HEALTH FACTORS IN ROAD SAFETY

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HEALTH FACTORS IN ROAD SAFETY

• Dermot Gorman
• Lothian Health/COSLA
• Scottish Road Safety Campaign Annual Seminar 2000

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OUTLINE

• Transport Inequalities HIA
• Transport, health and children
• Accident NHS statistics
• Partnerships for healthy transport policy

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HIA of Edinburghs Transport Policy

• HIA the estimation of the effects of a specified
  action on the health of a defined population
• Alex Scott-Samuel 1998
• 1. Identify impacts using a framework
• 2. Evaluate identified impacts
• 3. Make recommendations
• 4. Present findings to decision makers
• 5. Monitor the actual health effects arising
• Margaret Douglas 1998

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Edinburgh transport policy

• Scenario 1 cheap
• some 20mph limits
• improved paper information
• integrated ticketing

• Scenario 2 - 6.5 m
• 30-50 city at 20mph
• some traffic calming
• develop cycle network
• city centre pedestrianisation
• more Greenways
• 1 CERT busway
• park ride

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Who was considered?

• People with different risk profiles
• Affluent car owners
• Deprived non-car owners
• Workers/Commuters
• Young families
• Adolescents
• Elderly
• Unemployed
• Business interests

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Edinburgh transport policy main health impacts

• Accidents
• Pollution
• Physical activity
• Access to services
• Community networks
• Business and employment

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Transport and Health vulnerable groups always
worst affected

• Traffic accidents
• reduction tends to concentrate on engineering
• Pollution - noise - particulates benzene
• Reduced physical activity
• Communities - access and opportunities
• food, shops, jobs, recreation, social support

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Edinburgh HIA Conclusions

• The effect of transport on social exclusion is
  crucial should be more widely recognised
• All social groups gain most from spending more on
  public transport reducing car dominance
• Spending more on public transport narrows the gap
  between affluent and deprived
• Adolescents of all levels of affluence get
  benefits from spending more
• Health and business priorities are similar -
  restricting out of town development is important

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Road traffic accidents15 deaths, 200 serious,
2000 minor injuries120,000 deaths in WHO Euro

• Severity worse for pedestrians
• Vulnerable road users 35 of deaths
• Strategy for reduction based upon engineering,
  enforcement and education
• Inequalities a large feature
• international (10 fold difference in Europe)
  local (x5 by Depcat)
• 1/3 are under 25
• 13 million people in UK have no car access

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Scotland, children inequalities

• Scotland has a worse child pedestrian accident
  rate then England or EC
• Risk of death in pedestrian accident highly class
  related - 4 fold variation
• also uptake of Children's Traffic Club
• Children make up 17 of all casualties and 46 of
  pedestrian casualties

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RTAs to children

• Particularly hard to plan prevention
• Closely linked to deprivation
• Education and experience
• Data collection difficulties
• STATS 19
• Litigation
• AE Department
• Hospital Admission

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Physical Activity Health

• Heart disease
• Less diabetes osteoporosis - fewer falls and
  injuries
• Mental Health Wellbeing
• Respiratory Disease

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Physical Activity in Children

• A recent trend towards children taking
  dramatically less exercise, being fatter and less
  fit
• Fewer kids go out unaccompanied by an adult
• Behaviour patterns develop early - parents are
  bad role models

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Traffic calming in deprived areas

• Three types picked for different reasons
• Accident reduction (16 schemes 1.5m)
• Environmental traffic management (11, 1.6)
• Associated with Greenways schemes (10, 1.8)

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Traffic calming brings

• Improved safety for pedestrians
• Children allowed out to play
• More walking and cycling
• Public consultation is critical

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Safer Routes to School

• Encourages physical exercise
• Improves environment around schools
• Allows children to travel independently -
  important for social and personal development
• Children learn about transport and travel
• Helps parents and councils to save money

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Parents 47 have safety issues about their
childs route

• Parents want
• Safe crossing facilities on main roads
• Better public transport
• Slower speeds on main roads
• Safer cycle routes
• Co-operation with other parents
• Car sharing

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Sick Kids Cycle Study To monitor effects of more
cycle use

• 1. From Accident and Emergency records, identify
  who attended the RHSC
• 2. See how many were on STATS 19
• 3. Hospital admissions

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Sick Kids Cycle Study - Results

• 1.86 sets of AE notes with cycle injuries
• 2. 2 of these recorded through STATS 19
• 3.10 children were admitted i.e. seriously hurt
• Need better and integrated coding systems - like
  Australian crashstats.
• More information on AE Records would also help

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Council Health Authority joint work

• Road safety plans
• Transportation plans
• Safe routes to school
• Health Impact Assessment
• The NHS as an employer
• Planning health services
• Promoting green transport plans

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Conclusions

• Health is much more than not being hit by a car
• Children a good place to start
• Transport and inequalities go hand in hand
• NHS can work with local agencies
• Regional Plans, land use planning and Community
  Plans

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Contact

• Dr Dermot Gorman
• Consultant in Public Health Medicine
• Lothian Health / COSLA
• 148 The Pleasance
• EDINBURGH EH8 9RS
• e mail dermot.gorman_at_lhb.scot.nhs.uk
• Telephone [phone]