About transport and health

This section provides information on how transport impacts on human health in Aotearoa New Zealand. 

The importance of transport in our lives

Transport plays an essential role in New Zealand society. Transport connects us to healthcare services, education, family, community, shops and recreation. We rely on transport to get from one point to another, move goods around, get to work, and for everyday life. 

Cars are the main form of transport used in New Zealand. In 2023/24, New Zealanders spent the vast majority (81%) of their total travel time in motor vehicles. Much less travel time was spent walking (10%), on public transport (5%) or cycling (2%) [1].  

How does transport affect health?

Transport can impact our health through a number of ways, including:

• road traffic injuries and deaths
• air pollution
• noise pollution.

A lack of transport can also lead to social isolation and create barriers to accessing services, including healthcare. Motorised transport also relies heavily on fossil fuels, which contribute to greenhouse gas emissions when burned.

By contrast, active transport (such as walking and cycling) and public transport have positive health benefits, including increasing physical activity and improving mental well-being and heart health. 

The health impact of road traffic accidents

Traffic-related deaths and injuries are the main health impact of road transport in New Zealand [2]. Traffic injuries may affect all types of road users, though pedestrians, cyclists and motorcyclists are particularly vulnerable as they tend to suffer more severe injuries from collisions due to lack of personal protection. By comparison, vehicle occupants are protected by the vehicle body and fitted safety features (such as seatbelts or airbags). Vehicle occupant injury may be related to speed, vehicle type and the age of the vehicle, as newer models often have more and better safety features.

How a lack of transport can affect access to healthcare

Transportation is a basic but essential requirement for access to healthcare services [3]. Lack of access to transport (whether private vehicles or public transport) may lead to an inability to access medical advice or treatment, causing an ‘unmet healthcare need’ – that is, missing out on healthcare when it is needed, which can worsen health outcomes.

Active and public transport modes have benefits for health and the environment

Active transport, such as walking and cycling, has benefits for both health and the environment. The health benefits include increasing physical activity and producing less (or no) air and noise pollution. A key environmental benefit is the reduction in greenhouse gases that contribute to climate change [4]. 

Studies have shown that active commuting (such as walking or cycling to work) is associated with a reduction in cardiovascular risk [5],[6]. Use of public transport also increases physical activity, reduces air pollution (by not taking a private vehicle), is safer than travelling by private vehicle [7], and can improve mental health [8],[9].

Using active transport to and from school is an effective way for children to get some physical activity each day. Sport New Zealand estimates that in 2023, only 62% of New Zealand children aged 5–11 years met the physical activity guidelines for the amount of daily physical activity [10].  

The use of active transport and public transport can be limited by several barriers, including concerns about road safety, a lack of safe places to travel, and poor urban design. Public transport also needs to be reliable, affordable, frequent and easy to use, for people to use it.  In smaller towns and rural areas, public transport is often not available.

The size and age of the vehicle fleet impacts on environmental health

The use of motor vehicles can impact human health through air pollution, crashes and accidents, noise, and by accelerating climate change. In particular, motor vehicle emissions from petrol and diesel combustion affect outdoor air quality and human health. Road traffic noise can also affect health, particularly through high blood pressure resulting from stress associated with road noise [11].

It has been estimated that motor vehicle emissions caused 2,247 premature deaths in 2016 [12] – compared to 327 deaths from road traffic accidents that year [13]. Evidence also shows that diesel engine fumes can cause lung cancer [14]. The average age of a country’s vehicle fleet is an indicator of the efficiency of vehicles on the road. Older cars tend to be less fuel-efficient and produce more emissions.  Vehicle age is often also related to vehicle safety, with newer models having more and better safety features installed.

Environmental Health Indicators for transport

You can find the following indicators on our EHI website:

• Number of motor vehicles
• Main mode of transport to work on Census day
• Household travel time by mode of transport
• Active transport to and from school
• Unmet need for GP services due to a lack of transport
• Road traffic injury deaths and hospitalisations