Let’s get physical – Health and Transport

Physical activity is a fundamental means of improving physical and mental health. It reduces the risks of many diseases and benefits society by increasing social interaction and community engagement. Unfortunately, over half the population of Europe is not active enough to meet EU health recommendations, and the trend is towards less activity, not more. Encouragingly, in a recent survey within local government, 89% of respondents agreed that transport planning has a responsibility to promote health.

Physical inactivity is estimated to account for 600,000 deaths a year in Europe. Finding ways to increase physical activity reduces the risks of diabetes, cardiovascular diseases and cancer. In addition, physical activity can counteract the current epidemic of obesity that poses a new global challenge to public health. A potentially important way to respond to this challenge is to promote health-enhancing physical activity that can form a part of everyday life, not only an optional extra to be added at the end of a busy day.

Research has shown that transport systems can strongly influence opportunities to be physically active, both by facilitating walking and cycling and by enabling people to get to places to be active. A recent article in the British Medical Journal reviewing walking and cycling as an alternative to cars found evidence that targeted programmes can change people’s behaviour. When Enrique Peñalosa became mayor of Bogotá, one of his priorities was to make life easier for pedestrians and cyclists. Eleven years later, the city has expanded cycle paths and pedestrian zones and improved parks. Every Sunday from 7am to 2pm 120km of streets are closed to motor vehicles and are used for walking, skating and cycling. These are the kind of changes that make a city a nicer and healthier place to be.

While evidence of the importance of physical activity for health continues to accumulate, many governments realise that there is a need to tackle the urgent challenge of reversing the present negative trends and bring physical activity back into people’s lives. The scale of the problem requires developing a new understanding and new population-based approaches. Furthermore, it requires raising awareness and securing commitment across a range of stakeholders both within and outside public health. This implies developing relationships with those that play a major role in shaping our environments and communities, such as policy-makers and leaders from the health, transport, environment, sport, education, urban planning, media and business sectors.

Barriers to physical activity

One of the biggest economic and cultural influences in the last 30 years has been the growing demand for mobility. The increased use of cars has largely satisfied this demand, leading car mileage to grow by almost 150% since 1970. The ability to travel long distances has in turn played a role in promoting urban sprawl. This increases the dependence on cars to reach jobs, shopping centres and other amenities, and thus reduces opportunities for walking and cycling.

Fear of traffic can be a powerful deterrent to parents allowing their children to walk or cycle to school or play outdoors, especially in deprived areas. For example, in the UK, children from lower social classes are five times more likely to be killed on the road than those from higher classes. Much of this can be attributed to environmental conditions, for example: poorer children are more likely to live in urban areas with poor road safety and high-speed traffic.

Effective transport interventions

Some significant transport interventions in recent years offer interesting lessons. Transport for London’s report on scheme impacts showed that cycling increased by over 50% (with a 7% reduction in accidents) following the introduction of the congestion charge in 2003. Evidence from large-scale interventions like those in Odense in Denmark have also shown positive results. By the end of their four year programme, cycling traffic had increased by 20% and accidents involving cyclists had fallen by 20%. Furthermore, the evaluation identified savings for the health sector, mostly attributed to increased safety and reduced susceptibility to diseases linked to physical inactivity.

There are many other interventions from around the world that have demonstrated similar increases in physical activity and health benefits, proving that multi-level, coordinated action can improve participation in physical activity. Survey results in the UK suggest that the overwhelming majority of respondents accept that transport planning has a responsibility to promote health. This supports the idea that opportunities for action require the health sector to join forces with town planners, transport planners and architects to help create places where physical activity is easier and safer.