Driverless cars could be better for our health – but they could be a lot, lot worse

A driverless car in California, 2015. Image: Getty.

Driverless cars – autonomous vehicles – are coming. The topic is a constant presence in media; The New York Times Magazine recently devoted most of an issue to it.

The technological imperative is strong: if we have the technology, we have to use it. The economic imperative is even stronger. Many industries see big dollar signs. Governments want to be somewhat cautious, but they don’t want to be left behind.

The sales pitches are becoming clear: driverless cars will free drivers to do other things; driverless cars will reduce congestion because they can travel closer together; driverless cars will create massive economic opportunities.

We are also told driverless cars will be much safer, because human error causes more than 90 per cent of crashes.

Understanding how cars affect our health

Human-operated cars affect health in three main ways, all negatively. How might driverless cars be healthier?

First, car crashes killed around 1.25m people worldwide in 2015. The claims that driverless cars will kill fewer people are credible, but unproven.

Safety improvements will depend on the technology in the cars, which is currently being developed and tested. Safety also depends on how the surrounding environments are engineered or re-engineered to keep people and things from darting in front of driverless cars.

Second, cars kill people by creating pollution. Cars with internal combustion engines produce gases and particulates, which cause lung disease. Motor vehicles are also one of the biggest sources of carbon dioxide worldwide, which causes climate change.

The polluting effects of electric cars depend on how the electricity they use is generated. Thus, the pollution-related benefits of driverless cars depend on the mix of petroleum-powered versus electric-powered vehicles.

This mix is difficult to predict and likely to differ by country. The pollution effects of driverless cars will also depend on whether they travel more or fewer total kilometres than today’s cars.

Third, cars kill people because we sit while we drive, reducing healthier modes of transport like walking, cycling, or even taking public transport. Public transport is a healthy mode of travel because people generally have to walk or cycle to, from and between stops and stations.

Little physical activity and too much sitting independently contributes to the chronic diseases that kill most people in the world. Those diseases are usually heart diseases, strokes, multiple cancers, and diabetes.

Driverless cars will do nothing to reduce the effects of cars on chronic diseases unless they are introduced in a way that reduces the time people spend sitting in cars.

More than 90 per cent of the negative health impacts of cars result from the effects on physical activity, sitting, and chronic disease.

For example, modelling found that if 10 per cent of motorised transport in Melbourne was shifted to walking or cycling, improvements in disability-adjusted life-years for every 100,000 people (an indicator of quantity and quality of life) would be -34 (worse) for road trauma (mainly because cyclists might not be protected from cars), +2 for lung diseases, and +708 for the combination of heart diseases and type 2 diabetes.

Models for five other cities (Boston, Copenhagen, Delhi, London and Sao Paulo) supported the same conclusion.

Virtually all of the health impacts of cars are due to increasing risks for very common chronic diseases. Therefore it will not matter if people are sitting in driverless or people-driven cars.

One of the implications of these findings is that the people planning for driverless cars should explicitly consider the health consequences of driverless cars. Injuries from crashes and air pollution are routinely considered in transportation planning, but impacts on physical activity and chronic diseases are not.

Transportation planning goals and methods need to incorporate chronic disease impacts generally, but especially when planning a major disruption like accommodating driverless cars. Ideally, public health professionals will be at the table as questions are asked and decisions are made.


What will the ‘car 2.0’ era look like?

It is completely unclear what a world with driverless cars will look like.

The driverless future depends mainly on who is making decisions about driverless cars, and the outcomes are likely to vary across countries. Most of the discussion so far has been about the technology’s ability to keep driverless cars from running into each other and people on the streets.

Automobile companies, including both legacy (like Ford and Mercedes-Benz) and new entrants (like Tesla and Amazon) will certainly be speaking up, with an eye to maximising their profits and speeding up the transition. But who will be responsible for looking out for the public good?

The biggest health impacts are likely to be based on how cities are changed to accommodate driverless cars. It is clear that designing cities to be optimal for “car 1.0” has been a long-term disaster for health and environmental sustainability. Roads designed to meet transportation goals of moving as many cars as fast as possible are dangerous and unpleasant for pedestrians and cyclists.

Suburban-style developments are based on the assumption that people will drive everywhere they go. But building low-density housing, the separation of residences from jobs and shops, and disconnected street networks enforce automobile dependency.

Urban design and land use policies that create these environments have become common worldwide and have been shown to have numerous physical (chronic diseases), mental (stress), and social (isolation) health problems.

People are just starting to brainstorm how cities may change for “car 2.0”. The range in visions is enormous, with equally large implications for health. I have heard of two contrasting visions that would have very different health effects.

One vision is that people will continue to own private cars, but they will be driverless. The cars drive the owner to work, then they either go park themselves nearby or go back home and wait in the garage until the end of the workday.

