Transport is important for health. The Transport and Health Science Group (THSG) - an NGO that works closely with the Faculty’s Transport Special Interest Group - describes the benefits of travel as the 3 A’s:
- Access (to education, employment, services, goods, social networks, and leisure)
- Attractive environments (travelling to/through green and blue spaces)
- Activity
Only the first is mode-independent. In car-dependent societies, the harms from transport are predominantly due to motorised transport, particularly private cars/vans and lorries. These harms are Cacophony (noise), Carbon emissions, Casualties from collisions, Community severance, Concern and social isolation, Congestion, Contamination (of air and ground), Conurbation design, and Couch potatoes.
Cars are harmful to health
Cars act as determinants of health by shaping environments and the behaviours that contribute to individual and community well-being. Cars have even been described as the new tobacco; vectors of disease that produce pollution, cause collisions, and encourage sedentary lifestyles that negatively impact health, community well-being, and sustainability.
Private car use also exacerbates inequity, with most of the benefits accruing to car users and most of the harms falling on others, particularly the most disadvantaged. Politicians, many transport and spatial planners, and swathes of the population in moto-normative societies seem addicted to cars as the default mode, even where other options exist.
Although electric vehicles (EVs) produce less greenhouse gas emissions, air and noise pollution in use than conventional engines, they emit particulates from brake and tyre wear and cause the other harms listed above. Their growing adoption reinforces car dependency. Continued reliance on private vehicles (including EVs) limits mobility options, deepens environmental injustice, and perpetuates systemic inequities, alongside resource demand and safety risks.
Cars as commercial determinants of health
Commercial determinants of health have three components:
- unhealthy commodities that impact adversely on health
- commercial practices that market the commodity and political practices that enable a favourable environment; and
- globalisation of markets that normalise these practices.
Car advertisements are as unrealistic as cigarette advertisements were prior to the UK ban, portraying glamorous aspirational scenarios that users cannot achieve: e.g. showcasing cars driving through empty cities. Congestion, air pollution, noise, crashes, and impacts of climate change do not feature.
Auto-oil industry
Having compared cigarettes with cars, and smoking with driving, we can also compare the tobacco industry with the auto-oil industries, e.g. car manufacturers, petrol companies. These powerful multinationals prioritise profit over people and the planet’s health. There is significant resistance from multinational companies when public health measures challenge their interests. The car industry employs tactics used by other harmful commodity industries. British Petroleum (BP) is widely credited with popularising the “carbon footprint” concept through a marketing campaign in the early 2000s, shifting responsibility for the climate crisis onto individuals. The FIA’s approach to road safety focuses on individual travellers (especially pedestrians and cyclists). The World Bank’s industry-dominated Global Road Safety Partnership advocated road safety education as its primary intervention, ineffective in reducing road danger.
What can be done?
The first step is to recognise cars as a harmful commodity. Media advocacy played a key role in advancing tobacco control legislation. Strategically using media together with a broad range of partners can reframe public narratives, generating the political and societal support needed for policies enabling healthier choices at the population level. Coordinated collaboration of healthcare professionals, NGOs, public health bodies and their allies, nationally and internationally can counterbalance the political influence of the auto-oil industry; a major commercial determinant of health.
