Intended for healthcare professionals


Reducing road traffic

BMJ 1998; 316 doi: (Published 24 January 1998) Cite this as: BMJ 1998;316:242

Would improve quality of life as well as preventing injury

  1. Ian Roberts, Director (Ian.Roberts{at}
  1. a Child Health Monitoring Unit, Institute of Child Health, London WC1N 1EH

    On a balmy summer afternoon in London in 1896 Bridget Driscoll stepped off the kerb and into history as the first person to be killed by a car in Britain. At her inquest the coroner said he hoped such a thing would never happen again. Over the next 100 years, 475 000 people would die on Britain's roads, with 30 times as many seriously injured.1 So many deaths could not go unnoticed, but the effect of motorisation on walking very nearly has.

    The Road Traffic Reduction (UK Targets) Bill has its second reading next week. If it is enacted the Secretary of State will be required to implement policies to reduce road traffic by 5% by 2005, and by 10% by 2010. The bill is supported by a host of health, welfare, and environmental groups, including the BMA, Barnardos, the Child Accident Prevention Trust, the Children's Play Council, the Faculty of Public Health Medicine, Friends of the Earth, and the Royal College of Paediatrics and Child Health. Their concern is not only to reduce death and injury but also to counter the other adverse effects of motorisation.

    Car travel has decimated walking. National estimates of walking mileage first became available in 1972. Since then the annual average distance walked has fallen by 22%.2 The decline is greatest in 5–15 year olds, in whom mileage has fallen by 28%.2 A quarter of all car journeys are under two miles (3.2 km), and the proportion of children travelling to school by car has increased from 12% in 1975 to 23% in 1994.2

    The equation of transport policy with road traffic policy has left children, elderly people, and those without a car socially excluded in our “top gear” towns. Children are prevented from playing in the street and travelling independently3; adults without cars are excluded from out of town supermarkets and inconvenienced by edge of town hospitals poorly served by public transport.4 Yet both are included in injury statistics and suffer more than their share of noise and pollution.4 For many children being struck by a car is their first experience of car travel, and the risk of injury for children in families without a car is twice that of children in car owning families.5 This, and the familiar scenario of the elderly pedestrian waiting anxiously at the kerb, surely deserves the attention of any Downing Street social exclusion unit.

    A three kilometre walk uses up about half the energy in a small bar of chocolate.6 The same distance by car expends 10 times as much energy and from the wrong source.7 As physical activity and thus energy output has declined, the prevalence of obesity has increased.8 Inactivity contributes to cardiovascular disease, diabetes, osteoporosis, and hypertension.8 On the other hand, energy consumption by road transport is increasing rapidly.9 Private cars account for one eighth of all carbon dioxide emissions, and vehicle exhaust is a potpourri of pollutants.10

    Preventing disease and injury may not be the most persuasive reason to reduce car use: improving quality of life should be the stimulus for change. Urban living would be more enjoyable without the drone of traffic, the smell of exhaust, and the danger. Bumping into someone in the street could be a welcome opportunity for interaction, not the precipitant of road rage. Less traffic might regenerate the supportive social networks of community interaction and revitalise our inner cities. And congestion is bad for business. The Confederation of British Industry estimates that road congestion costs Britain £20 billion a year.

    As a private member's bill the Road Traffic Reduction Bill will need government support to succeed. The Department of the Environment, Transport, and the Regions has already made clear its intention to get people out of their cars, and the bill provides it with an opportunity to match its concern with commitment. Neverthless, the bill does have political enemies in the shape of a well organised road lobby, representing those who sell cars, roads, and petrol, and even with government support may face parliamentary obstructionism. Those MPs who are tempted to filibuster should think instead about the quality of life of their own and their constitutents' children.


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