Sickness and inequality

traffic and air pollutionMillions of people lead unhealthy, unfair lives because of danger and pollution from road traffic. The United Nations has recognised that those who are worst hit are often the most vulnerable, including the poorest people, as well as people who are disabled, elderly, and women and children. 

Traffic causes killer diseases as well as casualties

Respiratory disease due to outdoor air pollution, including significantly from vehicle exhaust emissions, is estimated to lead to the early deaths of more than three million people globally annually1. Diseases include stroke, heart disease, lung cancer, and both chronic and acute respiratory diseases such as asthma.

About nine in ten of these premature deaths occur in low- and middle-income countries, with the greatest number currently in south east Asia due to rapid industrialisation, including use of motorised vehicles1

There are a number of different pollutants in vehicle exhaust emissions. Read our quick guide to vehicle exhaust pollutants>

Exclusion of the poor and vulnerable

Cities with congested roads, under-investment in public transport systems, and lack of segregated paths for people on foot and bicycles, are particularly prejudicial against people with the lowest incomes, and other vulnerable people including children and the disabled. People in need find themselves instead stranded, with no affordable or efficient way to reach jobs, schools or other facilities without risk to health or life.

Across the poorest nations, roads to outlying rural areas are being paved rapidly to open up trade (enabling transportation of agricultural produce and minerals in particular) and also to help alleviate poverty by improving access to emergency services, healthcare, jobs, education, power and the internet. In China, the percentage of paved roads rose from 25% to 61% of total roads in the ten years to 2010.4 However, there are major downsides to this development. Larger, faster roads means casualties (often without adequate emergency services in place to care for these casualties), pollution and dangerous journeys for people on foot and bicycles. 

Fast roads divide and destroy small rural communities. In 2015 the BBC reported that Peddakunta, a village in India, has been dubbed the “village of highway widows” because nearly all its male adults had died trying to cross the four-lane National Highway 44 that has split the village in two. In Africa, large highways in cities have also caused carnage, such as the Nairobi to Mombassa highway in the Kenyan capital, which has extensive casualties and also suffers from congestion at the Mombassa end, with lorries stretching for miles. 

Across the globe, many children have to make arduous and dangerous journeys to reach their schools because of lack of public transport, foot paths and cycle paths.


Parents who are wealthy enough to transport their children by car often choose to do so if there are no safe alternatives and they are fearful that their child will be killed walking or cycling.

Consequently, many of the world's richer children do not have the opportunity to undertake the normal daily minimum exercise of walking or cycling that people need to maintain reasonable fitness. They may even be forbidden from playing in their neighbourhood or visiting their friends due to fear of traffic. 

Obesity, diabetes, and other conditions caused by reduced activity are on the rise. Every year, about three million people die from illnesses relating to being overweight5

Take action 

Get involved in our Vision Zero campaign for a world of safe, sustainable, healthy and fair transport.  Vision Zero campaign>

Learn more 

Learn more about the three crises on our roads>





1World Health Organisation, 'Fact Sheet no. 313' 
2United Nations Environment programme, 'Pollutants: particulate matter' 
3VCA, 'Cars and Air Pollution'
4Transportation Research Circular, The Promise of Rural Roads 2012
5World Health Organisation, Global Health Observatory data, 'Obesity'