Local authorities are responsible for drawing up and implementing local transport plans. Poor planning and regulation leads to preventable deaths and injuries (particularly among vulnerable groups); it also leads to air pollution, and social and economic isolation, and acts as a disincentive to people making healthier choices like cycling and walking.
In this section, we focus on what local authorities can do to promote active forms of travel, and to make roads and journeys safer.
How can active and safe travel affect health?
- Physical inactivity increases the risk of chronic conditions including heart disease, diabetes, and other obesity-related illnesses. Eight out of ten people do not do the recommended level of physical activity, and the poorer people are, the less likely they are to do so, which reinforces other health inequalities (Farrell et al 2013).
- Greater vehicle use also causes higher levels of air pollution, which may increase cardiovascular and respiratory conditions, and contributes to global climate change.
- There is a higher incidence of injury and death from traffic collisions in lower socio-economic groups; more than a quarter of child pedestrian casualties happen in the most deprived 10 per cent of wards (Power et al 2010).
- Traffic accidents cause around 250,000 casualties each year and kill almost 3,000 people. Those who live in the most deprived areas have a 50 per cent greater risk of dying from a road accident compared with those in the least deprived areas (Power et al 2010). Accident rates for children are four times higher in deprived areas.
- More than half of all serious and fatal injuries to pedestrians occur on roads with a 30mph speed limit (RoSPA 2011). On urban roads with low average speeds, any further reduction of 1mph reduces collisions by about 6 per cent.
- Cycling to work reduces the relative risk of mortality by almost 40 per cent through reducing the risk of cardiovascular disease, obesity and general health improvement, and results in lower absenteeism (Hendrikson et al 2010).
What are the possible priority actions for local authorities?
Nearly 80 per cent of car trips under five miles could be replaced by walking, cycling or using public transport (Cabinet Office Strategy Unit 2009). Local authorities could begin by promoting active travel among their staff, and work with major local employers across all sectors to do the same. To get people walking or cycling more, roads need to be safer and more pleasant environments; the single biggest reported barrier to cycling is a perception that it is dangerous, yet more young men die in car accidents than bike accidents.
To promote active forms of travel, local authorities can:
- work with employers to promote cycling to work, which reduces the risk of cardiovascular disease and obesity, and leads to better general health, resulting in lower absenteeism (Hendriksen et al 2010)
- use NICE guidance for local authorities to design and implement policies that promote cycling and walking as forms of travel or recreation (National Institute for Health and Care Excellence 2012)
- change public perceptions about cycling being dangerous by promoting the message that its health (and indeed cost) benefits outweigh the risk of accidents
- learn lessons from other successful schemes: the Cycling Demonstration Towns programme, for example, succeeded in reversing the national trend of a gradual decline in cycling levels for the first time in the United Kingdom outside London; and the Cycling City and Towns programme, implemented across 18 local authorities, included infrastructure improvements and cycle training for children and adults (Department for Transport 2012). In the private sector, GlaxoSmithKline’s Cycle to Work scheme, for example, greatly increased the number of employees cycling to work, from 50 to 450, through a combination of incentives and improved facilities (Transport for London, no date)
- promote the Cycle to Work scheme (Department for Transport 2011) – which reduces the upfront costs of buying a bike for commuting purposes – among local authority staff, and encourage local businesses to do the same
- work with clinical commissioning groups to jointly commission effective cycling and walking interventions, which will deliver savings for NHS budgets.
To make roads safer for pedestrians and cyclists, and reduce air pollution, local authorities can:
- create safe, attractive and enjoyable local environments, with roads that prioritise ‘place’ over cars to increase ‘walkability’, perceptions of safety, and reported quality of life. Living Streets can provide advice on community street audits to improve walkability, and authorities could support local Walking the Way to Health groups (Living Streets 2012; Walking for Health, no date).
