New health promotion idea: Discourage car travel

I am not surprised to learn that “fit fat” is healthier than “sedentary skinny.” This knowledge provides further incentive for physicians to get their patients moving. Consequently I disagree with Dr Richardson [“Pre­scrib­ing activity,” BCMJ 2012;54:221] that BC physicians’ advocacy for bicycle helmets has been a good example of health promotion. 

As an alternative to driving, I’m sure we all agree that daily utilitarian cycling is a superior choice—cycling maintains physical fitness, favors men­tal health, prevents both noise and air pollution, and, of course, does not constitute a menace to other road users. So then why don’t more people use bikes to get around? Because firstly, they think cycling is too dangerous, and secondly, they find motoring more convenient. 

Bike helmet advocacy and legislation unfortunately re­inforce the first perception, consolidating the misconception that cycling on roads is a high-risk activity. (Paradoxically, trail riding is much more dangerous, yet our law only applies to street riders!) Overestimated as the threat may be, the menace to utilitarian riders is motorists. But rather than endorsing protection, why don’t we address prevention of accidents? 

It’s about time that the medical community targets the primary cause of both sedentary behavior and traffic injuries: driving has become too fast, too cheap, and too convenient. Just as we did for smoking, physicians must target motoring as an unhealthy choice. We should make it an objective to promote measures that make driving slow­er, more expensive, and less convenient. We could start by lobbying for universal 30 km/hr speed limits in all residential areas and for the elimination of all free public parking. 

These two initiatives would be vastly more effective than bike helmets in achieving road safety for all users and would help society rediscover that legs are meant for locomotion.
—Thomas J. DeMarco, MD

Thomas J. DeMarco, MD,. New health promotion idea: Discourage car travel. BCMJ, Vol. 54, No. 8, October, 2012, Page(s) 383 - Letters.

Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.

For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit

BCMJ Guidelines for Authors

Leave a Reply