What are the health benefits of active travel, such as walking and cycling?
Walking and cycling as part of our travel routine – whether for an entire journey or to access public transport – can help us meet the NHS’s recommended targets for adults of at least 150 minutes of moderate activity or 75 minutes of vigorous activity each week. The availability, accessibility and usability of cycle lanes and safe walking routes are one important factor to encourage active travel.
Increasing how much physical activity we do and minimising how much time we spend sitting down helps us to maintain a healthy weight and reduces our risk of cardiovascular disease, type 2 diabetes, cancer and depression.
A good public transport system can further encourage active transport – with people walking and cycling more to access transport services. At a population level, higher rates of active travel can also reduce traffic, air pollution and road danger, providing wider benefits to people's health.
How does public transport access affect social exclusion and wellbeing?
Good transport connects us to friends and family, and enables us to access facilities that support our health, such as GPs. Transport also provides access to work, which is another important building block of good health, providing economic mobility beyond where we reside.
Reliable, accessible and affordable public transport services, and provision of cycle lanes and safe walking routes are important for social and economic mobility.
Problems with public and active travel provision can impact social and economic mobility. This can be a problem for people with low incomes and people who live in rural or other areas with limited public transport. 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.
Where we live and our demographic group – such as our age, income and disability status – can influence the different barriers we face when using public transport. This can cut us off from things we all need for day-to-day life, as well as contribute to stress, fatigue, low mood and social exclusion.
