What we know
What information do we have about the Eastern Board area?
What is the result of this on our health locally?
Policies
What is happening in the Eastern Board area?
References

Cycling, walking and the use of public transport promote health in four ways. They provide exercise, reduce fatal accidents, increase social contact and reduce air pollution.

Because mechanisation has reduced the exercise involved in jobs and housework and added to the growing epidemic of obesity, people need to find new ways of building exercise into their lives. Transport policy can play a key role in combating sedentary lifestyles by reducing reliance on cars, increasing walking and cycling, and expanding public transport. Regular exercise protects against heart disease and, by limiting obesity, reduces the onset of diabetes. It promotes a sense of well being and protects older people from depression.

Reducing road traffic would also reduce the toll of road deaths and serious accidents. Although accidents involving cars also injure cyclists and pedestrians, those involving cyclists injure relatively few people. Well-planned urban environments, which separate cyclists and pedestrians from car traffic, increase the safety of cycling and walking.

In contrast to cars, which insulate people from each other, cycling, walking and public transport stimulate social interaction on the streets. Road traffic cuts communities in two and divides one side of the street from the other. With fewer pedestrians, streets cease to be social spaces and isolated pedestrians may fear attack. Further, suburbs that depend on cars for access isolate people without cars - particularly the young and old. Social isolation and lack of community interaction are strongly associated with poorer health.

Reduced road traffic decreases harmful pollution from exhaust emissions. Walking and cycling make minimal use of non-renewable fuels and do not lead to global warming. They do not create disease from air pollution, make little noise and are preferable for the ecologically compact cities of the future.

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The Department of Regional Development Roads Service Travel Survey for Northern Ireland reported that in 2001-2003 we spent a total of twelve and a half days each year (or approximately 49 minutes per day) travelling within Northern Ireland. Just over eight days (or 67%) of this time was spent travelling by car and just over two days walking. The reliance on car travel in Northern Ireland is evident in that it makes up just over four fifths (83%) of the total distance travelled by Northern Ireland residents. It is significant that in Northern Ireland we walk on average 142 miles each per year, which is just over 2% of the total distance travelled.

The survey found that in 2001-2003 one fifth of all journeys were less than one mile, nearly two thirds of which were on foot (65%). Car was the dominant mode of transport for all journeys over one mile. Children aged 16 and under made just over six in ten of their journeys as car passengers, with most of the rest on foot. Women made one fifth of their journeys on foot, compared to 16% for men.

Overall adults made only 4% of their journeys by public transport compared to children who made 10% of their journeys by public transport. Nearly three quarters (73%) of the vehicles surveyed by the Roads Service had an annual mileage between 5,000 and 17,999 miles. Households containing one or more school-aged child were asked if their vehicles were used to take someone to school. In 2001-2003, two in five vehicles in these households were used to take someone to school. Three fifths (60%) of all vehicles in the survey were used to take someone to work.

The Roads Service survey also showed that in 2001-2003 36% of households in Northern Ireland owned one or more bicycles, 10% have two bicycles and a further 12% have three or more bicycles. Nearly 7 in 10 households lived within 6 minutes walk of a bus stop or place where they could get on a bus. Relatively few households had access to a train station. One member of each household was asked how long it would take them to walk to their nearest NIR station. Over three fifths said it would take them 44 or more minutes or that it was not feasible to walk. Overall, just a quarter of households lived within 26 minutes walk and only 11% lived within 13 minutes walk of an NIR station.

In the Eastern Board area, accidents represent almost 5% of the total deaths. One in four accidental deaths is due to motor vehicle accidents. In 2004, the road traffic accident mortality rate for males in the Eastern Board area was 15.1 per 100,000 deaths, compared to a figure of 5.9 for females.

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Probably the most important contribution of transport to health is through encouraging exercise – either walking or cycling – which protects against a number of illnesses including heart disease. There is strong epidemiological evidence that regular exercise, a balanced diet and not smoking are crucial to cardiac health. A further benefit of walking or cycling as a mode of transport comes in limiting progression of osteoporosis (loss of bone density that develops in older people, especially women, and leads typically to hip and arm fractures). Regular exercise and weight-bearing ensure continued bone strength and is probably more beneficial, on a population level, than current expensive drug treatments for osteoporosis.

Exercise is recognised to have mental health benefits through stimulating thought and protecting from depression. There is also a more complex relationship between mental health and the effect of traffic through ‘community severance’ (the separation of geographical parts of a community through traffic flows). Less traffic may also result in a better quality of life and communities that are more likely to be free from the dangers of road traffic. There may also be a link between mental health and traffic noise. Indeed the unpleasant effect of airport and major road noise are demonstrated through lower house prices.

There is widespread concern about air quality. While air the links between respiratory disease and traffic have been made, it is estimated that most people in towns spend 90 per cent of their lives indoors and about five percent in the open air and five per cent on transport. The major effects of respiratory disease are from indoor air. Coal fires are associated with respiratory diseases in childhood, while central heating and damp walls, creating environments for house dust mites and mould, increase allergic asthma. In external air, the smogs of nineteenth and early twentieth century cities have almost disappeared. Instead the major cause of air pollution is from motor vehicles. The health effects of vehicle air pollution can be separated into three parts: directly poisonous emissions, greenhouse gases affecting the global climate and small particles measured as black smoke. While acute smog episodes may temporarily increase asthma rates, the effects are mostly on people with previous respiratory disease. This suggests the need for policies much more complete than temporary car restriction.

A further result of transport on health is obviously that of accidents. Different road users have different accident profiles. Road injuries occur to people of all ages but there are different exposures by age. Pedestrian road deaths are highest in children and old people; young adults are particularly at risk as drivers and passengers of cars and motorbikes; cyclists are at risk at all ages.

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