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
Whistler