World Health Day

In France, air pollution is responsible for around 40,000 premature deaths per year.¹ Road traffic is one of the main sources of this pollution. According to the non-governmental organisation CITEPA, road traffic is the leading emitter of air pollutants, in particular nitrogen oxide, fine particulate matter (PM2.5) and carbon dioxide.² These emissions affect the respiratory tract, damage the cardiovascular system and are behind an increased risk of asthma, chronic bronchitis and heart disease.

This concentration of pollutants is particularly evident in large urban areas, where traffic density is highest. Paris and Lyon remain the only two French cities that regularly exceed the regulatory air quality standards for NO₂.³

In these circumstances, one solution is to reduce the dependence on private cars. Developing dense and efficient public transport networks helps to reduce the number of vehicles on the road and, consequently, the associated emissions.

Some cities have begun this transition with gradual steps. Bordeaux recently launched two new tram lines on its TBM network to connect outlying areas with the city centre without relying on a car; these have helped reduce traffic on several major thoroughfares.

After air pollution, noise pollution is the next biggest environmental risk to health in Europe, according to the European Environment Agency (EEA). Around 113 million Europeans are exposed over the long term to noise levels of at least 55 decibels caused by road traffic.⁴

This prolonged exposure is not without its consequences. The EEA estimates that it causes 12,000 premature deaths and 48,000 new cases of ischaemic heart disease in Europe each year.⁴ In France, a report by France's Environment and Energy Management Agency (ADEME) estimates the social cost of noise pollution at €147 billion per year, taking into account associated health conditions, sleep disturbances and lost productivity.⁵ Replacing a lot of cars with fewer public transport vehicles contributes to reducing overall noise levels in urban areas, to the benefit of local inhabitants.

But another difference lies in the actual travelling experience. Whereas driving requires constant awareness, public transport allows passengers to switch off and use that time for other activities: reading, listening to music or simply relaxing.

Although the WHO recommends that adults engage in at least 150 minutes of moderate physical activity per week, nearly a third of the world’s adult population (1.8 billion people) does not meet this minimum threshold.6

In France, the situation is particularly worrying: 40% of women and 24% of men are considered inactive due to their sedentary lifestyles.⁷ This has direct implications: an increase in the prevalence of type 2 diabetes, obesity and cardiovascular disease.

To help address these issues, everyday mobility is an often-overlooked opportunity. Almost all journeys by public transport involve some walking, and up to 90% of passengers walk to their stop or station. These walking segments (getting to the stop, changing lines, and leaving the stop or station) can account for up to half of the total journey time. Public transport users therefore get an average of 27 minutes of physical activity per day as part of their journeys, compared with just 8 minutes for motorists.⁸ Taking the bus or tram is therefore a way of reintroducing exercise into a daily routine.

Active transport also produces measurable benefits: cycling prevents nearly 2,000 deaths and 6,000 cases of chronic illness each year, and every kilometre cycled saves around one euro in social healthcare costs.⁹ Nationwide, this equates to €4.8 billion of savings each year, a figure that could double if, additionally, 25% of short car journeys were replaced by walking or cycling.

Daily commutes affect more than just physical health: they also have an impact on mental well-being. With stress, fatigue and sometimes a sense of insecurity, certain journeys can become sources of tension, particularly when they are long, unpredictable or unavoidable.

In France, 41% of people who have experienced depressive symptoms believe that their travel difficulties were a contributing factor.¹⁰ Conversely, journeys that are smoother, easier to navigate and less stressful can have a positive impact. They provide moments of respite during the day, allow the mind to relax and, more broadly, contribute to a better daily balance. Regular users of public transport thus develop a greater ability to adapt to the unexpected, which help to reduce their stress levels.

Changing how we get around is therefore not merely a practical choice, but also a way of discreetly but surely improving our well-being, Every choice to do with transport is, by extension, a choice that affects public health. And in this respect, public transport is one of the most effective solutions on the scale of a city.