nick cavill morning plenary -highlighting the costs and benefits of cycling

Highlighting the costs and benefits

of cycling

Nick Cavill PhD

ASSOCIATEScavillpublic health consultancy

Physical inac+vity: a global health burden

Source: WHO (2009). Global health Risks. Mortality and burden of disease attributable to selected major risk. Geneva. WHO

Ac+vity levels in England

42

31

6 4

0

10

20

30

40

50

60

70

80

90

100

men women

% ac+ve: self report

% ac+ve: objec+ve

0 10 20 30 40 50 60 70 80 90 100

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

men

women

Source: Health Survey for England 2008

Physical ac+vity: health benefits Children and adolescents •  improved cardiorespiratory

endurance •  muscular fitness •  favorable body composi+on •  improved bone health •  improved cardiovascular and

metabolic health biomarkers

Adults •  lower risk of early death •  heart disease & stroke •  type-‐2 diabetes •  high blood pressure •  adverse blood lipid profiles •  metabolic syndrome •  colon and breast cancers •  preven+on of weight gain •  weight loss when combined with diet •  improved cardiorespiratory and

muscular fitness •  preven+on of falls •  reduced depression •  cogni+ve func+on (older adults).

Physical ac+vity and health

Source: Dept of Health (2011) Start Active Stay Active. Adapted from US Dept of Health and Human Services (2008) Physical Activity Guidelines Advisory Committee Report

Promo+ng health through physical ac+vity: which would you choose?

Cycling: systema+c review

Broader benefits to public health

•  Improved air quality •  Improved social cohesion

•  Less noise •  Reduced traffic danger •  Improved environments for play and ac+vity

Cycling: the poten+al risks

•  Road traffic casual+es

•  Air quality •  Musculo-‐skeletal injury

Selected causes of death: 2008

115 2538

32647

0

5000

10000

15000

20000

25000

30000

35000

cyclists killed on road* All road users** CHD a\ributed to inac+vity***

Deaths, 2008

Source: * **DfT Road Traffic Casualties 2009 *** BHF statistics 2010 edition; McPherson et al 2002.

Benefits and risks: modelling

De Hartog et al, 2011

Benefits and risks: modelling

•  Physical activity ‘by far’ the most important •  “Concern about pollution exposure…is unfounded when

compared to the benefits of the cycling activity” •  Only includes mortality so total benefits likely to be much

higher

•  There exists the poten+al of a modal shi_ from oil-‐based car transport to food-‐based ac+ve transport, to yield important health benefits for car users and wider society, through reduc+ons in air pollu+on, physical inac+vity, and opportunity costs. Future research should quan+fy these effects under alterna+ve scenarios.

•  The greatest poten+al for health gain is by improving the walking environment and suppor+ng the most energy efficient form of transport—the bicycle.

•  The necessary changes are achievable and affordable and essen+al for sustainable development across sedngs. Levels of cycling can be used as a measure of progress towards a healthier sustainable future in both the developed and the developing world. The main obstacles to progress are not technological but poli+cal, in par+cular the financial interests of stakeholders.

Benefits and risks: HIA

Physical activity accounted for >70% of benefits

NICE Guidance

Environment: published 2008 Walking and cycling: in press

NICE economic modelling

The comparison of physical activity with other lifestyle interventions

440

17000

9515

0

2000

4000

6000

8000

10000

12000

14000

16000

18000

Physical ac+vity Sta+ns smoking cessa+on

Cost/QALY

Challenges

•  Paradigm shi_ in transport planning •  Culture shi_ for individuals •  Reaching those who do not want to cycle •  Reaching those whose health would benefit the most

nick cavill morning plenary -highlighting the costs and benefits of cycling

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