Nick Cavill

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Nick Cavill Specialist Advisor - Health
Promotion
Nick_at_Cavill.net www.cavill.net
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Influencing public health policy in favour of
cycling A comprehensive national approach
Nick_at_Cavill.net www.cavill.net
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Outline

• Introduction
• National Cycling Strategy (NCS) and Board
• English Regions Cycling Development Team (ERCDT)
• Context why health?
• Projects
• Review of health benefits and risks
• Structure of the health service
• Case studies
• Survey
• Conclusions

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National Cycling Strategy (1996)
Cycle trips/ person/ year

• Target double by 2002 and again by 2012
• Similar levels in Sweden and Germany
• Comprehensive approach
• Accessibility
• Safety
• Road priority
• Parking
• Theft
• Attitudes
• Resources
• Monitoring

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NCS Board (2002)

• Help ensure the implementation of the NCS
  outputs, aims and objectives.
• Focus on key tasks agreed annually with the
  Cycling Forum for England.
• Coordinating and integrating contributions to the
  NCS from all relevant sectors
• Monitoring progress on NCS outputs and targets.

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English Regions Cycling Development Team

• Ten regional co-ordinators
• 3 Cycle development co-ordinators
• 3 Specialist advisors
• Assess local cycling strategies
• Audit implementation
• Build networks
• Identify actions

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Why Health?

• Evidence of positive health impact compared to
  the risks
• Health benefits can be powerful motivators
• Cycling can contribute to the achievement of
  broader public health objectives
• Health service is the largest employer and a
  large generator of trips

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Health is a motivator
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1. Review of benefits

• Direct health benefits
• Coronary Heart Disease
• Diabetes
• Obesity
• Broader benefits
• Air quality
• Noise
• Danger
• Social exclusion
• Costs to society

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Obesity has tripled in 20 years
obese in England (BMI gt30)
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Risk of Cycling

• Perceived risk of cycling is high
• British Medical Association (BMA) has concluded
  that the benefits of cycling are likely to
  outweigh the loss of life as a result of crashes
• BMA report author (Mayer Hillman) estimated 201
  benefitrisk ratio

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Cycling is Safe

• Actual risk remains small one cyclist death per
  33m km of cycling
• Average cyclist could cover this in 21,000 years
• 3-7 third parties are killed per year in fatal
  bicycle crashes
• compared to 1,600 third parties killed in fatal
  car crashes
• Increasing cycling is a road safety measure
• Netherlands, Denmark. Critical Mass

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Cyclist deaths compared to deaths attributable
to inactivity
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2. Cycling in the National Health Service

• The National Service Framework for Coronary Heart
  Disease set a target for the development of
  green transport plans and employee-friendly
  policies by April 2002
• The New Environmental Strategy for the NHS also
  sets a target of the NHS having local transport
  strategies in place by October 2002.
• Achievement is patchy (at best)

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Recommended Action

• Understand and promote the health benefits of
  cycling
• include the broader benefits
• Stress the high benefitrisk ratio
• Help to get cycling on the public health agenda
• Make connections with local authority policies
• address National Service Frameworks
• The NHS as an employer and destination
• Travel plans link to Action Energy

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3. Manual of Case studies

• Examples of practice
• Strong health link
• Prescription
• Rehabilitation
• 2nd chance

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4. Survey of Directors of Public Health

• Baseline for 2002
• Online survey
• All Primary Care Trusts
• Measure progress in the NHS
• Policies
• Programmes
• Promotion