08 Sep 2009
Submission to the Northern Ireland Assembly Committee for Regional Development
Committee Inquiry into Sustainable Transport
The Institute of Public Health in Ireland
The Institute of Public Health in Ireland (IPH) aims to improve health on the island of Ireland by working to combat health inequalities and influence public policies in favour of health. The Institute promotes cooperation between Northern Ireland and the Republic of Ireland in public health research, training and policy advice.
IPH commends the Regional Development Committee on selecting sustainable transport as its subject for inquiry and welcomes the inquiry’s focus on identifying a move to more sustainable transport in Northern Ireland. IPH thanks the Committee for the opportunity to contribute views and experience.
1. To explore and clarify the social, environmental and economic aspects of sustainable transport
Transport provides a significant contribution to population health because of its impact on travel patterns, access to services, exercise and social connectedness.
1.1 Sustainable transport and health outcomes
A sustainable transport system can influence population health outcomes as it provides opportunities to increase levels of physical activity, improve air quality and enhance social interaction.
Increasing levels of physical activity in the population contributes to reducing coronary heart disease, diabetes, some cancers and obesity. It also improves mental health. The World Health Organization recommends adults undertake 30 minutes of physical activity everyday and evidence shows that only 30% of people take the recommended daily amount in Northern Ireland .
In Northern Ireland, obesity is a major concern and in 2005/06, 59% of adults were identified as either overweight or obese and 10% of children were obese. Physical activity can contribute to obesity which is identified as an important risk factor for a wide range of serious conditions including heart disease, cancer, hypertension and diabetes. If the current trend continues, IPH forecasts that over the period 2005 to 2015 there will be a 26% increase in the proportion of people with Type 2 diabetes. This has major consequences for Northern Ireland due to the loss of productivity and the costs of care. Treatment of obesity and related conditions have serious effects on the economy and threaten to engulf the health service. Obesity is estimated to cause 450 deaths per year, cost £14.2 million in lost productivity and £90 million in health and social care costs.
Current transport patterns have contributed to an increase in obesity. Urban sprawl, where land use spreads out into areas adjoining the edge of the city can increase car dependency and evidence shows that those living in such areas drive three to four times more than those who live in efficient, well-planned areas. It has also been shown that each additional hour spent in a car a day can be associated with a 6% increase in the likelihood of obesity. Sustainable transportation methods contribute to increased physical activity which in turn impacts on levels of obesity. Public transport can impact positively on physical activity levels as most trips begin and end with some form of physical activity with one study quantifying this as 19 minutes a day.
IPH recognise and support a move to a more sustainable transport system in Northern Ireland which would be beneficial for both individuals and the general population. Attractive and accessible features of transport design are essential in promoting exercise. Recent guidance from the National Institute for Clinical and Health Evidence (NICE) states that transport planners should ‘ensure pedestrians, cyclists and users of other modes of transport that involve physical activity are given the highest priority when developing or maintaining streets and roads which can be achieved by widening pavements and introducing more cycle lanes’.
IPH also recommend adopting a lifecourse approach which would consider the needs of young children through to elderly people. The number of children walking or cycling to school is rapidly decreasing which is a worrying trend as exercise habits established in childhood are a key indicator of physical activity in adulthood. Older people must also be catered for as exercise and social connectedness are critical aspects of a healthier older age. There is a need to review the travel patterns of all users to make sustainable transportation more attractive in terms of travel times, convenience and financial cost.
1.2 Sustainable transport and health inequalities
Health inequalities are the differences in outcomes between different population groups. There are a number of inequalities in Northern Ireland’s current transport system. Children from deprived communities are more likely to die as a result of a traffic collision. In Belfast, areas which exceeded air quality limits as a result of commuting traffic were all identified as deprived communities. Deprived communities are least likely to have access to private vehicles.
IPH recommend a sustainable transport system which ensures equity for all users.
