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.

 
 
 
 

A warped mirror: on gentrification and deprivation on London’s Caledonian Road

The London Overground crosses Caledonian Road. Image: Claude Lynch.

Capital cities are, more often than not, a focal point for the stark divide between rich and poor – places where the most economically deprived meet the most economically empowered. In London, these divides can be more than stark: they can be close, even intimate, and there are districts where crossing the street can be like entering a different world. One such street is the Caledonian Road.

Known local as “the Cally”, Caledonian Road runs for about a mile and a half, from Kings Cross to the Nags Head junction in Holloway, and was built in 1826 to provide a new arterial route to the north from the West End. At first, developments on the road were sparse; among the first notable buildings were the Royal Caledonian Asylum, which gave the road its name, and H.M. Prison Pentonville.

For some time, the northern half of the road was seen as far removed from central London, which stymied development. It wasn’t until the latter half of the 19th century residential development really got going. By the time Caledonian Road station opened on the Piccadilly line in 1906, the area was flush with Victorian terraces.

These, though, mainly lay on the eastern side. To the west, the proximity of King’s Cross prompted the development of heavy industry, particularly the clay kilns that were helping to build Victorian London proper. The divide had begun:  the east side of the street, the area known as Barnsbury, was notably quieter and calmer than the west side. Ever since the 19th century, the ‘V’ formed by Caledonian Road and York Way has been known for a high incidence of gang violence and social problems.

As in many parts of London, the end of the Second World War brought a chance to start from scratch. Many of the slums to the west of the Cally had been bombed to smithereens, and those that remained still lacked gas and hot water.

But this was the era of municipal dreams: Islington council cleared the slums and constructed the Bemerton Estate. Instead of reflecting the industrial history of the area, the estate reflected Barnsbury back at itself, treating Caledonian Road as some sort of warped modernist mirror. The square gardens of Barnsbury were reimagined as the spaces between the highrises of Bemerton, and this time, they were actually square.

The estate was immediately popular, its open design prompting a renewed sense of community in the west. But it didn’t last.

Square gardens on one side, not-so-square on the other. Image: Google Maps/CityMetric

As far back as the 1950s, Islington had already become synonymous with gentrification. Forty years later, before moving to Downing Street, Tony Blair’s London residence was Barnsbury’s leafy Richmond Crescent. House prices in the area have gone through the roof and now Barnsbury is mainly home to a the professional elite.


At the same time, though, Caledonian Road’s warped mirror has given Bemerton the exact opposite: in spite of attempts to rejuvenate it, downward spiral of deprivation and antisocial behaviour have blighted the estate for some time The promise of inviting square gardens and communal living has been inhibited by crime and poverty; the gardens lie empty, while those in Barnsbury thrive.

The disparity of wealth across Caledonian Road is regrettable. That’s not just because it speaks to a wider segregation of London’s rich and poor – a phenomenon exemplified last year by the Grenfell Tower fire in Kensington & Chelsea, the richest borough in Britain. It’s also because, in the Bemerton Estate, planners had thought they saw an opportunity to offer more Londoners the idyll of square gardens and leafy streets, often reserved for the richest.

It might be too much to claim the estate as a failure; events such as the Cally Festival aim to bring together both sides of the road, while other council programmes such as Islington Reads help to foster a greater sense of neighbourhood.

Road should never divide us; rather, they should unite those who live on either side. The spirit of Caledonian Road should cross the gap – just like the railway bridge that bears its name.