There is now irrefutable evidence proving beyond the shadow of a doubt that cars place a huge cost on societies worldwide: loss of health and human lives, degradation of urban environment, a changing climate, and an economic burden that is shared by drivers and non-drivers alike. Yet, even though we are aware of all those far-reaching negative consequences, we seem unable to deal with the threat of the automobile. In this article Roger Bysouth explores why it is so and what we can do to change it.

Cycling is healthy, compared with driving. Everyone knows that, even the most high-octane petrol head. This might not matter much if transportation were a marginal activity that took up only a very small part of people’s time and the world’s resources. But the trend all over the world is toward less physical activity, more driving and consequently worse health, primarily through obesity and pollution. Car driving is only one factor in this, but a very important one.

Then there are road deaths and injuries. The World Health Organisation (WHO), in its Global Status Report on Road Safety, 2009, predicts that deaths in road traffic will increase from 1.2 million per year (the ninth biggest cause) now to 2.4 million per year (the fifth biggest cause) in 2030. In 2007, road accidents cost the UK’s National Health Service £470m a year and the UK economy £8bn a year; all money that could have been better spent.

A Major Killer

The pollution and lack of physical activity that cars entail contribute to most of the other major killers that the WHO identifies in the world today. We have collectively achieved extraordinary reductions in deaths from communicable diseases. But we seem unable to deal with the threat from cars, a prime cause of other preventable diseases, like coronary heart disease, Type 2 diabetes and cancers which are affected directly by our habits. Our assessment of the health risk our lifestyle brings seems at fault, as though we are in denial.

Car driving has a still wider effect on health. Most deaths from road traffic injuries in most of the world, as calculated by the WHO in the report above, are not those of drivers but of vulnerable road users (cyclists, motorcyclists and pedestrians). The ill health from vehicle pollution disproportionately affects the world’s poor. Ultimately cars are contributing to climate change and so threatening the environment on which the health and well-being of all of us depend.

Medical care is a part of what determines health. The others are genetic, which can’t be changed, and environmental and societal, which can be changed, for better or worse. Car culture damages many of them: social support networks and an environment safe from pollution and the threat of injury, that offers the opportunity to be physically active.

If we are aware of its adverse health consequences, why does car culture have such a hold? Why, for many individuals, can it seem like an addiction? How has it become a pandemic? And what can we do about it?

A Complex Phenomenon

There is no single answer. Most of the relevant responses are perspectives on what car culture is. It’s seen as an ideology; a belief system; economics; disease, and habit. If we are to tackle it, we should first recognise it is a multi-faceted phenomenon that operates at many levels that reinforce each other. If we are to make any impact on any one aspect of it, for example if health agencies want to lessen its adverse health impact, we have to tackle it at all levels.

It would be useful to look at the ways through which other preventable health emergencies have been addressed. Since 1945 many major communicable diseases have been curbed. Recently there has been success on banning smoking in the west/north. None of these issues was a disease requiring a purely medical response.

Attitudes to smoking have changed in a generation. Where smoking was the norm for most adults and exposure an accepted part of everyday life, things are now very different. Many states, all receiving tax revenue for cigarettes legitimately sold and some profiting from a monopoly of domestic tobacco manufacturing, have tried to dissuade people from smoking for health reasons. Their motives are not only altruistic. The cost for dealing with smoking related disease is gigantic.

And all this has been achieved despite tobacco advertising, partly because this has often been restricted since the 1960s. The popular view of smoking has changed. In many places, it is now socially and legally unacceptable to smoke in public places including workplaces.

Just some of the lessons for addressing car culture are:

1. Seemingly entrenched attitudes can change. Think how the Dutch increased their cycling in the 1970s as a result of government action (see Lyn Sloman’s Car Sick, Green Books, 2006, p. 98).
2. Legislation can help persuade people to change behaviour, but can’t work on its own.
3. Political will is crucial. Governments want economic growth and car manufacture is seen as a keystone of national economies. So challenging the car industry is not an option for most governments. This article is written during the UK’s general election campaign. All major parties firmly agree on the need to boost economic growth, including through the car industry.
4. Influencing people through the media can be effective. Both advertisers and public health specialists can make a difference.

These lessons can help us to frame different responses to match the many aspects of car culture. Perhaps the most important changes need to be made in people’s minds.

Incentives and Disincentives

At the economic level there is a wide range of incentives and disincentives to persuade people to change modes of transport: improvements to public transport and better conditions for pedestrians and cyclists as well as taxation, congestion charging and carbon rationing. Other economic issues, like car ownership (and the low extra marginal costs of using cars), need to be addressed. In democratic states it is also important to spread awareness of the financial costs the car manufacturers currently externalise from their balance sheets, obliging the state to pick up: especially in the costs of treating preventable disease, transport infrastructure and more. Wouldn’t we rather be able to spend this on something else?

Another area of influencing people is advertising itself. Car culture is constantly reinforced by the auto industry’s advertising and its power is enormous, much stronger than the tobacco industry’s ever was.

The car industry would no doubt argue, as tobacco companies do, that they do not aim to increase the total number of people buying cars, merely to increase their company’s market share. It is true that there are many other ways in which car culture recruits converts, from children’s (especially boys’) toys, to popular magazines on cars and dedicated TV programmes. As commercial products, they exist because of demand for them. But they are, with car advertising, the everyday means by which car culture is stimulated.

The “Nudge” Effect

A related avenue for influencing people is the “nudge” effect (Richard H. Thaler and Cass R. Sunstein, Nudge, Improving Decisions About Health, Wealth and Happiness, Penguin, 2009). While preserving people’s right to choose an unhealthy option, “nudging” designs the way people are offered choices so, unless they have strong feelings, they are more likely to choose the healthy option. Examples include British local authorities successfully nudging people to switch from cars (see www.smartertravelsutton.org).

Public health campaigning can guide us in choosing messages. Studies show people may resolve to change health-related behaviour in response to shocking or shaming messages at times. But people are more likely to respond to encouraging, practical messages to help them deal with practical problems that could otherwise make them go back to their old ways. (See Geoff Mulgan, Influencing Public Behaviour to Improve Health and Wellbeing, an independent report, 2010.)

The treatment of addiction also offers models for influencing individual car addicts. Here are just a few of the many parallels between addiction and car culture:

• a pleasure-seeking risk-taking activity
• dependency that is both psychological (we believe we can’t do without it) and physical (poor health such as obesity, engendered by cars, makes us more dependent on them)
• denial about the scale of the problem
• withdrawal symptoms – what else are the stress and road rage associated with being stuck in traffic?

A “Natural Right”?

Finally, one of our core beliefs about car driving is that it is a “natural right.” Hence we encounter deep-seated attitudes, for instance that drivers have a right to use roads as they please, and to fuel at what they define as an affordable price. These are reinforced by advertising and other transmitters of car culture: the car lobbying organisations and media. But we know that such attitudes are not universal. Lyn Sloman (op. cit. p. 56) explains car drivers are not all unshakeable in their “addiction.” She cites evidence that around half of all car drivers would need little incentive to cut their car use. Different means might be needed to change other drivers’ behaviour; but already car culture does not seem as monolithic as before.

This article’s thumbnail picture of some possible responses only skims the surface of the subject. The key is to get a better understanding of how varied car culture is. This calls for that most difficult of tasks: looking at what we take for granted everyday and questioning it.

Roger Bysouth works in local government in the UK and is a freelance writer and illustrator. He owns one bike and has a Brompton on order, via his employer’s tax-free cycle loan scheme.