Transport has always shaped health. What is changing is the strength of the evidence, and the urgency of using it earlier in decision making.

That was the central message from a recent Bradford case study visit organised by CIHT, ‘Transport Routes to Better Health,’ which brought transport professionals face-to-face with public health researchers working at City Scale. The message was simple: by the time a scheme reaches detailed design, many of the biggest health gains (or harms) have already been locked in.

Professor Rosie McEachan, Director of the Born in Bradford (BiB) research programme and the Healthy Urban Places consortium, has spent more than 15 years examining how the urban environment influences long-term health. While not a transport project in name, much of BiB’s work sits squarely at the transport–health interface, particularly around traffic-related air pollution and inequality.

Bradford’s Clean Air Zone (CAZ) has become a key example. Collaborating closely with the local authority, Professor McEachan’s team helped ensure the scheme was both ambitious on air quality and sensitive to the needs of lower-income residents. Early findings suggest measurable improvements in respiratory health, with fewer GP visits and hospital attendances for breathing problems. That reduction in avoidable illness is already estimated to be saving the local NHS around £30,000 a month.

For Professor McEachan, the significance is clear: “You might not immediately think transport infrastructure is a key driver of health, but it absolutely is.”

Wellbeing and reduced inequality

Beyond emissions, she describes transport as a “fundamental enabler” of long-term wellbeing, particularly for young people. Reliable, affordable public transport affects access to education, jobs and social networks, all strongly linked to lifetime health outcomes and reduced inequality.

The challenge is timing. Health evidence often enters the conversation too late, once objectives, funding envelopes and design principles are already fixed. Professor McEachan argues that health needs to be explicit in the earliest stages of policy, from white papers to business cases. Her team is now working to embed health outcomes into the case for major regeneration and rail investment in Bradford, ensuring benefits such as reduced inequalities and improved wellbeing sit alongside passenger numbers and economic growth.

Professor Adrian Davis of Edinburgh Napier University, a public health doctor who has based himself and his research in the transport sector to break down siloes, has been building the evidence base linking mobility, physical activity and chronic disease for decades. He stresses that transport decisions influence far more than road safety and air quality. 

“We were designed to be physically active,” he says, noting that inactivity linked to car dependence contributes to cardiovascular disease, a leading cause of premature death in the UK.

Yet Professor Davis acknowledges that planners and public health professionals still often operate in parallel worlds. Different professional languages, funding structures and political timescales can all function as barriers. The solution, he argues, lies in closer working relationships and better translation of evidence into practice. 

“If you want to change the world and make it a better place, you have to get the best available science to practitioners,” he says.

Both see Bradford as a glimpse of a more joined-up model: multidisciplinary teams, shared data and trusted relationships between researchers, planners and public health leads.

Crucially, Professor McEachan emphasises that this approach is not unique to one city. With long-term data, strong partnerships and a commitment to embedding health in decision-making, she believes other places can adopt similar models and start building healthier transport systems from the ground up. 

Read more: Making the case for investment in active travel policy brief.

Image: aerial view of the West Yorkshire town of Bradford. Credit: Shutterstock.