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People tend to think of LTNs as a policy to make local streets nicer or better to walk or cycle, or perhaps if they oppose them, how they can make driving less convenient. But most people don’t think of LTNs as a public health policy.
The mass-motoring age has led to enormous changes in people’s patterns of movement, how we experience cities and even the air that we breathe. As with so much in our society, the distribution of benefits and harms from this has been grossly unfair.
In this blogpost we talk about how car-dominated cities have contributed to a public health crisis, and how the solution is to re-prioritise transport in cities away from cars, and reallocate roadspace to alternatives.
There have been four critical environmental health harms that have resulted from allowing cars to dominate our cities (there are others too, but these are key from a health perspective).
The mass-motoring age has led to enormous changes in people’s patterns of movement, how we experience cities and even the air that we breathe. As with so much in our society, the distribution of benefits and harms from this has been grossly unfair.
In this blogpost we talk about how car-dominated cities have contributed to a public health crisis, and how the solution is to re-prioritise transport in cities away from cars, and reallocate roadspace to alternatives.
There have been four critical environmental health harms that have resulted from allowing cars to dominate our cities (there are others too, but these are key from a health perspective).
Air Pollution
The Royal College of Physicians estimate the annual cost of urban air pollution at over £27 billion, with air pollution contributing to 30,000 premature deaths in the UK, stealing healthy years from people living in polluted areas.
These costs are not uniformly experienced. The most deprived communities of London more commonly live in the most polluted areas, creating a basic inequality in exposure. More deprived communities are also more at risk from pollution because of vulnerability from generally less good health.
Thankfully London’s strong policies to reduce car usage and air pollution since 2016, including ULEZ, support for electric vehicles and LTNs, mean that pollution concentrations have declined faster in areas of deprivation in London making action to tackle air pollution a rare equality success story. But there is much more to do.
Road Traffic Noise
Environmental noise is rarely given the attention it deserves and for this reason is considered a ‘neglected pollutant’. In fact, noise, just like air pollution, has very serious health implications caused by chronic (long term) exposure. Specifically, road traffic noise leads to significantly increased risk of heart disease, heart attacks, strokes and impairment to children’s learning.
Noise also causes nuisance and degrades quality of life. Finally, it leads to financial costs such as the need to upgrade building insulation and use expensive glazing when building homes in areas blighted by noise.
DEFRA estimates the annual social cost of urban road noise in England at £7-10 billion although this is likely to be a huge underestimate as it is based on noise mapping data which excludes noisy minor roads. Being a neglected pollutant, there are few detailed studies into the equality impacts of traffic noise, but loss of life years from the health impacts is associated with income deprivation in London.
Road casualties
Allowing cars to dominate densely populated areas has been catastrophic for public safety. In the UK in 2024 over 29,000 people were killed or seriously injured on our roads with an almost unbelievable 128,000 casualties of all severities. In Hackney 117 people were killed or seriously injured on our roads in 2024 with collision and casualty risk amongst the worst in London. Nationally the financial cost of this is over £55 billion.
But of course that does nothing to represent the human cost, the lives ruined and families ripped apart. Or how the risk and danger put people off making healthy active transport choices.
And just like air pollution, obesity and inactivity, the inequality of road casualties in London is glaring. The more deprived the area, the higher the risk that someone will be seriously injured or killed in a road traffic collision, with the 30 per cent most deprived postcodes having more than double the number of casualties per kilometre amongst people travelling in that area compared with the least deprived 30 per cent, and also more than double the casualty risk for the people who live in these postcodes.
Obesity and Inactivity
Between 1949 and 2019, UK motor vehicle traffic increased over twelve-fold from 28.9 to 356.5 billion annual vehicle miles, largely driven by steady growth in car traffic.
The Royal College of Physicians estimate the annual cost of urban air pollution at over £27 billion, with air pollution contributing to 30,000 premature deaths in the UK, stealing healthy years from people living in polluted areas.
These costs are not uniformly experienced. The most deprived communities of London more commonly live in the most polluted areas, creating a basic inequality in exposure. More deprived communities are also more at risk from pollution because of vulnerability from generally less good health.
