A new study seeks to quantify everything car culture costs us. Yet there are still more ways that auto-centrism hurts us all.

Car domination is directly responsible for at least one in every 34 deaths around the world, a new analysis finds — but that’s just the tip of a very large iceberg of the many ways that automobile dependence makes life worse for virtually everyone, even in places with very few cars.

In a staggeringly ambitious new literature review, a team of UK and Germany-based researchers combed through nearly 500 studies from around the world that quantified the many harms of “automobility,” an academic term for the interlocking systems of power and culture that conspire to make cars our primary mode of transportation.