Cambodian Journalists Alliance Association

Op-Ed: Combating Car-Induced Public Health Crisis

Workers paint a new traffic line to divide Hun Sen Boulevard, commonly known as "60 meters," before adding a concrete median, following several traffic accidents. Photo taken on Jan. 24, 2025. (CamboJA/Pring Samrang)
Workers paint a new traffic line to divide Hun Sen Boulevard, commonly known as "60 meters," before adding a concrete median, following several traffic accidents. Photo taken on Jan. 24, 2025. (CamboJA/Pring Samrang)

There is growing alarm as Cambodia’s roadways continue to exact a tragic toll on its population. Recent high-profile crashes, including a crash which caused the death of Cambodian rapper RuthKo, have jolted public attention to the obstinate issue of traffic safety in the Kingdom. 

According to data compiled from reports by the National Road Safety Council, the new decade is experiencing a steady stream of traffic accidents and casualties. The number of accidents, fatalities, and injuries in 2022 and 2023 has quickly rebounded from a reprieve in 2021 due to Covid-19-induced travel restrictions, with 2024 continuing the grim trend.

In the first half of 2024 traffic accidents and casualties exceeded the same period in 2023, with 793 versus 756 fatalities and 2116 versus 2072 injuries (a 5% and 2% gain, respectively, compared to the same period in 2023). Although 2024 has experienced an overall decrease in casualties from traffic accidents, the number of deaths and injuries has not improved significantly compared to previous years.

The trend in traffic casualty data indicates that progress on this issue has stalled, despite widespread recognition of the problem and a recent surge in government and civil society efforts to reduce traffic accidents, primarily focusing on changing road users’ behavior.

Official efforts which are overly reliant on changing the behavior of drivers is not only costly and ineffective; it obfuscates the broader role the transportation system as a whole has in determining safety outcomes.

Cambodia’s faltering effort to stem the public health crisis caused by motor vehicles is not a unique predicament. Globally, countries which have taken a “treat the symptoms but not the cause” approach have failed. On the other hand, countries which have adopted a systematic approach have been more successful. 

Over-reliance heightens risk

The persistent issue of traffic safety in Cambodia corresponds to our over-reliance on private motor vehicles as the primary means of transport. And this is not a local issue; countries which rely heavily on private means of transportation generally experience an increase in traffic casualties.

A comparative study conducted in the United States highlighted commuting via motor vehicles as the most dangerous mode of transportation. From 2011 to 2021, the death rate per 100 million passenger miles for passenger vehicles was 20 times higher than for buses, and 17 times higher than for passenger trains.

A number of underlying factors shape the United States’ troublesome road safety context, including the country’s over-reliance on private transportation.  The data tell a concerning story: the US is experiencing a reversal in road safety with a road fatality rate per capita of 11.4 per 100,000 in 2020 an outlier amongst developed countries. The trendlines in the US are worrisome—2021 saw the most pedestrians killed in the US in 40 years, and deaths among those biking rose 44% from 2010 to 2020. 

Cambodia should consider the case study of the United States, including its dependence on private vehicles as a cautionary tale. We should reevaluate our approach to be sure we aren’t following in the footsteps of a country that is becoming more dangerous for all commuters. 

Cambodia should also be paying attention to overreliance on private vehicles for a different public health reason. The negative health impacts of cars are not limited to traffic deaths and injuries. Another malicious culprit is the exhaust of combustion engines, which has been linked to negative health outcomes by a growing body of research.

The Danger of Motor Vehicles Lies Beyond Collisons

Last year, UNICEF Cambodia released the country’s first Children’s Environmental Health Assessment, which found that nearly one in five deaths among Cambodian children is attributable to air pollution. With transportation determined as the primary source of air pollution, according to UNEP Cambodia.

Globally, there is increasing concern about the public impacts of traffic-related air pollution. A study published in the Annals of Internal Medicine demonstrated elevated blood pressure levels after only 2 hours of exposure to polluted air from rush hour traffic. 

The study’s primary author, Dr. Joel Kaufman, noted that participants were recorded to have heightened blood pressure of 5 ml of mercury, equivalent to someone with normal levels being pushed to elevated or from elevated levels to stage 1 hypertension.

The study, which controlled for other variables such as driving stress, pointed to fine particulates produced by combustion engines being closely linked to the blood pressure increase.

Furthermore, a long-term study examining links between exposure to air pollution in childhood and respiratory diseases in adulthood reiterated the long term health danger posed by constant exposure to vehicle exhaust.