1.3 Sustainable transport and social connections
Alongside physical activity, a sustainable transport system contributes to improved mental health. A well planned transport system can facilitate social connections which are important for mental health. Neighbourhood designs most likely to promote social networks are those that are mixed use and pedestrian orientated, enabling residents to perform daily activities without the use of a car. As traffic volumes increase, people’s sense of neighbourliness decreases which results in decreased social connections.
IPH recommend a multi-sectoral approach to ensure sustainable transport systems are a key element of any new development or neighbourhood.
1.4 Sustainable transport and climate change
Climate change is identified as one of the biggest public health issues of the 21st Century. Northern Ireland has higher greenhouse emissions than the UK which can be attributed to our transport (and agriculture) emissions.
Urban areas are particularly affected by vehicle-related air pollution which can contribute to respiratory disease especially amongst vulnerable groups such as the elderly. Disadvantaged urban areas tend to be characterised by high traffic volume, with residents at increased risk of road traffic accidents.
IPH recommend DRD, through a sustainable transport approach, to reduce dependency on private transport by encouraging a modal shift to more sustainable travel patterns such as public transport, walking and cycling which can help to reduce greenhouse emissions and also improve overall air quality.
2. To identify the policies, attitudes and technologies likely to underpin a move to more sustainable transport in Northern Ireland
2.1 Current Northern Ireland transport policy
The Regional Transportation Strategy in Northern Ireland is due for review in 2012. This presents a great opportunity to change the focus of the current strategy from private road users to a more sustained transport system.
IPH recommend that sustainable methods of travel are central to the new Regional Transport Strategy. This requires a commitment to investing in public transport alongside cycling and walking routes. There is also a need to ensure that other government departments and sectors have shared responsibility for the strategy which will assist to create more sustainable neighbourhoods in Northern Ireland.
2.2 Working with UK and Ireland
The recent ‘Bridging the Gap’ publication by PricewaterhouseCoopers looked at transforming public transport in Northern Ireland and highlighted the lack of investment in public transport in Northern Ireland compared to the rest of the UK and Ireland. This publication highlighted the environmental, social and economic implications but gave no consideration to health implications.
The Department for Transport in the Republic of Ireland recently published ‘Smarter Travel: A Sustainable Transport Future’ . This strategy strongly recognizes the potential health benefits of a sustainable transport system which includes playing a central role in combating obesity.
IPH recommend DRD take a similar approach to that adopted by the Republic of Ireland to ensure health is a central component of any sustainable transport strategy.
2.3 Cross government action
It is recognised that many of the actions required for a healthier society lie outside the remit of the health sector. A cross government response is required to improve health. DRD have a responsibility to create an environment conducive to enhancing physical activity and also ensuring active participation in the Department of Health, Social Services and Public Safety, Obesity Prevention Steering Group (OPSG).
Northern Ireland’s broad based and cross government public health strategy Investing for Health recommended that all government policies should consider their impact on health. IPH has produced guidelines on Health Impact Assessment (HIA) and many policy-makers and practitioners have been trained in HIA. The Regional Development Committee could play a significant role by undertaking a HIA on sustainable transport policies and ensuring there is particular focus on health inequalities.
3 To make recommendations arising out of the above investigations
• It is evident that the development of a sustainable transport system can contribute to improved health in Northern Ireland. It is essential that any sustainable transport policy is assessed for its health impacts. This can be achieved by undertaking a Health Impact Assessment which seeks to minimise any negative health impacts and maximise any positive impacts.
• IPH calls for the health implications of any new sustainable
transport policy in Northern Ireland to be given consideration alongside
the social, environmental and economic aspects. The Department for
Transport in the Republic of Ireland’s ‘Smarter Travel: A Sustainable
Transport Future, provides an excellent example of how health can be a
central feature of any sustainable transport policy.
• As well as developing a longer term strategy, urgent and shorter term action is needed to coordinate current activities and ensure focus is on the most vulnerable groups. A strong strategic approach should link to other key government policies on sustainable development, regional development and social inclusion.
• There is a strong case for working with other jurisdictions including other parts of the UK, Ireland and Europe. This should be done in a systematic and transparent way, and used to identify areas of best practice.