The Lancet Planetary Health, June 2025

Effects of city design on transport mode choice and exposure to health risks during and after a crisis: a retrospective observational analysis

Rapid declines in city mobility during the early stages of the COVID-19 pandemic in 2020 resulted in reductions in citizens’ exposure to transport-related air pollution and associated health risks as many cities introduced non-pharmaceutical interventions designed to curb the spread of COVID-19. However, these benefits soon reversed during the pandemic’s recovery phase (ie, from September, 2020, onwards), especially in cities with designs that afforded mode shifts away from public and active transport in favour of private motor vehicles.

The aim of this study was to understand the association between global city designs, transport mode choices, and population-level risk exposure during 2020.