Transport has an impact on health through transport-related accidents, active travel, public transport, air quality and access to a range of services.
Transport can affect people by giving access to employment opportunities, education, leisure, healthcare and diverse food supplies. The development of an efficient transport network and vehicles has the potential to benefit health.
Increasing levels of motorised traffic have contributed to air pollution, noise, vibration, danger from vehicles and an increased fear of traffic. These issues particularly affect the most deprived and most vulnerable people in communities.
The rise in personal car use has meant liberation for people who are young and more affluent. More deprived, elderly and disabled people can become trapped in ‘residential islands’ surrounded by dense traffic, or without the means to access more distant facilities and services in out-of-town developments. This also applies to people in rural areas faced with dwindling local facilities and longer travel times.
Road traffic casualties are still one of the main public health challenges in the UK particularly for children and young adults.
The rise in personal car ownership levels has contributed to people being less active. This is a significant contributor to obesity, diabetes and cardiovascular disease.
This topic has links to the following JSNA topics:
1. What are the key issues?
In 2013, there were 368 collisions in Stockton-On-Tees, resulting in 418 casualties. There were 6 fatalities, 44 serious casualties and 368 slight casualties.
In 2013, there were 228 car occupant casualties in Stockton-On-Tees. Of the 228 casualties, 10 were ‘serious’, 2 were ‘fatal’ and 216 were ‘slight’.
The most recent trend analysis shows that there were 59 young car occupant casualties and 18 elderly car occupant casualties. Young drivers represent almost one-quarter of all car occupant casualties.
In 2013, there were 72 pedestrian casualties a significant rise of 25 (53%) on the previous year. The breakdown in severity of pedestrian casualties were 2 (fatal), 13 (serious) and 57 (slight).
In 2013, there were 62 pedal cyclist casualties. The breakdown in severity of pedal cycle collisions were 2 (fatal), 10 (serious) and 50 (slight).
In 2013, there were 29 motorcycle casualties. The breakdown in severity of motorcycle casualties were 9 serious and 20 slight casualties.
The 2011 Census states that only 6.2% of the working population travel actively to work.
In Stockton-On-Tees, an estimated 58.4% of people are active.
In Stockton-On-Tees, an estimated 26.1% of adults are classed as obese.
In Stockton-On-Tees, more than one in five children aged 11 years old are obese.
2. What commissioning priorities are recommended?
Facilitate and create increased opportunities for people of all ages to use ‘active travel’ in their daily routine for accessing education, employment or services.
Promote greater understanding of the health benefits of active travel and use events and programmes to introduce people to walking and cycling.
Increase the capacity of voluntary sector groups to deliver active travel programmes to sustain higher numbers of beneficiaries.
Improve detailed understanding of local access issues by improving the walking and cycling network information.
Consider health impact assessments for transport projects which have the potential to influence physical activity or such things as air quality and accessibility.
Commission programmes of education, training and publicity targeted towards reductions in road traffic accidents involving vulnerable road users.
3. Who is at risk and why?
Various factors influence the demand for transport as shown below.
Factors that affect transport demand (Litman, 2012):
Older (over 65-year-olds) and younger (18 to 20-year-olds) drivers are at particular risk of serious and fatal injuries on the roads.
Children are becoming less physically fit as they age.
A higher percentage of boys than girls (aged 2-15 years) meet the Government’s recommendations for physical activity.
There is no current evidence suggesting gender plays a significant role in determining the prevalence of obesity in adults. However, the NCMP shows that boys are significantly more likely to be obese than girls.
Children in the 10% most deprived wards in England are more than three times as likely to be pedestrian casualties as those in the 10% most affluent wards.
Although the most deprived areas produce the lowest levels of pollution, they are actually exposed to the highest levels of air pollution.
More people are active in households with higher income.
The distribution of overweight and obesity has a significant social gradient, with prevalence among people who are socially and economically deprived.
Disabled people are most likely to suffer an injury due to a trip or fall and therefore, will require longer periods of medical care than other groups.
Children and young people with a disability take part in physical activity and sport less frequently and their experiences are less positive than their non-disabled peers (Sport Scotland, 2006).
Injury rates are higher in black children when compared to their white and Asian peers.
People from minority ethnic groups tend to be less active compared to their white peers (The Information Centre, 2006).
People living within close proximity of motorised traffic can be affected as traffic vibration and noise cause stress, while congestion, traffic speeds and inconsiderate driving are a source of annoyance and fear for many.
Nationally in 2011, the majority (61%) of road collision related fatalities occurred on rural roads (40% on rural A roads and 21% on other rural roads).
While the evidence is varied, studies tend to show that cyclists and pedestrians are exposed to lower fine particulate matter and carbon dioxide concentrations when compared to those inside vehicles. The proximity to the pollution source(s) has a significant impact on the level of exposure levels experienced.
Nationally, whilst deaths peaked during the evening rush hour (and potentially dark nights), with a peak of 173 between 18:00 and 19:00 there were fatalities throughout the whole day.
Friday, Saturday and Sunday accounts for 50% of all deaths. Saturday and Sunday show evening peaks related to the periods following likely pub drinking and parties. On Sunday there are peaks following likely lunchtime drinking.
