We focus on four complex health issues more prevalent in urban areas
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Health effects of air pollution
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Our Programme Director, Kate Langford, explores the fairness and effectiveness of the ULEZ expansion in London.
Some of my neighbours aren’t happy.
I know because one of the unexpected joys of working from home has been getting to know them better.
I’ve heard arguments about whether it’s ok to use cones to save parking spaces outside (it’s not) and speculation about who the street’s fly-tipper could be.
But recently the ‘word on the street’ has turned to the ultra low emission zone (ULEZ), which expands across London, including our neighbourhood, this month.
As a public health geek, for me the benefits of the ULEZ expansion are clear, but I want to answer my neighbours’ questions. And the key question is “how is this fair?”. “It’s a tax on people like us”, they say.
The short answer is no. While the ULEZ expansion might feel unfair, it’s actually addressing an existing injustice.
City residents have no choice about the quality of air they breathe every day. And the people whose health is most affected contribute the least to air pollution.
There are no safe levels of air pollution and poor air quality is the single greatest external threat to human health. In London air pollution kills 4,000 people every year and research shows links between just one pollutant in our air and numerous cancers. Increasingly, we’re learning how exposure is linked to reduced cognitive function and even to Alzheimer’s.
I live off one of London’s main truck roads. In 2019, air pollution here broke the legal limit for nitrogen dioxide (NO2). And this pattern is repeated across the city: most Londoners are affected by air pollution but the areas with the highest levels are almost always neighbourhoods near main roads.
One-third of the air pollution in my area comes from road transport. Yet car ownership levels here are some of the lowest in the country – under 40% of households own a car, compared to 80% nationally. And this pattern is repeatedly nationally. Research shows it’s cars from the wealthiest households that contribute the most to transport related pollution. If there is a scale for fairness, it’s very much unbalanced: the choices of wealthier people are having profound effects on the health of others.
“ While the ULEZ expansion might feel unfair, it’s actually addressing an existing injustice.
While the ULEZ expansion might feel unfair, it’s actually addressing an existing injustice.
Yes. The current ULEZ, which covers central London, has almost halved the levels of nitrogen dioxide (NO2). Research suggests the expansion will reduce the air pollution difference between most and least deprived areas by 71% by 2030.
Meanwhile, modelling suggests the extended ULEZ could avoid almost 300,000 cases of air-quality related disease London-wide, by 2050. Also, it could prevent over a million hospital admissions. These numbers can feel abstract but imagine the impact that asthma can have on just one child.
We have a history in this country of bold, ambitious public health laws. These not only improve health but change what we view as acceptable. The ban on indoor smoking has had enormous health benefits, including reductions in strokes and heart attacks. The ban also made us realise just how horrible it had been to sit in a pub or restaurant surrounded by poisonous air, just to benefit a few smokers. The ULEZ could do the same for air in our outdoor spaces.
It’s important the ULEZ is introduced fairly. The Mayor of London has begun to do this through scrappage schemes, which give people money to scrap non-ULEZ compliant vehicles. But these schemes are underfunded and under huge demand. We need action from central government to ease the transition away from the most polluting vehicles.
And we need action from manufacturers. The expansion of the ULEZ sends a message to manufacturers that selling polluting vehicles is no longer an option and they need to respond to demand for cheaper, healthy vehicles. That will mean less traffic-related pollution for people in our cities and drivers no longer having to choose between convenience and clean air. Which, my neighbours agree, seems fair.
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