Thankfully London’s strong policies to reduce car usage and air pollution since 2016, including ULEZ, support for electric vehicles and LTNs, mean that pollution concentrations have declined faster in areas of deprivation in London making action to tackle air pollution a rare equality success story. But there is much more to do.
Road Traffic Noise
Environmental noise is rarely given the attention it deserves and for this reason is considered a ‘neglected pollutant’. In fact, noise, just like air pollution, has very serious health implications caused by chronic (long term) exposure. Specifically, road traffic noise leads to significantly increased risk of heart disease, heart attacks, strokes and impairment to children’s learning.
Noise also causes nuisance and degrades quality of life. Finally, it leads to financial costs such as the need to upgrade building insulation and use expensive glazing when building homes in areas blighted by noise.
DEFRA estimates the annual social cost of urban road noise in England at £7-10 billion although this is likely to be a huge underestimate as it is based on noise mapping data which excludes noisy minor roads. Being a neglected pollutant, there are few detailed studies into the equality impacts of traffic noise, but loss of life years from the health impacts is associated with income deprivation in London.
Road casualties
Allowing cars to dominate densely populated areas has been catastrophic for public safety. In the UK in 2024 over 29,000 people were killed or seriously injured on our roads with an almost unbelievable 128,000 casualties of all severities. In Hackney 117 people were killed or seriously injured on our roads in 2024 with collision and casualty risk amongst the worst in London. Nationally the financial cost of this is over £55 billion.
But of course that does nothing to represent the human cost, the lives ruined and families ripped apart. Or how the risk and danger put people off making healthy active transport choices.
And just like air pollution, obesity and inactivity, the inequality of road casualties in London is glaring. The more deprived the area, the higher the risk that someone will be seriously injured or killed in a road traffic collision, with the 30 per cent most deprived postcodes having more than double the number of casualties per kilometre amongst people travelling in that area compared with the least deprived 30 per cent, and also more than double the casualty risk for the people who live in these postcodes.
Obesity and Inactivity
Between 1949 and 2019, UK motor vehicle traffic increased over twelve-fold from 28.9 to 356.5 billion annual vehicle miles, largely driven by steady growth in car traffic.
This has transformed cities and towns to the point most streets suffer from negative effects. It has caused community severance and blighted streets for other uses, discouraged active travel and led to a collapse in physical activity with, for example, cycling miles plummeting from 14.7 billion in 1949 (when the population was 25% smaller) to under 4 billion today.
40% of 40 to 60 year olds are now doing less than 10 minutes of brisk walking each month, with the population overall being 20% less active than in the 1960s. Over a third of people are not doing enough physical activity to maintain good health.
Obesity and lack of physical activity are both strongly linked to deprivation. Between 2015 to 2016 and 2023 to 2024, the proportion of physically inactive adults increased in the most deprived areas of England and decreased in the least deprived areas, widening inequality over this period. In 2023 to 2024, the level of physical inactivity for adults in the most deprived areas was 2.3 times higher than for those in the least deprived areas.
It doesn’t take too much imagination to see a link between the disproportionate levels of pollution, road danger and noise in more deprived areas and the fact people in them are so much less active. Who wants to walk, cycle or exercise on busy, traffic-dominated, noisy and polluted streets?
The impact on children
The effect of ever-increasing car dominance on children has been particularly stark. As a group legally unable to drive, in the space of a generation they have lost the ability both to travel independently and to safely play in the streets around their homes.
In London as a whole 23.2% of children in Year 6 were considered obese in 2024/5, compared to 22.2% in England, but this masks big disparities depending on Borough and deprivation. Hackney is one of the 10 worst London Boroughs for childhood obesity, with 24.9% of year 6 children here being obese.
40% of 40 to 60 year olds are now doing less than 10 minutes of brisk walking each month, with the population overall being 20% less active than in the 1960s. Over a third of people are not doing enough physical activity to maintain good health.
Obesity and lack of physical activity are both strongly linked to deprivation. Between 2015 to 2016 and 2023 to 2024, the proportion of physically inactive adults increased in the most deprived areas of England and decreased in the least deprived areas, widening inequality over this period. In 2023 to 2024, the level of physical inactivity for adults in the most deprived areas was 2.3 times higher than for those in the least deprived areas.
