World-wide, 3000 people are killed and 30 000 are seriously injured on roads every day. Road-traffic injuries are predicted to rise by 2020 to third place in the global burden of disease. There are also broader effects of transport on health, including respiratory illnesses from air pollution and cardiovascular and mental health benefits of walking and cycling. Epidemiological methods can be used to investigate causation, but what scientific methods will provide evidence of the effectiveness of public-health interventions—and what interventions are politically possible? Road accidents can be controlled through legislation, engineering, or health promotion. A systematic review of transport and health identified 28 other systematic reviews of interventions in these fields, with search criteria of at least a reasonable standard. The evidence, however, remains incomplete, may sometimes assess intermediate rather than health outcomes, is open to publication bias, and may not be generalisable across cultures. As better evidence is awaited, new policy interventions need to be considered, introduced, and evaluated. (Author/publisher)
Samenvatting