One of the pleasures of blogging here has been the focus that this community has on issues of public health. Doing everything we can to maintain the health and well-being of populations through a shift into a different model of life is an issue that is deeply important to me – I don’t always agree with everyone who writes here on these issues (and, of course, they don’t always agree with each other ), but I am struck with admiration of the degree of concern for the public welfare expressed by my Science Blog Colleagues.
Which is why I’m being so presumptuous (since I am a science writer, not a physician or medical researcher) as to suggest a new direction for my fellow bloggers who focus on public health issues. With any luck they will find that now that Andrew Wakefield’s false claims about vaccine-autism link are thoroughly discredited (for the bazillionth time – and can I just say how pleased I am, since I personally, as the parent of a child with severe autism, would like to know what actually *does* cause autism and we’re unlikely to find that out it by doing another 40 studies on a discredited line of reasoning) that they have some free time on their hands. My suggestion would be to focus on another public health crisis – arguably the biggest one we face – our dependence on cars for personal transportation.
Even before NASA released its study demonstrating that road transport was the single largest driver, in economic terms, of anthropogenic global warming, with all the public health implications that included, we knew that our current transportation paradigm, which prioritizes personal vehicles, was a major detriment to public well-being.
Worldwide, we can attribute 1.2 million deaths per year and 40 million injuries significant enough to merit a doctor visit to auto-related accidents. There are 40,000 deaths in the US alone annually that are car-related. The disability claims alone from car-related loss of work and permanent injury come in the hundreds of millions of dollars (all data from Pat Murphy’s _Plan C_ 168-169 originally taken from the NTSB). Motor Vehicle accidents remain the leading cause of death in children
We also know that motor vehicles affect the public health in other respects. Besides the role of particulate emissions and pollution from road traffic in rates of asthma and lung disease and a host of other health problems, we know that motor vehicle ownership is associated with obesity and a reduction in exercise. In just one study in Colombia (where there is a meaningful population that doesn’t own cars), household motor vehicle ownership was shown to be significantly correlated with male obesity
Up until now, the focus has been on reducing the severity of inevitable car crashes – on booster and car seats for children, safety belt use, new technologies for those who can afford newer vehicles. But while the impact of these changes has been significant in relationship to per capita deaths, the expansion of the population, increase in total cars owned and trips taken means that the difference between 1975, before any of the above safety measures were instituted and 2008 was quite minute. That is, all of our gains are being lost to Jevons Paradox .
A significant move towards a society with reduced auto-related mortality, illness and disability would involve getting people to get rid of their cars, to reduce overall trips taken, to travel shorter distances – ie, the famous “lifestyle changes” that are so central to almost any major health issue.
Like all lifestyle changes, this requires both conversations with those affected, and also public policy changes. This is probably a lot less fun for most of us than debating people who deny that vaccines work – most of us are implicated in the car culture ourselves. There are at least as many factors preventing people from getting rid of their cars or substantially reducing their mileage as there are getting them to make other lifestyle changes involving diet and exercise. And yet, one way we could significantly reduce illness and mortality would be to reduce car usage and ownership.
While giving up all vehicles may not be viable for people, many households could reduce the number of trips they make weekly, many households could carpool for at least some activities, or consolidate errands. Most households could incorporate more use to public transportation, bicycles or “shank’s mare” (walking). Car use is in many respects an acquired behavior, like smoking. Unlike smoking, it can be necessary, but people do not always have to make life choices that maximize their car usage and needs.
As a participant in the Riot for Austerity, a program that encourages people to reduce their resource use to 1/10th of the American average, we had people in 14 nations and in every possible life situation attempt to reduce their usage, and nearly everyone – no matter what their personal situation, no matter where they lived, whether they were physically able bodied or had children, no matter how long they commuted were able to reduce vehicale usage by 25-50% – this is in the absence of public policy changes like more public transportation. Many were able to reduce their usage further still, but at a minimum, most people should be able to make some inroads in their transportation usage – one study found that more than 25% of all trips were largely discretionary
If cars were properly perceived not as a necessity and status symbol, but as a public health threat, we could begin to make significant inroads into their reduction – and to reduction of greenhouse gasses from them. Even beginning to speak as though car related pollution, disability and death were not inevitable outcomes of a lifestyle that can’t be seriously reconsidered, but as though cars are a significant threat to public health begins to open up a conversation that as yet, we are simply not having.
Emissions data indicates we will have to deal with our internal combustion engine problem – if not, we get the scenarios visible in the previous post on this site. No one wants that. So we must begin to address the reality that we can’t all have private cars – and that case begins from the language of the public good – and public health.