In recent years, the global automotive landscape has undergone a significant transformation with the rapid rise of Sports Utility Vehicles (SUVs). Originally designed as niche vehicles for off-road enthusiasts, SUVs now dominate the new car market, comprising approximately half of all new vehicle sales worldwide. This surge is even more pronounced in regions like the United Kingdom, where recent data indicates that SUVs accounted for a staggering 63% of new car sales in 2024, up dramatically from just 12% in 2010. This shift reflects broader trends in vehicle design and consumer preference, but it is not without profound implications for public health, road safety, and environmental sustainability.
SUVs are distinguished by their larger dimensions—most notably their increased height, width, and weight—compared to traditional passenger cars. This increase in size is part of a phenomenon often referred to as “carspreading,” which describes the gradual enlargement of vehicles over time. Modern SUVs feature taller and squarer front ends, commonly called bonnets, which have been linked to more severe impacts during collisions with pedestrians and cyclists. Scientific analyses reveal alarming statistics: adults struck by SUVs face a 44% higher risk of fatality than those hit by standard-sized vehicles, while the risk jumps to 82% for children. These figures underscore the heightened danger posed by SUVs in urban environments where vulnerable road users share space with motor vehicles.
The design features of SUVs inherently create hazardous conditions for pedestrians and cyclists. The elevated bonnet surfaces increase the forces exerted on the head and torso in collisions, leading to more severe injuries. Moreover, these vehicles often have larger blind spots, which compromise driver visibility, particularly for small children close to the vehicle. For instance, modern SUVs like the Land Rover Defender have driver viewpoints obstructed to the extent that a 4-year-old child standing directly in front of the vehicle effectively disappears from view. This restricted visibility significantly heightens the risk of accidents during low-speed maneuvers such as parking or navigating crowded city streets.
Automotive manufacturers have steadily increased the dimensions of new vehicles over the last decade and a half. Data reveals that the average bonnet height of new cars in Europe rose from 77 centimeters in 2010 to 84 centimeters in 2024. Likewise, the width of vehicles has incrementally expanded at a rate of approximately 0.5 centimeters annually. This continuous upscaling exacerbates existing safety issues and further constrains urban mobility, squeezing the limited space available for cyclists and other two-wheeled transport modes. The consequences extend beyond safety concerns; the proliferation of larger vehicles undermines efforts to promote active transportation, which offers critical health benefits through increased physical activity and reduced air pollution.
The environmental footprint of SUVs also raises serious climate and public health concerns. Larger SUVs consume more fuel than smaller vehicles, resulting in higher carbon dioxide emissions per kilometer traveled. Even when compared to standard models equipped with gasoline engines, SUV variants typically emit significantly more greenhouse gases due to their increased mass and aerodynamic drag. The environmental toll does not stop at emissions; the production of larger vehicles demands greater quantities of raw materials such as steel, aluminum, and plastics, contributing to resource depletion and increased manufacturing energy consumption. This intensifies the carbon footprint embedded in the life cycle of these vehicles.
Additionally, SUVs contribute disproportionately to urban air pollution through particulate matter generated by tire and road surface wear. Heavier vehicles exert greater pressure on tires and pavement, accelerating degradation and releasing fine particles into the atmosphere. These fine particulates are particularly insidious as they penetrate deeply into pulmonary tissue and enter the circulatory system, where they are linked to chronic respiratory and cardiovascular diseases. Consequently, the rising prevalence of SUVs conflicts with public health objectives aimed at reducing exposure to harmful air pollutants and associated premature mortality.
Addressing the multifaceted challenges associated with the surge in SUV sales requires coordinated policy action at local, national, and international levels. Some municipalities have already begun experimenting with targeted interventions; cities like Paris have introduced higher parking fees for larger vehicles to disincentivize their urban use. Cardiff is poised to follow suit, potentially becoming the first UK city to implement this approach. Such policies aim to internalize the external costs imposed by large vehicles, thereby encouraging consumers to opt for smaller, safer, and more sustainable alternatives.
Vehicle taxation systems represent another strategic lever to influence consumer behavior, though many current frameworks inadequately penalize larger cars. Reforming these tax regimes to impose higher fees on SUVs could create economic incentives aligned with public health and environmental goals. Furthermore, incorporating explicit vehicle dimensions into registration certificates could raise awareness among consumers and policymakers about the growing size of cars, fostering informed decision-making and public debate regarding vehicle design trends.
From a regulatory perspective, safety rating programs could integrate new criteria such as a “child visibility test” to promote designs with lower bonnet heights and improved driver sightlines in urban contexts. These measures could encourage manufacturers to rethink vehicle architectures, prioritizing pedestrian safety and minimizing blind spots. Simultaneously, stricter regulations to curb the increasing dimensions of vehicles—particularly bonnet heights and widths—are vital to counteract the current upward trajectory and mitigate associated risks.
Health professionals and organizations have a critical role to play in this discourse. Given their position as trusted opinion leaders, they can amplify calls for evidence-based policies that reduce the negative impacts of carspreading on public health and the environment. Their advocacy could galvanize broader societal engagement and political will to implement comprehensive measures that balance mobility needs with safety and sustainability imperatives.
In conclusion, the proliferation of ever larger vehicles, notably SUVs, poses a complex array of challenges that demand urgent attention. These vehicles exacerbate risks of severe injury and death among vulnerable road users, contribute significantly to greenhouse gas emissions and air pollution, and disrupt efforts to promote healthier, more active urban transportation. Through a combination of fiscal incentives, regulatory reforms, safety standards, and public advocacy, it is possible to reverse the trend toward ever-bigger cars and foster a safer, cleaner, and more equitable transportation future.
Subject of Research: Not applicable
Article Title: Reducing the harms from ever larger cars
News Publication Date: 5-Nov-2025
Web References: http://dx.doi.org/10.1136/bmj.r2162
Keywords: Sport utility vehicles, Environmental issues
