Abstract
The transport system influences health, including the onset of new cancers, in both positive and negative ways. Transport affects the frequency of cancer via access to healthcare, employment and other goods and services of society; physical (in)activity; exposure to transport-related pollution and climate change. In addition, avoidable transport health impacts overload the health system that delivers cancer care. The current transport system in Aotearoa/New Zealand is the result of policy choices made in the last 50–70 years which have privileged the private motor vehicle. We discuss examples of local work to support a healthier transport system, including action research with government partners creating infrastructure to support healthy travel, health professional advocacy in transport policy processes and involvement in coronial processes and a subsequent government advisory group. These, and other attempts at change, have had limited impact because of the elements that hold the current system in place; the weak regulatory architecture and institutions, commercial influences on policy and funding arrangements. Creating a healthy, cancer-preventing transport system requires not just focus on specific policy changes but reform of the policy making apparatus to ensure healthy people and planet are at the centre of decision making.