4. What is the level of need in the population?
The Tees Valley Transport Monitoring Report (http://www.teesvalleyunlimited.gov.uk/media/39881/tees_valley_monitoring_report.pdf) provides a wealth of statistical data for all modes of transport and monitors trends and changes over recent years. Several examples of tables within this document are shown below:
Tees Valley casualties by severity
Tees Valley casualties by age
Average vehicle speed
Tees Valley bus patronage
5. What services are currently provided?
Interventions to improve safety are developed using detailed casualty data, plus national and local studies. Current programmes include:
Evidence of progress for these interventions is published in Stockton’s annual Road Casualty Review.
6. What is the projected level of need?
Increasing car ownership in the North East will lead to increased levels of traffic and therefore a likelihood of increased risk.
An aging population will increase the level of risk in drivers who are over 65 years old.
Sedentary lifestyles brought about by increasing car ownership and decreasing amounts of daily activity may lead to increases in clinical obesity levels.
7. What needs might be unmet?
The current economic climate has placed severe pressures upon levels of investment in transport infrastructure. Traditional traffic engineering interventions on the road network are capital intensive and becoming increasingly difficult to fund, particularly as all of the ‘easy wins’ have already been made. There are thus fewer higher-return sites available in an already highly engineered environment, and those that remain are costly, and with poorer returns. Major reductions in the capital budget therefore mean that far fewer schemes can be delivered.
Softer measures in education, training and publicity will have a crucial role to play in making roads safer. However, public sector revenue budget cuts and the removal of specific funding streams such as the road safety grant have placed pressure on this area too. Beyond the current programmes of delivery to vulnerable road users, there is a particular requirement to support the needs of young drivers and the needs of an aging population with more older people driving.
Active travel/casualty reduction
There are missing links in the Stockton-On-Tees cycle route infrastructure. There also remain some significant barriers which separate communities and restrict active travel.
Cyclist training for year 5 and year 6 is covered by the Council’s training provision, and funded by the Department for Transport’s allocation for Bikeability levels 1 & 2. Turning young, basic-level cyclists into capable and regular commuters does however require further investment and there is currently a shortfall in provision for on-road training at Y7-11 (ages 11-16) for Bikeability Level 3. DfT funding for this is now becoming available but it requires local match funding to gain access to a DfT Bikeability grant.
Results from the Big Lottery-funded Active Travel project (based at The Hub) have shown that there is latent demand for higher levels of cycling and walking amongst adults, for both workplace commuting and also leisure and everyday transport. Pilot schemes for older cyclists (’Silver Cyclists’) have proven both popular and effective (Active Travel Monitoring Report, Sustrans 2011). Pilot funding has come to an end, and alternative funding will be required going forward.
The Government’s local transport white Paper, Cutting Carbon, Creating Growth: Making Sustainable Local Transport Happen DfT 2011 sets out the Government’s vision for a sustainable local transport system that supports the economy and reduces carbon emissions. The principal focus for action will be at local level. The key points in the paper are reducing the number of grant-making schemes and decentralising decision-making powers to local authorities, local economic partnerships (LEPs) and voluntary community and social enterprises (VCSEs). The Tees Valley has been successful in securing Local Sustainable Transport Funding in 2015/16 from the DfT for a range of measures to promote sustainable transport and increase residents levels of activity and access to services and employment.
8. What evidence is there for effective intervention?
Cairns J, Warren J, Garthwaite K, Greig G, Bambra C; Go slow: an umbrella review of the effects of 20 mph zones and limits on health and health inequalitie: Journal of Public Health, 2014.
NICE. Preventing unintentional road injuries among under-15s. NICE Public Health Guidance 31, 2010. guidance.nice.org.uk/ph31. http://www.nice.org.uk/guidance/ph31/resources/guidance-preventingunintentional-road-injuries-among-under15s-pdf.
Pucher J, Buehler R. Making cycling irresistible: lessons from the Netherlands, Denmark & Germany. Transport Rev 2008;28(4):495–528.
9. What do people say?
Consultation is a key aspect of transport-related activity. In the preparation of the Council’s LTP3 document, the consultation process sought opinions by a number of means during 2010:
Details of the consultations are at http://www.stockton.gov.uk/resources/transportstreets/ltp3/2277550.pdf. Headline findings are as follows:
Council website consultation
Youth viewpoint survey
Viewpoint survey & consultation event
Area transport strategies
The area transport strategies (ATS) are based on the four area boards of Stockton
Renaissance, the local strategic partnership, were consulted in the development of LTP3. Their principal objectives for their communities are:
Central area objectives
Eastern area objectives
Northern area objectives
Western area objectives:
10. What additional needs assessment is required?
A better understanding is needed of the links (and barriers) between leisure and commuter cycling, i.e. how to turn more weekend cyclists into people who cycle to work, school and on similar short-range journeys.
Name: Richard McGuckin
Name: Jonathan Kibble
Job Title: Principal Transport Officer
phone: 01642 526735
Local strategies and plans
National strategies and plans