It doesn’t take too much imagination to see a link between the disproportionate levels of pollution, road danger and noise in more deprived areas and the fact people in them are so much less active. Who wants to walk, cycle or exercise on busy, traffic-dominated, noisy and polluted streets?
The impact on children
The effect of ever-increasing car dominance on children has been particularly stark. As a group legally unable to drive, in the space of a generation they have lost the ability both to travel independently and to safely play in the streets around their homes.
In London as a whole 23.2% of children in Year 6 were considered obese in 2024/5, compared to 22.2% in England, but this masks big disparities depending on Borough and deprivation. Hackney is one of the 10 worst London Boroughs for childhood obesity, with 24.9% of year 6 children here being obese.
Obesity, inactivity and the isolation caused by traffic-dominated streets also affect mental health. Shockingly, data from the Programme for International Student Assessment (PISA 2022) shows that the UK’s 15-year-olds had the lowest average life satisfaction in Europe. More children in City and Hackney have risk factors for poor mental health than in both the rest of London and England as a whole.
By contrast, in the Netherlands, where residential districts are routinely designed as traffic-filtered ‘Woonerf’, and children independently access comprehensive networks of safe protected cycling infrastructure, children are healthier and have been assessed by UNICEF as the happiest in the world.
So how do LTNs fit into all this?
LTNs can play a very significant role in addressing these 4 public health issues.
Both academic studies and council monitoring data show LTNs have contributed to large falls in air pollution in London.
An Oxford University Study also shows LTNs reduced noise both within the LTN and on boundary roads and led to more pleasant natural soundscapes.
One critical benefit is to safety. A recent comprehensive study in the BMJ of 113 LTNs showed LTNs were associated with a 35% reduction in all injuries, rising to 37% for deaths and serious injuries. The study concluded that creating these LTNs prevented more than 600 road injuries that would have otherwise taken place, including 100 involving death or serious injury, without any negative effect on boundary road safety. Hundreds of families saved from the devastation of road violence by this simple policy.
And of course, with cleaner air, peaceful low-noise environments and confidence in the safety of local streets (alongside a reduction in the priority for short car journeys), comes a clear incentive to use active travel to get around. A survey of Hackney residents, the Walthamstow Mini-Holland study, and others, have shown a consistent trend towards increased minutes of walking and cycling in the LTN areas, which will inevitably translate into health benefits.
Charity ‘Playing Out’ and academic Tim Gill identify transport policy as critical to improving health and social outcomes for children. To tackle childhood obesity it is essential that local streets are suitable for children to play, that children can easily and independently access outside space, parks and leisure facilities, and have regular incidental activity (such as travelling actively to school). LTNs can achieve all of these aims.
It is common to hear about alleged inequalities from LTNs. People wrongly say they only benefit rich people. Or they close the roads and restrict freedom. But there is not nearly enough consideration of the existing harms that come from doing nothing, or treating the current car-dominated state of our streets as natural or inevitable. Our message to politicians is this:
Not taking action, or following less effective traffic reduction policies, is causing huge harm and inequality right now.
We know how to fix this, the solutions are clear, now we have to urgently get on and do it.
Here’s what we think Hackney Council should do:
By contrast, in the Netherlands, where residential districts are routinely designed as traffic-filtered ‘Woonerf’, and children independently access comprehensive networks of safe protected cycling infrastructure, children are healthier and have been assessed by UNICEF as the happiest in the world.
So how do LTNs fit into all this?
LTNs can play a very significant role in addressing these 4 public health issues.
Both academic studies and council monitoring data show LTNs have contributed to large falls in air pollution in London.
An Oxford University Study also shows LTNs reduced noise both within the LTN and on boundary roads and led to more pleasant natural soundscapes.
One critical benefit is to safety. A recent comprehensive study in the BMJ of 113 LTNs showed LTNs were associated with a 35% reduction in all injuries, rising to 37% for deaths and serious injuries. The study concluded that creating these LTNs prevented more than 600 road injuries that would have otherwise taken place, including 100 involving death or serious injury, without any negative effect on boundary road safety. Hundreds of families saved from the devastation of road violence by this simple policy.
