Injuries and transport

1
Injuries and transport

• Dr Jenny Mindell
• London Health Observatory

2
Transport and positive effects on health

• Access to
• education
• employment
• leisure
• services
• shops
• people
• Physical activity (walking, cycling)
• increases well-being, improves mental health
• reduced heart disease, obesity, diabetes, high
  blood pressure, osteoporosis, some cancers

3
Transport and negative effects on health

• Air pollution
• Community severance
• lack of access to goods, services, people
• Fear of attack or injuries
• leading to loss of independent mobility
• loss of self-esteem
• journeys foregone - loss of access
• Injuries
• Noise pollution
• Sedentary lifestyle

4
Too high a priceInjuries and accidents in London

• Caroline Lowdell, Justine Fitzpatrick, Ruth
  Wallis, Jenny Mindell, and
• Bobbie Jacobson (editors)

5
Report aims

• To provide a comprehensive view of injuries and
  accidents in London
• To estimate the economic cost of injury and
  accidents to London
• Highlight opportunities for prevention through
  interventions that are known to work

6
Types of injuries looked at

• Road traffic accidents
• Fires
• Poisonings (including suicide, deliberate
  self-harm and accidental)
• Falls
• Assault and homicide

7
Outputs available

• www.lho.org.uk
• Full report
• Executive summary
• A new tool for accessing local data at local
  authority level
• A national and local policy overview
• www.lho.org.uk and www.matrixrcl.co.uk
• Full report on the economic costs of injury and
  accidents to London

8
The toll to Londonersaverage number per year
(1997-2000)
9
Cost of injuries(in millions of pounds)
10
London in EuropeStandardised mortality ratios
for accidents. London 100(Source Megapoles)
11
London in EnglandAge-standardised mortality
rates - types of accidents 1997-99. (Source ONS)
12
London in EnglandAge-standardised mortality
rates - road traffic accidents 1997-99. (Source
ONS)
13
Special factors at work in London

• Congestion and low traffic speeds - collisions
  may occur at lower speeds
• Heavy traffic flows in residential and commercial
  areas are a hazard to pedestrians
• Car ownership is lower than average - more people
  are travelling on foot
• High levels and use of public transport may
  reduce the road traffic death toll compared to
  elsewhere

14
Road traffic accidents in London

• Pedestrian injuries
• 31 aged 3-18
• more likely to be killed or seriously injured
  than other casualties
• hospital admission rates high in
• inner London
• people aged 5-14 or 75
• Ambulance call outs for RTA
• mostly younger age groups (5-39)
• minor or no injury in over half of calls

15
Age-specific admission rates for RTAs in males
1997/988-1998/99
16
Inequalities within LondonRoad traffic accident
rate by location and by drivers residence.
(Source LAAU)
Location
Drivers residence
17
Inequalities within London

• People from deprived communities are more likely
  to be killed or seriously injured by road traffic
• The very young and the very old are accidents
  most affected victims
• Young men are predominant victims of many
  specific types of injury e.g. Road Traffic
  Accidents, poisonings, assault
• Alcohol and drugs play a major role in many types
  of preventable injury

18
Speed

• is a contributory factor in over 1,100 deaths on
  Britain's roads every year - one-third of all
  fatal crashes
• destroys the quality of life of communities
  through intimidation, excessive noise air
  pollution
• removes the freedom to walk or cycle without fear
  of serious injury or worse

19
20mph zones in Hull

• Implementing 20 mph zones since mid 1990s
• Introduced partly because of high accident rates
  and high cycle use.
• By 2000 had 80 zones now 40 of residential
  streets
• Total crashes within zones installed in 1996/7
  down by 56
• Number of killed seriously injured down by 90
  
• High cost-effectiveness of traffic calming - 4
  million cost of schemes in Hull repaid at least
  10 times over (1,160)

20
Reducing speed in residential streets

• Routine use of 20mph zones
• eg Hull
• Home zones - 10mph, pedestrian priority
• Enforcement
• also considered as car crime by politicians,
  police public
• speed cameras not painted yellow!

21
Summary of recommendationsThe report makes 19
recommendations including

• Cross-government as well as London leadership to
  overcome the fragmentation of effort.
• A national strategy to reduce alcohol and in
  particular to reduce the legal blood alcohol
  limit from 80 to 50mg/100ml.
• Transport and other resources from regional
  government and other sources should target areas
  and groups in London where inequalities are
  highest.

22
Outputs available

• www.lho.org.uk
• Full report
• Executive summary
• A new tool for accessing local data at local
  authority level
• A national and local policy overview
• www.lho.org.uk and www.matrixrcl.co.uk
• Full report on the economic costs of injury and
  accidents to London