The horrendous costs to human health of motorised transportation in (Indian) cities
In the first of three articles, Henrik Valeur confronts us with a full catalogue of the health problems caused by motorised transportation in India's cities. The seemingly endless list suggests that the question of mobility may not be the balance between public and private forms of motorised transportation, but between motorised and non-motorised forms such as walking and cycling.
In India there are now 200 times as many motor vehicles (including two-wheelers) as there were 50 years ago with the numbers having increased from 0.7m in 1961 to 142m in 2011. In Delhi alone, more than 1,000 new motor vehicles have been registered every day during the past decade.
By 2030 three times as many motor vehicles are expected on Indian roads and about 250 million more people are expected to live in Indian cities. The problems related to motorised transportation in Indian cities-especially the costs to human health — may thus increase many times during the next couple of decades.
Human health effects
Sweden, for instance, only had 2.9 traffic-related deaths per 100,000 inhabitants while India had 11.1. Yet, the Swedes had 29 times as many cars per inhabitant as the Indians. Thus, relative to the number of cars, the chances of dying in a traffic accident in India are about 100 times higher than in Sweden.
One most immediate problem are traffic accidents, which result in injuries, mutilations and fatalities. These are, however, very unevenly distributed. Sweden, for instance, only had 2.9 traffic-related deaths per 100,000 inhabitants (in 2008) while India had 11.1 (in 2009). Yet, the Swedes had 29 times as many cars per inhabitant (522 out of 1,000) as the Indians (18 out of 1,000). Thus, relative to the number of cars, the chances of dying in a traffic accident in India are about 100 times higher than in Sweden.
The health effects of air pollution include chronic respiratory diseases like asthma, bronchitis, emphysema and lung cancer. Air pollution may contribute to or increase the risk of cardiovascular diseases, including coronary heart disease, other forms of cancer and damage to the immune system, impaired foetal development and cognitive decline. The high concentration of hazardous gases and particulates from diesel engine vehicles is of special concern in Indian cities where black and blue fumes leach from all sorts of vehicles including buses, lorries, auto-rickshaws, motorcycles and even new diesel engine cars, and where levels of fine particulate matter exceed national guidelines (60 µg/m³, already three times above WHO recommendations) in 27 out of 32 Indian cities. The people who suffer most are those who make a living on or next to polluted urban roads, such as rickshaw drivers and street vendors; those who live in close proximity to these roads; and those who have to walk or cycle long distances on these roads (usually because other means of transportation are not available to them).
These people also suffer from the noise created by honking, motor engines and tires moving on asphalt, which may cause high blood pressure and heart diseases, changes in the immune system and sleep disturbance. It may also cause stress and stimulate aggression and anti-social behaviour. Even birth defects can be attributed to noise pollution.
Even public transport can be unhealthy
Users of public transportation may be exposed to stress-provoking factors like delays, overcrowding, smells and bad behaviour, which may again lead to more inappropriate and undesirable behaviour. Commuters frequently exposed to stress may experience an increase in blood pressure and the risk of heart disease and heart stroke. Both acute and chronic traffic-related stress can seriously damage the memory and reduce learning abilities.
By opting for motorised transportation we opt out of exercising our bodies. In fact, we hardly move our body at all while travelling. At the same time, motorised transportation may prevent others from moving their bodies too. Motorised transportation thus becomes the single most important contributor to sedentary modern lifestyles. Lack of physical activity affects the immune system, causes the body to decay and impairs children's development. And children who grow up in cities often lack opportunities to play. While physical activity may reduce anxiety and stress, physical inactivity may lead to cognitive impairment, depression and reduced self-esteem. It will also lead to obesity and while this was "once considered a high-income country problem, overweight and obesity are now on the rise in low- and middle-income countries, particularly in urban settings", according to the World Health Organisation (WHO), which estimates that the number of overweight children is now more than three times higher in "developing" countries than in "developed" countries.
"Once considered a high-income country problem, overweight and obesity are now on the rise in low- and middle-income countries, particularly in urban settings", according to WHO, which estimates that the number of overweight children is now more than three times higher in "developing" countries than in "developed" countries.
Obesity may result in mental, social and physical problems, including cardiovascular disease, sleep deprivation, cancer, degradation of joints, asthma and diabetes type 2, which may lead to heart disease, stroke, loss of eyesight, kidney failure and amputation. The slightly perverse situation in India is that it is now home to both the largest number of hungry people and the largest number of people with diabetes.
Lost opportunities for development
The costs of treating traffic-related health problems put a heavy burden on national budgets and thus restrict government's capacity to promote development. In its 2009 report on road safety in South-East Asia, the WHO set the costs of road traffic injuries and deaths in India alone at $11.5 billion. According to the WHO, most of the people killed on the roads "are young and aged between 15 and 44 years, thus corresponding to the most economically productive segment of the population."
Traffic congestion, accidents and traffic-related diseases cause loss of human skills and talent, work capacity and innovation. When people are stuck in traffic jams on the roads or waiting for delayed flights, trains and busses, they are largely unproductive. And to account for possible delays people may allocate more (unproductive) time or they may end up late for meetings, classes and other appointments.
Furthermore, rushed and careless driving, fumes of blue and black smoke, endless traffic jams and relentless honking combine to create an extremely hostile environment in which few people want to live, let alone work, if they have a choice. Current modes of transportation may thus discourage foreigners from settling in Indian cities while encouraging locals, especially the well-educated, to move away.
Various studies show that air pollution, noise, stress and physical inactivity have a significantly negative effect on cognitive development. A recent study from Denmark, that was intended to show the importance of breakfast for children's learning abilities, revealed that breakfast doesn't make much difference. What really matters, the researchers found, is age, sex and how children reach school. If they transport themselves, by walking, running or bicycling, their ability to concentrate, and thereby to learn, is significantly higher, even several hours later, than if they are transported to school. Yet another reason to promote walking, cycling and other healthy means of transportation in Indian cities.