Project: Exploration of Concepts of Health held by Highways/Transport Cabinet Members /Councillors in England C27

Reference: STP 14/5/23

Last update: 31/12/2009 12:14:32


The objective of this project is to assess how health is conceptualised among local government elected councillors serving on highways/transport committees. In particular, whether this conforms to a biomedical model, which sees health impacts as largely those of pollution and casualties, or whether wider determinants of health are identified. The project will highlight any differences found in perspective by region or authority type.


The 1998 Transport White Paper, A New Deal for Transport: Better for Everyone, highlighted the importance of health and the need for changes in transport in order to improve health. Health can be conceptualised narrowly as treatment of sickness and injury, such as harm arising from transport pollution or road crashes. Conversly, health can also be conceptualised more broadly, so that its connections with transport are more substantive. For example, to include the health protective function of physical activity and its role in enabling social support networks to function.

Local authority elected councillors are responsible for key decision making in transport planning. Their conceptualisations of health can determine whether the health promotion potential within Government transport policy initiatives is grasped at the local level.

The project provides an opportunity to map a country-wide overview of such key decision-makers' perspectives, highlight any regional variations or differences by authority type, and what this may mean for the presentation of future transport policies and initiatives.


University of Westminster
Transport Studies Group, 35 Marylebone Road, London, NW1 5LS
+44 (0)20 7911 5073

Contract details

Cost to the Department: £24,100.00

Actual start date: 01 December 2002

Actual completion date: 10 November 2003


An exploration of concepts of health held by highways/transport Cabinet Members/Councillors in England
Author: Dr Adrian Davis
Publication date: 01/10/2003

Summary of results

  1. The objective of this study has been to assess how health is conceptualised among local government highways/transport Cabinet Members/Committee Councillors. In particular, it has sought to assess whether this conceptualisation conforms to a biomedical model, which sees health impacts as largely those of pollution and casualties, or whether wider determinants of health are identified. Wider determinants include the health protective value of physical activity, and the importance of streets as places where social support and social capital can be developed and sustained. The perspectives of local government highway committee Chairs is critical in the delivery of central Government transport policy initiatives. Hence, a better understanding of their conceptualisations of health, and so its perceived relevance in local transport planning, should help identify barriers or opportunities in progressing Government transport policies.

    A literature review of lay concepts of health identified various ways in which lay people, that is, those other than health professionals, conceptualise health. While it is likely that lay beliefs are to a greater or lesser extent imbued with some expert knowledge because of direct contact with health professionals and through the media, an important determinant is socio-economic status or class. Income and education enables people to more readily conceive of health in a positive and holistic way. In contrast, poorer individuals may perceive health in a more restricted way as the ability to function and the absence of ill-health. Other determinants such as ethnicity, age and gender also have an influence on lay concepts of health.

    Primary data has been gathered through a postal questionnaire and telephone interviews. The former revealed that when highway committee Chairs think of health at the individual level they most readily think of mental well-being, physical fitness, and absence of ill-health. Telephone interviews revealed a link between mental well-being and stress when related to transport.

    Most respondents think that transport has a responsibility to promote health and a majority also take health-related issues into account when considering their highway authority's programme of works. The main issues are:
     Accidents and safety concerns
     Air pollution and air quality
     Walking and cycling
     Access issues
     Stress.

    Of these, accidents are clearly considered the most important, with air pollution and air quality, walking and cycling, ranked similarly but some way below that of accidents. There was a clear focus in the postal questionnaire on inner city/town centres as the geographic areas where transport-related health issues are most likely to be located. However, telephone interviewees gave significant attention to access issues in rural areas.

    The 1998 Integrated Transport White Paper was seen as marginally influential in how highway committee Chairs think about transport and health-related issues, although London Borough Chairs were least influenced. Telephone interviews suggested that there was a perception of a lack of resolve to deliver on the objectives set out in the White Paper which could have health-related benefits.

    Health-related issues are perceived by the majority of highway committee Chairs as having become more significant in transport planning within local government since 1998. Specific issues identified were:
     Road traffic accidents
     Walking
     Air quality
     Cycling.

    Telephone interviewees also discussed the issue of rising levels of overweight and obesity in England, and whether transport and transport policy had an influence or effect. Most felt that it did contribute to this problem. If reflected among highway committee Chairs across the country this concern about transport's influence on weight gain in the population could act to encourage greater efforts to be focused on increasing physically active transport options.

    In summary, this research has identified that highway committee Chairs believe that transport planning has a responsibility to promote health. Key issues span both traditional areas of health-related transport such as road traffic accidents and pollution but also include the health promotive issues of walking and cycling. Further encouragement and financial support from DfT for programmes of work that either directly or indirectly address health-related transport issues are viewed as important by many highway committee Chairs.