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Cycling for public health

We review the connections between infrastructure, cycling and health

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The UK government is on a health kick. After a personal brush with death, which Prime Minister Boris Johnson attributed in part to his own health, the headlines this week allude to unprecedented controls on the food industry, including advertising regulations, and cycling being ‘prescribed’ by medical professionals.

Substituting sedentary transit or driving for cycling, whether on a bike or an adaptive cycle such as a tricycle, and walking, will never be a magic cure for everyone’s physical and mental health. But when leaders support making the change from sitting on a bus or inside a car accessible, safe and enjoyable with real and effective changes to our transportation network, it can only help.

Infrastructure, cycling and health

More cycling isn’t the magic pill for obesity, but it is one of the best ways to reduce inactivity levels – and inactivity, even putting aside weight, is a huge issue for far too many of us – and by the way, that includes me. With my own 90 minute round-trip cycling to and from the LCC workplace having been cut since the onset of lockdown, I’ve definitely felt the impact of losing this important part of my normal routine. Increased activity levels lead directly to a huge reduction in heart disease, cancer, and help tackle many other health issues, including obesity. But more than that, as anyone who cycles will tell you, it feels marvellous to do. For many of us our trips to work and school are the highlights of our days.

Of course, simply prescribing cycling isn’t enough to get loads more people cycling. Experts talk of an ‘obesogenic environment’ – in other words, a complex set of factors that help people become obese and keep them there. This means responses to this issue must be systemic. As part of that, prescribing cycling won’t be enough – we’ve been asking people to cycle more for decades and they haven’t, because the roads are too scary to cycle on. That’s part of the obesogenic environment – for decades, we’ve designed our streets, and spent our money, for the benefit of motor traffic, not to protect our community’s health and wellbeing as they travel.

Children and schools

We have been here before. “Lifestyle illnesses” are a critical health threat to Londoners. It is particularly upsetting that the Mayor reports that approximately two in five of our children are overweight or obese. Last September, Paul Lindley was appointed to the London Child Obesity Taskforce. Refreshingly, they developed their approach by listening to children, families and carers on what changes they need in their communities and in their journeys.

The findings were articulated in ‘Ten Ambitions for London’s Children.’ One of them is “the routes we take are safe, fun, nice places to walk, cycle and play.” This is exactly where schemes such as main road cycle tracks and low traffic neighbourhoods, as set out in our Climate Safe Streets report, come in to play. It isn’t enough to ask Londoners to change habits of a lifetime. They must be supported in doing this with the provision of a road network that is safe, accessible and enjoyable for their cycling across all of London.

We need our city’s school runs to be cycle-able so that our children and young people can enjoy getting to and from school in ways that supports their physical and mental health, which we discussed in our recent webinar about the ‘sustainable school run.’ At the moment, the poorest communities in London are saddled with surviving in the most hostile places in which to cycle and walk. If they don’t get the urgent built environment changes needed to deliver this ambition for children – it will be unfulfilled.

Spend £27 billion on active travel not driving

Another ambition for London’s children from the report, no less relevant to LCC, was that “all families have enough money for healthy food and activities.” It’s a lot to expect anyone to cycle if they can’t afford a safe and comfortable bike that suits their mobility needs. The government has pledged £27 billion in funding for driving-focused road spending. It’s long past time for access to cycling, which is a public (health) benefit, to get its due share of the treasury box.

The health and care sector must be part of the change

Of course, there’s also a discussion about physicians healing themselves. Unfortunately, much of the NHS and wider care sector is ‘car sick’, with health and care sector figures often found to oppose cycling schemes because of their driving commutes, and the ongoing arguments about free car parking at hospitals underlines this. We need a health system that protects its users’ and workers’ wellbeing in how they travel: for patients, their visiting friends and family, and colleagues alike. Over 800 NHS and care sector workers joined our membership scheme since April. Their safety, enjoyment, and the security of their cycles must be a central concern for their leadership. And over 190 GPs, consultants and other healthcare staff have recently written to the Health Minister asking for the same things.

We need more secure cycle parking at hospitals and other health and care premises, particularly in inner London. Everyone who works in the care sector should have a safe place to keep their cycle while at work, and there also must be ample storage for visitors, including people using larger cargo cycles and tricycles. The healthcare sector must support them in making that change by supporting the crucial infrastructure changes which make people feel safe in confident in cycling, whether on adaptive cycles such as handcycles and electric-assisted cycles, as well as un-powered two wheelers.

LCC’s collaborations with the NHS

During the pandemic and lockdown, LCC has worked with the NHS in West London to get bikes to key workers to keep them fit and healthy and avoid public transport journeys. We are now working with WestTrans to look at cycling at key NHS sites and identifying the barriers for that site or trust stopping more people accessing those sites by cycling. In this process we will help doctors and nurses to cycle more and understand the benefits to their health.

The more champions for cycling there are inside the health and care system, the more likely that positive cycling messages will reach patients. We have seen prescribing cycling announcements before and it hasn’t worked on a large scale because of a lack of funding for public health cycling project and the lack of a culture of active travel in the NHS. This is an opportunity to do better and make a lasting impact.

What London and UK leaders need to do

We call on TFL, London Boroughs, the UK Government and healthcare organisations to take cycling seriously and pledge to provide real leadership in making cycling enjoyable, accessible and safe for everyone. We are seeing progress and the recent surveys of travel patterns have shown significant increases in cycling for transportation. The vast majority of people support cycling being made accessible and safe, as shown in the recent #Bikeisbest survey conducted by YouGov. The science is not in doubt. Let’s make London healthier, together – and now.


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A group of Climate Safe Streets champions gathered around a cargo bike all wearing green tee shirts.