Select Committee on Transport, Local Government and the Regions Appendices to the Minutes of Evidence

Memorandum by the Faculty of Public Health Medicine (RTS 04)


  I am writing to you as President of the Faculty of Public Health Medicine in response to the rules to increase the visibility of speed cameras that were announced on 3 December. We are concerned they appear to give the message that DTLR is only concerned about excess traffic speed in the small number of locations where there have been several deaths or serious injuries from collisions. The emphasis on conspicuity could even give the impression that motorists need only restrict their speed when they are approaching a brightly coloured traffic camera.

  We recognise that this is not the government's intention, but it does reflect the commonly held view among some members of the public, and especially among lobbying groups for motorists, that traffic speed is only a problem if someone gets killed or seriously injured. In contrast, we take the view that excess traffic speed has many adverse health effects and that a more holistic approach that promotes safer driving and reduces the social acceptability of driving at excessive speed is needed.

  There are two main public health arguments in support of the latter approach. The first is the effect of traffic speed on health inequalities; the second is based on the very wide impact of traffic speed on patterns of daily living and social networks.

  These arguments are briefly summarised below, and an appendix of background information with supporting references is attached.

Excessive speed is a major cause of deaths and injuries, especially in children

  Speeding is dangerous for the driver (for whom it is a self-imposed risk), passengers and other motorists, but it is especially dangerous for vulnerable road users such as cyclists and pedestrians, particularly children and older people.

  Trauma is the most common cause of death among children, and road traffic injuries account for half of these. Two thirds of deaths and serious injuries among children involve child pedestrians injured in road crashes.

  The death rate from road traffic injuries for children in the UK is twice the European average. Most of these injuries occur in urban areas, and excessive speed is the single most important factor in such crashes.

  Even apparently low levels of speeding pose significant risks. For each 1 per cent increase in speed there is a 5 per cent increase in mortality; in many urban and residential situations travelling at the legal speed limit may be too fast.

Adverse health impacts of speeding are much more than deaths and injuries

  Road traffic injuries are, however, only one manifestation of the health impacts of excessive speed. Fast traffic on busy roads impairs pedestrian and cyclist access to goods and services, and leads to community severance. Access is a particular problem for those with impaired mobility, such as the elderly and people with disabilities. These problems, which are associated with marked social inequalities, may have an even greater impact on health than traffic injuries. Social support networks have a positive protective effect on both physical and mental health, and low levels of social support are strongly associated with excess premature mortality.

  Excess speed, especially when associated with late braking, increases local air pollution and noise levels with potential adverse effects on respiratory, cardiac and mental health.

Physical inactivity is a major public health problem

  Across the UK physical inactivity now has a greater absolute effect on levels of coronary heart disease than smoking, and the problem is increasing, with dramatic increases in overweight and obesity; this is particularly worrying among children. One of the main reasons for reduced activity levels is the decline of walking and cycling resulting from perceptions of danger from fast traffic.

Speeding contributes to some of the biggest health inequalities in the UK, particularly in relating to child pedestrian deaths

  The Chief Medical Officer has highlighted health inequalities as one of the main themes of his Annual Report. Tackling the problems suffered by disadvantaged people as a result of excess speed and traffic will make a major contribution to meeting the inequalities targets and creating a more equitable society.

  Children in social class V are four times more likely to die from road crashes than those in social class I; this gap is increasing.

  People living in deprived areas are the most likely to suffer the adverse health effects of traffic, such as deaths and injuries, respiratory problems from air pollution, stress from noise pollution, and community severance. These problems are all made worse by excessive speed. People without access to cars, especially children, mothers of young children, and those who are unemployed, and older people, are particularly affected.

  Focusing attention on a relatively small number of locations with a poor crash record does nothing to address the wider consequences of excessive speed; the implication that speed is only a problem in certain places may in fact make them worse. The reliability of crash data as an indicator of the level of danger posed by a road is also highly questionable: it is well recognised that people avoid walking and cycling on roads they perceive as dangerous: both motorways and pedestrian precincts both have low levels of pedestrian casualties, but clearly pose very different levels of danger.

  The inevitable conclusion drawn by many public health professionals is that there is a very strong case for more widespread introduction of lower speed limits, particularly in deprived urban areas, allied to broader and stricter enforcement. Increasing the visibility of speed cameras may work to discourage illegal speeding in specific locations, but will do nothing to reduce average speeds across the road network and make our towns, villages and neighbourhoods safer.

Professor Sian Griffiths OBE


12 December 2001


  Road traffic injuries account for 49 per cent of all accidental deaths in children.[1] Almost two-thirds of the deaths plus serious injuries in children occur in pedestrians.[2] There is a very sharp social gradient for both incidence of and mortality from road traffic injuries in children. The death rate fell in each social group between 1981 and 1991 but the decline in social classes I and II (32 per cent and 37 per cent respectively) was much larger than in social classes IV (21 per cent) and V (2 per cent), thus increasing further the steep social class gradient, which is now fourfold from social class I to V for all road traffic deaths and fivefold for pedestrian deaths.1,2 This reflects a number of factors which are all unequally distributed. Exposure is greater for children in low income families, as they have less access to other modes of transport. Risks are also higher per kilometre walked. There is an exponential rise in risk to pedestrians with increasing traffic speed.[3] Speeding is more common in less affluent areas.2 Children from low income families cross more roads,[4] are more likely to be unaccompanied,2 and may have less understanding of road safety.2