- introduce 20mph speed zones where appropriate. The evidence suggests that in high casualty areas, 20mph limits can reduce traffic accidents, injuries and deaths (RoSPA 2012). In London, for example, they have led to a 42 per cent reduction in casualties compared with outside areas (Grundy et al 2008). However, costs can outweigh benefits, so choosing roads and areas carefully is critical (Steinbach et al 2013)
- prioritise densely populated areas with consistently high accident rates, and residential areas around common urban destinations, including developing safer routes to school (as recommended by the Royal Society for the Prevention of Accidents, RoSPA).
However, enforcement (or lack of it) is often an issue with speed limits and other safety measures. Where signs-only schemes are introduced, experience shows that other (‘soft’) interventions such as community engagement may be needed to maximise effectiveness (Toy 2012)./p
The business case for different interventions
The overall costs to society of transport-induced poor air quality, ill health and road accidents are huge, exceeding £40 billion; traffic accidents alone cost around £9 billion annually (Cabinet Office 2009).
Replacing car journeys with walking or cycling, and making roads and neighbourhood environments safer and more pleasant, could therefore deliver considerable savings. For instance, for every £1 spent on cycling provision, the NHS recoups £4 in reduced health costs, while the economy ‘makes’ 35p profit for every mile travelled by bike instead of car. If England were to match spending levels on cycling infrastructure in the Netherlands, the NHS could save £1.6 billion a year (Burgess 2013).
Breaking this down, getting just one more person to walk to school could pay back £768 (Department of Health et al 2011) (with savings of between £539 and £641 a year for every person who cycles instead of using their car (Davis 2012)) in terms of the health benefits to individuals, savings in NHS costs, productivity gains, and reductions in air pollution and congestion (Cabinet Office 2009; Sinnett et al 2011).
There are also wider benefits for local authorities and businesses. GlaxoSmithKline’s Cycle to Work scheme, for example, reduced the parking space required for staff; the more consistent journey times of cyclists also contributed to improving productivity (Transport for London, no date).
Further resources and case studies
- An up-to-date systematic review of the health benefits of active travel, which looked at 24 studies from 12 countries, six of which were conducted with children (Saunders et al 2013).
- Living Streets has published a report reviewing the evidence for the health, economic and social benefits of better walking environments, using UK-based case studies (Sinnett et al 2011).
- RoSPA has produced a road safety factsheet that looks at the evidence on lower traffic speeds and health, and the effectiveness of 20mph speed zones (Royal Society for the Prevention of Accidents 2012).
- Sustrans has produced key facts and figures on physical activity and health, including the targets people should be aiming for (Sustrans, no date).
- NICE has produced guidance for local authorities on promoting cycling and walking as forms of travel and recreation (National Institute for Health and Care Excellence 2012), which summarises actions for local authorities from NICE’s existing work on physical activity and other areas.
- The Physical Activity Network for the West Midlands (now part of Public Health England) has produced case studies on successful local schemes to get people more active by walking and cycling (Physical Activity Network for the West Midlands, no date).
- Value for Money: Economic assessment of investment in walking and cycling, compiles the best available cost-benefit evidence from the United Kingdom and abroad from recent studies that have calculated health benefits alongside other benefits such as savings in travel time, congestion and accidents (Davis 2012).
- The Department for Transport has produced a speed limit appraisal tool to help councils assess the full costs and benefits of proposed speed limit schemes (Department for Transport 2013b).
- The Department for Transport has also recently produced a circular with guidance on setting local speed limits (Department for Transport 2013a).
- Walking for Health has evaluated different walking schemes, and how they contribute to meeting NICE public health guidance (Walking for Heath 2013).
- Transport for London’s Cycling for Business report includes examples of good practice and case studies of successful Cycle to Work schemes (Transport for London, no date).
- Living Streets Scotland has published a Community Empowerment Toolkit (Living Streets Scotland 2012) to show local residents how they can improve their streets and public places, which includes numerous case studies and activities.
- Living Streets has brought together more than 20 case studies on local projects that aimed to increase walkability, with some outstanding results (Living Streets 2012).
For references please see Improving the public's health: references appendix
Next section: Warmer and safer homes