By Margaret Douglas - Chair of the Public Health and Sustainable Transport Group

Transport and health

Transport matters for health. It gives access to amenities, services and employment, and supports social connections. But motorised transport has adverse health impacts - through air and noise pollution, carbon emissions, injuries, sedentary behaviour, stress and routes cutting across communities. Prioritising cars exacerbates these effects and increases health inequalities, disadvantaging people who cannot access a car or else experience financial hardship through having to own and maintain a car.

In Scotland, 29% of households do not have access to a car. Accessible, affordable and frequent public transport is essential to ensure everyone can benefit from the transport system. People often walk to and from stations and stops, gaining incidental physical activity benefits. Walking, wheeling and cycling are active modes of travel that increase physical activity levels, informal social contact, opportunities to be in green or blue spaces and footfall for local businesses.

Transport in the pandemic

The COVID-19 pandemic has had a significant impact on Scotland’s transport system. We set up the Public Health and Sustainable Transport Group (PHSTG) to understand these changes and inform policy responses to what has happened. In October 2020, we published a report into how transport use changed in Scotland due to restrictions associated with the pandemic. It found significant changes in the number of trips people were making and how they travelled. There had been a large reduction in public transport journeys, while car use had fallen but was rising again. There had been increased walking and cycling for recreation with an overall increase in cycling, but not walking, compared to previous years. The report highlighted the need to limit increases in car traffic, support long term viability of public transport and support walking, wheeling and cycling as restrictions eased.

Recent trends

The PHSTG has continued to monitor trends. Figure 1 shows the steep fall in car, bus and rail journeys in March 2020. The total number of journeys remains lower than before the pandemic, partly because many people are still working from home. In surveys by Transport Scotland, between 37% and 48% of people state that they intend to continue working from home more often after the pandemic. Despite this, the number of car journeys has risen and is now very similar to 2019 levels. On the other hand, bus and rail journeys are still far below the pre-pandemic level. The same surveys show concern about transmission of the virus on public transport, with more than a third of people saying that they would continue to avoid public transport and use their car more. Many people walk to and from bus stops and railway stations so the reduction in public transport use will also have reduced incidental walking. Overall, data suggests that the proportion of journeys made by car has increased, and that this may continue for some time. Without continuing additional support, public transport services may become less viable, increasing transport exclusion for people who cannot access a car. Given the adverse effects of car traffic on health already mentioned, these trends will have a negative impact.

Image caption Figure 1: COVID-19 related trends in travel (Source: Transport Scotland)

Policy responses to improve health

The PHSTG has worked to identify and inform policies and actions that improve the health impacts of transport. The trends suggest a need for more action to limit further increases in car travel, protect public transport services and support active travel.

The group recently completed a health impact assessment (HIA) of road space reallocation. This considered evidence from both temporary road space reallocation schemes, used during the pandemic to enable pedestrians, wheelers and cyclists to physically distance, and more permanent initiatives that have reallocated space from cars. The HIA found that these can benefit health through reducing the adverse health effects of traffic, encouraging active travel, supporting access to greenspace and supporting local businesses. It highlighted the need to ensure the reallocated space is accessible to everyone including disabled people, and to accompany road space reallocation with improvements in other modes of transport, to reduce transport exclusion and provide a realistic alternative to car travel.

The group has also published an evidence briefing on the health impacts of the target to reduce car kms by 20% by 2030, and is now scoping the likely health impacts of the route map to achieve this target.

Transport will continue to affect health after the pandemic. The PHSTG will continue to work together to gather evidence of these links and inform responses to improve sustainable transport, benefit health and reduce health inequalities.

Read about how transport use changed in Scotland due to restrictions associated with the pandemic.

Read our evidence briefing to support a 20% car km reduction by 2030.

Read our recent health impact assessment of road space reallocation.

Last updated: 13 June 2022