Public Health

Why we don’t walk and cycle enough and what to do about it

It is well established that the trade off between health and economic productivity is a false trade off. Covid has taught us this (ref) and it was well established already (NHSA and CMO report).

Here there is a focus on transport policy, the role of DfT and active travel within that.

1            Transport as a health issue

Before I get going, I frame it here as a HEALTH issue. You could equally frame it all as a CLIMATE issue with relatively little change in the actual words used.

The impact of transport on health was very helpfully summarised by the Health Foundation last year.

Poor air quality kills people. We don’t walk enough, we don’t cycle enough, we drive too much especially for short journeys (30% of all journeys in South Yorkshire are less than 500m, a third).

This is bad for us, and bad for the planet. ALL journeys are “health related” – by rote of whether we sweat or not in travel, or whether we contribute to or alleviate air quality in those trips. Most of those short trips can be considerably quicker by bike than car.

2            Creating a cycling and walking culture

We all talk about creating a cycling culture, but that DOES need to be created. It is worth a watch of Motherload  – both inspiring and uplifting of how one mum (and lots of others) are changing the way they think about transport for them and their families. There is a lot in there on culture and a lot on engineering. Most of the people who see it will be bike dorks, but the key to creating a cycling culture is about making it seen and understood outside the bike dork group (DOI I am one of them). I did a brief summary and reflections.

I should say at this point of course, walking and public transport also matter hugely, maybe MORE than cycling).

However the significant modal shift that government seeks wont be solved by simple behavioural fixes and nudges. It will take significant investment shift away from transport investment to support driving. Infrastructure and the right standards for it matter. Glasgow Centre for Population Health published a report on learning over last 10 years around active travel. In short not much change delivered by individual behaviour change, significantly more change by infrastructure + committed leadership. The key shift is to build active travel infrastructure into all developments with a build it and they will come mentality (and the evidence supports that they will – see this story from Paris and Groningen). There are plenty of road maps (sic) on building active travel into our places, see this from Arup on a walking world and this from TfL on healthy streets.

3            To get to an answer of why we don’t walk and cycle much, follow the money – we don’t invest much

On infrastructure there is no doubt there is much more every city can do, however on this it is worth noting recent 2019 IFS report documenting a 42% cut in local spend on transport. The critical picture is here. Furthermore funding broadly for active travel has a very low starting point


There are plenty of investable ideas set out by Arup – building activity into design phase, TfL Healthy streets framework , the stuff done on low traffic neighbourhoods.  “a few schemes to encourage more cycling” won’t lead to much large scale change. Focus on the rules and the fundamental dealbreakers.

Within the transport sector, car is king, this skews investment in active travel. Why is this as it is – basically the ROI model is ALL wrong

Much is made of the transport hierarchy with pedestrians at the top of it, yet investment priorities don’t reflect this. Of course there have been substantial positive shifts during covid in many towns and cities, we have a historic opportunity to lock these in and accelerate them further.

Refurbishing 10 miles of the M62 costs roughly the same as the whole of the active travel budget for DFT for England (ref needed). There are rather a lot of 10m stretches of motorway being refurbished. Of course it is no surprise we never build many miles of cycle lane etc – there’s no money by the time DfT and Highways England have built all those 7 lane smart motorways. The national budget for active travel is in the order of £338m, and for roads – £27.4bn.

There are plenty of reasons why the current investment model is as it is.

Transport for work (seems standard economic model) vs transport for transport as one of the drivers of an economic model. The work aspect is hardwired in the DNA of most documents I see. I get this, it’s understandable. But people travel for all sorts of other reasons, inc many short journeys. That collectively has impact on road capacity and AQ no?

The basic economic model based on cars and road capacity as a solution to congestion which underweights the externalities of too much driving and too many cars). Thus we allocate the transport resources to build roads, build roads then we don’t ease congestion and don’t achieve any modal shift. The DfT Transport Appraisal Guidance (TAG) which the DfT use to assess major schemes is very much focused on the Treasury’s Green Book 5 Case Model, placing a significant weight on the economic impacts of investment. 

However 1) DfT prioritise devolved transport schemes based on GVA (wages*people) impact alone, 2) The evaluation of ROI for roads and other transport schemes fails to include their environmental and health and well being impact (obviously interlinked). There isn’t much (any?) focus on externalities. (see here 123 for further detail on this).

The health return on investment of modal shift

Woodcock demonstratedsignificant NHS benefit active travel (see table 5 and fig 1) and TfL highlighted the  health benefit of transport policy in London, as did this study highlighting the impact on both life expectancy and GDP from modal shift.

The wider economics

This piece considered the economic effects from driving vs cycling studied in Copenhagen and was an exercise in calculating the externality of car travel; for every one KM by car costs society about €0.17  society gains €0.16 for each KM cycled, or when all costs and benefits are considered it is Six times more expensive to travel by car than by bicycle. This study was in part used to justify significant investment in cycle infrastructure since it offers returns, while encouraging driving has large costs. Copenhagen has shown the most impressive recent increase in cycle rate, even from a high base: up from 36% to 45% in two years (seemingly due to major road disruption from constructing 17 new metro stations at once.

