Health, Wealth and Happiness. The benefits of cycling last through your life

I made three short videos during the study tour two weeks ago. As it happens, all three of them show children and teenagers using the cycling infrastructure in one way or another.


A cycle-path through a residential area in Assen followed by a crossing which is safe for all to use


Teenagers in one corner of a park in Groningen. It was a sunny afternoon, so thousands of people had ridden their bikes to different corners of this and other parks. It's similar if you cycle to the beach.


In this video there's not so much cycling as walking. 6000 people, mostly from primary schools around Assen, take part each year in the local Avondvierdaagse. Participants walk 10 km each day on four consecutive evenings. Because of the number of people taking part they often cause a little disruption on roads and cycle-paths in and around the city, but this isn't the sort of thing that any reasonable person would complain about.

Most, if not all, towns in the Netherlands have an event like this, modelled after the internationally famous Nijmegse Vierdaagse. The Nijmegen event attracts an amazing 45000 participants who each walk a minimum of 50 km per day (reduced to 40 km per day for people under 20 or over 50 years old) for four days in order to earn their medal.

Why are children important ?
Why do I concentrate so much on young cyclists ? That's easy to answer. Today's children are the only possible source of tomorrow's adult cyclists and children are a common interest of the whole population. Children love to cycle and cycling is a transport mode which can offer children a greater degree of freedom and affordability than anything else that is open to them.

If we don't "get them when they're young", i.e. at the age when the affordability and freedom offer a unique combination then we must instead try to convince older people to take up cycling when they've already formed a habit of travelling by other means and when they can more easily afford other means.

Under 18s in The Netherlands make a huge proportion of their
journeys by bike. 0.8 journeys per day for under 12s, 1.7
journeys per day for 12 to 16 year olds. Adults cycle less but
even over 75s make an average of one trip every three days.

Countries which fail to achieve a high cycling rate amongst the young will struggle even more to achieve it amongst adults.

Promoting cycling for everyday journeys is not the same as promoting it as a sport. As others have noted before, sports like swimming or playing tennis are worthy but they are of no use to travel to school or to visit friends. But cycling requires something that other "sports" do not. While any road design will suffice in order to transport people to a swimming pool or tennis court, those same roads very possibly will not suffice so far as making cycling attractive and accessible enough that people who are not cycling enthusiasts will see riding a bike as something for them. To achieve a high modal share amongst young children and teenagers requires our streets and cycle-paths to be so subjectively safe that not only do children feel safe, but that all their parents expect them to be safe as well. This is how the point is reached where children are given the freedom to travel independently.

Adult obesity in OECD countries. Can they be compared
directly ? As some are "self-reported", methodologies
clearly vary between countries.

The avondvierdaagse youtube video (above) was made public a few days ago and one of the first comments asked "Where are the overweight children?". According to the figures I've seen, obesity levels in the Netherlands are somewhat lower than those of many other countries, but not actually near the lowest.

As for what proportion of children are obese, that's difficult to judge. Some figures put this as high as 7% of the total, which would mean you'd expect to see two obese children in each classroom. Is this true ? I don't actually know as I don't work in a school and I've never studied this. It seems high, though. To my eyes there are obviously fewer really large people here than in the UK and that's despite our province, Drenthe, being worse than average for The Netherlands as a whole. I am given to wonder whether differences in methodology of reporting obesity might mean that little can be learned from the comparison of figures which come from different countries. I've seen the same thing with cycling modal share figures, which are almost never gathered in the same way in different countries. In fact, there are often several different conflicting figures available for modal share even for the same town.

Dutch children have the same taste for overly fatty food and soft drinks as those who live elsewhere. However, unlike children elsewhere, the great majority of Dutch children walk or cycle to school. It doesn't stop with getting to school, though. School trips are by bike too (including regular weekly trips to play sports) and children make trips to go shopping, visit friends or buy fast food by bike as well. Without the cycling habit (12 to 16 year olds each make an average of about 1.7 trips by bike each day), it is very likely that obesity would be a bigger problem here than it is.

UNICEF Index of child
well-being. High cycling
countries in orange.

Health, Wealth and Happiness for everyone
In my view, adults owe the next generation the best start in life and the best future we can possibly provide them. If children can cycle then they already have a head start. The freedom of Dutch children is a good part of what makes this country score so well on the UNICEF index.

However, we could also do what is required to enable mass cycling purely for selfish reasons. Let's pretend for a moment that we're not bothered at all about children. Just for the next few paragraphs, think only of the adults...

Dutch doctors find that cycling helps to treat many ills amongst adults. Dutch companies gain a competitive advantage due to their cycling employees. The tax payer gains because when all the costs and benefits are worked out, it's cheaper to build high quality cycle facilities than not to build them. Motorists benefit because more cycling results in fewer traffic jams.

The advantages of cycling keep on adding up, but in order to reap these rewards it is necessary to build infrastructure which offers everyone a very high degree of both safety and convenience.

