In 1989 seven people gathered in Manchester Town Hall to found the Transport and Health Study Group. Dr. Stephen Morton, who called the meeting, became Chairman. At the time the perception of transport professionals and public health professionals alike was that injuries resulting from crashes were the main health consequence of transport. The seven founders of the Transport and Health Study Group thought the relationship went much further. Dr. Morton had called the meeting because he perceived that the out of town shopping centres created by a car-oriented spatial planning system increased health inequalities by depriving people without cars of access to important lifestyle choices. Others present at the initial meeting spoke about community severance, heart disease caused by insufficient cycling and walking, and the contribution of transport to climate change. We saw potential for a major interdisciplinary field of study. But to envisage that field having its own journal would have seemed extremely ambitious. So would the idea that the Transport and Health Study Group might have its own Parliamentary Advisers, have a European Committee or be the centre of a professional alliance with major professional organisations. A more immediate ambition might have been to be able to mention transport and health without being suspected of insanity.
Health on the Move was an important first step ( THSG, 1991). Prepared by discussion seminars, it was the first coherent, comprehensive account of links between transport and health. Much of it, though, was speculative. By the time Health on the Move 2 came to be written twenty years later, the evidence base had developed and we were writing a serious, scientific textbook ( Mindell et al., 2011) We won’t wait 20 years before updating Health on the Move again – we will do it in installments, revising it chapter by chapter through articles published in this journal (see editorial: Mindell, 2014).
Debating scientific evidence and publishing definitive accounts of the body of knowledge is the first duty of a scientific society. THSG, as its name suggests, is first and foremost a scientific society. But when scientific knowledge interacts with important areas of political decision making it is not enough just to publish scientific material. It must be used to frame recommendations for action and draw them to the attention of those who need to act on them. That is why Health on the Move 2 includes a comprehensive range of recommendations, which Sir Liam Donaldson, the former Chief Medical Officer for England, kindly described as combining creativity with scientific rigour ( Donaldson, 2011).
Active travel is the biggest single issue at the moment. The evidence that walking and cycling are good for health is compelling – entirely feasible targets for active travel are capable of contributing as much to reducing heart disease as the range of other interventions. If a pharmaceutical company invented tomorrow a drug to dramatically reduce the risk of obesity, hypertension, osteoporosis, diabetes, heart disease, and depression, and make people feel better at the same time, it would watch its share price go through the roof. Physical activity can do all these things, and active travel can also help reduce carbon emissions and congestion.
We still find ourselves having to fight defensive campaigns, such as resisting proposals for compulsory cycle helmets which will do little for cycle safety but will have a serious adverse effect on cycling levels, not least because they feed misconceptions about cycle safety. Comparing like for like (for example accounting for age and comparing cycling around town with driving around town not with overall driving statistics dominated by long safe motorway journeys), the risks of cycling are comparable to those of driving (Mindell et al., 2012). For most age groups cycling is slightly more risky but only to a degree which corresponds to risks people take without thinking in their everyday life (for example when they make a journey by car rather than by train or drive on an all-purpose road rather than a motorway). These risks are vastly outweighed for the individual by the health benefits and for society by the reduced risk to third parties. The argument, however, is not just that the risks are outweighed. More fundamentally than that, the increased risk of cycling over driving is not large enough for people to be concerned. They accept similar risks unhesitatingly. Indeed the only risk difference large enough to worry about is in the opposite direction – cycling is safer for young male drivers/cyclists.
Active travel and cycle safety may be the biggest issue but we also have important contributions to the debate on congestion, disability, the impact of streetscape on social support, travel to health services, and many other issues. In the airport debate we believe in an international high speed train network that can confine the need for aviation to flights over oceans and polar ice packs and local links in very remote areas like the Arctic. No transport policy or project can now be regarded as complete if it has neglected its health impact.
Reproduced, with permission, from the Journal of Transport & Health Vol 1 issue 1 March 2014