Why better bus services matter for health and equality

Dr Karen Conduit-Turner, Public Health Registrar at NHS Tayside joined Public Health Scotland (PHS) for 10 months to work with the Public Health and Sustainable Transport Partnership. Here, she reflects on the importance of bus services for health in local communities.

Buses play a huge role in daily life across Scotland, yet for many people the transport options available simply do not support their wellbeing. Transport poverty is when transport options are not available, reliable, affordable, accessible or safe. This harms health. It limits opportunities by making it harder to reach essential services, stay connected and live healthy lives.

Buses make up 74% of all public transport journeys in Scotland, adding up to around a third of a billion journeys each year. They are especially important for people on low incomes, disabled people, young people and older adults. This is why we recently published “Why buses matter for health and reducing transport poverty”, a report that brings together research evidence, data on Scotland’s bus system and insights from stakeholders.

How buses support health

Buses help people reach all of life’s essentials like education, work, shops, healthcare and social activities. They reduce isolation by keeping people connected. Even the simple act of walking to and from the bus stop adds movement and exercise to daily routines.

When services don’t meet their needs, people feel cut off and excluded.

Our stakeholders all agreed that buses matter:

"Buses are an essential part of a sustainable transport system, helping address environmental issues and supporting the wellbeing of communities and individuals."

Alison Harley, Programme Manager, Climate Action Scotland

Where improvements are needed to reduce transport poverty and support better health and health equity

Stakeholders feedback and national data point to challenges in five areas.

Availability: Bus services and use have declined, with rural communities facing the biggest gaps.

Reliability: Congestion, roadworks and road layouts cause delays, leaving buses slower than car trips.

Affordability: Fares have risen faster than inflation. Many people who would benefit most from free bus travel are not eligible.

Accessibility: Disabled passengers still face barriers including physical access issues, difficulties with digital ticketing and poor bus stop design.

Safety: Although buses are safer than cars, concerns about antisocial behaviour and personal safety remain, especially after dark.

Stakeholders also highlighted the need to work together with stronger community engagement, better consideration of health in transport planning and improved access to healthcare through partnership working. Public Health Scotland will continue to support this through its work with the Public Health and Sustainable Transport Partnership.

‘We want to ensure that mental health and lived experience are at the heart of all transport service design’.
Mahdi Saki, Programme Development Officer, Mental Health Foundation

A fairer transport system for the future

Transport poverty is not inevitable. With coordinated action and investment in high quality bus services, Scotland can create a transport system that supports healthier lives, stronger communities and greater equality.

Read the full report here: Why buses matter for health and reducing transport poverty

Read more about transport poverty: Transport Poverty: a Public Health Issue

Find out about: Transport Scotland: Scottish Transport Statistics 2024

Read more about PHS’s recently published: Together we can: our 10-year strategy to 2035, which sets out a vision for people having fairer and faster access to care.

If you are interested in knowing more about health and transport, please join the Public Health and Sustainable Transport Learning Network by contacting: phs.healthyenvironments@phs.scot.