Last week the biggest review of health equity in England, The Marmot Review 10 Years On, revealed inequality in life expectancy between the wealthiest and most deprived people in England had increased. Inequality in healthy life expectancy, the number of years lived in good health, was even greater. This means people in more deprived areas spend more of their shorter lives in ill-health than those in less deprived areas. Whilst the report focuses on England, the damage to health and wellbeing in Scotland, Wales and Northern Ireland is similarly unprecedented.
Large inequalities exist in virtually every city and town across the UK. Whilst the climate emergency has become common vocabulary, we are also facing a health emergency with millions of people being left behind.
Where people live and their ability to reach everyday services, employment and to participate in society play a significant role in determining their health.
In 2019, through Bike Life, the largest assessment in cycling, Sustrans explored how social inequality relates to cycling and transport in partnership with 12 cities and urban areas.
The data set, a representative survey of almost 17,000 residents across these areas, showed that only 54 per cent of residents from socio-economic groups D and E (people in semi-skilled and unskilled occupations, and people not in employment) have access to a car, in comparison to 88 per cent of residents from socio-economic groups A and B (people in managerial jobs and professionals).
In the UK we have largely designed our cities and towns around cars. Whilst this policy has benefited the rich, it has been to the detriment of many people often on lower incomes or not in employment.
Furthermore, poorer public transport provision and fewer local amenities often exist in disadvantaged neighbourhoods. And where it does exist, public transport is expensive. This means that people who are already suffering from health inequalities are either excluded from accessing the basic everyday needs that other people take for granted or pushed into greater poverty.
So how could cycling help?
Some 68 per cent of journeys anywhere in England are less than five miles. At a relaxed pace you can cycle this distance in 30 minutes. Cycling has the potential in the UK to be a cheap, fast and healthy mode of transport for everyone. However, Bike Life found only 10 per cent of people from socio-economic groups D and E cycle once a week and 75 per cent never cycle.
Importantly, this isn’t because people do not want to cycle. In fact, 30 per cent of people from socio-economic groups D and E would like to start cycling. And the same situation exists for other groups less likely to cycle – for example women, people from ethnic minorities and disabled people.
Bike Life data shows road safety is a large barrier for people from all of these groups. However, we also found barriers more specific to people from socio-economic groups D and E: for example, 19 per cent of them do not see cycling as an activity “for people like them”, compared to just 9 per cent from socio-economic groups A and B. Cycling should be an activity that everyone, regardless of their sex, ethnicity, ability or background should feel welcome to participate in.
So what can national government and city and town leaders do to ensure cycling is a genuine mobility choice for people, especially those suffering from poor health compounded by a lack of transport options?
Firstly, we need to ensure health outcomes are the primary objective for cycling and transport policy – the number of people cycling is less important than who is cycling and the benefits they gain. Second, we need to dramatically increase investment in infrastructure and ensure this is better connected to more deprived neighbourhoods and the needs of the people who live there. Finally, we need to support people to cycle – this includes training and community programmes but also support to access a suitable cycle, especially for those not in employment.
Tim Burns is senior policy advisor at walking and cycling charity Sustrans. To read the Bike Life 2019 report click here.
This article is from the CityMetric archive: some formatting and images may not be present.