If we're to achieve mass cycling amongst adults we have to enable it for children so that the pattern is established and can continue through their entire life. Not only is cycling good for physical health, but also for mental health. Happy and healthy children have a better chance of becoming happy and healthy adults.

Teenagers ride home three abreast from their school 17 km away while young children riding a shorter distance in the opposite direction are overtaken by racing cyclists. All these people, and myself as well, need the same infrastructure i.e. that which is easy to understand and offers direct and safe journeys. This consistent high quality experience can be achieved where there are cycle-paths and where there are not. Why aim for anything less ?

A new version of the UNICEF report was published in April. The Netherlands is still in first place, Finland, Sweden and Germany are still within the top six.

Britain reduces the cost of motoring, battles the cost of obesity

This week in Britain:
Fuel duty curbs are multibillion pound tax cut for drivers.


£4.2 billion is spent on obesity every year by the NHS.

Stairs are dangerous - wear a helmet

In 2008, 716 cyclists died on the roads of the United States. It's quite a death toll - it would of course be better if there were fewer. However, by comparison, 12000 people die each year on stairs in the same country. It's much the same pattern in any country. Stairs are much more dangerous than bicycles. Nearly 17x as dangerous.

This article provides a list of helpful tips to prevent injuries from falling:

Here are some tips from the American Academy of Orthopaedic Surgeons and the National Athletic Trainers’ Association to help prevent injuries from falls.

Keep muscles and bones strong, by following an exercise regimen:

1. Strength training with weight bearing and resistive exercise works for all age groups.
2. Practice exercises designed to help improve balance.
3. Exercise at least three days a week to improve strength, flexibility and balance.
4. Choose low-impact exercises, such as yoga, tai chi and Pilates to avoid stress on joints.
5. Stretch daily to improve flexibility and mobility.

Make your home safer with simple improvements:

1. Good lighting, without extension cords, to eliminate dark areas.
2. Slip-resistant walking surfaces.
3. Grab-bars and a night light in the bathroom.
4. Handrails on both sides of stairs extending one foot beyond last step.
5. Remove throw rugs from doorways and hallways.

If you have fallen before, follow these recommendations:

1. Consider a full physical evaluation and balance screen, including vision and hearing tests.
2. Wear shoes with good support, such as lace-up oxford shoes with leather soles and rubber heels.

What's more, "The actual number is probably much larger. We believe most stair incidents are not reported". This is a scandal ! Stairs are demonstrably dangerous. So much so that they are the second largest cause of unintended injuries in the United States. When will we see national campaigns about stair safety, advocacy of helmets and special safety clothing for use of stairs ?

Why are Stannah stair lifts only marketed to the elderly ?

Children should be taught to use Stannah stair lifts. We can save lives with a campaign for this. Parents should set an example by always using a stair lift themselves.

Oh, hang on, there's a worse problem
Wait. Stairs are only the second largest cause of unintended injuries. What's the largest cause ? You'll perhaps not be surprised to hear that Motor vehicles are actually the largest cause of unintended injuries. Perhaps we should be putting our efforts on safety there.

And it gets worse. If you look not just "unintended injuries" but at "preventable causes of death" for the USA, the picture changes again. Now the 43000 deaths per year due to Traffic Collisions looks a little less significant as there are five other greater preventable causes of death. However, up there in the number two position, are 112000 deaths per year due to "overweight and obesity".

With this, cycling comes into the picture again. If the population can be convinced to take regular daily exercise as a part of their everyday lives, there is a very good chance of reducing that enormous death toll. If these people cycle instead of drive, they not only will reduce their chance of being one of 112000 dying each year due to being overweight or obese, they'll also reduce their chance of having anything to do with the 43000 deaths due to motor vehicles.

By comparison, the 716 deaths of cyclists now look a bit less significant. So why are cyclists the focus of so much "safety" campaigning ? In any case, helmets can only do so much. Of those 716 cyclists who lost their lives on American roads in 2009, only some will have died due to a head injury. Of those who died due to a head injury, only some won't have been wearing a helmet at the time of the crash. And of the non-helmet wearing cyclists who died of head injuries amongst the 716, only some might have had their lives saved by wearing a helmet. The potential gain to society by scaremongering over bicycle helmets is small. By comparison, the potential gain by encouraging people out of cars and onto bikes is enormous. Also the potential gain by re-arranging the streets to resemble those of the Netherlands is also enormous. Dutch cyclists are the safest in the world, with a death rate per km cycled 5x lower and an injury rate 27x lower than in the US, even though helmets are very rarely seen except on sport cyclists.

Note that because many of the other preventable causes of death catch up with us only as we get older, if you're an American aged between 1 and 44, the most likely preventable cause of death for you is a motor vehicle crash. For children aged between 9 and 18, it is the most common preventable cause of death worldwide.

If you want to make children safer, and cyclists safer too, then don't campaign for cycle helmets, or for improvements in stair safety either. The thing to do is to copy what has been done in the Netherlands. In particular, this campaign, and always keep an eye on the need for a high degree of subjective safety.

