Dr. James Smith
How healthy we are is central to our experience of our lives. Our physical and mental health influence how good each day is and ultimately determines how many days we have. But what determines our health? Could how we travel around really be crucial to our health?
Well yes – how we move around is a critical factor in our health. But no – it’s not simple. This blog explores the relationship between our everyday travel and our health, and of course climate change.
How travel impacts health
How we move around determines how much physical activity we get, how exposed we are to the risk of accidents, and how clean the air we breathe is, but also how we interact with our local community, how we use our money and time and to a large extent our carbon footprint. All of these affect our health.
Physical inactivity is responsible for about 9% of premature deaths worldwide and is associated with many diseases including heart disease, depression, dementia, diabetes, breast and bowel cancer. It is recommended that adults, aged 19-64, do at least two and a half hours of moderate physical activity per week, for example by doing 30 minutes a day five days a week. This may seem a lot and many people don’t meet this. But if you can integrate this into your daily routine it suddenly doesn’t seem that hard. 15min each way to work for 5 days a week and you’re there, and of course this can be part of a longer journey involving another form of transport such as the train or the bus. This is why helping people to move easily between different modes of transport is important.
In Cambridgeshire particulate air pollution is estimated to be associated with the equivalent of 257 premature deaths a year. It isn’t just the lungs it is bad for but also the heart and arteries. I can’t wait for the day when standing at a crossing with my children I don’t have to worry about them breathing the exhaust fumes anymore because all the cars and buses are electric. Another harm from our transport system is road traffic injuries. 393 people were killed or seriously injured on the roads of Cambridgeshire and Peterborough in 2013. 20mph speed limits and making more protected space for cycling both aim to help this.
One of the interesting things which can happen if we change how we move about is the impact it can have on how we interact with each other. It can be a lot easier to stop at a local shop when passing on a bike or on foot rather than in a car. The more we are connected to our communities, the more we interact, the more we share, the better it is for our wellbeing, the better it is for our resilience as a local community. This is really important as we have to cope with increasing climate change and other challenges.
And we shouldn’t forget that our current transport system is one of the biggest contributors to our carbon footprint with domestic transport emissions a quarter of the UK footprint.
How are we doing in Cambridge and what more should we do to improve these problems?
Cambridge is already way ahead of many places in England, particularly in terms of the number of us who cycle. But we are also far from where we could be in the future.
The Cambridge Guided Busway with its attached cycle path is a notable example of a large scale investment. The conclusions of a research study to understand its impact on physical activity in commuters are awaiting publication but results published already show that the ‘supportiveness’ of the local environment predicts the uptake of walking and cycling. (link below)
There are further substantial improvements planned in and around Cambridge. Recently the Greater Cambridge City Deal Board approved a 5 year programme costing £180.52 million including several bus priority systems and cycling improvements such as the ‘Chisholm trail’ to link the city from north to south.
With these it feels like we are going in the right direction but I am concerned that they don’t take us sufficiently far fast enough and that we may be ‘locking in’ changes such as some road redesigns and car parking, which don’t fit with where we need to get to in the end. Traffic and parking space in the city remain tricky problems. In addition to improving cycle paths and public transport other ideas like electric car sharing clubs and making space for more cargo bike use and parking could help with this.
The Visions 2030 project computerized visualizations help us to imagine what a place might look like when some of these ideas come together. Modelling of the health impact of these scenarios showed striking and substantial health benefits. Our task in Cambridge is to bring together existing plans and visions such as the Cambridge Cycling Campaign vision with other aspects such as public transport, electrification of transport, and wider urban redesign so we can get every last bit of benefit from our health system and stop the harms we are currently seeing from it.
What can we do as members of the public?
In talking about transport, health and climate it is easy to self censor what we aspire to based on our automatic sense of what is practical, what can be done based on where we are now, on not wanting to seem to be taking too extreme a position. We put our own brakes on change. But when I find myself doing this I remind myself of a memory I have of seeing a patient in a hospital bed in the middle of having a heart attack, of seeing the pain on his face as we scrambled around getting him some pain relief. He didn’t make it. It was horrible. Many things will have contributed to his heart disease but air pollution and lack of physical activity are likely to have been important. This is the reality of what we are talking about when we talk about transport. It is about real people, people who are loved, suffering heart attacks, asthma attacks, road traffic accidents and all the effects of climate change across the world. It is not some abstract list of diseases. It is here and it is now. The faster we can change to a way of moving around which doesn’t cause all this the more of us will be healthy to experience all the joy and wonder of life. Surely it’s okay to be ambitious in this context.
My conclusions having considered our transport system from the perspective of being a public health doctor, a concerned local resident and a parent are that of course we should try to change how we get around ourselves – walking, cycling, using public transport and the like – but really what we need to be doing is describing the sort of transport system we really want, the sort of Cambridge we really want. We should engage with the campaigns and political process around us and unashamedly ambitiously call for clean air, safe roads with space for cycling, zero emissions, affordable public transport and more.
We are moving in the right direction in Cambridge but we aren’t moving quick enough. We need to imagine just how good a place this could be to live in and rush towards it.Dr James Smith is a Cambridge based public health doctor who works independently to protect and improve health by fighting climate change. He has previously worked for Public Health England and the NHS Sustainable Development Unit on the issue of climate change. He can be found on Twitter @drjnsmith and has a blog at www.drjnsmith.com
- Physical Activity Guidelines on NHS Choices including for different age groups and for muscle strengthening activity
- Commuting and Health (Cambridge Guided Busway) study
- Visions 2030 project
- Moving Forward – Travel and Health in Suffolk (2013) – an example of a health based vision for local transport
- Cambridge Cycling Campaign Vision
- Evidence on a Page. Excellent transport and health evidence summaries on a wide range of topics