Evidence
Alert

Cycling to work lowers risk of illness and death compared to driving

People who cycle to work are at lower risk of cardiovascular disease, cancer and death than those who drive. This is seen across all occupational groups and suggests that cycling to work could benefit people from all economic backgrounds.

The UK government has advised against using public transport during the coronavirus pandemic. This could result in more people commuting by car, which may increase air pollution and lead to people getting less exercise than before.

If fewer people are able to travel by public transport due to social distancing, measures to make cycling easier and safer could improve the nation’s health.

What’s the issue?

Lack of exercise is linked to 3.2 million deaths a year worldwide according to the World Health Organization. By contrast, physical activity is associated with health benefits such as a lower risk of heart disease, type 2 diabetes and some cancers.

Commuting to work is a potential source of physical activity. Researchers wanted to see how someone’s choice of transport could affect their health. They looked at whether people who cycled, walked or took public transport were likely to live longer than people who commuted by car.

This finding may be particularly relevant when people are being told to avoid using public transport to reduce the spread of the coronavirus that causes COVID-19.  More people may be travelling by car than usual.

What’s new?

Researchers used Census data from over 300,000 people in England and Wales in 1991, 2001 and 2011 to determine the mode of transport used to get to work. These people were followed for up to 25 years to see who had died or developed cancer or cardiovascular disease. The team included data on their occupation and socio-economic status in the analysis.

They found that cycling to work reduced the risk of illness or death. The health benefits were seen across all occupations.

Compared to those who commuted by car:

  • people who cycled to work had a reduced risk of dying from any cause (20% lower), of dying from cardiovascular disease (24% lower) and of dying from cancer (16% lower)
  • people who commuted by train had a reduced risk of dying (10% lower), of dying from cardiovascular disease (21% lower) and of being diagnosed with cancer (12% lower)
  • people who walked to work had a reduced risk of being diagnosed with cancer (7% lower).

Why is this important?

The current pandemic is an opportunity to rethink many aspects of society. If fewer people are travelling by public transport due to social distancing, more will be driving to work.

This could increase the risk of death and disease as well as impacting air quality in urban areas. The Lancet Planetary Health paper suggests that providing safe, convenient access to cycle infrastructure could reduce deaths from cancer and cardiovascular disease. Policies which aim to increase walking, cycling, and public transport could also reduce air pollution.

People in lower socio-economic groups have an increased risk of disease and early death. In this study, the link between cycling and improved health was consistent across people of all occupations. The findings suggest that promoting cycling across society could have the greatest health benefit for people from disadvantaged groups.

What’s next?

Future research should explore what motivates people to change their habits such as how they travel to work. These motivations might vary in different socio-economic groups.

Walking to work was associated with a lower risk of cancer diagnosis compared to driving, but its impact on the risk of dying from diseases such as cancer and cardiovascular conditions was unclear. More research into walking would help.

The health effects of public transport are less well understood than those of walking and cycling. It is possible that people who use public transport are also physically active in the course of their journeys, while walking to and from a train or bus station. More research is needed on this topic.

This study only looked at the mode of transport used to get to work. Further research could investigate the potential health benefits of travelling for other reasons. It would also be interesting to see if the findings apply to people who work part-time.

You may be interested to read

The full paper: Patterson R, and others. Associations between commute mode and cardiovascular disease, cancer, and all-cause mortality, and cancer incidence, using linked Census data over 25 years in England and Wales: a cohort study. The Lancet Planetary Health. 2020;4:E186-E194

An easy-to-read report on another research project: Chatterjee K, and others. The commuting and wellbeing study: understanding the impact of commuting on people’s lives. UWE Bristol, UK, 2017

An evidence-based approach for national and local action to address the physical inactivity epidemic. Reseach and analysis: Everybody active, every day: framework for physical activity. Public Health England, last updated 2018.

Funding

This study was funded by the NIHR School for Public Health Research and an NIHR Professorship Award.

Commentaries

Study author

Private car use will need to be reduced to meet future health goals, and climate commitments. Business as usual will mean continuing high levels of physical inactivity, which is linked to obesity and other metabolic diseases and ultimately death.

Interventions to improve health can often lead to worsening inequalities as those best positioned to take advantage are those with existing better health. It was surprising and reassuring to see in this study that the benefits of cycling appear to apply to everyone.

Richard Patterson, MRC Postdoctoral Fellow, Public Health Interventions, University of Cambridge

Researcher

This study will strengthen the case for active travel in public policy. Car use is likely to increase during COVID-19 unless incentives are given for cycling or walking. Increased spending on safer cycle lane and walking infrastructure, including closing certain roads to cars, would help. Cycle to work schemes and courses to improve road skills and confidence could encourage more people to commute by bike.

Disincentives to private vehicle use, such as increased tax and parking charges, are not appropriate in the current situation. They would be unfair to commuters with long term conditions, caring responsibilities and those living in rural areas with poor public transport. A park and ride system in cities could be a good compromise for some of these issues.

Anne-Marie Bagnall, Professor of Health & Wellbeing Evidence, Leeds Beckett University

Conflicts of Interest

None declared.