TRANSPORT AND HEALTH · 2018-09-28 · Car ownership rate per capita is also increasing EHI...

TRANSPORT AND HEALTH

How transport affects the health of

New Zealanders

Kylie Mason

Presentation to the Transport Knowledge Hub

22 February 2018

Outline

1. How does transport affect health?

2. EHI transport indicators: What is the data telling us?

3. What is the overall health impact of road transport in NZ?

How does

transport

affect health?

• Notes

How does

transport

affect health?

Traffic crashes

Air

pollution

Noise pollution

Road safety for

vulnerable road usersActive transport

Climate change

Barriers due

to lack of

transport

Public transport

Traffic crashes

• Cause many deaths, injuries, disability

• In NZ, a few hundred people die each year in traffic crashes

• Cyclists, pedestrians and motorcyclists are more vulnerable

road users

HOW TRANSPORT AFFECTS HEALTH

Air pollution from motor vehicles


• Particulate matter (PM10, PM2.5)

• Nitrogen oxides (NOx)

• Carbon monoxide (CO)

• Sulphur oxides (SOx)

• Carbon dioxide (CO2)

• Ozone (ground-level)

• Volatile organic compounds (VOCs)

• Hydrocarbons (HC)

• Polycyclic aromatic hydrocarbons (PAHs), eg

benzo(a)pyrene (BaP)

Transport is a key source of air pollution


Health effects from air pollution

Health effects mainly from:

particulate matter (PM2.5, PM10),

but also NO2, CO, others

Health effects include:

• Premature death

• Lung (respiratory) diseases

• Heart (cardiovascular) disease

• Some cancers

Air pollution: All cars and roads are not equal


• Diesel vehicles produce

• more particulate matter (PM)

• but less CO, hydrocarbons

• Diesel exhaust fumes cause

lung cancer

• Busy roads have higher air pollution levels

• Higher health risk within 300–500m of state highways

Noise pollution

Source: Hammer MS, Swinburn TK, Neitzel RL. 2014. Environmental noise pollution in the United States: developing an effective

public health response. Environ Health Perspect 122:115–119.

Physical activity – active and public transport

• Produces no air/noise pollution, greenhouse gases

• Physical activity reduces the risk of many health

issues:


Cancer

Cardiovascular

disease

Obesity

Mental health

Diabetes

Bone density

Low physical activity – the health burden

• An estimated 1435 deaths were attributable to low

physical activity in New Zealand in 2015


Note: DALY = disability-adjusted life year, and is the sum of years of life lost (YLL) and years lived in disability/ill-health (YLD)

Source: Global Burden of Disease Study 2015

Other health impacts from transport

Lack of transport

• Barriers to accessing services and goods, eg

• Healthcare services

• Shops and healthy food

• Social isolation and loneliness

• Associated with increased mortality, depression,

high blood pressure, dementia

Greenhouse gas emissions from transport sector

• 20% of NZ’s total GHG emissions


Environmental Health Indicators

for transport:

What is the data telling us?

What is an environmental health indicator?

EHI TRANSPORT INDICATORS

• Describes the link between the environment and human

health

• Provides information for action

EHI transport indicators

• Number of motor vehicles

• Active transport to and from school

• Main mode of transport to work on Census day

• Household travel time by mode of transport

• Unmet need for GP services due to a lack of transport

• Road traffic injury deaths

• Road traffic injury hospitalisations


The number of motor vehicles is increasing


0

500,000

1,000,000

1,500,000

2,000,000

2,500,000

3,000,000

3,500,000

4,000,000

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Number of vehicles

Year

New Zealand's vehicle fleet, 2000-2016

Other

Bus

Trucks

Motorcycles

Lightcommercial

Lightpassenger

Source: Ministry of Transport

Car ownership rate per capita is also increasing


In 2014,

New Zealand

had the

highest car

ownership rate

per capita

in the OECD

0

100

200

300

400

500

600

700

800

2000 2002 2004 2006 2008 2010 2012 2014 2016 2018

Number of light vehicles per 1000

people

Year

Light vehicles per 1,000 population, New Zealand, 2001-2016

Diesel vehicle numbers continue to climb


Light diesel vehicles

Diesel trucks

Diesel buses0

100,000

200,000

300,000

400,000

500,000

600,000

700,000

20

00

20

01

20

02

20

03

20

04

20

05

20

06

20

07

20

08

20

09

20

10

20

11

20

12

20

13

20

14

20

15

20

16

Number of diesel vehicles

Year

Diesel vehicles in New Zealand, 2000-2016

Children’s mode of transport to school


Main mode of transport to work on Census day


Source: Census 2013

Unmet GP need due to a lack of transport


• Affected 148,000 New Zealanders in 2016/17 (~3%)

