The British Medical Journal published the findings
of a huge research project last week comparing health outcomes for people in
the UK who travel to work in different ways. They found that the 2% of people
who regularly commuted by bike had a 40% lower death rate, a similar reduction
in cancer deaths, and less than half the risk of dying of heart disease. Regular walking commuters also had
reduced risks of dying from heart disease.
Obviously some of this difference may be
because the cyclists are healthier in the first place, but the differences are
huge, and very statistically significant (i.e. very very unlikely to be a
chance finding). So the potential benefit to the health of the UK from a large
increase in ‘active’ commuting is massive. But how can this be done.
In rural Zambia, almost all journeys to
work are on foot or by bike. The mass of cycling and walking commuters on the
roads in the morning and evening would gladden the heart of any public health
doctor. If only the UK population
would do the same. The difference is also very obvious when one looks at the
muscles on display. The glutes, the six packs and particularly the back muscles
of most Zambians would be the envy of many a pilates instructor.
So how have they managed to achieve this
situation? And can we copy from them?
First of all they have very little
alternative! There are a few cars that operate as taxis but they are
unaffordable for the majority. Secondly, they have really taken on the bicycle
in the last ten to fifteen years. They can buy cheap new bikes from china for
$70 or so, and recycled bikes from the US and Europe for even less. They are
used as much for transporting goods (especially huge bundles of firewood) as
people. The bicycle is ideal here
as the terrain is pretty flat and paths between the tiny villages on the clay
earth make an excellent flat surface.
There are also few people who live more than 10 km from their work.
So many of us cannot really follow their
example.
Unfortunately it seems more likely that
they are beginning to follow ours!
If you do have an office job in Zambia, or
work for example as a safari guide, you will be sitting down most of the time,
and there are very few opportunities to take recreational exercise unless you
are young and fit enough to play for one of the many football teams. So
economic development seems certain to worsen the outlook here for the ‘Diseases
of affluence’, and we do often see slightly overweight office workers or
housewives with pot bellies and diabetes and high BP. And the toll from these diseases in
terms of Strokes and Heart failure is bad now and certain to increase.
We have just finished “National Health
Week” in Zambia. One of the daily messages sent out to everyone with a mobile
phone last week was ‘Exercise 3-4 times a week to reduce your risk of Heart
Disease and Diabetes.’ Pretty hard
to understand if you are subsistence farmer! And hard to understand in a
society where for most people physical exercise is work, and rest is physical
rest.
So the image of happy cycle commuters is
great, but we cannot learn from Zambia how to get there. They may learn from us
about the dangers of a sedentary society, but it will be a hard lesson.
The positive images we can try to follow,
are those of Amsterdam and Copenhagen, where bikes exceed cars for commuter
journeys. To get there we just
need to invest massively in cycle infrastructure, regulate or tax car commuting, and get employers onside in
terms of secure bike parking etc.
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