Calling for a more coherent policy response to driving harm

High rates of population-level driving are associated with multiple adverse health outcomes arising from road crashes, air and noise pollution, physical inactivity, global warming, and social and economic isolation. However, population-level driving is not widely treated as a public health issue, and efforts to reduce driving harms focus on lowering the prevalence of specific high-risk behaviours and exposures (e.g. speeding or drink-driving), not on reducing overall levels of population-driving itself. Silence on driving harms pervades because driving and cars have become deeply embedded in our surroundings, in our policies, and in our social fabric. Urban planning approaches prioritize mobility over access, and the ever-increasing road capacity, combined with underinvestment in walking and sustainable transport, has made society car dependent. Thanks to the influence of the road lobby, the harms of driving are underestimated and overlooked, while measures that make walking, cycling, and public transport the easiest option are viewed with suspicion. Policy responses to reducing population-level driving, as measured by vehicle kilometres travelled per capita and relative mode share, can create positive change. Efforts should focus on (i) improving population-level accessibility-by ensuring shops, schools, and public facilities are close to where people live and work; (ii) making walking and cycling possible and desirable; (iii) realigning incentives for transport so that walking, cycling, and public transport are cheaper and easier than driving; and (iv) communicating effectively and deliberately about transport, health, and happiness.