Buses, bicycles and building for health

Dr Jenna Panter writes about her research that found that Cambridgeshire’s ‘guided busway’ is encouraging people to be more active on the commute, and what this might mean for health in our daily lives.

BuswayMost of our time is now spent sitting, whether it’s in the car, at a desk or on the sofa. It is well established that inactivity increases the risk of developing many health conditions including diabetes and coronary heart disease. At the same time, we face the threats brought about by greenhouse gas emissions and climate change. A growing number of voices – from pressure groups to elected mayors – argue that one way to start tackling both issues might be to get us out of our cars, and walking, cycling and using public transport instead. However, not only are our towns and cities rarely well designed for this, but good evidence on how our environment actually affects our travel behaviours has been slow to emerge. This is partly because these relationships are difficult to measure – our complex and changing towns and cities frequently don’t lend themselves to the controlled study designs traditionally used in trials of drugs, or indeed of physical activity interventions targeting individuals. I have been involved in research in Cambridgeshire which presented an opportunity to investigate this question, and its results do indeed indicate that changing the design of transport systems can encourage walking and cycling.

In 2001, the need for new transport infrastructure in Cambridgeshire was clear to travellers and transport planners alike, with the main A14 trunk road suffering from congestion at peak times. A ‘guided busway’ was proposed, which would run from Huntingdon and St Ives into Cambridge and connect with key destinations such as the railway station and the Biomedical Campus. Comprising a new bus network, park-and-ride sites and a traffic-free path for pedestrians and cyclists, the busway offered alternative ways to travel and was intended to encourage commuters to leave their cars at home. It was, however, a controversial scheme: by 2010 it had cost £181 million and was subject to flooding and delays due to contractual disputes between the construction company and the Council. There were no plans to evaluate this transport project from a public health perspective, beyond the monitoring of basic passenger numbers and traffic data. So, in the MRC Epidemiology Unit and CEDAR at the University of Cambridge, we took the opportunity to investigate the potential of a scheme like this to promote walking and cycling and thereby improve public health.

We measured the health, travel and physical activity patterns of nearly 500 commuters working in Cambridge before and after the opening of the busway. We found that after it opened, those who lived closer to the busway were more likely to increase their time spent cycling on the commute than those who lived further away. These results remained even after taking account of other potential explanations why someone might change their mode of travel, including moving home or changing job. We found three other results which give us confidence in our conclusions. Firstly, we wondered if people might compensate for their more active commute by doing less physical activity in their spare time, but we didn’t find any evidence that they had. Secondly, we found a stronger effect on active commuting among those who were least active before the busway opened. Finally, those who lived closer to the busway were also more likely to reduce the share of their commuting trips made entirely by car than those who lived further away. These findings suggest that the overall increase in cycling includes some new cycle commuters, and doesn’t merely reflect existing cyclists making more or longer trips.

We also conducted interviews with a variety of commuters. These found that people had diverse experiences of the new system, depending on where they were travelling to and from and how they had travelled previously. Many thought the new buses were convenient and accessible. Others found the ticketing system confusing to begin with and disliked the lack of lighting along the path, but measures have now been taken to address these issues.

So why might interventions like the busway work to get us more active where other efforts haven’t succeeded? After all, who doesn’t want the healthier, happier, longer life that increased physical activity might bring? Knowing the facts, it seems, isn’t enough. Other research I’ve been involved in, looking at a programme of new walking and cycling routes developed by the charity Sustrans, showed that whether people used the new routes was mostly driven by the presence of the infrastructure itself, bypassing explicit considerations of changes in safety or pleasantness. This suggests that the environment is shaping our behaviour even when we don’t realise it – and in many towns and cities, unfortunately, this influence is often not for the better. We lead busy lives, and everything from the escalator to the car encourages us to indulge our instincts to conserve energy.

We can’t be active all the time, and our bodies do need to rest. But too much inactivity isn’t doing us any good either. We need to build towns and cities that making walking and cycling the easy option, whether for entire journeys or just part of the way. Our studies are providing important new bricks in a growing wall of evidence to support building for health.

Related research

  • Jenna Panter, Eva Heinen, Roger Mackett and David Ogilvie. The impact of new transport infrastructure on walking, cycling and physical activity. American Journal of Preventive Medicine. http://dx.doi.org/10.1016/j.amepre.2015.09.021
  • Other relevant recent papers:
    • Eva Heinen, Jenna Panter, Roger Mackett and David Ogilvie. Changes in mode of travel to work: a natural experimental study of new infrastructure. International Journal of Behavioral Nutrition and Physical Activity, 2015; 12: 81. www.ijbnpa.org/content/12/1/81
    • Jo Kesten, Cornelia Guell, Simon Cohn and David Ogilvie. From the concrete to the intangible: understanding the diverse experiences and impacts of new infrastructure. International Journal of Behavioral Nutrition and Physical Activity, 2015; 12: 72. www.ijbnpa.org/content/12/1/72