On why cars should come with a health warning, and maybe our cities should too

News from the front desk #388: The health risks of car dependency were spectacularly revealed this week. A study in respected medical journal Heart found that if you’re getting to work by active means – walking, cycling or even public transport – you’re 11 per cent less likely to get heart disease or have a stroke, and 30 per cent less likely to die from them if you do fall victim, compared to those who exclusively rely on a car. Those who use active transport for non-commute travel reported a 43 per cent reduction in fatal cardiovascular deaths too.

And – we’re not done yet – for people not regularly commuting, getting around by more active means of transport means an eight per cent lower risk of dying from all causes. If that’s not a clarion call for more focus on and investment in active transport, we don’t know what is.

The UK-based study wasn’t trifling by any means. It took data from more than 350,000 people (mainly urban areas) and followed their movements for years, controlling for other variables. And while it’s not like we haven’t heard this sort of evidence regarding inactivity borne out of car dependency before, it is rarely done with such a large, comprehensive sample.

The researchers said the findings could therefore “shift the overall balance of evidence” to show with certainty the benefits of active travel in preventing heart disease (and let’s not forget productivity and environmental benefits while we’re at it).

In Australia, like most developed nations, heart disease is our number one killer. In 2016, according to the Heart Foundation, 19,077 people died from the disease, representing 12 per cent of all deaths, and it was a contributing factor in 34,810 deaths, or 22 per cent of all deaths. In 2014/15, 620,000 Australians had heart disease.

So an 11 per cent reduction in developing the condition and a 30 per cent reduction in mortality – by stepping away from the car – is a huge deal.

Maybe cities should come with a health warning too

In the study about two-thirds of commuters relied exclusively on the car to travel to work. Unfortunately car dependency is an even bigger issue in Australian cities than the UK’s.

More than two-thirds (68.7 per cent) of people got to work by driving in the 2016 census. Add in those travelling in cars as passengers, motorcycles, trucks and taxis and that figure balloons to 75.6 per cent – more than three quarters of the population.

The results aren’t just to do with attitudes, though. It’s about the shape our cities are in. It goes to the very heart of how our cities are managed and grown. And with the way our major cities are currently being run, it’s unlikely things will get better anytime soon, and they could even get worse.

Take Sydney for example. This week University of Sydney professor Stephen Greaves warned the city was at a “tipping point” that could see people abandon public transport and get back in their cars. The rail network, he said, was straining under the weight of increasing passenger demand, particularly from new developments around train stations. While transit-oriented development is the planning policy du jour, the transport investment needed for it to succeed has not occurred. And it’s making public transport increasingly uninviting.

“People are weighing up the quality of the journey. On the trains and the buses it’s become more of an issue as they’ve become more crowded and people may weigh up taking an Uber to work or driving again,” Professor Greaves told the Sydney Morning Herald.

His warning has been echoed by the Property Council of Australia’s latest report, Creating Great Australian Cities, which found our cities are in poor shape: compared to their international peers they’re “less well serviced by high capacity infrastructure, less coordinated and less well managed”.

The country’s cities were behind international peers on congestion, public transport coverage, commute distance, length of commute times and journey times, it said.

The PCA is calling for a shift to “high amenity, medium density, multi-polar metropolitan living supported by great public transport”.

Perhaps we should be capturing some of the windfall gains landowners are getting from rezonings around our stations in order to fund some of this great public transport.

It gets worse further out

The accessibility of public transport and ability to commute via active transport are obviously big issues. Those living far out of the CBD have less public transport coverage, and walking or riding to work are also less likely to be options.

It’s perhaps why the health outcomes in outer suburbs are so much worse than in inner ones.

• See Mind the gap: Why you’ll die earlier in Sydney’s west

In the UK study, only 17 per cent of adults lived within easy walking distance (2km) of work and only 35 per cent lived within easy cycling distance (5km). In Australian cities, again, these figures would be much worse due to our low density, poor cycling connectivity, and even poorer attitudes towards cycling and cyclists. The researchers, however, said there were still ways to be more active.

“It is possible to incorporate more physical activity into journeys without completely replacing motor vehicle use – for example, by using public transport, or walking or cycling parts of longer journeys made by car,” the authors said.

“These travel patterns involve more physical activity than exclusive car use and can add up over the course of a typical working week to a substantial amount of activity.”

This points to a better focus needed on providing commuter car parks and bike storage facilities at stations (on top of increased transport services and investment, of course).

Universities working to get people out of cars

How Australian cities can coax more people from cars and into more active forms of travel is currently a hot topic. This week, as the UK research was released, a group of Australian universities announced new funding to investigate the most effective ways of encouraging people out of their cars and incorporating physical activity in their daily travel.

The “health by stealth” partnership is looking at the most effective ways of getting people to leave their cars at home and incorporate more physical activity into their lives.

It’s being led by the University of Tasmania’s Menzies Institute for Medical Research, with support from Deakin University and the University of Sydney’s Institute of Transport and Logistics Studies, where Professor Greaves is located.

Lead researcher Dr Verity Cleland said the study would look at ways to “make the healthy choice the easy choice”.

“Healthy transport options including walking, cycling and public transport, lead to health gains and increased social contact and connectedness while reducing traffic congestion, accidents and air pollution,” Dr Cleland said.

Professor Greaves said the study would also look at those in regional cities, which have in the past been neglected.

“The long-term benefit of the study will be a greater understanding of the barriers and triggers to encouraging healthier travel choices as well as better measurement of the travel/health outcomes of such options.”

Those findings couldn’t come sooner.