Sutton Four Oaks ward cycling/walking advantages

54-57 Allison Street, Digbeth Birmingham, B5 5TH
tel 0121 632 6753
January 12, 2005

Cycling and walking in Sutton Four Oaks..the health and cost benefits

Dear Councillor
As you know Pushbikes is trying to make cycling and walking safer and more popular in Birmingham. As outlined below there would be tremendous benefits for citizens of Sutton Four Oaks, and Pushbikes would appreciate your support in encouraging the Council (and Primary Care Trusts) to make the changes needed for safer and more cycling and walking.
Our cycling model is based on tried and tested policy, which has been implemented in cities such as Amsterdam (50% cycling), Ferrara, Copenhagen, Cambridge, Hull and central London.
What would be the benefits for Sutton Four Oaks?

1	Diabetes is increasing at 10% year, and cycling/walking reduce the risk of diabetes 50%. There are 21,690 people in Sutton Four Oaks, and 5% will be diabetic (1084 patients). Thus in 10 years there may be 2169 people with diabetes. But if 50% of us started cycling as in Amsterdam, the increase would be negligible. Looking another way, there are about 217 cyclists at present, 1% of the population. By 2015, for every 217 extra cyclists (1%) in Sutton Four Oaks, there would be 11 people with diabetes instead of the expected 22.
2	Obesity.....cycling and walking halve the amount of obesity & heart diesase. Obesity is likely to cost £4.25m/year in Sutton Four Oaks , at todays prices, in 2015...as it will then account for 17% of the healthcare budget, reducing the amount spent on other conditions. If 50% cycled or walked these costs would be halved. Similarly, for every 217 (1%) extra cyclists in Sutton Four Oaks, there would be £21,000/year less needed treating obesity, and nearly 108 fewer people obese.
3	Cancer risks are halved by regular exercise. There are about 75 deaths each year from cancer in Sutton Four Oaks . For every 8 people cycling/walking, 1 case of cancer will be prevented. Thus, if half the population cycled or walked every day, 19 deaths/year would be prevented in Sutton Four Oaks.
4	Road traffic accidents cause about 3 deaths or serious injuries in Sutton Four Oaks each year. The World Heath Authority notes that if speeds were 10mph slower, risks would be halved, that is 1.5/year. In addition, slower speeds make cycling and walking safer and more popular. Each death/serious injury costs the state £1m, so it is likely Sutton Four Oaks would save £1.5m. This money could be spent on other social services, education, or housing. Slowing speeds largely needs a culture change, with publicity, and could be achieved cheaply, although spending on traffic calming would be needed.
5	Crime costs Sutton Four Oaks £25m/year, and there are about 50 serious crimes a year in the ward. It is known that exercise such as cycling and walking reduces criminal behaviour by about 33%. On this basis, every 1% increase in cycling/walking would be likely to save £80,000/year in Sutton Four Oaks by reducing crime.
6	Education expenditure is £25m/year in Sutton Four Oaks. Educational achievement increases 18% with sports programs, so the ward would gain nearly £2.25m in extra educational value and qualifications if the number of peope taking regular exercise increased by 50%, or about £50,000 increase in achievement for each 1% (217) extra walking or cycling.
7	Mental health costs £3m/year in Sutton Four Oaks. Again, exercise reduces depression and improves mental health in 40-50%. This would be likely to result in mental health savings of £30,000 for every 217 (1%) increase in cycling or walking in Sutton Four Oaks . In addition, there would be less time off sick, and much less family disruption.
8	Substance abuse and drug use costs may be expected to be about £25m/year in Sutton Four Oaks. Yet substance abuse is reduced by 30% in those that exercise regularly. Once again, savings could be expected to be £100,000 year for each 217 (1%) increase in cycling or walking, with less smoking, binge drinking, and other drug use.
9	Social exclusion and urban deprivation are worst in poorer sections and ethnic minority parts of the community. These are the people with the worst health who would gain the most cycling and walking more. Teenage pregnancy rates are also lower with exercise.
10	Blindness and partial sight are also related to lack of exercise, as lack of exercise increases rates of diabetic retinopathy, and almost certainly macular degeneration (Macular degeneration is linked to smoking, and smoking rates are lower in those that exercise, and higher blood pressure, which is also lower with exercise). There are currently about 500 people with these conditions in Sutton Four Oaks, and about 1 in 10 will become partly sighted as a result. For every 217 (1%) increase in cycling or walking in Sutton Four Oaks, 2.5 fewer people would be expected to become blind.
11	Pollution would be greatly reduced by cycling, walking, bus lanes, and less traffic. Nearly 8% of cardiovascular disease in the city may be attributed to road pollution, and probably a similar number from cancer. In Sutton Four Oaks, about 150 people die each year from heart disease and cancer, perhaps 12 of these due to pollution from cars. The only cost effective way of reducing pollution is encouraging more cycling and walking, and providing an efficient bus service, which requires bus lanes and less car traffic.

At present cycling and walking rates are reducing in Sutton Four Oaks, roads are faster than ever, traffic increasing, bus lanes are being abandoned in the city, with massive increases in obesity and diabetes. Planned pro-cycling and walking measures will not be not sufficient to significantly influence behaviour or make cycling safer, and Dr Jacky Chambers' advice has been ignored for years.

We have shown there would be great benefits of more cycling and walking to the people of Sutton Four Oaks. But to achieve this we need such measures as cycle paths, slower speeds, more bus lanes, less traffic, and Primary Care Trusts supporting cycling and walking officers encouraging individuals to cycle.
Your support is needed in the Council to persuade the Cabinet members and Transportation Department to implement such measures.

