Healthy and Sustainable

Healthy and sustainable: why walking and cycling are central to public health policy

Philip InsallDirector, Active Travel, Sustrans

Transport policy has damaged public health

• climate change emissions

• local air pollution• obesity epidemic• road danger• difficulties of access• quality of life

Global climate change

Climate change is also a public health issue

Climate change killed 150,000 people in 2006,

according to the World Health Organisation*

*www.who.int/globalchange/climate

0

20

40

60

80

100 EU urban population exposed to air pollution above EC limits, %, 1999

Source: European Environment Agency

ozone nitrogen oxides PM10 particulates

Polluted urban air

Europe, 2005:41,000 dead

1.9 million injured

The roads AREdangerous

Road casualties

Inactive lifestyles• obesity• cardio-vascular

disease• type II diabetes• many cancers• mental ill-health….• cost over €15 billion

in UK alone

“Besides the human costs of inactivity in terms of mortality, morbidity and quality of life, the report highlighted an estimate for the cost of inactivity in England to be £8.2 billion annually. This excludes the contribution of physical inactivity to overweight and obesity, whose overall cost might run to £6.6 - £7.4 billion per year according to recent estimates.”

Choosing Activity: a physical activity action plan (DH, 2005)

Physical inactivity is a big problem

We eat too much, and choose unhealthy foods

We are not active enough, including in our travel choices

A worldwide epidemic of obesity

Who do you think?

Who leads the world in obesity?

….. the following slides are courtesy of the Centers for Disease Control and Prevention, USA…..

Obesity Trends Among U.S. Adults1985

Source: Behavioral Risk Factor Surveillance System, CDC

No Data <10% 10%–14%



No Data <10% 10%–14%



No Data <10% 10%–14%



No Data <10% 10%–14%



No Data <10% 10%–14%



No Data <10% 10%–14%



No Data <10% 10%–14% 15%–19%



No Data <10% 10%–14% 15%–19%



No Data <10% 10%–14% 15%–19%



No Data <10% 10%–14% 15%–19%



No Data <10% 10%–14% 15%–19%



No Data <10% 10%–14% 15%–19%



No Data <10% 10%–14% 15%–19% 20%-24%



No Data <10% 10%–14% 15%–19% 20%-24%



No Data <10% 10%–14% 15%–19% 20%-24%


No Data <10% 10%–14% 15%–19% 20%-24%



No Data <10% 10%–14% 15%–19% 20%-24% ≥25%


(*BMI ≥30, or ~ 30 lbs overweight for 5’4” person)


No Data <10% 10%–14% 15%–19% 20%-24% ≥25%



No Data <10% 10%–14% 15%–19% 20%-24% ≥25%


Predicted UK growth in obesity-related disease by 2030From “Our health, our care, our say” white paper

0%

10%

20%

30%

40%

50%

60%

Stroke Angina Heart Attack Hypertension Type 2 diabetes

+5%

+12%+18%

+28%

+54%

Source: Living in Britain 2004: Results from the 2002 General Household Survey; National Food Survey 2000 Table B1

Source: Fox / Hillsdon presentation to UK government Foresight policy development programme on obesity

The UK obesity epidemic…..….. is explained by <1.5 kg per annum weight gain

Distance walked per person per annum…..

Source: Fox / Hillsdon presentation to UK government Foresight policy development programme on obesity

0

100

200

300

400

500

600

1975/6 1989/91 1995/7

Walk miles

Car miles x 10

The UK obesity epidemic…..….. is explained by <1.5 kg per annum weight gain

….. equivalent to 1kg of fat gain, per annum….. fell 110km over 20 years…..

We have made our environments “obesogenic”

Levels of cycling (DfT 1996)

UK

Sw

eden

Ger

man

y

Sw

itzer

land

2%

10% 11%

15%

Prevalence of overweight children (IOTF 2002)

22%18%

15% 16%

Environments condition behaviour

Modification of social, economic, and environmentalfactors may yield greater health dividends than individual lifestyle approaches. Indeed such interventions may be necessary before individual lifestyle approaches can be effective.

