A justice perspective on transport and health

This chapter presents a justice perspective to transport and health. It is well understood that the health benefits and burdens related to transport are not distributed evenly over the population. This holds for exposure to transport-related air pollution, for traffic risks, for access to healthy foods, for opportunities for active travel, and so on. Empirical studies often equate disparities with inequalities and inequalities with inequities. These terms, however, have a distinct meaning. The terms differences, disparities, and inequalities are in its essence descriptive terms. The terms inequities and injustices, in turn, imply a normative judgment of these differences. In this chapter, three possible perspectives on justice in health are briefly discussed. It is proposed that the just health framework developed by Norman Daniels is the most suitable perspective for a discussion on transport and health. Daniels argues that a health inequality “is unjust when it results from an unjust distribution of the socially controllable determinants of population health.” This perspective clarifies, first, that virtually all transport and health literature focuses on the social determinants of health and, second, that the analysis of the unjust disparities in these social determinants should be an essential part of the literature on justice and health. This chapter continues to explore what an “unjust distribution” may mean for three distinct social determinants of health: transport-related air pollution, traffic risk, and opportunities for active travel. This exploration underscores that a justice approach to transport and health goes beyond the mere mapping of disparities and suggests that, in some cases, some level of disparity may well be in line with requirements of justice. This chapter ends with a call on researchers of transport and health to more explicitly engage with notions of justice than is currently the case.