Public health costs of road safety

Christopher Peck – CTC, the national cycling charity (UK)

Velo-City 2013 Vienna

What is road safety?

“By 2020 there will be 1.9m killed each year on the roads, 50m injured.” – UN Decade of Road Safety

Road deaths in GB 1930-2010

Cycle fatalities have fallen by 92% since the 1940s

Rate per 100,000 people

19501952

19541956

19581960

19621964

19661968

19701972

19741976

19781980

19821984

19861988

19901992

19941996

19982000

20022004

20062008

20100

10

20

30

40

50

60

70

Fata

lities

per

100

,000

Per billion kms

19501952

19541956

19581960

19621964

19661968

19701972

19741976

19781980

19821984

19861988

19901992

19941996

19982000

20022004

20062008

20100

20

40

60

80

100

120

Fata

lities

per

bill

ion

kms

How to get it wrong, spectacularly“As you massively increase the amount of people who cycle, your figures for deaths go up. On the European table I have here, the Netherlands is fourth from the bottom, with 0.84 per 100,000 of population, whereas we [UK] are seventh with 0.17. …I think the Netherlands might want to come and see us to find out how we are making sure that so few people are killed in cycling terms as we increase the numbers of people cycling, because the figures would indicate that we can perhaps do a bit better than them.”- Road Safety Minister Mike Penning, speaking in the UK Parliament in 2012

Measuring risk of cycling, wrong and right

Pedestr

ians

Cyclist

s

Motorcyclis

ts

Car occu

pants

Bus occu

pants

Van occupan

ts

HGV occupants

Other veh

icle occu

pants

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

Others killed in collision with road user

Road user killed

Road

dea

ths

Cars, buses, van and lorries present far more risk to other road users, whereas pedestrians, cyc-lists and motorcyclists are more often victims.

Which road user is involved in the most road deaths?

453

107

362

883

7 34 27 28

Cyclist

s

Motorcyclis

ts

Car occu

pants

Bus occu

pants

Van occu

pants

HGV occupan

ts0

2

4

6

8

10

12

14

16

18

20Ro

ad d

eath

s of t

hrid

par

ties p

er b

illio

n m

iles

Per billion miles travelled cycles are involved in fewer deaths of other road users than any other mode of trans-port.

Which road user represents the most danger per mile travelled?

19781979

19801981

19821983

19841985

19861987

19881989

19901991

19921993

19941995

19961997

19981999

20002001

20022003

20042005

20062007

20082009

20102011

20

25

30

35

40

45

50

55

60

65

70

UK USA Netherlands Italy Germany Sweden

% o

bese

or o

verw

eigh

t

Overweight and obese, 1980-2011

In the USA, obesity increased from

Obese15%

Over-weight32%

Normal or under

53%

1978

Obese36%

Over-weight33%

Normal or under31%

2010

Public health consequences of…

All deaths Cancer Diseases of the circulatory system

Transport accidents Cycles -

100,000

200,000

300,000

400,000

500,000

600,000

484,367

143,181 139,706

1,815 98

2011

Eng

land

and

Wal

es d

eath

s

59,568

83,613

Other cancers

Breast, prostate, colorectal

Physical inactivity reduces mortality risks of these cancers by 30-50%

Around 35% of cardiovascular diseases attributable to physical inactivity + another ~25% partly attributable to air pollution

Where ‘road safety’ goes wrong

• Any intervention or law that reduces physical activity will almost inevitably do more harm than good.

• de Jong (2012) – helmet legislation or promotion only has a net health benefit if injuries prevented exceed health costs lost to reduced cycling.

• This is: “very difficult to achieve except in extreme circumstances”

Numbers of people killed or seriously injured Very bad

Rate of death or injury to users per 100,000 population (current) Poor

Rate of death or injury per mile, trip or hour (measured by some) Better

Rate of death or injury to third parties (danger posed) GoodOverall public health impact of different transport modes (road death or injury caused AND air quality, cardiovascular disease etc)

Best

Conclusions • Set targets and measure the right things…

• Get the balance right between promoting cycling for public health and road safety campaigns or laws which deter people from cycling

Questions?

• How is safety and risk measured where you live?

• How do we change institutional and organisational approaches to risk and safety?

Thanks!Christopher Peck CTC – the national cycling charitychris.peck@ctc.org.uk