Public health versus public policy? An appraisal of British urban transport policy.

The most visible aspect of the relationship between transport and health is in the realm of road traffic accidents (RTAs). But the effects of transport policy upon the public health are much wider-ranging. They include exacerbation of social and health inequalities, separation from directly health-protective amenities and social isolation, as well as health damage by physico-chemical pollution. It is arguable that these factors may account for more years of life lost annually than do RTAs. The current focus on accident reduction as the sole means of avoiding adverse health effects of transport distracts attention from the wide health erosive effects of road traffic. Universal mobility and accessibility, independent of the car, is required for public health protection and advancement, since private transport carries many external, and poorly recognised health costs.