When friends from my home town of Miami visit Edinburgh, where I now live, one thing they always remark on is the quality of life here. Sure, Miami has more sunny days, a mild winter, South Beach and Lionel Messi, but it is practically impossible to get around there without a car. Compare this with Edinburgh, where you can walk, cycle, or take the bus or tram. Travel is free on public buses for under 22s, and while low-traffic neighbourhood (LTN) schemes aren’t perfect, the council is rolling them out in the pursuit of a vibrant, active city. Edinburgh’s commitment to pedestrians is not about banning cars, but about making it cheaper and simpler to replace short-distance single occupancy journeys with alternatives that have far-reaching benefits for the city’s inhabitants and the planet. It’s about making it easier to get to school, work or the city centre without relying on a car. Even so, Edinburgh is far behind other major “active” European cities. It only takes a visit to Amsterdam, Paris, Oslo, Barcelona or Copenhagen to see the huge policy efforts made to create cities that are easy and safe to navigate – and where six-lane highways jammed up with cars stuck at 5mph just don’t exist. Miami, by contrast, has taken the approach of increasing lanes on highways, where people sit in traffic for hours trying to get across town. Unfortunately in Britain, progressive moves towards better designed cities have been hijacked by debates on ultra-low emission zones (Ulez) and LTNs, and jargon such as modal filters, which provoke increasing amounts of rage in certain quarters. Prime minister Rishi Sunak has taken aim at these green policies, no doubt believing that this could be one way to attract votes in the nearing general election. But as jargon and acronyms dominate the headlines, I wish political point scoring could be replaced with a real conversation about what a “healthier city” could look like: better public transport, safer streets for women, less traffic, accessible walking and cycling, and replacing some car journeys with other options. Many of the arguments (and counter-arguments) made for reducing cars have centred on the environment. But the real reason that cities such as Amsterdam adopted a less car-centric approach in the mid-20th century had to do with a more immediate concern: children being killed by speeding cars. In 1971, more than 400 Dutch children died in traffic accidents. It was a parent group, Stop de Kindermoord (stop the child murder), angered by the large number of deaths that forced politicians to rethink the design of once car-dominated cities in favour of more inclusive urban planning. In 2021, 17 children across the Netherlands were killed in traffic accidents. Measures such as reducing speed limits to 20mph have been shown to work in reducing severe injuries and deaths from cars. In Edinburgh, road deaths dropped by 23% and serious injuries fell by 33% a year after its 20mph speed restriction was introduced. Despite this, UK ministers are reportedly considering plans to limit councils’ powers to impose 20mph speed zones as part of a wider crackdown on “anti-motorist” policies. There is a balance to be found between people getting to where they need to go in reasonable time and a safe travel speed. But “anti-motorist” policies aren’t the real cause of traffic slowing down. There are simply too many cars on the road, resulting in jams and standstill traffic, and the obvious solution is to provide alternative, affordable options. Paris, Amsterdam and Barcelona have all focused on cycling, which has the additional benefit of increasing physical activity in the population. Paris mayor Anne Hidalgo has committed to making the city “100% cyclable” through new segregated bike lanes, integration of bike networks, more bike parking and better routes to link the suburbs and the main city. As 90% of the Netherlands’ population are regular cyclists, it is no surprise that the Dutch are the most physically active population in the world. Getting people moving should be of the utmost priority for public health authorities, given that sedentary behaviour is a major risk factor for chronic disease such as diabetes, high blood pressure, cancer, heart disease and stroke. Exercise also contributes at a cellular level to better mental health. The biggest risk to pedestrians and cyclists is car drivers and other motorists, and having to navigate busy streets and junctions where the risk of getting injured is high. But elsewhere, these problems have already been addressed. In Amsterdam, Munich and Paris (to name a few cities), physically separate cycle lanes segregate cyclists from dangerous situations. Research shows that if these are built, people then use them. Bike use goes up, car usage goes down and physical activity within the population increases. The design challenge for cities is to build movement into daily life so that it becomes practical, invisible, economical and social. But it requires political leadership to make bold decisions in the face of lobbying by the car industry and motorists, along with investment in the proper infrastructure to ensure cyclists can complete their daily journeys as easily as possible. Rising air pollution in cities from motor vehicles is implicated in rising rates of asthma attacks, chronic coughs, heart attacks, strokes, lung cancer and dementia. Hundreds of doctors in London have written to the mayor Sadiq Khan about the health benefits of reducing car use within the city and the dangers of high levels of air pollution to their patients. One consultant in respiratory medicine, Dr Laura Jane Smith said: “My parents ask me why their breathing is so bad when they do all the right things – stop smoking, exercise, and eat well. The answer is air pollution.” These are the kinds of debates we should be having: about what kind of cities we want to live in. Instead, politicians are taking aim at Ulez and LTNs – terms that will be meaningless to many – to stoke up political support. One of the best parts of living in Edinburgh is witnessing its gradual transformation into a “healthier city”. We have a long way to go to catch up with European cities leading the charge, but the improvements in quality of life for those of us who live here should be held up as a shining example of what is possible for all of us with the right political will: longer, healthier and happier lives. Prof Devi Sridhar is chair of global public health at the University of Edinburgh