Memorandum by the Institute of Child Health
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 the inquest
into her death the coroner said that he hoped that such a thing
would never happen again. Over the next hundred years 200,000
pedestrians would die on Britain's roads, with ten times as many
seriously injured. The government then as now, did next to nothing.
Car travel was a sign of progress and you can't stand in the way
The political neglect of road danger must be
one of the greatest unsolved mysteries of the twentieth century,
and at the dawn of a new millennium we must struggle to understand
some curious inconsistencies. Why for example, is the death of
a child following abuse taken as clear evidence of the failure
of our collective efforts to protect children, whereas a child
pedestrian death represents only the failure of an individual
child to stop, look and listen?
With successive government's blind to the problem
of road danger, parents have done whatever they could to protect
their children. They kept their children away from traffic. Never
before in the history of children have their horizons been so
limited, their freedom so curtailed, their environment so circumscribed.
1989 may have been the "Year of the Child," but the
century belonged to the motorist. The confusion of transport policy
with traffic policy left children, the elderly and those without
a car, socially excluded in our Top Gear towns. Children excluded
from street play and independent travel, non-car owning adults
excluded from out of town supermarkets and disadvantaged by edge
of town hospitals, yet both included in injury statistics and
with the lion's share of noise and pollution. For many children
being struck by a car was their first experience of car travel.
The risk of pedestrian injury for children in families without
a car is twice that of those in car owning families. This surely
warrants the attention of any social exclusion unit.
About a year ago, my daughter and I went to
the Natural History Museum to look for something about walking.
We had already been to the Transport museum but strangely enough
there was very little about walking as a form of transport. At
the Museum we found a photograph of fossilised footprints. In
1978 Mary Leaky was excavating a stratum of volcanic ash at Laetoli
in Tanzania. She knew the stratum to be 3.5 million years old.
The trail of fossilised footprints she uncovered is the earliest
evidence of upright walking by humans. The development of walking
marked a milestone in human evolution. With the hands free to
make tools the development of intelligence now held a particular
survival advantage. In one sense we don't walk because we're humanwe're
human because we can walk. From its earliest African origins through
the long march of time walking has been the most simple and most
human form of transport... Until the great traffic pandemic of
the twentieth century changed everything. 200,000 pedestrian deaths
left an imprint of its own. Car travel has decimated walking.
National estimates of walking mileage have been available since
1972. But since then there has been a 20 per cent fall in average
distance walked. The decline is greatest in children. For children
between five and fifteen years walking mileage has fallen by 28
Getting about uses energy, but getting about
by car uses the wrong kind of energy. Although energy input from
the diet has fallen, energy output from physical activity has
fallen even more, with the results that we are now seeing an epidemic
of childhood obesity. But the full health consequences of the
death of walking may not become apparent for decades. It is estimated
that one in four women living to age 90 will sustain a hip fracture.
There is a linear relationship between the risk of hip fracture
and bone mineral density. In women, bone density peaks in early
adulthood, remains stable until the menopause and then falls.
Bone density in old age depends on peak density and rate of loss.
Physical activity increases both peak density and reduces post-menopausal
loss. The decline in walking is thought to be one of the main
reasons for the doubling of hip fracture rate since the 1960s.
Road traffic crashes cost an estimated £14.8
billion each year, a figure that was confirmed on the Today Programme.
Nevertheless, only a fraction of this amount is spent on road
safety. When considering whether to fund small scale traffic engineering
interventions, such as traffic calming or 20 mph zones, the government
quite rightly considers carefully the cost effectiveness of these
interventions. But any cost-effectiveness analysis must surely
take into account the current and future cost to the NHS from
the adverse health impacts of traffic.
Early humans are usually depicted as savages.
To do so affirms our unique position in evolutionary history.
But there were three sets of footprints at Laetoli. Two larger
sets, accompanies by a third smaller set, possibly those of a
child. It is tempting to imagine that the imprints in the ash
were those of a family, walking together across the Serengeti.
The comfortable companionship of walking has no counterpart in
car travel. Walking together is a relationship between equals.
Car travel is steeped in inequality. Politicians invariably describe
the unprecedented freedoms that car travel has brought. They forget
that one quarter of families in Britain have no access to a car.
Car ownership is greatest in affluent middle aged men. People
like John Prescott. Sixty four per cent of men own cars compared
to 35 per cent of women, and 96 per cent of households in the
highest income quintile own a car compared with 42 per cent in
the lowest. Yet the disadvantages of car travel are experienced
mainly by women and children, the elderly and the poor. Ironically
women and children are now the main focus of government efforts
to reduce car travel.
Last year Mr Hague described the Government's
attempt to reduce traffic volume and speed as a war on the motorist.
Last year over 300 children died on Britain's roads with 4,000
seriously injured. Only a politician with Mr Hague's experience
could describe road tolls, car parking charges and speed reduction
as war, whilst ignoring road trauma with its twisted metal and
torn flesh. There is a war but it was the motorist that declared
war on children.
Dr Ian Roberts
Director, Child Health Monitoring Unit
Institute of Child Health
University College London