Hence, motor vehicles are a menace to public well-being. Directly killing and maiming travelers and spewing pollution, resulting in long-term health consequences. 

When more commuters choose to drive—be it cars or motorcycles—the more risk they are exposed to. A 2022 study by Dr. Yat Yen examining the commuters’ behavior in Phnom Penh revealed a high level of motor vehicle dependency, with on average 80.6% of commuters utilizing motorbikes, three-wheelers, and cars for daily trips—the highest risk options.

This is why current efforts by government bodies and CSOs to enforce correct driving rules and encourage good driving behavior can never create enough positive impacts to reverse the trend. 

Learning From Successful Examples

To mitigate the public health burdens caused by motor vehicles, the most impactful solution is to reduce the number of motor vehicle trips taken. Fewer trips means fewer commuters are at risk and decreases overall transport-related pollution. Daily private motor vehicle trips should be substituted with safer and less polluting means of transportation, namely public transit and active commute options like walking and biking.

To see the extent to which this strategy can improve safety, we can examine the improved road safety in cities like Oslo, which induced a decline in the share of motor vehicles used in daily trips. This strategy has resulted in significantly reduced road deaths and injuries. 

Oslo’s authorities didn’t just rely on top-down enforcement to elicit behavior change. Instead, they took action to redesign large roadways and create dedicated bus lanes and bicycle lanes. They also designated more one-way streets, widened sidewalks, reduced speed limits, restricted vehicle traffic in the city’s center, and improved pedestrian crossings. Their actions reduced vehicular modal share in Oslo to only 29% in 2022, shifting commuters to public transit (31%), and active commuting (38%).

In order to undertake these initiatives, Oslo needed to make changes in governance. The authority to make changes to streets was shifted from the city’s police to local authorities, who were able to more quickly evaluate safety and rapidly implement appropriate interventions prioritizing the safety of vulnerable road users.

Moving Beyond Enforcing Rules & Good Behavior

Oslo’s success is also owed to a safe system approach that recognizes the outsized influence of large systems in determining outcomes. Rather than focusing on changing the individual behavior of users, authorities in Oslo recognized that the system as a whole should be built around safety.

For Cambodia, the most important step involves the reduction of vehicle trips in the first place. With fewer trips, there will be fewer pollutants and fewer travellers at risk. This step requires the involvement of city planners and policymakers to enact changes to Cambodian cities’s land-use zoning and building regulations.

Reforms to land-use zoning should aim to make this system flexible and responsive to local context, to improve mix-use buildings and walkability, and oriented around public transit. 

A land-use planning strategy which categorizes land based on mobility profile would be particularly impactful. A building’s placement should take into account how users commute to and from it and the intensity of traffic generated by users of that space. This way of planning allows authorities to make planning decisions based on the capacity of existing street networks and the impacts to urban mobility.

Pairing urban land-use changes with modifications to parking lot requirements in buildings will further discourage preference for private vehicles. City planners should tailor parking requirements according to the local context. For example, dense areas of the city (especially near public transit) should require the least amount of parking, thereby encouraging commutes via public transit or active commuting.

Additionally, building regulations can also be leveraged to improve walkability by providing shade, creating safer spaces, and creating a welcoming public realm.

Secondly, city planners must shift as many commuters as possible to the safer forms of mass transport, like public transit, walking, and cycling. By optimizing public transit through disentanglement, modifying boulevard design to add designated bus lanes, and prioritizing resources to reclaim and rebuild sidewalks to MPWT’s standards.

Thirdly, on a microscale, physical interventions should be made along streets to manage vehicle speeds, create physical separation for vulnerable road users, and decrease vehicle traffic volume. The design approach should aim to reduce the likelihood of accidents, mitigate crash severity, and prioritize the protection of vulnerable road users (pedestrians and micro-mobility users).

Lastly, when investigating traffic crashes, NRSC should enhance understanding of underlying root causes of crashes by placing emphasis on road design as a major factor. A change in tune by the national body will accelerate systematic interventions by government institutions and civil society. 

Currently, the price being paid by Cambodians is tragic. And the prognosis is not bright should we continue with the status quo.

Cambodian towns and cities are projected to continue their growth, and so will the amount of trips taken. However, the dangers posed by motor vehicles do not have to increase. As successful examples have shown, moving policy decisions away from private vehicle dependency can reverse the deadly trend and minimize destructive impacts.

Safer and healthier cities are possible if practical and impactful solutions are implemented.

Note: Ses Aronsakda is a research fellow at Future Forum.

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