Until relatively recently, the `conventional wisdom' was that air pollution from vehicle emissions had no adverse effect on health and that health considerations were irrelevant to transport policy. Looking back, the health aspects of transport cannot be dismissed so easily. In the first part of this chapter, the author argues that: (1) transport emissions do affect health; (2) the magnitude of their effects is dominated by the growth and pervasiveness of the total volume of traffic; and (3) transport policy has usually acted to increase that growth. In the second part, he assesses the `new realism' in transport thinking, which began to arise in the UK in 1989, when the Department of Transport produced projected increases of 83% to 142% traffic growth by 2025, which exceeded what the British road network could support. The `new realism' was the recognition that supply of urban road space could not be increased to match demand, therefore demand would have to be reduced to match supply. Demand management quietly but quickly became part of every urban transport policy, which in principle nearly everywhere proposed an environmentally friendly package, though justified in economic terms. The health argument is now likely to be well received, because it is consistent with this new approach.
Abstract