In the aftermath of another horrific mass shooting in the United States, the rest of the world is, as is customary after these all-too-familiar incidents, shaking its collective head in disbelief.

What seems particularly incomprehensible is that such a tragedy will, in all likelihood, lead to no meaningful action.

But before we get too self-righteous, we might want to consider whether similar aberrations or blind spots exist in New Zealand public policy. One issue that warrants serious consideration, particularly in light of recent events, is our attitude to cars and the transport culture that prevails as a result.

The parallels are clear. When it comes to transport policy in New Zealand, as with gun control in the US, it's as though all reason and evidence goes out the window. As a society we seem willing to tolerate all manner of "collateral damage" as a trade-off for the perceived benefits.

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After each incident - a mass shooting in the US or a multiple fatality on our roads - along with a sense of déjà vu comes a feeling of resignation.

Deep down we know that after all the thoughts, prayers, condolences and exhortations to act have subsided, nothing meaningful will be done to prevent the next tragedy.

Our road toll has been rising over recent years, with fatality rates increasing since 2013 after many years of decline. Yet there has been no overwhelming public outcry. There is, at some level, collective acceptance of a manifestly unacceptable situation.

Transport policies continue to prioritise traffic flow and reliability for motorists over safety for everyone. We continue to tolerate children being killed on their way to school as somehow being an acceptable price to pay for the freedom and convenience that driving provides.

Like gun deaths in the US, it doesn't have to be this way. In the Netherlands, for example, the road fatality rate in 2014 was 2.8 per 100,000, less than half of New Zealand's rate of 6.5.

Now, you're probably thinking, "but we're nothing like the Netherlands". However, until the 1970s, neither was the Netherlands.

In 1972 more than 3000 people died on Dutch roads; in 2014, despite a significant increase in population, that number had dropped to 570. This staggering decline was prompted by political advocacy by Dutch citizens who recognised their "car problem" and lobbied government to address it.

In addition to deaths and injuries as a result of road traffic crashes, New Zealand's car culture has many other devastating impacts on our health and wellbeing. More than 1000 people die prematurely every year in New Zealand as a result of air pollution, much of which is attributable to motor vehicles.

Our car dependence also leads to a massive and unnecessary burden of disease associated with physical inactivity, not to mention locking in patterns of behaviour and urban design that exacerbate climate change, the greatest threat to global public health this century.

New Zealand's car problem is also highlighted by the inordinate amount of public funds we are prepared to sink into major roading projects that effectively double down on the congested, polluting, disease-inducing system we have.

Transport authorities have had to be dragged kicking and screaming to support Skypath, a crucial walking and cycling link across the Auckland Harbour Bridge, despite the fact that it costs peanuts.

At the same time, billions of dollars are spent on "roads of national significance" after perfunctory cost-benefit analyses and minimal scrutiny because, well, they're nationally significant (obviously - it says so in the name).

On the one hand, we have to fight to get active and public transport infrastructure that offers real solutions to our transport problems, while on the other hand we are required to actively oppose road building projects that threaten to exacerbate those problems.

Further evidence of our deeply embedded and problematic car culture, and the resulting irrationality of decision making and outcomes, can be seen in how we allocate public space.

Cities and town centres, which in many other countries are attractive, pedestrianised public spaces, in New Zealand are often uninviting, noisy and polluted areas as a result of traffic and parked cars.

Despite private motor vehicles commanding the vast majority of space on urban transport corridors, there is a general reluctance to concede any of this space to enable other transport modes.

For example, local retailers vehemently protest the removal of carparking to allow installation of cycle lanes, even when there is clear evidence that doing so is good for business.

Whichever way you look at it, the decisions we make about cars - whether it be funding for infrastructure, regulation to improve safety, promoting healthy environments or allocation of public space - are irrational and harmful. Logic, proportion, and judicious balancing of pros and cons are hard to detect in any such discussions.

Other countries with more progressive, evidence-based and humane approaches to transport no doubt look at countries like ours in disbelief. We need to talk about our car problem.

• Dr Rhys Jones (Ngāti Kahungunu) is a public health medicine specialist and senior lecturer in Māori health at the University of Auckland.