Highlighting the                            costs and benefits                                of cycling                  ...
Physical	  inac+vity:	  a	  global	  health	  burden	   Source: WHO (2009). Global health Risks. Mortality and burden of d...
Ac+vity	  levels	  in	  England	                                                          	  100	                         ...
Physical	  ac+vity:	  health	  benefits                                             	  Children	  and	  adolescents	       ...
Physical	  ac+vity	  and	  health	  Source: Dept of Health (2011) Start Active Stay Active. Adapted from US Dept of Health...
Physical	  ac+vity	  and	  health	  Source: Dept of Health (2011) Start Active Stay Active. Adapted from US Dept of Health...
Promo+ng	  health	  through	  physical	  ac+vity:	  which	  would	  you	  choose?	  
Cycling:	  systema+c	  review	                                 	  
Cycling:	  systema+c	  review	                                 	  
Broader	  benefits	  to	  public	  health	  	  •  Improved	  air	  quality	  	  •  Improved	  social	     cohesion	  	  •  ...
Cycling:	  the	  poten+al	  risks	  	  •  Road	  traffic	     casual+es	  	  •  Air	  quality	  	  •  Musculo-­‐skeletal	   ...
Selected	  causes	  of	  death:	  2008	                                                  	                                ...
Selected	  causes	  of	  death:	  2008	                                                  	                                ...
Selected	  causes	  of	  death:	  2008	                                                  	                                ...
Benefits	  and	  risks:	  modelling	  De Hartog et al, 2011
Benefits	  and	  risks:	  modelling	  •  Physical activity ‘by far’ the most important•  “Concern about pollution exposure…...
•  There	  exists	  the	  poten+al	  of	  a	  modal	  shi_	  from	  oil-­‐based	  car	  transport	  to	     food-­‐based	 ...
Benefits	  and	  risks:	  HIA	  
Physical activity accounted for >70% of benefits
NICE	  Guidance	                                     	  Environment: published 2008                               Walking ...
NICE	  economic	  modelling	  
The comparison of physical activity with       other lifestyle interventions18000	                                        ...
Challenges	                                       	  •    Paradigm	  shi_	  in	  transport	  planning	  •    Culture	  shi...
Nick cavill   morning plenary -highlighting the costs and benefits of cycling
Nick cavill   morning plenary -highlighting the costs and benefits of cycling
Nick cavill   morning plenary -highlighting the costs and benefits of cycling
Nick cavill   morning plenary -highlighting the costs and benefits of cycling
Nick cavill   morning plenary -highlighting the costs and benefits of cycling
Nick cavill   morning plenary -highlighting the costs and benefits of cycling
Nick cavill   morning plenary -highlighting the costs and benefits of cycling
Nick cavill   morning plenary -highlighting the costs and benefits of cycling
Nick cavill   morning plenary -highlighting the costs and benefits of cycling
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Nick cavill morning plenary -highlighting the costs and benefits of cycling

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

  1. 1. Highlighting the costs and benefits of cycling Nick Cavill PhDcavill ASSOCIATESpublic health consultancy
  2. 2. 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
  3. 3. Ac+vity  levels  in  England    100   100   90   %  ac+ve:  self  report     90   men   80   80   %  ac+ve:  objec+ve     women   70   70   60   60   50   50   42   40   40   31   30   30   20   20   10   6   10   4   0   0   1997   1998   1999   2000   2001   2002   2003   2004   2005   2006   2007   2008   men   women   Source: Health Survey for England 2008
  4. 4. Physical  ac+vity:  health  benefits  Children  and  adolescents   Adults    •  improved  cardiorespiratory   •  lower  risk  of  early  death   endurance   •  heart  disease  &  stroke  •  muscular  fitness   •  type-­‐2  diabetes  •  favorable  body  composi+on   •  high  blood  pressure  •  improved  bone  health   •  adverse  blood  lipid  profiles  •   improved  cardiovascular  and   •  metabolic  syndrome   metabolic  health  biomarkers   •  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).    
  5. 5. 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
  6. 6. 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
  7. 7. Promo+ng  health  through  physical  ac+vity:  which  would  you  choose?  
  8. 8. Cycling:  systema+c  review    
  9. 9. Cycling:  systema+c  review    
  10. 10. Broader  benefits  to  public  health    •  Improved  air  quality    •  Improved  social   cohesion    •  Less  noise    •  Reduced  traffic  danger    •  Improved  environments   for  play  and  ac+vity    
  11. 11. Cycling:  the  poten+al  risks    •  Road  traffic   casual+es    •  Air  quality    •  Musculo-­‐skeletal   injury    
  12. 12. Selected  causes  of  death:  2008     Deaths,  2008  35000   32647  30000  25000  20000  15000  10000   5000   2538   115   0   cyclists  killed  on  road*     All  road  users**     CHD  aributed  to   inac+vity***   Source: * **DfT Road Traffic Casualties 2009 *** BHF statistics 2010 edition; McPherson et al 2002.
  13. 13. Selected  causes  of  death:  2008     Deaths,  2008  35000   32647  30000  25000  20000  15000  10000   5000   2538   115   0   cyclists  killed  on  road*     All  road  users**     CHD  aributed  to   inac+vity***   Source: * **DfT Road Traffic Casualties 2009 *** BHF statistics 2010 edition; McPherson et al 2002.
  14. 14. Selected  causes  of  death:  2008     Deaths,  2008  35000   32647  30000  25000  20000  15000  10000   5000   2538   115   0   cyclists  killed  on  road*     All  road  users**     CHD  aributed  to   inac+vity***   Source: * **DfT Road Traffic Casualties 2009 *** BHF statistics 2010 edition; McPherson et al 2002.
  15. 15. Benefits  and  risks:  modelling  De Hartog et al, 2011
  16. 16. 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
  17. 17. •  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.    
  18. 18. Benefits  and  risks:  HIA  
  19. 19. Physical activity accounted for >70% of benefits
  20. 20. NICE  Guidance    Environment: published 2008 Walking and cycling: in press
  21. 21. NICE  economic  modelling  
  22. 22. The comparison of physical activity with other lifestyle interventions18000     17000  16000    Cost/QALY  14000  12000   9515  10000   8000   6000   4000   2000   440   0   Physical  ac+vity     Sta+ns     smoking  cessa+on    
  23. 23. 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    

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