Transport and public health in China: the road to a healthy future

Abstract

Transportation-related risk factors are a major source of morbidity and mortality in China, where the expansion of road networks and surges in personal vehicle ownership are having profound effects on public health. Road traffic injuries and fatalities have increased alongside increased use of motorised transport in China, and accident injury risk is aggravated by inadequate emergency response systems and trauma care. National air quality standards and emission control technologies are having a positive effect on air quality, but persistent air pollution is increasingly attributable to a growing and outdated vehicle fleet and to famously congested roads. Urban design favours motorised transport, and physical activity and its associated health benefits are hindered by poor urban infrastructure. Transport emissions of greenhouse gases contribute substantially to regional and global climate change, which compound public health risks from multiple factors. Despite these complex challenges, technological advances and innovations in planning and policy stand to make China a leader in sustainable, healthy transportation.

Figure 1

Disease burden of road injuries for several countries, 1990–2015 as (A) DALYs per 100,000, and (B) proportion of total DALYs.

Figure 2

Traffic accidents, injuries and fatalities in China, 1970–2015.^{, , ,}

Figure 3

Road injury mortality rate by province in 2005, 2010 and 2015.^{, ,}

Figure 4

Age-specific road injury mortality from death registration data for rural female, rural male, urban female and urban male, 2014.

Figure 5

Police-reported traffic fatalities by road use type from 2001 to 2015. ‘Other’ refers to other motorized and non-motorized vehicles (e.g., animal-drawn; farm vehicles; etc.).

Figure 6

Relative change in transportation air pollutant emissions from passenger cars and trucks between 1980 and 2014. The relative change is the annual change in million tons (Mt) emitted by passenger vehicles and trucks combined as a fraction of baseline 1980 emissions for CO, HC (VOC), NO_x, and PM, which were 1.7, 0.2, 0.5, and 0.1 Mt, respectively.