Lawlor et al, Journal of Epidemiology and Community Health

A cross-sector issue

With cross-sector solutions

Transport policy can now contribute to healthy, low-carbon lifestyles

Restrain private motor traffic

“we recommend that the government develops and strengthens requirements for Local Transport Plans, such that by the end of 2008 they can include statutory targets for reduction in urban traffic”

Royal Commission on Environmental Pollution Report on the Urban Environment, 2007

Changes people can really make

“For most people, the easiest and most acceptable forms of physical activity are those that can be incorporated into everyday life. Examples include walking or cycling instead of travelling by car…..

At least five a week; the Chief Medical Officer’s report on physical activity, 2004

“Urban planners .…. need to integrate health and active living considerations fully into their work…… transport officials can provide a balanced transport system that enables residents to walk or cycle to shops, school and work.”

Promoting physical activity and active living in urban environments, World Health Organisation, 2006

Urban transport and healthy living

Mobility….. or accessibility?


• Transport policy has prioritised mobility : the ability to travel – sometimes long distances


• Accessibility : access to the goods and services people need

• the ideal is maximum accessibility with minimum mobility

Potential for change

Analysis of travel behaviour shows very significant potential for change to more active modes

Constants in travel behaviour

Five out of six trips begin or end at homeSpatial orientation

Only one in five trips is work-relatedActivities

10% are not further than 1km, 30% are not further than 3km and 50% are not further than 5km

Car trips

On average, people make three trips per day, spending one hour travelling

Daily mobility

Potential for change

What scale of travel behaviour change is possible?

Potential for sustainable travel modes% trips per person: Sustainable Travel Demonstration Towns

359

Circumstances enforce car use

Actual usage (walking, bicycle, public transport)

9

2735

No adequate alternative




35

29

27

9No adequate alternative


Only subjective reasons against STM



Immediate potential for walking, cycling & public transport

Environmental factors “enforce”private motorised

modes

Potential for sustainable travel modeswithout significant environmental modification

6436

Potential for sustainable travel modeswith environmental intervention

75

25

Walking, cycling & public transport

Motorised private modes

“Idealistic, unrealistic, radical…..”

Idealistic, unrealistic, radical?

Mode choice in Basel, Switzerland% trips per person

75

25

Walking, cycling & public transport

Motorised private modes

Examples of intervention

What should we do to make urban transport systems better?

Re-allocate road space

Take space from motor traffic and return it to walking and cycling

Bristol, UK

Wien, Austria

Keep motor traffic out

Nordrhein-Westfalen, Germany

Design for healthy, sustainable travel

• Target: cycling up from 12 to 25% of urban trips• Investment: €1.4 billion, 1978 - 2006• Some cities now achieve 35% of trips by bike

London Congestion Charge

Significant, incremental, long-term

Show leadership

Case study: Odense

Odense – Denmark’s “cycling city”• 185,000 citizens (typical Scandinavian city)• multi-year programme – main intervention 1999 – 2002• central government funding at €11 per capita per annum• main focus on cycling • very wide range of measures• physical measures – bus and cycle priority• promotion and marketing – many initiatives• monitoring

Odense – results (1999 – 2002)• cycling up 20%, still growing• car traffic down 15%• shift to shorter local journeys• increase in walking• public transport travel fell too • improved road safety• raised physical activity levels• significant reduction in cost of ill-health• Odense continues to innovate…..

Case study: National Cycle Network

Composition of the Network

Traffic-calmed urban roads

Quiet rural roads and lanes


Traffic-free greenways (30% of total)


Designed for multiple trip purposes

leisure and recreation…

…shopping and personal business...

…commuting to work...

…school travel

… attractive traffic-free routes...

…without gaps or obstacles...

…with iconic, memorable structures...

Art and the travelling landscape

Development of the Network

National Cycle Network 1995: plans for 2,500 miles (4,000km)

National Cycle Network5,000 miles (8,000km) open in 2000

National Cycle Network10,000 miles (16,000km) in 2005

….. and construction continues…..

The National Cycle Network: changing people’s travel behaviour

• 338 million active trips in 2006• 50:50 walking and cycling• 91 million replaced a car trip• 78% “more active thanks to the

Network”• focused on deprived

neighbourhoods• used for all trip purposes

Walking and cycling investment is excellent value for money

cost : benefit analysis of three UK construction projects• average benefit : cost ratio

20:1• motor transport projects, ratio

3:1• many road transport projects

have negative value

Date post:	15-Mar-2016
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