This would be a dream for car companies, because everyone would keep buying cars, and they would wear out faster because the cars might make two work roundtrips per day instead of one. This scenario would make traffic worse and would provide essentially no health benefits compared to car 1.0.

A second vision assumes that driverless cars would be considered as part of a broader concept of urban mobility that focuses on moving people instead of cars. The emphasis would be on active modes, with greatly improved access to public transport and corporate-owned shared driverless cars used as supplements to the other (healthier) modes.

There would be fewer cars, which would be in use most of the time, so the need for parking would be dramatically reduced.

Think about what could be done with the huge amounts of land now used for parking. Sidewalks could be widened, protected bicycle paths could be added to many streets, and linear parks could be created.

Parking lots and garages could be redeveloped into much more profitable people-oriented uses, revitalising cities and opening land for affordable housing. Cities would benefit from an increased tax base, allowing them to expand public transport. People would benefit by avoiding the huge costs of owning a car.

Which future will we choose?

The transition to driverless cars is an opportunity to create more walkable/bikeable/sustainable/liveable cities that provide a multitude of benefits for residents, businesses and governments.

However, we could waste the opportunity so that car 2.0 merely continues the mistakes and negative health and environmental consequences that car 1.0 has been delivering for the past century.

The critical difference lies in who is making the decisions and what the criteria for success are. Public health professionals should be among the decision-makers, because the consequences are too important to leave to engineers and corporate leaders.

The ConversationThe main criteria should deal with how to use driverless car technology to make people’s lives better and make our cities healthier, more liveable, and more sustainable – not to maximise profits.

Jim Sallis, Professorial Fellow, Mary MacKillop Institute for Health Research, Australian Catholic University; Emeritus Professor, Department of Family Medicine and Public Health, University of California, San Diego

This article was originally published on The Conversation. Read the original article.

 
 
 
 

In South Africa's cities, evictions are happening despite a national ban

An aerial view shows a destroyed house in Lawley, south of Johannesburg, on April 20, 2020. The city has been demolishing informal structures on vacant land despite a moratorium on evictions. (Marco Longari/AFP via Getty Images)

On the morning of 15 July, a South African High Court judge ruled that the city of Cape Town’s Anti-Land Invasion Unit had illegally evicted a man when it destroyed the shack where he was living.

That afternoon, the Anti-Land Invasion Unit was out again, removing shacks in another informal settlement.

Evictions were banned in South Africa for nine weeks, after the national government placed the country under a strict Covid-19 lockdown in late March. At present, eviction orders are automatically suspended until the country moves to a lower “alert level” and can only be carried out with a special order from a judge.

Yet major cities including Cape Town, Johannesburg and eThekwini (created through the merger of Durban with several surrounding communities), have continued to use municipal law enforcement agencies and private security companies to remove people from informal housing. In many cases those operations have been conducted without a court order – something required under regular South African law.

Around 900 people were evicted from three informal settlements in eThekwini during the eviction ban, according to the Church Land Programme, a local NGO. Its director, Graham Philpott, says it’s also aware of evictions in other informal settlements.

While evictions aren’t a “new experience” in these communities, the NGO released a report on lockdown evictions because they were “so explicitly illegal”. “There was a moratorium in place,” Philpott says, “and the local municipality acted quite flagrantly against it. There’s no confusion, there’s no doubt whatsoever, it is illegal. But it is part of a trend where the eThekwini municipality has acted illegally in evicting the poor from informal settlements.”

Evictions also took place in Cape Town and Johannesburg during so-called “hard lockdown” according to local activists. In eThekwini and other municipalities, the evictions have continued despite restrictions. In Cape Town, authorities pulled a naked man, Bulelani Qholani, from his shack. That incident, which was captured on video, drew condemnation from the national government and four members of the Anti-Land Invasion unit were suspended. 


The cities say they’re fighting “land invasions” – illegal occupations without permission from the land owner.

“Land invasions derail housing and service projects, lead to the pollution of waterways, severely prejudice deserving housing beneficiaries and cause property owners to lose their investments over night,” Cape Town’s executive mayor, Dan Plato said in a statement. (Plato has also claimed that Qholani did not live in the shack he was pulled from and that he disrobed when municipal authorities arrived.)

South African municipalities often claim that the shacks they destroy are unoccupied. 

If they were occupied, says Msawakhe Mayisela, a spokesman for the eThekwini municipality, the city would get a court order before conducting an eviction. “Everything we’re doing is within the ambit of the law,” Mayisela says. But “rogue elements” are taking advantage of Covid-19, he added.

“We fully understand that people are desperately in need of land, but the number of people that are flocking to the cities is too much, the city won’t be able to provide housing or accommodation for everyone overnight,” he says. 

While eThekwini claims to be a caring city, local activists say the evictions show otherwise.

In one case, 29 women were evicted from shacks during the hard lockdown. With nowhere to go, they slept in an open field and were arrested by the South African Police Service for violating the lockdown, Philpott says.