4            Beyond the evidence – Framing matters and challenging dodgy ideas and or vested interests 

It isnt all about the evidence. There is a substantial belief gap also to contend with, and a lot of vested interests and lobbying for status quo

Here are some

4.1         This is a a war on cars or motorists

it isnt but it is a war on the harm caused to our children’s lungs, or our planet that we will give to our grandchildren)

4.2         But building bike lanes will kill passing trade for businesses.

Increased levels of cycling can bring benefits for everyone, whether they cycle or not. Bicycles take up far less road space than cars and emit no toxic fumes. They’re good for our high streetsEvery Study Ever Conducted on the Impact Converting Street Parking Into Bike Lanes Has on Businesses

4.3         We see questions of why are parks and bike lanes are an investment for health and well being, but why not roads

4.4         Its quicker to drive.

Nope. Motorists are only marginally quicker than cyclists, shows DfT modelling (and the cyclists had time added on for parking). And do cyclists really take five minutes to park their bikes? DfT data shows that on A-roads, motorists average 27mph but only average 11.6mph on urban streets.

4.5          But the “we aren’t Copenhagen or Amsterdam”.. 

30 years ago, both were car parks. Of course not every city can be like Copenhagen or Amsterdam, look through historic photos and it can be seen that 30 years ago both cities were gridlocked.

4.6         Exposing the lobbying and tactics of powerful vested interests

oil and car industry stand to loose from significant shift from car to non car modes of transport. Have a look at the tactics of other industries that may sell us stuff that’s bad for us, and we may get an insight into possible tactics. Have a read of Merchants of Doubt

Not to be forgotten is the enormous subsidy we give to fossil fuels, effectively making driving cheaper than the true cost (never mind taking into account the externalities). The petrochemical infustry (and lots of others) probably don’t want this to change.

4.7         “The economy” question. This will all be “harmful to the economy”.

Nope. But needs debunking.

There is a narrative on this, but rarely any data. In fact plenty of data to the contrary

The EPA in the USA (Clean Air Act and the Economy) have considered the question of the economic benefit of a clean air act at some length – benefit from addressing health related issues, clean air and growing economy are symbiotic, sustainable technology and related industries itself a driver for economic growth. As ever people have completely different word views on this…. And doubtless US Treasury more influenced in a traditional way?

This RAND study (AQ related) in Pittsburgh  noted concern re improving air q having a detrimental effect on economic performance – by being see as “anti business” and “anti car”. When you factor health INTO the econ equation it is FAR more straightforward. Then factor climate in and it changes the fundamental economics fundamentally.

4.8         We need more road space to solve congestion

We should also get into the issues re cars / road capacity / congestion economics. How much does traffic congestion cost UK Econ. The reverse counterfactual also has consequences INRIX demonstrated that traffic congestion will cost UK economy £300bn over a decade or so, so the issues around cars & road capacity as a solution to congestion does matter.

Building more roads doesn’t seem to solve the problem it promised to solve.

It’s a bit like building more hospitals? – you can never have too many, but too many give adverse consequence.

The classic research on whether expanding (trunk) roads caused more driving is from SACTRA, summarised here – seems horribly hard to measure conclusively, and contexts vary, but it seems to conclude that broadly more roads = more driving.

We KNOW the supply led demand hypothesis is in play with regard to roads / cars. Some seem to doubt the same is in play for cycle infrastructure/ bikes. The evidence supports the opposite – build it and they will come, Paris – cycling up 50%.

Lastly this is an excellent thread on congestion / road capacity

5            Concluding thought

We want all more cycling and walking. We all want better air quality. It REALLY matters for our health, our climate and many other reasons. All of this is based on “health” relatively narrowly defined. If one factors in the costs and consequences of carbon in a climate perspective, my guess is that it amplifies the benefits of shift (or the cost of not shift) by orders of magnitude.

There is plenty that local places can and should do. There is more we can do o the interconnectedness of policies. We often put active travel and cycling in one box then consider cars, road building and fossil fuel policy in completely separate spaces.

Changing the rules by which the system operates might. Here I have focused on some of the constraints at government level. The real leverage points are here, and we shouldn’t neglect the importance of leverage points.  Here the focus is on active travel and DfT perhaps also HMT and DEFRA. The outcome – modal shift – is something that impinges on climate, air quality, obesity policy and well beyond. 

Every govt dept creates (or worsens) health, thus every department should be responsible for the health consequences of their policy programme and investments. Whilst  DHSC might “own” health policy it also has to be the responsibility of every govt dept – in this case as a minimum HMT or DfT and DEFRA

2 replies on “Why we don’t walk and cycle enough and what to do about it”

Interesting article, but the comparison of building more roads to more hospitals is a case of false equivalence. Building more hospitals doesn’t cause more folk to be sick, whereas building more roads means folk drive more because of induced demand, so congestion never eases.


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