Put health at the heart of transport policies, says BMA report

BMJ 2012; 345 doi: (Published 12 July 2012) Cite this as: BMJ 2012;345:e4766

Re: Put health at the heart of transport policies, says BMA report

Kmietowicz is right to highlight this excellent report which builds on recent World Health Organization publications (1,2). Healthy transport can potentially have a major impact on some of our urgent public health challenges including obesity, diabetes and heart disease (1,3). But, transport policy can have a positive or negative impact on health.

We agree, current transport policy is anti-health and discriminatory. In relation to injuries for example, Sonkin et al found steep social class gradients in road traffic injury death rates (4). However, enough is known about effective and promising public health strategies to justify action now (5).

One aspect of cycling and walking that we think should have been stressed more both in the report and the article by Kmietowicz is that both can be fun and enjoyable. This is particularly important because for some people they will be trying to make some quite difficult changes to behavior. To support them with this, action will be needed in micro and macro environments (1).

Appendix 3 of the report is particularly helpful as it provides an overview of the key recommendations from NICE public health guidance relevant to transport and health. It clearly shows who should take action and what they should do.

The report recognises that no single measure will be a silver bullet and highlights roles for a wide range of groups including healthcare and road safety. However, crucially, strong commitment and leadership is needed from the Government. The time appears to be right for action, perhaps politicians from the Departments of Transport and Health can capitalize on the current interest in the Olympics and launch a major initiative that would help to integrate health into transport policy.

1) World Health Organization. Physical activity and health in Europe: evidence for action. Copenhagen: WHO, 2006.

2) World Health Organization. Promoting physical activity and active living in urban environments. Copenhagen: WHO, 2006.

3) British Medical Association. Healthy transport = healthy lives, July 2012.

4) Sonkin B, Edwards P, Roberts I et al. Walking, cycling and transport safety: an analysis of child road deaths. The Journal of the Royal Society of Medicine 2006; 99: 402-5.

5) National Institute for Health and Clinical Excellence. NICE public health guidance 31: Preventing unintentional road injuries among under-15s: road design. London: NICE, 2010.

Competing interests: No competing interests

13 July 2012
Emily C. Watson
Foundation Year 2 Doctor
Dr Michael C.Watson, Associate Professor, University of Nottingham.
Northern General Hospital
Herries Road, Sheffield. S5 7AU
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