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Curl, A., & Kiddle, R. . Transport poverty in Aotearoa NZ: A healthy and sustainable transport system is needed. Public Health Expert Briefing. https://www.phcc.org.nz/briefing/transport-poverty-aotearoa-nz-healthy-and-sustainable-transport-system-needed

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Curl A, Kiddle R. Transport poverty in Aotearoa NZ: A healthy and sustainable transport system is needed. Public Health Expert Briefing. . https://www.phcc.org.nz/briefing/transport-poverty-aotearoa-nz-healthy-and-sustainable-transport-system-needed

Summary 

Transport poverty is an urgent public health issue in Aotearoa New Zealand (NZ), intensified by rising fuel price and cost of living pressures. Many households already spend a large proportion of their budgets on transport, and rising fuel costs mean people either absorb higher expenses or miss essential trips. 

Missed trips reduce opportunities to access healthcare, education, food, employment and social connections – key determinants of health. Absorbing increased fuel costs can force trade-offs such as cutting back on food or home heating, with well documented physical and mental health consequences. 

Central and local government investment in a healthy and sustainable transport system that reduces reliance on private vehicles will make us more resilient to fuel price increases. This can be achieved through urban planning, investment in walking, cycling and public transport infrastructure, and tailored rural mobility solutions. These approaches reduce health inequities associated with transport poverty, reduce exposure to fuel price shocks and support healthier communities. 

Recent hikes in petrol and diesel prices related to the ongoing conflict in the Middle East, along with existing cost-of-living pressures, are hitting household budgets hard. 

Transport costs already place a considerable burden on household budgets, with the average household in Aotearoa spending $252 per week, or 15.7% of all expenditure on transport costs.1 Our research shows that 75% of participants in low-income communities struggle to afford transport costs.2 This has likely risen in 2026, with fuel price increases placing extra burdens on household incomes. According to recent reports, on average, households are spending $65 a week extra on fuel.3

Our reliance on cars to get around means many people have little alternative but to absorb the increasing costs or to miss out on essential trips such as taking kids to school, attending health care appointments, or getting to work. Our recent research suggests those in peri-urban and rural areas are most exposed to fuel price increases, due to high car reliance, and limited capacity to adapt.4 Spending on transport is often at the expense of other essentials like food or home heating. Whether people miss trips or spend extra on transport, the impacts are harmful to health.  

Affordability of transport is one component of transport poverty.6,7 Recent work by Public Health Scotland outlines key ways that transport poverty contributes to poor health and health inequities:

  • Reducing opportunities for education, work, social contacts, leisure activities and nature, and buying affordable and nutritious food
  • Reducing access to health care services, which can delay diagnosis and treatment
  • Reduce opportunities for community engagement6 

Table 1 highlights examples of health and wellbeing impacts of missed or reduced travel due to high transport costs.

Table 1: Examples of health impacts of reduced travel due to high transport costs.

Domain of impactHealth impacts of missed trips
FoodPeople may skip trips to the supermarket.
Food prices have increased due to higher transport costs.8
Money may be spent on transport, instead of food.5
Reduced access to healthy food, leading to poor nutritional outcomes.9,10
Healthcare Transport costs are a common reason for missing appointments or being unable to access healthcare.11,12
Missed appointments and unmet need in healthcare impacting disease outcomes, quality and life and mortality rates through delayed diagnosis and treatment.11-14
Around 134,000 adults miss out on GP appointments a year due to transport issues.15
Maternity care is missed because of transport issues.16
Education There are suggestions that school attendance rates have dropped in response to rising fuel prices, especially where long distance travel is required.17,18
Social connection & leisure activitiesVisiting friends and relatives, or attending leisure activities with others, can often be seen as more optional trips, and may be most likely to be missed, with consequences of decreased community engagement and social isolation.10
EmploymentLack of transport can prevent people from entering or maintaining employment.19,20
Transport poverty is associated with unemployment and employment instability.21

