Cycling & Health in the East Midlands

1. Cycling & Healthin the East Midlands Helen Ross Senior Public Health Manager Dept of Health – East Midlands

2. Summary of session • Presentation - Cycling and Health • Changes in the Health Service • Why is cycling important to health? • What is happening in the region to promote good practice? • What can you do to make it easy for more people to cycle more often?

3. Changes in the Health Service • Health White paper – see Department of Health Website • Public health white paper – December? • Proposal to replace Strategic Health Authorities and Primary Care Trusts. • GP consortia to develop and take on commissioning of health services. • Fast pace of change • Accompanied by cost pressures in the Health service and Local Authorities

4. Why is cycling important to health? • Where cycling replaces driving; - • An important part of Sustainable Development; - 'development which meets the needs of the present without compromising the ability of future generations to meet their own needs.’ * • There is a legal duty to cut carbon emissions under the 2008 Climate Change Act. Cycling instead of driving will contribute. • Peak Oil: when the maximum rate of global petroleum extraction is reached, after which availability of production will decline. Global oil production is expected to peak and begin its decline within the next 10 years. • Saves money • Health co-benefits • Trust-wideSustainable Travel Plans by 2010 * http://www.defra.gov.uk/sustainable/government/publications/ukstrategy/documents/Chap1.pdf

7. 17% travel Building energy use 24% Procurement 59% NHS carbon footprint1 21 million tonnes CO2e 15 1 England. NHS Sustainable Development Unit 2010

9. Obesity is growing at an alarming rate, with a significant impact on individuals, the NHS & society as a whole • Health impact of obesity: • 58% type-2 diabetes • 21% of heart disease • 10% of non-smoking related cancers • 9,000 premature deaths a year in England • Reduces life expectancy by, on average, 9 years. • Costs of obesity: • NHS - £4.2bn • Wider economy - £15.8bn • Foresight estimate costs to economy of £50bn by 2050 Foresight report: By 2050, 60% of men and 50% of women could be clinically obese

10. A Vision Successful health organisations in 2050 will;- • be low carbon, highly efficient in their use of resources • commission and provide high quality services that deliver health improvement as well as treating ill health. • be resilient to the predictable impacts of climate change.

11. Transport / Travel Estimated 5% of all journeys on road are NHS related Bus routes, bike routes, covered and secured bike racks near doors, showers, drying rooms and lockers….

12. Health co-benefits Walking, cycling, eating locally grown fruit and vegetables, eating less red meat are both good for health and good for the environment. 13

13. The Marmot Review • Improving active travel across the social gradient includes providing incentives to increase levels of active travel as well as initiatives to improve safety to encourage active travel. • The provision of cycling infrastructure can lead to a long-term increase in cycling and a reduction in cycle casualties. • Substantial increases in the number of cyclists also leads to reductions in the numbers of cyclists killed or seriously injured. • The presence of pavements or footpaths that are well maintained with good surfaces, cycle paths, and street lighting increases the number of walking and cycling trips. • Lowering speed limits improves quality and access for active travel and improves safety for pedestrians and cyclists. • Traffic calming measures reduce speed as well as the volume of traffic, and the frequency and severity of traffic accidents, leading to increased walking and cycling. • In London, where 20 mph zones have been introduced, injuries have decreased by 40 per cent, with cyclist injuries falling by 17 per cent and pedestrian injuries by a third.

14. Do the risks of cycling outweigh the health benefits? • The answer is, quite clearly, no: the actual risk of cycling is tiny. • one cyclist death per 33 million kilometres of cycling • being sedentary presents a much greater risk. • Over 50,000 people die in the UK each year due to coronary heart disease related to insufficient physical activity, compared to around 100 cyclists killed on the road. • safety risks are outweighed by the health benefits by a factor of around twenty to one. Source: Active Travel Survey

