Table 3

Summary details of transport and access to health and social care services reviews

CitationIntervention(s)Summary of results
Bunn et al35Area-wide traffic calming schemes (creation of one ways, speed humps, etc)Intervention has potential to reduce traffic injuries and deaths: road user deaths (pooled RR 0.63, 0.14 to 2.59) and injuries (pooled RR 0.89, 0.8 to 1.00) decreased.
Egan et al36New road building (major urban roads, bypasses, major connecting roads)Little evidence that major new urban roads reduce injury incidence. Bypasses do appear to reduce injury accidents on main routes, but this may be achieved at the cost of displacing accidents to secondary routes.
Ogilvie et al34Population-level interventions to promote shift from using cars to walking and cycling (engineering measures; financial incentives; providing alternative services)Mixed evidence of effects of engineering interventions but financial incentives and providing alternative services had some success in changing journey type. Absence of evidence rather than evidence of no effect.
Shults et al33MLDA laws and BAC lawsDecreasing the MLDA increased road injuries (effect range −2% to 38%), whereas increasing the MLDA decreased road injuries (effect range −33% to −6%). Decreased BAC led to decreases in vehicle crashes.
Pilkington and Kinra37Fixed or mobile speed camerasAll studies reported a reduction in road traffic collisions and casualties, with the reduction in the vicinity of the camera ranging from 5% to 69% for collisions, 12 to 65% for injuries and 17% to 71% for deaths.
Access to health and social care services
Anderson et al38Cultural access—“culturally competent healthcare” (language and culture training for health professionals, use of interpreters, etc)No evidence on health outcomes found, however, healthcare use and access increased.
Lewin et al39Cultural access—lay health worker interventions (intended to promote health, manage illness or support people) delivered in primary and community healthcare settingsIn comparison with usual care, promising benefits were shown for promoting the uptake of immunisation in both children and adults (pooled estimate RR 1.30, 1.14:1.48). May also be effective in promoting the uptake of breastfeeding (pooled estimate RR=1.05, CI 0.99 to 1.12).
Pignone et al40Cultural access—health education materials for patients with low literacyMixed effects on health, difficult to draw conclusions due to diversity of outcomes, interventions and quality of studies.
Gruen et al41Improving geographic access—specialist outreach clinics in primary care or rural hospital settingsSpecialist outreach appears to improve access to primary care and self-reported health (eg, a decrease in disease symptoms in the intervention group (pooled RR 0.63, CI 0.52 to 0.77)).
  • BAC, blood alcohol concentration; MLDA, minimum legal drinking age.