The health impacts of traffic-related exposures in urban areas: Understanding real effects, underlying driving forces and co-producing future directions

The world is currently witnessing its largest surge of urban growth in human history; a trend that draws attention to the need to understand and address health impacts of urban living. Whilst transport is instrumental in this urbanisation wave, it also has significant positive and negative impacts on population health, which are disproportionately distributed. In this paper, we bring together expertise in transport engineering, transport and urban planning, research and strategic management, epidemiology and health impact assessment in an exercise to scope and discuss the health impacts of transport in urban areas. Adopting a cross-disciplinary, co-production approach, we explore the key driving forces behind the current state of urban mobility and outline recommendations for practices that could facilitate positioning health at the core of transport design, planning and policy. Current knowledge on the health-related impacts of urban transport shows that motor vehicle traffic is causing significant premature mortality and morbidity through motor vehicle crashes, physical inactivity and traffic -related environmental exposures including increases in air pollution, noise and temperature levels, as well as reductions in green space. Trends of rapid and car-centred urbanisation, mass motorisation and a tendency of policy to favour car mobility and undervalue health in the transport and development agenda has both led to, and exacerbated the negative health impacts of the transport systems. Simultaneously, we also argue that the benefits of new transport schemes on the economy are emphasised whilst the range and severity of identified health impacts associated with transport are often downplayed. We conclude the paper by outlining stakeholders' recommendations for the adoption of a cross-disciplinary co-production approach that takes a health-aware perspective and has the potential to promote a paradigm shift in transport practices. (C) 2016 Elsevier Ltd. All rights reserved.