15. What can happen to promote good practice in the region? • Health Impact Assessments? Consideration of ‘Human Health’ is a legal requirement in a Strategic Environmental Assessment (SEA) and a health impact assessment (HIA) is an integral part of a SEA to identify and inform health issues in Plans. Undertaking an HIA should provide an evidence base to help the decision making process in developing effective Local Transport Plans, and to mitigate the negative effects on health and well‑being In addition, it should help: ● secure consistency between the Local Transport Plan and work associated with Sustainable Community Strategies and Local Area Agreements; ● coordinate the public health concerns in respect of air quality, noise and climate change; ● contribute to the wider agenda relating to quality of life and reducing health inequalities. Local transport authorities are required to consult such others as they consider appropriate. This could include GPs, Primary Care Trusts, Hospitals, NHS Trusts

16. What is happening? • East Midlands NHS Sustainable Development Network • Aims to equip NHS organisations to develop sustainably and specifically to reduce their carbon footprint whilst improving the quality, productivity and effectiveness of their health improvement and care services.

17. Cycling for Health • NHS Nottingham City has been working closely with the local authority for many years to promote cycling, including initiatives aimed at NHS employees; work to influence the local transport plan; and more recently as one of Cycling England’s Cycling and Health Innovative Pilot Projects. • The PCT project delivers a wide range of promotional activities in conjunction with Ridewise, a local cycle training company. • These include cycle training for members of priority community groups; free loan bikes; promotional activities and offering free cycle training for NHS staff. The unique aspect of the project is that it enables NHS staff to refer people into the scheme • Clients have been signposted to the scheme from a wide range of community health professionals including Health Trainers; Physical Activity Advisors; Exercise Referral Instructors; YMCA staff; Healthy Minorities team and NHS staff themselves. The project exceeded its two year training target in the first 11 months, and introduced people to cycling from a wide range of backgrounds.

18. References NHS Carbon Reduction Strategy, NHS SDU, 2009 Sustaining a Healthy Future. Taking action on climate change. 2008. FPH. Gabrielle Walker and David King. The Hot Topic Taking the Temperature – Towards an NHS Response to Global Warming NHS Confed. (2007) The Health Dividend – Coote, A, King’s Fund Sustainable Energy - Without the Hot Air. David J.C. MacKay (Dec 2008) Global health, global warming, personal and professional responsibility, Cambridge Medicine, Pencheon D, Vol 2, No 22, 2008 Health Practitioners Guide to Climate Change; Griffiths et al, Earthscan 2009 The Department of Health Physical Activity web pages can be found at: http://www.dh.gov.uk/en/publichealth/healthimprovement/physicalactivity/index.htm Foresight Report http://www.foresight.gov.uk/OurWork/ActiveProjects/Obesity/KeyInfo/Index.asp http://www.ic.nhs.uk/ Fair Society Healthy Lives: -The Marmot Review – Strategic Review of Health Inequalities in England post 2010 – february 2010 ISBN 978–0–9564870–0–1 Good Corporate Citizenship Assessment Model - Sustainable Development Commission; –www.corporatecitizen.nhs.uk Government policy on cycling is found at: A sustainable future for cycling http://www.sdu.nhs.uk/ Cycling England usefully collates data at: http://www.dft.gov.uk/cyclingengland/site/wp-content/uploads/2009/01/cycling_ and_health_full_report.pdf NICE (2008) Guidance on the promotion and creation of physical environments that support increased levels of physical activity: http://www.nice.org.uk/Guidance/PH8 Cycle Touring Club collects health data at: http://www.ctc.org.uk/DesktopDefault.aspx?TabID=4629 Information on the Health Impact Assessments can be found at: http://hiagateway.org.uk/ Active Travel Strategy the successful results of the first round of cycle

19. Internet resources • Emphasis website – sustainable development section • www.nef.org.uk/ • New economic perspectives and sustainable energy solutions • www.energysavingtrust.org.uk/ • Energy Saving Trust: great for all aspects of saving energy

20. What can you do to make it easy for more people to cycle safely more often? • “The future is not some place we are going to, but one we are creating. The paths are not to be found, but made, and the activity of making them, changes both the maker and the destination” Deborah James