And of course, with cleaner air, peaceful low-noise environments and confidence in the safety of local streets (alongside a reduction in the priority for short car journeys), comes a clear incentive to use active travel to get around. A survey of Hackney residents, the Walthamstow Mini-Holland study, and others, have shown a consistent trend towards increased minutes of walking and cycling in the LTN areas, which will inevitably translate into health benefits.
Charity ‘Playing Out’ and academic Tim Gill identify transport policy as critical to improving health and social outcomes for children. To tackle childhood obesity it is essential that local streets are suitable for children to play, that children can easily and independently access outside space, parks and leisure facilities, and have regular incidental activity (such as travelling actively to school). LTNs can achieve all of these aims.
It is common to hear about alleged inequalities from LTNs. People wrongly say they only benefit rich people. Or they close the roads and restrict freedom. But there is not nearly enough consideration of the existing harms that come from doing nothing, or treating the current car-dominated state of our streets as natural or inevitable. Our message to politicians is this:
Not taking action, or following less effective traffic reduction policies, is causing huge harm and inequality right now.
We know how to fix this, the solutions are clear, now we have to urgently get on and do it.
Here’s what we think Hackney Council should do:
- Our Manifesto
- How to Fix Main Roads
- How rethinking parking can create a lower traffic Hackney
- Hoxton LTN
- Dalston LTN
Yes air was (slowly) getting cleaner as the fleet electrifies, but the evidence showed ULEZ massively accelerated this leading to compliance with UK air quality objectives 184 years earlier than would otherwise have been the case, saving thousands of lost life-years in the process. Despite this London remains non-compliant with WHO air standards to protect health, and cleaner vehicles still emit significant particulate pollution (PM2.5) from tyre and brake wear. To resolve this we cannot just rely on vehicles with lower tailpipe emissions (and there are many other good reasons for wanting to reduce car journeys anyway). Peer-reviewed evidence shows LTNs reduce air pollution both within the areas and on boundary roads. The idea they increase pollution on boundary roads is plainly false and easily disprovable. There is not a single road in Hackney with worse air than before the 2020 LTNs and the main (boundary) roads have seen the biggest improvements.
In respect of safety, whilst there was continuous improvement over several decades there has actually been minimal progress on safety in the past decade in the UK, with KSIs plateauing. It is important also to distinguish a traditional road safety approach which has focused on protecting people in ever more insulated cars, from road danger reduction which tries to protect vulnerable road users outside cars. The BMJ study linked is very strong direct evidence of the lives saved by LTNs. This is a strategy that is proven to work.
The article does not report there is ‘almost no evidence’ of the noise effect on health it says there is limited evidence of the association between noise and deprivation. The health impacts of traffic noise are backed by very strong evidence and are beyond dispute - have a look at the WHO Environmental Noise Guidelines for the European Region. The impact of LTNs on noise is mainly just a matter of physics: There is a simple relationship between traffic flows and noise. Because the decibel is a logarithmic scale, broadly you need to halve traffic flow to achieve a perceptible (3dB) change in noise. Many LTN streets see reductions of 50-90% in traffic flows so noise will greatly improve on those roads. Major boundary roads do not generally see any traffic flow increases, but where these do occasionally exist, they are nowhere near the 100% increase in flow needed to perceptibly increase noise on a major road. A more typical 5-10% flow change is not sufficient to perceptibly alter noise level. For this reason, LTNs have huge potential to address environmental health harms from traffic noise.
Obesity is complex and we have certainly never claimed LTNs alone can solve this, but they are an important part of the solution. Obesity is caused by a combination of behaviour, environment, genetics and culture. PHE and the WHO recommend a ‘whole systems approach’ to tackling obesity which includes action on transport and streets and measures to increase physical activity. See also the WHO Global Action Plan on Physical Activity which specifically advocates for urban planning policies to prioritise walking wheeling and cycling over motorised transport.
Finally your contention LTNs benefit rich middle class people at the expense of working class people is false and thoroughly debunked. In fact the opposite is true. We wrote a blogpost on this here: https://www.lowtraffichackney.org/latest-news/do-ltns-favour-rich-people
From your comments, and the necessary length of our reply to what you posted, this one would be a pertinent read too: https://www.lowtraffichackney.org/latest-news/low-traffic-but-just-not-like-this-why-councils-are-choosing-ltns-and-how-to-tell-real-evidence-from-misinformation