• More than 7% of Māori and Pacific adults affected

1.1 0.6 3.1 2.8 4.81.0 1.8 2.8 3.5 7.20

1

2

3

4

5

6

7

8

9

1 (least deprived) 2 3 4 5 (most deprived)

Percent (%)

NZDep2013 quintile

Unmet GP need due to a lack of transport, by

socioeconomic deprivation (NZDep2013), 2016/17

Children Adults

Source: New Zealand Health Survey

Traffic crash deaths: An increasing road toll since 2013


Source: Ministry of Transport

0

100

200

300

400

500

600

700

800

19

90

19

91

19

92

19

93

19

94

19

95

19

96

19

97

19

98

19

99

20

00

20

01

20

02

20

03

20

04

20

05

20

06

20

07

20

08

20

09

20

10

20

11

20

12

20

13

20

14

20

15

20

16

20

17

Number of deaths

Year

Annual road toll in New Zealand, by transport mode, 1990-2017

Total

Vehicle occupant

Motorcyclist

Pedestrian

Cyclist

379

deaths

Age group patterns in mortality rates vary by mode of transport


1.50.4 0.1

13.5

1.3 1.30.2

5.6

1.60.6

0.1

5.0

1.10.6 0.3

8.4

0.5

2.1

0.4

0

2

4

6

8

10

12

14

16

Vehicle occupant injury Motorcyclist injury Pedestrian injury Cyclist injury

Age

-sp

ecif

ic r

ate

per

10

0,0

00

Mode of transport

Road traffic injury deaths, by age group and mode of transport, 2005-2014

0–14 years 15–24 years 25–44 years 45–64 years 65+ years

*

Traffic injury death rate is higher for Māori than non-Māori


12.41.2

1.7

0.24.80.9 0.6 0.2

0

2

4

6

8

10

12

14

Vehicle occupantinjury

Motorcyclist injury Pedestrian injury Cyclist injury

Age-standardised rate per 100,000

Mode of transport

Road traffic injury deaths, by Māori/non-Māori and mode of transport, 2005–2014

Māori Non-Māori

Highest rate of traffic injury deaths in most deprived areas


3.3

0.6 0.60.1

3.6

0.80.6

0.1

4.4

1.1

0.50.2

5.2

1.20.8

0.1

7.7

1.0 1.0

0.2

0

1

2

3

4

5

6

7

8

9

10


Age

-sta

ndar

dise

d ra

te p

er 1

00,0

00

Mode of transport

Road traffic injury deaths, by NZDep2013 quintiles and mode of transport, 2010-2014

NZDep Q1 (least deprived) Q2 Q3 Q4 Q5 (most deprived)

Motorcyclists at more risk of death, per time spent travelling


Transport injury hospitalisations increased from 2014 to 2016


0

20

40

60

80

100

120

2000 2002 2004 2006 2008 2010 2012 2014 2016


Year

Road traffic injury hospitalisations by mode of transport, 2001–2016

Total

Vehicle occupant injury

Motorcyclist injury

Pedestrian injury

Cyclist injury

Higher hospitalisation rates outside of major towns and cities


35

159

4

63

24

7 6

83

26

72

67

29

61

0

10

20

30

40

50

60

70

80

90

100


Age

-sta

nd

ard

ised

ra

te p

er 1

00

,00

0

Mode of transport

Road traffic injury hospitalisation rate, by urban/rural classification, 2014-16

Main urban area Secondary urban area Minor urban area Rural

Regional differences in transport injury hospitalisation rate


154 72 71 73 95 99 108 145 92 90 72 60 48 55 91 74 108 63 71 64 770

20

40

60

80

100

120

140

160

180

200

No

rth

lan

d

Wai

tem

ata

Au

ckla

nd

Co

un

ties

Man

uka

u

Wai

kato

Lake

s

Ba

y o

f P

len

ty

Tai

raw

hit

i

Ha

wke

s B

ay

Tar

anak

i

Mid

Cen

tra

l

Wh

ang

anu

i

Cap

ital

an

d C

oas

t

Hu

tt

Wai

rara

pa

Nel

son

Mar

lbo

rou

gh

Wes

t C

oa

st

Can

terb

ury

Sou

th C

ante

rbu

ry

Sou

ther

n

New

Ze

ala

nd


District Health Board

Road traffic injury hospitalisation rate, by District Health Board, 2016

District Health Boards New Zealand

Children’s road traffic injuries (0-14 years)


