The health benefits of cycling

A study has shown that cycling is a good way to prevent chronic diseases and lower premature mortality, with substantial savings for public health insurance budgets and communities. Sandrine Cabut discusses the study in an article on the Le Monde website.

Cycling, a cheap and effective medicine

Ten thousand steps and counting: Could bicycle shops soon compete with pharmacists? A new French study has shown that cycling is a highly effective way of preventing chronic diseases and lowering premature mortality, with substantial savings for both health insurance institutions and the community.

In the US, where the cycling culture is still relatively small, it would only take a modal shift of 25% of short trips of less than 5 kilometers done on a bike instead of in a car to roughly double the benefits, according to a study coordinated by Kévin Jean, senior lecturer in epidemiology at the French National Conservatory of Arts and Professions (CNAM), and economist Philippe Quirion, director of research at the National Center for Scientific Research (CNRS). The article, in press in the journal Lancet Regional Health Europe, is already available in preprint.

A few months ago, the researchers showed that a modest increase in the use of two modes of active transportation – cycling and walking – could prevent 10,000 premature deaths a year in France, and generate savings of €34 billion by 2045.

This time, they set out to estimate the extent to which cycling could contribute to health promotion in a country where its practice is limited (the proportion of trips made by bicycle under 3%, compared with over 15% in Denmark and the Netherlands). To do this, they took as their starting point the 2019 “People’s mobility” survey, the latest edition of this 10-year INSEE study, conducted among 14,000 people.

That year, before the Covid-19 epidemic, the average distance cycled daily was 0.32 kilometers for adults aged 20 to 89, representing an average time spent on the bike of 1 minute and 17 seconds, with wide variations according to age and gender. Important details: At all ages, the proportion of cyclists was much lower among women. Furthermore, in 2019 electric bikes accounted for just 6% of kilometers traveled.

Based on these modest practices, the team calculated that nearly 2,000 premature deaths were avoided that year, and as many as 6,000 chronic diseases. A total of five pathologies (breast and colon cancer, dementia, diabetes, cardiovascular disease), for which there is a very strong link with physical activity, were taken into account. The chronic disease with the highest number of cases avoided was type 2 diabetes (3,743 cases), followed by cardiovascular pathologies (1,578 cases). “These health benefits could be underestimated, as we were unable to include pathologies such as depression, where the benefits of physical activity are also proven,” Jean said.

This corresponded to savings of €191 million in direct medical costs (ambulatory care, hospitalization, and paid sick leave). The researchers even estimated that the gain was 25 times higher – €4.8 billion – for so-called intangible costs (the monetary value that society attributes to a human life or a year of life). Based on a sum of 5 billion kilometers cycled in 2019, each kilometer was equivalent to around €1 in avoided healthcare costs.

If we model a 25% shift in trips of less than 5 kilometers from car to bike, this could prevent 4,000 premature deaths a year, with 2.6 billion in intangible costs saved, plus a significant reduction in CO2 emissions (0.257 megatons).

Cycling has increased significantly since Covid-19, at least in some cities, so there’s every reason to be optimistic. This work also gives decision-makers an additional argument for financing bike paths. “Creating cycling infrastructure, which we know encourages cycling, particularly among women, is a public health policy,” said Jean. It’s also a way of moving towards parity: In this study, 75% of the improvements benefited men.

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