If you thought Australia was the envy of the rest of the world in terms of having the most physically active people, think again. Peter McCue, executive officer for the New South Wales Premier’s Council for Active Living, recently gave a talk entitled, “Walk hand in hand: health and transport collaborations,” organised by C3 Collaborating for Health. According to him, Australia is actually a car based society comparable with the United States rather than with countries like the Netherlands or Denmark, where active travel (walking or cycling to work) is quite established, or with cities like London, where run-commuting (running to work) is popular.
McCue said that Sydney, a sprawling metropolis of more than 12 000 km2 (Greater London is about 1572 km2) has traditionally been an “auto city,” and the residents in the outer suburb, who tend to live further away from train stations, do much more driving than residents in the inner city.
I learnt that driving to work is associated with weight gain, and that for every additional hour spent in a car every day, there is a 6% increase in the likelihood of obesity. Transport should therefore be seen as a key social determinant of health.
By contrast, active travel has a number of benefits: it decreases air pollution, congestion, energy use, as well as parking costs.
There are resources like the HEAT tool for walking and cycling that calculate the health benefits (in terms of mortality reduction) of walking and cycling, and are generated jointly by both the transport and the health sector.
One of the most realistic solutions is to try and persuade people to walk instead of using their cars for short trips (e.g. 1 km). A reduction of 5% to 10% of car trips under 1 km could save $134 million and $224 million over 5 and 10 years, respectively. There is an economic benefit of $2.12 per kilometre walked and $1.43 per kilometre cycled per person.
McCue gave examples from around the world of multiagency initiatives aimed at promoting active travel and active lifestyles. In New York City, the health, planning, and transport sectors have joined up to establish evidence based “active design guidelines” to help architects and designers create buildings, streets, and urban spaces that are more conducive to engaging in physical activity. In Vancouver, a city that usually competes with Melbourne and Sydney for the accolade of “most liveable city,” there is a “health and community design lab” that integrates health into transportation planning in the Metro Vancouver Region.
Andy Haines spoke about the vicious cycle of the increase of greenhouse gas emissions due to cars, which subsequently makes cities less conducive to active travel. He said that there needs to be a balance between the freedom to drive and the freedom to engage in active travel. He added that many hospitals don’t even have any active travel plans or plans to reduce car commuting by both staff and visitors.
Peter McCue wrapped up his talk by inviting the audience to come to Sydney in 2014 for the Walk 21 Conference, whose aim is to “champion the development of healthy sustainable and efficient communities where people choose to walk.”
I’m sure I won’t make it to Sydney, but I already feel quite fortunate for being able to walk to work.
Tiago Villanueva is the editorial registrar, BMJ.