29 32 27 18 29 24 30 21 22 15 10 14 7 130

5

10

15

20

25

30

35

20

01

20

02

20

03

20

04

20

05

20

06

20

07

20

08

20

09

20

10

20

11

20

12

20

13

20

14

Number of deaths

Year

0

1

2

3

4

5

2000 2002 2004 2006 2008 2010 2012 2014

Crude rate

per 100,000

Year (3-year moving average)

Children’s traffic injury deaths (among children aged 0-14 years), 2001-2014, numbers and crude rate per 100,000

Unequal impacts seen for children as well


Children’s traffic injury deaths by ethnic group (2009-2014) and NZDep2013 quintiles (2010-14), (crude rate per 100,000)

1.0 0.7 1.0 1.1 2.70

1

2

3

4

1 (least

deprived)

2 3 4 5 (most

deprived)

Crude rate per 100,000

NZDep2013 quintile

3.2 1.1 0.9 0.9 1.50

1

2

3

4

5

Māori Pacific Asian European/Other Total

Crude rate per 100,000

Ethnic group (prioritised)

By ethnic group By NZDep2013 quintiles

What is the

overall health impact

of road transport

in New Zealand?

Our approach – a ‘rapid assessment’

• Aims to answer the question: ‘How many deaths in NZ are

attributable to road transport?’.

• Estimated the health burden from:

• Motor vehicle traffic crashes

• Air pollution (PM10, NO2)

• Noise pollution

• Used an ‘environmental burden of disease’ method

• Used by the World Health Organization

• Co-authors of the study: Professor David Briggs and Professor

Barry Borman

HEALTH BURDEN OF ROAD TRANSPORT

Conceptual framework

• Research project in 2015

Briggs, D., Mason, K., Borman, B. (2016). Rapid Assessment of Environmental Health

Impacts for Policy Support: The Example of Road Transport in New Zealand. International

Journal of Environmental Research and Public Health,2016; 13(1): 61

Environmental burden of disease method

3. Calculate % of deaths attributable to exposure

(‘population attributable fraction’, PAF)

5. Calculate number of attributable deaths


1. Identify the

diseases caused

by each exposure

PM10: All-cause mortality

NO2: All-cause mortality

Road traffic noise:

ischaemic heart disease,

stroke, hypertensive

diseases

2. Identify % of NZ

population exposed

to each exposure

4. Get the number of

deaths for identified

diseases

Health burden of road transport in New Zealand

Road transport accounted for an estimated 650 deaths in 2012

Briggs, D., Mason, K., Borman, B. (2016). Rapid Assessment of Environmental Health Impacts for Policy Support: The Example

of Road Transport in New Zealand. International Journal of Environmental Research and Public Health,2016; 13(1): 61


650

308

218

65

59

0 200 400 600 800

Total

Road traffic crashes

Particulate matter (PM10)

Nitrogen dioxide exposure

Noise

Number of attributable deaths

19,244

13,974

3,426

1,023

821

0 5,000 10,000 15,000 20,000 25,000

Total

Road traffic crashes

Particulate matter (PM10)

Nitrogen dioxide exposure

Noise

Number of attributable years of life lost (YLL)

Comments from this study

Lack of exposure/monitoring data in New Zealand

• We estimated:

• population exposed to high nitrogen dioxide levels

• population exposed to road traffic noise

• Our study excluded exposure to ozone, VOC, CO

NZ results were comparable internationally

• But higher health loss from road traffic crashes

Showed importance of considering health impacts outside of

road crashes


Summary:

What does it all mean?

Key messages

• High reliance on cars in New Zealand

• Road transport has a substantial impact on health in NZ

• Traffic crashes, air pollution, noise pollution,

barriers to accessing services

• Unequal impacts of transport on health

• Motorcyclists, and to a lesser extent, cyclists

• Māori and Pacific peoples, people living in high

deprivation areas

• People living close to busy roads

SUMMARY

Key messages

Evidence supports encouraging more

use of active and public transport

• Move away from reliance on car use

and fossil fuels

Active and public transport have multiple benefits

• less air pollution, noise pollution, greenhouse gases

• more physical activity

improvement in the health and wellbeing of NZers

SUMMARY

To find out more

www.ehinz.ac.nz

HealthSpace – an online mapping tool for exploring

regional health data

healthspace.ac.nz

HealthSpace example: Using active transport to work,

by territorial authority, 2013

healthspace.ac.nz

Thank-you for your time!

For more info,

visit our websites:

www.ehinz.ac.nz

healthspace.ac.nz

or email:

Kylie Mason [email protected]

EHI team [email protected]

TRANSPORT AND HEALTH · 2018-09-28 · Car ownership rate per capita is also increasing EHI...

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