Yours sincerely,
David Kinshuck MBBS MBA FRCOphth, Be Cycling Campaign, Pushbikes
Member of the Royal College of Ophthalmology Ocular Public Health Group

References	this page and the abstracts/full articles can be viewed online... www.brum.org > Be Cycling > Sutton Four Oaks
Cycling network & model	http://europa.eu.int/comm/environment/cycling/cycling_en.pdf
diabetes	http://www.rcn.org.uk/news/congress2002/congressitems/diabetes.php
obesity	http://www.healthaffairs.org/press/mayjune0302.htm http://www.publications.doh.gov.uk/nsf/diabetes/delivery/ch6/prevention.htm http://www.idfa.org.uk/publications/HOC_obesity.pdf Chief Medical Officer: At least five a week: Link, Evidence on the impact of physical activity and its relationship to health
cancer	Am J Epidemiol. 2004 Nov 1;160(9):860-7. Link Commuting physical activity and risk of colon cancer in Shanghai, China. Hou L, Ji BT, Blair A, Dai Q, Gao YT, Chow WH. Am J Epidemiol. 1996 Jul 1;144(1):42-50. Link Physical activity in relation to colon cancer in middle-aged men and women. White E, Jacobs EJ, Daling JR, Division of Public Health Sciences, Seattle, others & more (view online)
road safety and speed	http://www.who.int/world-health-day/2004/infomaterials/world_report/en/ http://www.who.int/world-health-day/2004/infomaterials/world_report/en/main_messages_en.pdf http://www.who.int/world-health-day/2004/infomaterials/world_report/en/speed_en.pdf Evaluation of the health effects of a neighbourhood traffic calming scheme Link J Epidemiol Community Health. 2004 Oct;58(10):837-40. Morrison DS, Thomson H, Petticrew M., Greater Glasgow NHS Board,
crime	http://www.ausport.gov.au/fulltext/2003/aic/rpp49.pdf http://www.aic.gov.au/publications/tandi/ti249.pdf http://www.gateshead.gov.uk/CrimeAudit5.pdf
education	http://www.aic.gov.au/publications/tandi/ti249.pdf Soc Sci Med. 2003 Aug;57(4):577-93.Link Health behaviours and health in adolescence as predictors of educational level in adulthood: a follow-up study from Finland. Koivusilta L, Rimpela A, Vikat A. Department of Social Policy, University of Turku, Finland. J Epidemiol Community Health Link Health related lifestyle in adolescence predicts adult educational level: a longitudinal study from Finland. Koivusilta L, Rimpela A, Rimpela M. Department of Public Health, University of Turku, Finland Prev Med. 2004 Dec;39(6):1115-25. Link Age, gender, and urban-rural differences in the correlates of physical activity. Plotnikoff RC, Mayhew A, Birkett N, Loucaides CA, Fodor G. Center for Health Promotion Studies, University of Alberta
mental health & substance abuse	http://www.ncbi.nlm.nih.gov/en14962 J Behav Med. 2002 Oct;25(5):425-38.Link Relations between youth antisocial and prosocial activities Duncan SC, Duncan TE, Strycker LA, Chaumeton NR, Oregon Research Institute Soc Sci Med. 1990;31(5):551-6. Link Sport participation and perceived health status: a study of adolescents. Thorlindsson T, Vilhjalmsson R, Valgeirsson G. Department of Social Sciences, University of Iceland. Soc Sci Med. 1990;31(9):963-9. Link Self-perceived health among sports participants and non-sports participants. Lamb KL, Roberts K, Brodie DA, Department of Sociology, University of Liverpool, Child Care Health Dev. 1997 May;23(3):207-16. Link Diet, smoking and exercise: interrelationships between adolescent health behaviours. Coulson NS, Eiser C, Eiser JR, Department of Psychology, University of Exeter, UK. Eur J Public Health. 2001 Sep;11(3):294-300. Link Patterns of unhealthy behaviour in Finland, Laaksonen M, Prattala R, Karisto A Health Educ Res. 1999 Apr;14(2):225-33. Link Sport activity in adolescence: associations with health perceptions and experimental behaviours. Ferron C, Narring F, Cauderay M, Michaud PA. Cost of drug use http://www.gdcada.org/stories/price.htm
teenage pregnancy rate is higher in those without exercise	J Sch Health. 2000 Jan;70(1):5-17. Link Youth risk behavior surveillance. National Alternative High School Youth Risk Behavior Survey, United States, 1998. Grunbaum JA, Kann L, Kinchen SA, Ross JG, Gowda VR, Collins JL, Kolbe LJ. J Adolesc Health. 1999 Sep;25(3):207-16. Link High school athletic participation, sexual behavior and adolescent pregnancy: a regional study. Sabo DF, Miller KE, Farrell MP, Melnick MJ, Barnes GM.
ethnicity & social exclusion	Med Sci Sports Exerc. 1998 Nov;30(11):1608-15 Link. Physical activity in urban white, African-American, and Mexican-American women. Ransdell LB, Wells CL. Department of Kinesiology and Health Promotion, University of Kentucky
diabetic retin.	http://medweb.bham.ac.uk/easdec/prevention/diabetes_and_the_family.htm
macular degeneration	http://www.goodhope.org.uk/departments/eyedept/armd%20patho l.htm#A%20healthy%20lifestyle
pollution	http://news.bbc.co.uk/2/hi/health/3991633.stm http://airviro.smhi.se/cgi-bin/airweb.station.cgi?Bristol_street&first