Physical activity, Air Pollution and Transport

41% of the adult population in England are insufficiently active (HSE 2012: 35% men, 46% women)

Walking and cycling:

• can provide the same health benefits as sports or other exercise
• can increase cardiorespiratory fitness
• to work is as effective as a training programme and can fulfil the recommendations for physical activity.
• and it’s good for the local economy

Car commuters in Adelaide, Australia gained more weight over a 4 year study than non-car commuters.  The effect was particularly pronounced when comparing those who had sufficient leisure time

• Switching from car to active travel or public transport: Body Mass Index fell by 0.32kg/m2 (95% Confidence Interval 0.05-0.60)
• Switching from car to active travel: Body Mass Index fell by 0.45kg/m2 (95% Confidence Interval 0.11-0.78)
• Switching from active travel or public transport to car: Body Mass Index rose by 0.34kg/m2 (95% Confidence Interval 0.05-0.64)

The benefits of walking and cycling include:

• Activity
• Age-independent
• Affordable
• Access
• Air quality
• Flexible
• Mental health
• Less sick leave
• Longevity

Health impacts of Air Pollution include:

• Asthma
• Other respiratory disease
• Heart attacks
• Stroke
• Lung cancer
• Obesity
• Neuro-developmental disorders
• Neuro-degenerative diseases

There are 40,000 deaths per year in UK from air pollution and costs in the  UK exceeds £20 billion a year. More vulnerable populations disproportionately in poorer communities, the old, the young and those with existing circulatory or respiratory disease.  Poorer communities are disproportionately exposed to air pollution.

Transport should be about shifting people or freight, not cars or lorries.

• Motor vehicles are the only increasing source of air pollutant emissions in the UK
• Transport benefits accrue more to car users
• Harms from motor vehicles accrue more to poorer, more deprived communities

The policy response should be to reduce car use and spatial planning that does not assume or encourage car use

• ↑ Active travel – ↑ physical activity
• ↓ Emissions of pollutants
• ↓ Serious injuries
• ↓ Transport inequalities

The media – and doctors – notice injured cyclists. They don’t recognise the dangers of not cycling.

The actual risk for cycling (Figures for England 2010-2):

Risk of death for males (20.8 per billion kilometres)

• 1 per 48,000,000 kilometres cycled
• Individual risk: one fatality every 32,000 years (assuming typical cyclist rides about 1,500km pa)

Risk of death for females (16.9 per billionn kilometres)

• 1 per 59,000,000 kilometres cycled
• Individual risk: one fatality every 39,000 years

The Transport Planning Heirarchy

A default national speed limit of 20 mph on residential streets would make a lot of difference to fatalities:

• Reduces risk of collision
• Reduces injury/fatality consequences if collision occurs
• Reduces fear of traffic
• Makes streets more pleasant places for social use, including children’s play
• Encourages walking & cycling

So far

Local Authorities covering 13.5 million people in UK have implemented it locally

National legislation is:

• Much cheaper
• Changes the accepted norm more quickly – affecting drivers’ behaviour
• Smoother driving, reduces pollution
• Improves police enforcement
• Adds less than a minute to most journeys

HSE 2005 timed walk data showed road crossings are set too quickly for more than 3 in 4 older people and  children, parents, those in wheelchairs or with other impairments, with luggage, etc.

We should invest in active travel.

Public Health England:

“Health-promoting transport systems are pro-business and support economic prosperity …enable optimal travel to work with less congestion, collisions, pollution, and.. support a healthier workforce.”

• Set a legal minimum % of national & local transport budgets to be spent on active travel (eg 5%? 10%?)
• Better quality pedestrian environment
• More, better cycling infrastructure (especially junctions)

Invest in Public Transport instead of subsidising car travel

• Building roads
• Costs to society from car use (externalities)
• Benefits (social & economic) of public transport
• Easier & cheaper to travel by public transport
• Average cost vs marginal cost for car use
• Reverse the Beeching cuts to reinstate local rail services
• Bus regulation to enable joined-up thinking and journeys that work
• Faster replacement to Euro VI standards
• Retrofitting existing buses & coaches

Funded by

• Not building /widening major new roads
• Road charging (polluter pays) &/or taxation on fuel, reflecting costs to society (NOT scrapping fuel duty rises for cars!)

Faculty of Public Health. Local action to mitigate the health impacts of cars.

5 Priorities for national government:

1. Default 20mph speed limit nationally for residential streets
2. Better crossing facilities – more crossings, more time
3. Invest in active travel
4. Invest in public transport
5. Enforcement of existing laws & rules

This was presented at our conference Public Health Priorities for Labour