  Fear of injury is a well-founded concern. Rates of serious injuries and fatalities from road traffic collisions are highest in the young and the old.[5] Children who walk or cycle in Britain have twice the European average risk of death from a road traffic collision.[6]

  Community severance was shown by Appleyard and Lintell in their classic study in San Francisco.[7] They studied three parallel streets in an area with a homogeneous population in terms of social class, income, education and mix of ethnic origin. Traffic volumes had increased considerably in two of the streets 10 years previously, so by the time of the study, the three streets carried light, moderate or heavy traffic. Both the number of friends and of acquaintances of residents were inversely proportional to the volume of traffic in their street. Use of the street for social activities, predominantly meeting places and conversation by older residents and teenagers and play by children and teenagers, was common in the light traffic street and almost absent in the heavy traffic street, with the moderate traffic street being in between. The street with little traffic promoted a rich social climate and a strong sense of community, whereas the heavy traffic street was used solely as a corridor and there was no feeling of community. This was also borne out by the area considered as "home territory" by the residents. Those living on the light traffic street included at least their whole building and often the whole street. Those on the heavily trafficked street often felt even part of their own flat was not home territory because of the intrusion of traffic noise, making them live just in the back part of their home. Families with young children had mostly moved out of the street with heavy traffic, because of the adverse effects on quality of life. The elderly and those too poor to move became isolated within their own homes in the heavy traffic street. Deterrents to use of the street for social areas were not only perceived danger from speeding traffic but also hassling by strangers, even though inside passing cars.7 The loss of social networks, as described in this study, has a significant impact on health.[8]

  A 1992 report for the Transport Research Laboratory commented on the threat to pedestrians of narrow pavements; speeding traffic; vehicles ignoring red traffic lights, rarely stopping at pedestrian crossings, and going onto the pavement; and of the hazard to cyclists of speeding traffic. In the three areas of London studied, between one-third and a half of comments by respondents concerned perceived risk, particularly for children and the elderly.[9] Another TRL study demonstrated that every 1 per cent increase in speed produces a 5 per cent increase in deaths and serious injuries.[10]

  A British national survey in the early 1970s found that outdoor noise and fumes was the second commonest complaint after pedestrian danger, followed by traffic noise penetrating the home.[11] Twenty years later, people were disturbed outdoors by smoke, fumes and odour from traffic-derived air pollution not only because of the smell and soiling but also out of concern for their effects on health. Indoors, noise was a greater problem, although soiling was also a nuisance.[12] Traffic noise in San Francisco interfered with sleep, conversation or watching television for more than a third of respondents and with eating or working in one-fifth. Perception of noise and vibration correlated strongly with traffic volume (r=0.46). Almost one-third (29 per cent) lived in the back of the house to reduce this, except on the light street.11 In Huddersfield, traffic noise interfered with relaxation and sleeping for 20 per cent and home-based leisure activities for 10 per cent of respondents. Such noise, fear of traffic injuries, and dirt and fumes from traffic were considered very important quality of life issues by around one-quarter of respondents.[13]

1   Roberts I, Diguiseppi C, Ward H. Childhood injuries: extent of the problem, epidemiological trends, and costs. Injury Prevention, 1998; 4:S10-S16. Back

2   MacGibbon B. 13b Inequalities in health related to transport. In Gordon D, Shaw M, Dorling D and Davey Smith G (eds) Inequalities in health: the evidence, Bristol: Policy Press, 1999, pp. 185-95. Back

3   McCarthy M. 7 Transport and health. In Marmot M and Wilkinson RG (eds) Social determinants of health, Oxford: Oxford University Press, 1999, pp 132-54. Back

4   Davis A. 13a Inequalities of health: road transport and pollution. In Gordon D, Shaw M, Dorling D, and Davey Smith G (eds) Inequalities in health McCarthy M. 7 Transport and health. In Marmot M and Wilkinson RG (eds) Social determinants of health, Oxford: Oxford University Press, 1999, pp 132-54. Back

5   Powell G and Taylor S. Health of the Nation, accidents and deprivation in Kensington & Chelsea, and Westminster, London: K & C and W Health Authority, 1997, 6-31. Back

6   Jarvis S, Clarke M, Cryer C, Davidson L, Evans S, Sheriff C, Stone D, Ward H and Yates D. Injury prevention, London: British Medical Association, 2001. Back

7   Appleyard D, Lintell M. The environmental quality of city streets: The residents' viewpoint. American Institute of Planners Journal, 1972; 38:84-101. Back

8   Berkman LF, Syme SL Social networks, host resistance and mortality: A nine-year follow-up study of Alameda County residents. American Journal of Epidemiology 1979 109:186-204. Back

9   Smith JD, Gurney A. Community effects of traffic congestion: A review of the London Assessment Study Data, Crowthorne, Berkshire: Transport Research Laboratory, 1992. Back

10   Finch D, Kompfner P, Maycock G. Speed limits and accidents. Crowthorne, Berkshire: Transport Research Laboratory, 1994. Back

11   Appleyard D, Gerson MS, Lintell M. Livable Streets, Berkeley: University of California Press, 1981. Back

12   Williams ID, McCrae IS. Road traffic nuisance in residential and commercial areas. Science of the Total Environment, 1995; 169:75-82. Back

13   Jones S, Kingham S, Briggs D. Kirklees case study, Huddersfield: Environment Unit, Kirklees Metropolitan Council, 1997. Back

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