Wednesday, 19 August 2015

What can Public Health do for cycling?

We know cycling is great for people's health, and in a country like the Netherlands the population gain significantly from the regular exercise they get from their bikes. As we hear more about the impact of lifestyle choices on health, what are the people in charge doing to promote active transport for everyone?

Ask not what cycling can do for public health, ask what public health can do for cycling. 

A couple of years ago responsibility for 'public health' moved from the NHS to Local Authorities. This change means councils must consider health when they plan all of their activities - education, transport, planning and all the rest.

It was hoped this change would cause a step change in the way councils worked with a new emphasis on cycling and walking. However that didn't happen, so what are the reasons and what can we do about it?

The problem

Public health professionals know that a big shift to active travel is needed to combat our sedentary lifestyles & improve the health of the population. However this hasn't translated in to action from councillors and engineers who are following different priorities.

    We can't afford the NHS if we continue like this.

    Lack of physical activity places a huge burden on our health services. The cost of treating the associated health complications comes at a time of constrained budgets. The rapid growth of conditions like Type 2 Diabetes could make the NHS unsustainable as we know it. Unfortunately there isn't a magic bullet and public health can't solve this on their own.

    Must transport be part of the solution?

    Transport departments will ask why they're being expected to adopt a new set of aims and priorities. To answer this local councils need to consider other ways they could fill the physical activity deficit in their communities and whether that is affordable.

    For instance we could ask:
    • How much money did they spend on leisure services last year?
    • What proportion of the physical activity needs of the population were realised by their leisure services programmes?
    • Can this fulfil the activity needs of the community and is it affordable?
    We can't afford to solve this without using all of the opportunities we have to promote healthy activity. Transport departments are in control of much of our public space and budgets public health professionals can only dream of. We need transport to be part of the solution by promoting active transport, improving our health and saving the NHS from spiralling costs.

    Because it's no longer just about cost effectively getting people from A to B.

    • We need to emphasise and give credit for outcomes (like more people cycling) rather than big showy projects (many cycling schemes are about small scale interventions with small budgets).
    • We should not accept health impacts being regarded as secondary considerations with journey times being used to justify projects which fail to promote cycling and walking.
    • Roads must be designed to make cycling and walking viable options for everyone.
    We need to keep reinforcing these messages with every consultation and when we talk or write to our politicians.

    The invisible killer you can't escape

    Finally, we all need to talk about air pollution a lot more. The impacts on children, the old and the weak are truly shocking and the evidence continues to pile in.

    Progress has been made by Client Earth and EU regulations but the scale of the problem is huge and far too little is being done about it. We need to push for local government action to address sources of pollution close to our homes, schools and hospitals.