The problem with being healthy

It is a truism that health is the foundation of a satisfying and useful life: as the old joke goes “If I had known I was going to live so long; I’d have taken better care of myself.” Indeed, much of the modern economy is based on the proposition that people will pay for things that will make them healthier (or, at least, will enable them to tell themselves, or other people, that they are “taking better care of themselves”.) In practice, of course, in the richer parts of the world people routinely make choices that are NOT the healthiest: the food they eat is the most striking example and the prevalence of conditions such as diabetes are evidence that the lure of health is less powerful than the temptations engineered by cooks (or, perhaps it would be more accurate to say, by food technologists and marketers.)

Published on 16 January 2025

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In transport, too, the power of the healthy choice is over-rated. For most of human history, for most people, the only way to get around was to walk. Evolution delivers the most efficient and effective solutions for the environmental niches that an organism inhabits and bipedal locomotion was one of the things that enabled homo sapiens to prosper. But homo sapiens also benefitted from collaborative, social behaviours that have resulted in progressive, additive, tool-making behaviours (or “technology” in the shorthand) and we have built highly complex societies that exploit and depend on long-lasting physical installations (“infrastructure”) that support lifestyles far removed from the presumed small-scale, hunter-gatherer ways of our ancestors. It turns out that, given the choice, people much prefer not to walk. After three and a bit million years of evolution, suddenly in the last two hundred years, we have built a world in which is it normal (in the global north, at least) not to walk.

Our response, as transport professionals, has been to create new jargon (“Active travel”) and to build marketing plans to sell the idea that there could be advantages in moving around under our own steam. And the idea that we seem to have alighted on is that telling people it is more healthy is what will change their behaviour. This is most apparent in the discussion around cycling which, in my unscientific impression is always sold as being about health. (There is a certain, small irony in this because cycling is much more energy-efficient than walking so anyone wanting to exercise to burn up energy would be much better leaving the bike behind.)

Everywhere you look there is lycra, special clothing and bikes with 18 gears, carbon fibre frames and clicky-clacky shoes. Now, I’ve absolutely nothing against cycling as a sport (and recent Olympic games have given us many UK cycling athletes to be proud of)….but it’s got as much to do with cycling as a means of transport as Usain Bolt has with walking round the corner for a bottle of Prosecco and a packet of crisps.

It is intuitively obvious that anyone who wanted to get fit would already have worked out that cycling might be good, but perhaps a better way to point out the limitations of the approach is to compare the UK with similar countries. In the Netherlands or Germany, for instance, (both Northern European countries with high populations concentrated in urban centres and weather that could be (generously) described as only intermittently warn and dry) more people cycle, more often. And the people who cycle are predominantly women who are not wearing special clothing and are using bicycles not because they are trying to get fit, or train for a triathlon, but because it is the cheapest and most convenient way to get around.

In the UK this is not the picture you will see. Like people who buy a dog because walking it will give them exercise…and then drive the dog, in the car, to the park (dog owners take more car journeys) in the UK the majority of cyclists are men and 25% more cycling happens for pleasure than as a means of transport. I can’t repeat enough: I’m not against cycling as a hobby and all those people enjoying themselves in the fresh air is a good thing…it’s just that it is nothing to do with cycling as a means of transport. It is the confusion between these two messages that I think is unhelpful.

What would alternative messaging look like? Well according to one insurance company the average cost of running a car in the UK is just short of £4000 a year. Leaving aside the distorting effect of averages (the supposed average parking cost of year of £29 is probably the cost of parking for one day in some city centres) a cost of buying and running even a highly configured bike (say, an e-tricycle, if we want to start thinking about the concerns that people may have about hills, carrying shopping etc) are many times smaller. Of course you aren’t going to be cycling from London to Leeds…but the typical car journey is much, much shorter than this.

And my experience running late in London the other day might, in fact, be quite common: I had to get from Kings Cross station to my dentist. Walking would have taken 45 minutes (very healthy, though!); the bus 35 minutes and the tube 30 minutes, including the time taken to get to and from the stops/stations at either end. A taxi was, in theory at least, quicker at 20 minutes (although probably 10 times more expensive than the bus and MUCH less predictable in times of time taken) but a bike (easily rentable from outside the station – pedal or e-bike alternatives available) was 12 minutes: I literally had to cycle because everything else would mean I was late. But where is the messaging reminding people that bicycles are cheap, quick (for the normal mile or two journeys we mostly take) and easy to park? Why always the health?

What about the elephant (or is it a sabre-toothed tiger) in the room: people’s perception of their own safety when cycling. Well, it turns out that the health benefits of cycling far outweigh the risks in terms of road safety, air pollution and so on. It’s not even close.

Finally, it might be worth thinking about another way of thinking about health. My car journey is bad (in terms of air quality, and the risk of fatal, of life changing injuries from collisions) for other people’s health, not just my own. If we extend the idea of “health” to the metaphorical health of our towns and cities we remember that walkers and cyclists spend more in local shops than car drivers.

See, I’m not really against health…can we just lay off the lycra, though, please?

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