At present, there is a "wrong headed" attempt to make cycle helmets compulsory in Northern Ireland. The last day to sign a petition against this is today.

Update a bit later in the day: Some people in the comments are getting a bit too interested in exact statistics for how dangerous stairs are. Actually, this isn't really the point. The point is that there are many things more dangerous than cycling, however you count them. This post is about keeping a sense of perspective about different risks. There is simply too much scaremongering about cycling.

Note that exercise is listed as one of the things that improves your chances when climbing stairs. Cycling is also low impact exercise, so ride a bike and you're safer there too. In the photo at the top, Judy risks climbing the stairs of a local lookout tower - without wearing a helmet. I'll end on a serious note: Hold the rail when you walk on stairs. It might save your life.

The state of walking and cycling in the USA

"Over one-third of the U.S. population is under age 16 (cannot legally drive) or over age 65. Streets designed just to move cars are leaving behind the most vulnerable road users, often making them prisoners in their homes or completely reliant on others to drive them around. Less than half of states and major U.S. cities have adopted complete streets policies that require that roadways be designed and built with all users in mind." - So says the Alliance for Biking and Walking 2010 Benchmarking Report.

Cycling rates correlate well with rates of investment in cycling, not only within the USA, but also internationally. The success of the Netherlands has come due to investing in the needed facilities - and the facilities really are needed:

"States with the lowest levels of biking and walking have, on average, the highest rates of obesity, diabetes, and high blood pressure. In contrast states with the highest levels of biking and walking have, on average, the lowest rates of obesity, diabetes, and high blood pressure. In addition, where rates of biking and walking are greater, more of the adult population is likely to achieve the 150 minutes of weekly moderate-intensity aerobic activity recommended by the Centers for Disease Control and Prevention (CDC). According to CDC, physical activity can reduce your risk of dying early from the leading causes of death, like heart disease and some cancers."

2015 update
Progress is only possible with continued funding. Sadly, the Cycling Embassy of Denmark reports that funding for cycling in Denmark has been cut. There is no country on earth which can expect cycling to grow organically without support and that includes Denmark and the Netherlands.

The graph shows comparative figures for several cities giving an indication of how funding of cycling is linked to the resulting modal share. Amsterdam spends $39 per person per year and has a 35% modal share, Copenhagen spends $13 and achieves a 20% modal share, Berlin spends $6 for a 10% modal share, Portland spends #3.50 for a 4% modal share, the USA as a whole spends $1.50 for a 1% modal share (cycling and walking combined). Thanks to The Fietsberaad for the pointer to this report

Cycling as medicine

Fietsersbond, together with medical insurance company Zilveren Kruis Achmea, have a new book called "Fietsen als medicijn", or "Cycling as medicine".

A quick translation of part of the website:

"The book is about the relationship between the bicycle and health. Obesity, hart and cardio-vascular illness, diabetes and depression are at the top of the list of preventable problems. They cause much personal harm and result in high costs in health care. But there is one "all on one" house, garden and kitchen medicine: The bike. In the book, normal people tell how cycling makes them healthier and experts put the medical value of the bicycle in plain language, both for prevention and cure."

They go on with a few examples. e.g.

• Housewife Monique Ilbrink (120 kg / 260 lbs ) takes her children to school in a bakfiets. 'If I didn't cycle, I'd get fatter'"
• Former gardener Peter van de Ven cycled after his two heart attacks to become fit again. He is addicted to cycling and now seldom uses a car.
• Marco Meijerink tells how he can keep his insulin level better under control by cycling.
• Dr Willem Heckman uses the bike as an anti-depressive. 'A daily round trip of 40 km works just as well as a pill, but without side-effects'

There are other health stories on the blog, including how cycling saves employers money due to lower sickness costs.

Update January 2010: This book has now been placed in thousands of doctors' waiting rooms in the Netherlands.

Eating ourselves to death ?

The UK newspaper "The Independent" just ran an article entitled "Eating ourselves to death".

Obesity is rising fast in the UK. Deaths due to obesity have risen by 35% over five years, even though there is a lot of under-reporting (read the article). By the year 2050, the cost to tax payers of medical problems due to obesity through the National Health Service and other agencies is expected to rise to £50bn a year. That is a huge amount of money. Just maybe spending a small proportion of that sum on truly encouraging cycling might be a way of reducing this vast expense later on ?

It's pretty obvious from walking down the road here that there are far fewer obese people in this country. It's also obvious that there are a lot more active people.

In related news, the BBC recently had a story on how "Increasing activity levels in middle age can prolong life as much as giving up smoking". Another good reason to promote cycling. Dutch over 60s make a quarter of all their journeys by bike. They are relatively fit and trim, and they have a longer life-expectancy than British people - despite the higher smoking rate and availability of food as pictured here.

The image is of poffertjes (small pancakes served in this case with cream, strawberries and lots of sugar) and beer as eaten by a participant on one of our tours last year. Delicious, and not too unhealthy so long as you are getting plenty of exercise on a cycling holiday.