When people continue to travel, rising transport costs may come at the expense of other essentials. Such trade-offs have consequences for health, such as the well-established poor health outcomes associated with being unable to heat the home. There are also direct mental health and wellbeing consequences associated with energy and transport poverty.22-25

Some people may be able to adapt and travel less or travel by a different mode of transport, and there may be health benefits associated with fuel price increases, where people are able to walk or cycle rather than drive.26 However, where walking and cycling happen in an unsafe environment, people may be exposed to harms from road traffic injuries or air pollution, another dimension of transport poverty.6

Solutions to transport poverty

The NZ Government’s response so far has been to provide relief payments of $50 per week to those receiving in-work tax credits. This is a short-term, reactive approach rather than one that addresses our high reliance on imported liquid fuel in the longer term and would reduce vulnerability to future shocks. The relief payments also exclude many of those most at risk of transport poverty, such as those out of work, students, and unpaid carers. 

To more fundamentally support those most at risk through the current situation, there needs to be a focus on longer-term solutions that reduce dependence on petrol and diesel. This will ultimately reduce the health risks associated with high reliance on private car use27 and reduce our exposure to health harms from global geo-political shocks to fuel prices. 

The most effective long-term solution is to reduce the need to travel in the first place. This requires urban planning and design that makes walking and cycling the natural choice, through intensification that shortens trip distances, mixed land uses that put services within reach, and streets designed to prioritise people over cars. Even in urban areas, many people have to travel long distances, and therefore often rely on a car to access basic services. For example, less than half of Christchurch residents live within a 10-minute walk of a GP.13 Cross-sector planning can support better accessibility to essential destinations such healthcare, supermarkets, playgrounds, and schools. Having shorter distances to travel can reduce the need to travel by car, making people less exposed to fuel price changes. 

Investment in safe walking and cycling infrastructure expands the realistic transport choices available to people, and ensures that when fuel price increases prompt a shift towards active travel, that shift occurs in safer conditions.28,29 Similarly public transport investment by both central and local government can support network expansion, service reliability and frequency, reducing reliance on private vehicles and reducing vulnerability to fuel price increases. 

In rural areas, it is hard to overcome the need to travel greater distances, making walking and cycling difficult and public transport harder to provide. Support for mobility initiatives such as community transport, demand responsive transport options or community car-pooling can help support people in rural communities. Other options include mobile services, such as libraries and healthcare, which can reduce the need to travel. 

Alongside reducing vulnerability to fuel price increases, the solutions outlined here are beneficial to human health and the environment. Reducing car reliance benefits health in multiple ways. 

What this Briefing adds 

  • Transport poverty is widespread and restricts access to determinants of health, including healthcare, food, education, employment and social connections. 
  • Fuel price increases exacerbate transport poverty, increasing unmet health needs.  
  • Paying more for fuel means less spending on other items, such as food and home heating, which is harmful to health.
  • Reducing reliance on private vehicles strengthens resilience to fuel price shocks while delivering cobenefits for human and environmental health.

Implication for policy and practice 

  • Short-term relief payments provide temporary support but do not address the structural drivers of transport poverty and exclude many of the people most affected by fuel cost rises.
  • Resilience to fuel cost shocks demands a deliberate shift away from private vehicle dependency, a reduction in the need to travel, and sustained investment in low-carbon transport alternatives.
  • Building a healthy and sustainable transport system widens opportunities, reduces health inequities and protects communities from global fuel price volatility.

 

Authors details 

Assoc Prof Angela Curl, Department of Public Health, Faculty of Medicine, University of Otago, Christchurch | Ōtākou Whakaihu Waka, Ōtautahi

Dr Rebecca Kiddle, Spatial Justice Aotearoa.

Creative commons

Public Health Expert Briefing (ISSN 2816-1203)

References

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Public health expert commentary and analysis on the challenges facing Aotearoa New Zealand and evidence-based solutions.

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