“These evictions are dehumanizing people whose dignity is already compromised in many ways,” says S’bu Zikode, the president of Abahlali baseMjondolo, a community organization whose Zulu name translates to “the people of the shacks”. 

“It has reminded us that we are the people that do not count in our society.”

Municipal law enforcement and private security contractors hired by cities regularly fire rubber bullets, or even live ammunition, at residents during evictions. Some 18 Abahlali baseMjondolo activists have been killed since the organization was founded in 2005, Zikode says, most by the eThekwini Land Invasion Unit and Metro Police.

(Mayisela says that if city employees have broken the law, Abahlali baseMjondolo can file a complaint with the police. “There is no conclusive evidence to the effect that our members have killed them,”  he says.)

Other Abahlali baseMjondolo activists have been killed by what Zikode calls “izinkabi,” hitmen hired by politicians. Two eThekwini city councillors were sentenced to life in prison 2016 after they organized the killing of Thuli Ndlovu, an Abahlali baseMjondolo organizer. A member of the Land Invasion Unit who is currently facing a charge of attempted murder after severely injuring a person during an eviction remains on the job, Zikode says.

South Africa’s 1996 constitution is intended to protect the public from arbitrary state violence and guarantees a right to housing, as well as due process in evictions. But for Zikode, the South African constitution is a “beautiful document on a shelf”.

“For the working class and the poor, it’s still difficult to have access to court. You’ve got to have money to get to court,” he says. 

The actions by municipal law enforcement are breaking down social trust, says Buhle Booi, a member of the Khayelitsha Community Action Network, a community group in the largest township in Cape Town.

“There’s a lack of police resources and those very few police resources that they have, they use to destroy people’s homes, to destroy people’s peace, rather than fighting crime, real criminal elements that we see in our society,” Booi says.

For him, it’s a continuation of the practices of the colonial and apartheid governments, pushing poor people, most of whom are Black, to the periphery of cities.

Around one-fifth of South Africa’s urban population live in shacks or informal dwellings, according to a 2018 report by SERI. Many more live in substandard housing. City governments maintain that the shacks destroyed during anti-land invasion operations are unfinished and unoccupied. But Edward Molopi, a research and advocacy officer at SERI, says that this claim is an attempt to escape their legal obligations to get a court order and to find alternative accommodation for affected people. 

The roots of the current eviction crisis go back to apartheid, which barred non-white people from living in cities. Between the 1940s and 1970s, tens of thousands of people were forcibly relocated from neighbourhoods like Johannesburg’s Sophiatown and Cape Town’s District Six to remote townships.

In the 26 years following the end of apartheid, deepening economic inequality and rampant unemployment have limited access to formal housing for millions of South Africans. Government housing programs have mostly focused on building small stand-alone homes, often on the peripheries of cities far from jobs and amenities.

While these well-intentioned projects have built millions of homes, they’ve failed to keep up with demand, says Marie Huchzermeyer, a professor at the Centre for Urbanism & Built Environment Studies at the University of the Witwatersrand in Johannesburg. Government-funded housing projects “will never on it’s own be enough,” she says. “It has to be accompanied by land release.”

Government policies call for the “upgrading” of informal settlements and the formalization of residents’ occupation. But “there are still very, very, very few projects” of that nature in South Africa, Huchzermeyer says. “Even if it’s an informal settlement that’s been around for 20 years, there still seems to be a political wish to punish people for having done that.” The government wants people to go through the formal process of being given a house, she says – and for them to be thankful to the government for providing it.

At the municipal level, change will require “real leadership around informal settlement upgrading and around ensuring that land is available for people to occupy,” she says. 

Despite the end of enforced racial segregation, spacial apartheid remains a factor in South Africa. There are few mixed-income neighbourhoods. Those who can afford to often live behind walls in sprawling low-density suburbs, while the poor live in overcrowded slums and apartment buildings.

The creation of the apartheid city “didn't happen by chance,” says Amira Osman, a professor of architecture at the Tshwane University of Technology. “It was a deliberate, structured approach to the design of the city. We need a deliberate, structured approach that will undo that.”

Since last fall, Johannesburg’s Inclusionary Housing Policy has required developments of 20 or more units to set aside 30% of those units for low-income housing.

The policy, which faced significant opposition from private developers, won’t lead to dramatic change, says Sarah Charlton, a professor at the Centre for Urbanism and Built Environment Studies, but it is “an important and significant step.”

Zikode isn’t optimistic that change will come for shack dwellers, however.

“People in the high positions of authority pretend that everything is normal,” he says. “They pretend that everyone is treated justly, they pretend that everyone has homes with running water, that everyone has a piece of land – and hide the truth and the lies of our democracy.”

Jacob Serebrin is a freelance journalist currently based in Johannesburg. Follow him on Twitter.